Antibiotics for lower back pain study hits headlines

Some rather ‘overexcited’ media coverage followed publication of a study in which antibiotic treatment of one particular type of chronic lower back pain was found to be more effective at one year than placebo in reducing back pain and disability, according to NHS Choices, which cautions that further research is needed and that the research certainly does not mean that everyone with lower back pain should be offered antibiotics.

All the patients in the trial had ‘Modic type 1 changes’ – signs of bone swelling in the lower back confimed with MRI scans – and had been in pain for six months or more after a slipped disc. The possibility that the swelling could be caused by bacterial infection and therefore treatable with antibiotics was tested in this randomised controlled trial. The NHS Choices commentary also highlights some limitations in the research.