Bodywork

Q:

Is a Bacterial Infection Causing My Back Pain?

I run a lot and feel like I’ve had back pain forever. I read about a new study that found bacterial infections cause 40 percent of chronic back pain. Does that study apply to athletes with back pain? Should I ask my doctor about getting tested for a bacterial infection?

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A:The short answer: No. 

“Folks shouldn’t be concerned that [sports-related back pain] is some bacterial-driven condition,” says Dr. Craig Denegar, professor of kinesiology at the University of Connecticut. “Moreover, treating it on the off chance that it could be—the harm is far worse than the condition.”

The studies you read were published in the April issue of the European Spine Journal. In the first study, researchers looked at people with herniated lumbar discs who subsequently developed bone edema—a condition similar to a fracture—in the vertebrae adjacent to the herniated discs. The study showed a significant correlation between bacterial infection and bone edema.

In the second study, researchers found that a 100-day course of Amoxicillin significantly reduced back pain in patients who had herniated discs and bone edema.

If you’ve never been diagnosed with a herniated disc, and don’t have bone edema, antibiotics likely won’t cure your back pain. (Sorry!) If you are experiencing these things, Denegar says it’s pretty unlikely you’d still be running. The people who responded positively to antibiotics, he says, “Weren’t running. They were in constant pain.”

The procedure to determine if you have a bacterial infection in your spine is invasive; doctors would likely perform it only after confirming with an MRI that you have a herniated disc and bone edema.

Moreover, antibiotics are not harmless. “They’re problematic,” Denegar says. “They’re going to create gastrointestinal problems in some individuals, which may affect athletic performance.” And there’s also the concern you’ll increase your chance of developing antibiotic-resistant infections from taking unnecessary medication.

THE BOTTOM LINE: “Should the athlete with back pain be talking with their physician about a bacterial infection?” Denegar asks. “The answer is no, unless they have disc degeneration and long-standing isolated back pain.” 

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