This article is from the source 'guardian' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.

You can find the current article at its original source at http://www.guardian.co.uk/society/2013/may/07/back-pain-breakthrough-major-operations

The article has changed 2 times. There is an RSS feed of changes available.

Version 0 Version 1
Back pain breakthrough could eliminate need for major operations Back pain breakthrough could eliminate need for major operations
(5 months later)
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.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.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.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.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 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 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 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.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.
The treatment is controversial because greater use of the drugs can lead to more antibiotic resistance, already a major problem in hospitals around the world. The scientists have joined forces with a small team of experts to make educational material and guidelines for doctors and surgeons, to help them target the right patients.The treatment is controversial because greater use of the drugs can lead to more antibiotic resistance, already a major problem in hospitals around the world. The scientists have joined forces with a small team of experts to make educational material and guidelines for doctors and surgeons, to help them target the right patients.
Our editors' picks for the day's top news and commentary delivered to your inbox each morning.