Lower back pain: the work of bacteria?

In the recent Global Burden of Disease study, lower back pain was ranked as one of the leading causes of disability in Australasia, second only to cancer. There has been immense interest and controversy surrounding the novel study which reported the effectiveness of antibiotic treatment for patients with low back pain. While some leading international spine surgeons believe that this work is worthy of a Nobel Prize, two commentaries in the BMJ have indicated that further research is needed before a change in medical practice.

Their methodology was based on a previous study which found that 84% of individuals with disc herniation were infected with the bacteria Proprionbacterium acnes (P.acnes).

However, there is conflicting evidence as to whether P.acnes is the cause of the condition, as previous studies have reported the absence of the bacteria in people with low back pain, as well as other data showing the bacteria in people with a variety of spinal conditions.

Donna Urqhart of the DEPM has been issued a one year grant for $48,500 by the Faculty of Medicine to shed further light on the issue. Her research will focus on whether the bacteria are present in the spinal disc and bone, and if so the pattern of back pain associated with the type of bacteria.

This research could form a crucial part in formulating the future treatment of back pain for sufferers worldwide.