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Spinal infection? 

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

A new study in the European Spine Journal shows weirdly good, strong results treating low back pain with … antibiotics? No, really! The implication is that some cases of stubborn and inexplicable back pain may be caused by an infection, and — stranger still — an infection with a wee beastie that may be getting into spines thanks to brushing your teeth. Talk about unintended consequences! Body In Mind has a terrific, sensible analysis by Dr. Neil O’Connell, which is essential reading. There are all kinds of caveats, of course, in particular that the study focused on a specific sort of back pain in rather carefully chosen subjects — so it’s probably not going to work on the average frustrated back pain patient.

Nevertheless, it’s a marvellously eyebrow-raising and strange test result. I’ve always wondered if “the answer” to low back pain might be like this, something really odd (or, more like, several odd somethings). It’s the kind of answer that is inevitable-ish: all the “reasonable” candidate explanations for most chronic low back pain have been checked and found hopelessly wanting, and all that’s left is the odd stuff that no one’s checked yet. And perhaps it’s this: an infection! Which no one saw coming, any more than anyone “called it” in the 70s that stomach ulcers would turn out to be caused by Helicobacter pylori.

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