Dr. Cataldie's Corner

Can Antibiotics Cure Chronic Back Pain?

Maybe. We are going to be hearing a lot about this and I wanted to give you all a preliminary report of what I know about it so far.  This just hit Medscape on May 8th and it is already all over the media. Here are the results of the studies that indicate 40% of chronic low back pain related to a herniated disc may be caused by a bacterial infection in the damaged disc. The name of the bacteria found in 40% of the herniated discs sampled from chronic back pain patients is Propionibacterium acnes. This bacteria is common in human skin, hair, and gums.  In the studies, some patients were put on antibiotics for 100 days (yes 100) and others were not. Of the antibiotic taking patients, 74% had constant pain before the 100 days of antibiotics and at the end of that time only 20% had constant chronic pain. Now, 65% of those patients still reported some pain. And, 100 days of antibiotics is not without side effects. The authors are not advocating putting all patients with chronic low back pain on antibiotics. There are some non-invasive tests that may indicate who is more likely to benefit from this long term antibiotic therapy. I see many chronic pain patients at Woodlake. Chronic pain is an invitation to opiate and/or benzodiazepine addiction. Some of you know we are in the process of opening an outpatient addictionology practice. I am not a pain specialist nor do I hold myself out to be one. I am an addictionologist but I am certain I will continue to see chronic pain patients in my practice. My opinion is that opiates make chronic pain worse at many levels. There are alternate ways to help with chronic pain and this may certainly be one of them for select patients. There are some additional alternatives we are looking into with other non-narcotic pain centers in other states. Of course, one of the best things you can do for yourself if you have chronic back pain is to stop smoking cigarettes.
In the meantime, I will continue to dig into these studies on chronic back pain and antibiotic treatment and get more information to you via this blog. Again, I want to provide you with information you want and need, so let us know if you want us to get more information about chronic pain to this blog. Thanks.
Louis Cataldie, MD
Diplomate ABAM

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