Back Pain Discovery Potentially Revolutionary and Game Changing

May 8th, 2013

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Throughout medical history, it was always believed that peptic ulcers were simply the result of gastric acid and inadequate mucus lining within the digestive tract, the primary causes being diet and stress.   Sufferers lived for years with ulcers, with acid blockers, antacids and dietary changes helping to control the severity and symptoms of the ulcer.   More often than not, however, these measures did not result in the ulcer disappearing.

That all began to change in the late 1990′s.   Evidence for bacterial infections being involved in peptic ulcer disease had existed for many years, but conflicting experimental results lead early researchers to conclude that the bacteria detected in the stomachs of ulcer patients was caused by laboratory contamination.  Indeed, the treatment of ulcers with antibiotics had been established as early as the 1950′s, but failed to gain widespread acceptance.  It was not until the late 1990′s that a number of clinical studies conclusively proved that the overwhelming majority of peptic ulcers are caused by the bacteria Helicobacter pylori and that its treatment with antibiotics can cure upwards of 80-90% of ulcers.  Doctors Robin Warren and Barry Marshall, both of Australia had spearheaded the research that ultimately discovered the role of bacterial infections in ulcers.  They shared the Nobel Prize for this discovery in 2005.

The discovery forever changed how we view and treat peptic ulcers.   It did not entirely invalidate the role of stress in the formation of ulcers, since it likely plays a roll in producing the conditions where a bacterial infection can take root, but it resulted in new tests and protocols and the use of antibiotics in treating and curing peptic ulcers.  Countless lives have thus been improved.

We may now be on the cusp of a breakthrough that will dwarf the discovery of bacterial infections as the root cause of most ulcers

Via the Guardian:

Back pain breakthrough could eliminate need for major operations

The figures make for grim reading. When all costs are considered, the NHS spends more than £1bn each year on back pain. More than half goes on hospital costs. But £140m covers GP consultations, with even more spent on physiotherapy sessions. On any given day, 1% of the national workforce is on leave with a back problem.

Most people recover from acute back pain within six weeks but for a fair portion, around 8%, the problem becomes long-term. In the past, doctors prescribed bed rest for back pain. They now accept that only makes the pain worse, and instead recommend physical exercise, or at least staying active.

In more than 80% of cases, there is no clear cause of back pain. But to the long list of factors, from lifting and posture, to stress and anxiety, scientists in Denmark have now added bacteria.

Microbes should not be lurking in the spine, but Hanne Albert and her team at the University of Southern Denmark found a common bug called Propionibacterium acnes inside the slipped discs of patients who had operations for the problem. The bacteria normally live without oxygen, in hair follicles, or at the bottom of crevices in teeth, but brushing teeth can sweep them into the bloodstream.

The bacteria should pose no threat as they circulate around the body, but when a person has a slipped disc, the body grows fresh blood vessels that reach into the soft disc to repair the tissue. This gives the bacteria a route in, where they can thrive, scientists believe. As the bacteria grow, they cause inflammation around the disc, and release propionic acid, which irritates nerves, and may even cause the painful microfractures seen in vertebrae around the disc.

The Danish researchers found that a long course of common antibiotics, lasting three months, killed off the bacteria, and alleviated pain in most patients who took part in their trial. All had been in pain for more than six months and showed signs of vertebrae damage in MRI scans. They took six to eight weeks to feel better.

The drugs must be taken for so long because the blood supply to spinal discs is very poor. Once the disc is free from infection, the inflammation dies down, and the vertebrae begin to heal.

The discovery could transform the treatment of chronic lower back pain and save health services millions of pounds by doing away with unnecessary operations. When patients have no other options, surgeons can fuse damaged vertebrae, or transplant artificial discs into their spines, but both of these operations might largely be replaced with courses of antibiotics.

WOW!

You probably know someone with chronic back pain. Perhaps you have it. It’s very common. Millions around the world suffer from chronic back pain and it can have an enormous effect on quality of life. For many, it’s not the severity of the pain as much as the fact that it never goes away. For others, back pain flares frequently to the point of extreme intensity. Many live for their entire life without ever getting lasting relief from back pain.

While this discovery does not apply to all back pain sufferers, it is still a very large portion. If infections are to blame, then this is not simply a treatment to relieve the symptoms, but rather a cure that can offer the potential for lasting relief of the chronic pain that has plagued some for decades.

The benefits go beyond just easing suffering, however. Back pain results in billions of dollars being spent by individuals, health insurance companies and national health benefits. Surgeries are common and include such things as spinal fusion. Many go through long physical therapy or use products like orthopedic shoe inserts, back braces or supports for relief. Regular Botox injections have been used to treat lower back pain. Other therapies include transcutaneous electrical nerve stimulation, pain killers, anti-inflammatory drugs and muscle relaxants.

Even beyond the direct cost of treating so many, massive savings could potentially be had from everything from disability payments to workers compensation to overall reduced productivity. The prevalence of back pain really makes the potential for revolutionary changes mind-boggling.

There is another point here that should not be lost. There are many out there who will claim that the big pharmaceutical companies are so powerful that any research which could hurt their bottom line simply won’t happen or the discoveries will be suppressed. Yet, that is exactly what this study is. Granted, curing 40% of back pain sufferers is not likely to drive any drug companies bankrupt, but it will not help them when it comes to profits. Back pain sufferers are exactly the kind of customers drug companies love. For decades on end, they are reliable customers, taking huge doses of pain killers, anti-inflammatory drugs, muscle relaxants and drugs to aid in their sleep. Chronic pain often leads to the need for antidepressants. Surgeries and hospital stays result in the need for numerous drugs and medical supplies.

Antibiotics, on the other hand, are cheap, and drug companies only make modest profits off the sale of most antibiotics. The treatment of a back infection, even if it requires one hundred days of therapy is still a one-shot event. It’s not the kind of reliable decades-long drug consumer that pharmaceutical companies make so much of their money off of.

Note that, as with any such study, one must be cautious and not assume this is yet proven. That said, the data looks very very good and compelling. I would say there is every reason to be optimistic. Perhaps cautiously optimistic, but still optimistic on this one.

You can read the actual study here. Sorry, it’s not free, unless you have access to an academic journal service. 

(Someone was kind enough to send me a copy but asked that I not post any part of it)


This entry was posted on Wednesday, May 8th, 2013 at 7:47 pm and is filed under Good Science, Misc. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
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19 Responses to “Back Pain Discovery Potentially Revolutionary and Game Changing”

  1. 1
    DV82XL Says:

    Having spent most of 2001 writhing in pain on the floor from a slipped disk and still suffering the odd two or three month relapse since, I was blown away by this when I read the item yesterday. As you say, it’s too early to go off the deep end, but God I hope there is something to this, and if so, that I’m a candidate.


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  2. 2
    Q Says:

    So many chiropractors and accupuncturists and other various alternative and naturopahtic practitioners working on back pain and suddenly a very promising study comes from mainstream science. Who could have ever thought that would happen???


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  3. 3
    Tony Mach Says:

    When I read use of “long-term antibiotics” and pathogens that “hide in the tissue”, then my alarm goes off, because these are talking points of quacks (cf. “Chronic Lyme”).

    The research you posted may or may not be legit (and the antibiotics are at least limited to three month), but there are potentially many things wrong with this. Like what happens after three-month of antibiotics without improvement of back pain? Another three month? There is no way of testing if it has worked – unless you consider cutting into the spine before and after the therapy as “doable”. And what about the “good” bacteria? How do you replenish them after the therapy? You probably need to do a fecal bacteriotherapy to restore the gut flora. The fecal bacteriotherapy would be a good idea anyway, but how exactly do you select an “healthy” donor?

    This whole thingy is not easily reproducible in an research setting, it is impossible to test for in an clinical setting and it opens a world of woo for doctoring around – I won’t hold my breath.


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  4. 4
    DV82XL Says:

            Tony Mach said:

    This whole thingy is not easily reproducible in an research setting, it is impossible to test for in an clinical setting and it opens a world of woo for doctoring around – I won’t hold my breath.

    Well if you look this was a double-blind randomized clinical controlled trial by a legitimate group of rheumatologists working in a hospital center. While I’m not running out to bug my doctor for a prescription for a 100-day course of Bioclavid on the strength of this one study, I don’t believe it can be dismissed out of hand as potential quackery.


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  5. 5
    Chris Says:

    test comment


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  6. 6
    Chris Says:

    “fecal bacteriotherapy would be a good idea anyway, but how exactly do you select an “healthy” donor?”

    Fecal bacteriotherapy?!!!
    Oh my gosh, am I reading right here?
    A stool transplant?
    Talk about a comment that is full of s#@t !

    There is no logical reason why it would not work.
    However why resort to those lengths when you can simply eat more, of a wide variety of fermented foods.
    These foods end up in the gut anyway.
    Examples include yoghurt and/raw unpasteurised milk, sauerkraut, fermented soy, etc.
    I have already linked to Wikipedia on the issue of probiotics on another article on this site.

    And I can’t see why people here don’t see the obvious problems with antibiotics which includes risking antibiotic resistance. What if you develop a severe lung, or other infection shortly therafter and you receive antibiotics that no longer work. However if they work as a cure for chronic, severe bank pain it may be worth the risk.

    I wonder how colloidal silver would fare in eliminating the same bacterial infection discussed in this article.
    That is one of the things CAM would recommend trying first.
    I’m trying to reply to other comments on the article on bicarbonate of soda on this website, but it doesn’t seem to go through, I mailed Dr Buzzo/Stephen about it.


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  7. 7
    DV82XL Says:

            Chris said:

    Fecal bacteriotherapy?!!!
    Oh my gosh, am I reading right here?
    A stool transplant?
    Talk about a comment that is full of s#@t !

    Except of course it not only works but is grounded in good science

    https://en.wikipedia.org/wiki/Fecal_bacteriotherapy

    http://www.mayoclinic.org/medicalprofs/fecal-transplants-ddue1012.html


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  8. 8
    I'mnotreallyhere Says:

    “alleviated pain in most patients who took part”

    There’s a big difference between 51% and 99% of people, and it’ll be interesting to know how long after the treatment they followed patients to ensure there wasn’t a recurrence. Given the growing concerns over anti-biotic resistant strains of bacteria, there’s going to be some serious hand-wringing on this one.

    Exciting stuff nonetheless. I’m glad to think that I’m probably young enough that this will be a common treatment by the time I need to worry too much about back pain.


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  9. 9
    Bas Says:

            DV82XL said:

    Having spent most of 2001 writhing in pain on the floor from a slipped disk and still suffering the odd two or three month relapse since, I was blown away by this when I read the item yesterday. As you say, it’s too early to go off the deep end, but God I hope there is something to this, and if so, that I’m a candidate.

    Why not do a trial for 3 months?
    It helped me with Lyme disease.
    The disadvantages of an antibiotics trial are marginal compared with continue on the present path!


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  10. 10
    DV82XL Says:

            Bas said:

    Why not do a trial for 3 months?
    It helped me with Lyme disease.
    The disadvantages of an antibiotics trial are marginal compared with continue on the present path!

    Let’s see – should I take the advice of my trained, licensed physician who I have known for thirty years, or the advice of some internet troll who I hold in utter contempt due to his transparent ignorance and stupidity? Tough call…..


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  11. 11
    Bas Says:

    -:)
    It is your health.
    I did it while my physician hesitated as she had some objections because it did not fit with the guidelines in NL.

    But she understood my argument that acting according those guidelines did not bring a real solution during a year, so something else had to be tried …


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  12. 12
    ebohlman Says:

    Harriet Hall over at Science-Based Medicine wrote about this study earlier this week. She thought it was promising but should not be overhyped pending replication, and reminded us that it’s only applicable to at most 35-40% of cases of lower back pain.


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  13. 13
    drbuzz0 Says:

            ebohlman said:

    that it’s only applicable to at most 35-40% of cases of lower back pain.

    That is still a lot of people. A LOT.


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  14. 14
    Chris Says:

    I am not a big fan of antibiotics, but all Bas said was:

    “Why not do a trial for 3 months
    It helped me with Lyme disease.
    The disadvantages of an antibiotics trial are marginal compared with continue on the present path”

    DV82XL, you really are a nastypiece of work!

    Need I remind you that you said (above):
    “Having spent most of 2001 writhing in pain on the floor from a slipped disk and still suffering the odd two or three month relapse since, I was blown away by this when I read the item yesterday. As you say, it’s too early to go off the deep end, but God I hope there is something to this, AND IF SO, THAT I AM A CANDIDATE.”

    He was actually trying to help you!!!
    But you don’t deserve anyone’s help, you actually deserve to rather suffer in pain!


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  15. 15
    DV82XL Says:

    The last thing I need is ‘help’ from ignoramuses and peckerwood trolls. Given what I’ve seen from ether of you I would be inclined to reject any treatment outright if ether of you recommended it on that bases alone.

    Yes I hope something comes of this research, but I will wait until it is vetted by the medical community before I would risk a treatment that may have side effects or other issues hitherto unknown. Taking antibiotics without real cause may leave one open to other infections or contribute to the resistance problem both of which could make things much worse.


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  16. 16
    drbuzz0 Says:

            Chris said:

    I am not a big fan of antibiotics,

    O_o

    Interesting there. Not a fan of what is arguably the biggest single medical breakthrough… ever? Perhaps it is less important than germ theory, as that is what enabled it. But… not a fan of antibiotics???

            Chris said:

    He was actually trying to help you!!!
    But you don’t deserve anyone’s help, you actually deserve to rather suffer in pain!

    Well that is a rather nasty thing to say.

    But in any case, I cannot speak for DV82XL, but I would be willing to hazard a bet that his back pain is considerably less than it would be if not for modern medical treatments.


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  17. 17
    Calli Arcale Says:

    I’m not a big fan of *taking* antibiotics, but antibiotics themselves are awesome. I get recurrent UTIs, due to a urinary diverticulum (not bad enough to be worth fixing surgically), so I’m very aware of the side effects they can cause. I tend to tolerate them reasonably well, but the yeast infections are something I’d sooner do without. (And no, eating yogurt and taking probiotics hasn’t helped me. But the yogurt was at least delicious.) So I would want to see more work done before attempting a trial of this on myself or a loved one. It would also be nice to have a clinical test for the bacteria, so you’re not shooting in the dark.


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  18. 18
    Thomas Jørgensen Says:

    Would the logical next experiment not be to inject an antibiotic into the spinal fluid? Would seem likely to be much faster and alleviate the concerns about promoting antibiotic resistant bacteria strains.


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  19. 19
    Tara Says:

    I’ve heard that wearing a corset can alleviate certain back pain as well!! Look it up!


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