A Simple Course Of Antibiotics Could Cure Chronic Back Pain In 40% Of Patients

Chronic Back Pain

A vast majority of people suffer from chronic back pain at least once in their life time. Severe back pain can interfere with a person’s day to day activities and is one of the commonest causes for job-related disability. Chronic back pain takes longer time to heal and might even lead to other serious conditions. Chronic back pain typically lasts for more than three months and the exact cause of the pain is difficult to determine. Chronic back pain most often happens between the age of 30 and 50. It is often caused by the body’s ageing process. Sedentary lifestyle with a lack of exercise might also cause chronic back pain.

As part of the study it was demonstrated that there is an association between chronic back pain and Propionibacterium acnes, which is a type of bacteria that is commonly found on human skin and primarily causes acne. The study was led by Hanne B. Albert and his fellow associates.

The researchers formed a sample population of 162 adults who had chronic back pain for more than six months owing to a spinal disc herniation, commonly known as slipped disc. The adults who were part of the study also tested positive for Modic type-1 changes, referred to as bone oedema. Numerous MRI scans were done on the sample population to confirm that they had Modic type-1 next to the slipped disc area. The sample population was randomly divided into two groups. The members of one of these groups were subjected to 100 days of antibiotic treatment comprising amoxicillin clavulanate tablets three times a day. The members of the other group were subjected to an identical placebo for 100 days. The health of all the participants was monitored at the beginning of the study. Subsequent evaluation of their health was also done without the individual participants knowing whether they were on antibiotics or placebo. Their health was again evaluated after the completion of the 100-day period and then again one year after the start of the study. While evaluating the health of the participants, the researchers focused on changes related to back pain and disease related disability. The participants were asked to fill out a 23-item Rolland Morris Disability Questionnaire (RMDQ) with Yes and No as the two options for each question. The scores of the questionnaire ranked from zero to 23 with a higher score depicting an even worse condition.

A thorough statistical analysis of the results was done. The main observations of the study are listed below:

• The group that was subjected to antibiotics showed marked improvement in their disease related disability after 100 days of treatment. This group exhibited even further improvement when examined after a period of one year.
• The RMDQ score of the antibiotic group improved from 15 to 11 after the 100-day treatment. The score further improved to 7 after one year of the treatment. On the other hand the score of the placebo group came down from 15 to 14 after the 100-day mark and remained unchanged after one year of the experiment.
• The pain relief and the disease specific disability improvement were gradual in the patients. The improvement was exhibited six-eight weeks after the start of the antibiotic treatment and in some patients the improvement was observed only after the completion of the 100-day treatment.
• The improvements in the patient’s disease specific disability continued long after the treatment. Patients reported continuous improvement even six months after the treatment.
• The antibiotic group also reported common side effects associated with the intake of antibiotics. These included stomach upsets, burping, flatulence, and loose bowel movements.

It is important to remember that antibiotics should only be considered helpful for curing chronic back pain only if a bacterial infection has been found. An inappropriate use of antibiotics might lead to the production of resistant bacteria which can prove to be fatal.

Chronic Back Pain: Causes And Cures

The most common causes of chronic back pain include sports injuries, accidents, and health conditions such as migraines, arthritis, sciatica, spinal degeneration, diabetes, shingles, and cancer. Ageing is another common cause of back pain. As you grow older, the bone strength and muscle elasticity tend to decrease. The vertebrae are normally cushioned by spongy pads of cartilages commonly known as intervertebral discs. These discs act like shock absorbers for the spinal column and provide flexibility for the movement of the back. When people stretch or lift very heavy objects, it might cause a strain or a spasm in the muscles or the ligaments of the back. This can further rupture the discs resulting in severe back pain.

Back pain can be diagnosed by x-ray imaging, discography, CT-scans, MRI scans, electrodiagnostic procedures, and bone scans.

Common lines of treatment for chronic back pain are listed below:

• Hot and cold compresses: Hot and cold compresses can help in reducing pain and inflammation in patients suffering from chronic back pain. If a person has suffered a lower back injury, a cold compress should be immediately applied several times a day for about 20 minutes. Hot compresses can be followed up after 2-3 days of the cold compress treatment.
• Bed rest: Complete bed rest for 1-2 days is also recommended for patients suffering from severe back pain. The patient should also try to lie on one side with a pillow in between the knees to help reduce the pain.
• Exercise: Exercising under guidance from a physiotherapist is very helpful in building up muscle strength.
• Medications: Various medicines such as over-the-counter analgesics, anticonvulsants, anti-depressants, and opioids are very helpful in treating severe back pain.