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Can antibiotics cure back pain?

In mid-2013 there was a gush of headlines announcing a breakthrough ‘worthy of a Nobel Prize’: that a simple course of antibiotics could cure nearly half of people suffering from back pain.

Michael Mosley looks a little more closely at this research, and reveals that behind the impressive PR and the counter-claims of conflicts of interest, there is indeed a very interesting piece of research at the heart of this storm. However, it is not quite what many of the headlines claimed.

It appears that some sufferers of crippling chronic back pain – those whose MRI scans show distinctive white patches in the affected vertebrae, could be suffering from infections of the bacterium Propionibacterium acnes. This bacterium normally lives on the skin, and in fact causes acne there, but it can enter the bloodstream and from there, it seems, get into damaged discs in between vertebrae. Unexpectedly, it seems that they can thrive there, and create a damaging and painful infection. Treatment for about 100 days with the right, specific, antibiotic can – in some cases – clear up this infection and hence greatly improve the resulting back pain.

However, there are two important caveats: firstly, that bacterial infection is not the cause of every achey back – only very specific patients might be helped by this. Secondly, that this is only a preliminary piece of research, and far more studies need to be done to see whether this is a genuine breakthrough.