European Spine Journal has just published a new piece of research which may prove to be a breakthrough for sufferers of some types of chronic low back pain. The type of person who may benefit from this breakthrough is one who has experienced a disc herniation, often referred to as a 'slipped disc'.
It has been observed that on MRI (Magnetic Resonance Imaging) scans individuals who have disc herniations will also often have changes in the appearance of the bone in the adjacent vertebrae. These changes are described as modic changes. The cause of these vertebral changes has until recently been unclear, however it is now thought that they are caused by a low grade bacterial infection within the spine.
This new research (a double blind RCT) investigated the effect of a 100 day course of antibiotic treatment for patients suffering with low back pain of greater than 6 months duration. These subjects had confirmed disc herniation and vertebral modic changes on MRI scans. The results showed that the group treated with antibiotics had a highly significantly greater reduction in back pain and back pain related disability at 1 year follow-up when compared with the control group who took the placebo.
In my chiropractic practice I certainly see some patients who may benefit from this new treatment. I don't as yet know how the national health service here in the UK will respond to this new research. It appears that there may already be some private options for those keen to investigate this further.
It should be noted that this treatment is not for all chronic back pain patients. Back pain is common; said to affect 80% of people at some point in their lives and nearly 50% of people are likely to have an episode of back pain at some point this year. This new treatment looks most likely to help those with severe, chronic back pain following a disc herniation confirmed by MRI.
Chiropractic continues to be well positioned to help treat simple or mechanical low back pain as outlined in 2009 NICE Guidelines. I am however excited by this new research as it may provide a new and effective avenue to help some sufferers of back pain.