Disc Infection

[katwilson04]

I was advised that I may have a disc infection which is resulting in a new level of pain I have never had before. My surgeon wants to put me on a course of Antibiotics, and if there is any infection there, that should hopefully get rid of it. It's a 100 day course, but not much research has been done. My GP has out right said NO they won't prescribe them. Anyway, has anyone heard or been on this medication for disc infection? Would welcome any advice!

[Bananas5]

I can't do links but this maybe what he means.....

Antibiotics could cure 40% of chronic back pain patients

Scientists hail medical breakthrough by which half a million UK sufferers could avoid major surgery and take antibiotics instead

• Join the scientist behind the discovery in a live webchat

Woman with back ache

Scientists in Denmark found that 20% to 40% of chronic lower back pain was caused by bacterial infections. Photograph: Alamy

Ian Sample, science correspondent

@iansample

Tuesday 7 May 2013 09.30 BST

Last modified on Thursday 21 January 2016 15.30 GMT

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Up to 40% of patients with chronic back pain could be cured with a course of antibiotics rather than surgery, in a medical breakthrough that one spinal surgeon says is worthy of a Nobel prize.

Surgeons in the UK and elsewhere are reviewing how they treat patients with chronic back pain after scientists discovered that many of the worst cases were due to bacterial infections.

The shock finding means that scores of patients with unrelenting lower back pain will no longer face major operations but can instead be cured with courses of antibiotics costing around £114.

One of the UK's most eminent spinal surgeons said the discovery was the greatest he had witnessed in his professional life, and that its impact on medicine was worthy of a Nobel prize.

"This is vast. We are talking about probably half of all spinal surgery for back pain being replaced by taking antibiotics," said Peter Hamlyn, a consultant neurological and spinal surgeon at University College London hospital.

Hamlyn recently operated on rugby player Tom Croft, who was called up for the British and Irish Lions summer tour last month after missing most of the season with a broken neck.

Specialists who deal with back pain have long known that infections are sometimes to blame, but these cases were thought to be exceptional. That thinking has been overturned by scientists at the University of Southern Denmark who found that 20% to 40% of chronic lower back pain was caused by bacterial infections.

In Britain today, around 4 million people can expect to suffer from chronic lower back pain at some point in their lives. The latest work suggests that more than half a million of them would benefit from antibiotics.

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"This will not help people with normal back pain, those with acute, or sub-acute pain – only those with chronic lower back pain," Dr Hanne Albert, of the Danish research team, told the Guardian. "These are people who live a life on the edge because they are so handicapped with pain. We are returning them to a form of normality they would never have expected."

Claus Manniche, a senior researcher in the group, said the discovery was the culmination of 10 years of hard work. "It's been tough. There have been ups and downs. This is one those questions that a lot of our colleagues did not understand at the beginning. To find bacteria really confronts all we have thought up to this date as back pain researchers," he said.

The Danish team describe their work in two papers published in the European Spine Journal. In the first report, they explain how bacterial infections inside slipped discs can cause painful inflammation and tiny fractures in the surrounding vertebrae.

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Working with doctors in Birmingham, the Danish team examined tissue removed from patients for signs of infection. Nearly half tested positive, and of these, more than 80% carried bugs called Propionibacterium acnes.

The microbes are better known for causing acne. They lurk around hair roots and in the crevices in our teeth, but can get into the bloodstream during tooth brushing. Normally they cause no harm, but the situation may change when a person suffers a slipped disc. To heal the damage, the body grows small blood vessels into the disc. Rather than helping, though, they ferry bacteria inside, where they grow and cause serious inflammation and damage to neighbouring vertebrae that shows up on an MRI scan.

In the second paper, the scientists proved they could cure chronic back pain with a 100-day course of antibiotics. In a randomised trial, the drugs reduced pain in 80% of patients who had suffered for more than six months and had signs of damaged vertebra under MRI scans.

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Albert stressed that antibiotics would not work for all back pain. Over-use of the drugs could lead to more antibiotic-resistant bacteria, which are already a major problem in hospitals. But she also warned that many patients will be having ineffective surgery instead of antibiotics that could alleviate their pain.

"We have to spread the word to the public, and to educate the clinicians, so the right people get the right treatment, and in five years' time are not having unnecessary surgery," she said.

Hamlyn said future research should aim to increase the number of patients that respond to antibiotics, and speed up the time it takes them to feel an improvement, perhaps by using more targeted drugs.

The NHS spends £480m on spinal surgery each year, the majority of which is for back pain. A minor operation can fix a slipped disc, which happens when one of the soft cushions of tissue between the bones in the spine pops out and presses on nearby nerves. The surgeons simply cut off the protruding part of the disc. But patients who suffer pain all day and night can be offered major operations to fuse damaged vertebrae or have artificial discs implanted.

"It may be that we can save £250m from the NHS budget by doing away with unnecessary operations. The price of the antibiotic treatment is only £114. It is spectacularly different to surgery. I genuinely believe they deserve a Nobel prize," said Hamlyn. Other spinal surgeons have met Albert and are reviewing the procedures they offer for patients.

[katwilson04 in reply to Bananas5]

That sounds like it yes. My GP doesn't believe the research and findings, as its so new to the market.

[Bananas5 in reply to katwilson04]

It's been around a few years although didn't check date on that article.

Would it be worth printing this and showing your GP? Usually pain consultants or surgeons tell GP what meds they want you on and GP does the script.

There is more info if you google it. This was just one i kept.

x

[katwilson04 in reply to Bananas5]

My Surgeon sent her everything, probably something along these lines too, all the findings he had, studies etc, but they just won't help. Yes I've had them prescribe me medication before and the GP ordered it, but this time they won't budge, out right saying no chance! Xx

[Bananas5 in reply to katwilson04]

Did GP give a valid reason? Or waffle a lot without using the word...cost?

Ask your pharmacist how much they would cost.

x

[katwilson04 in reply to Bananas5]

I haven't seen the letter, but was told by another GP that they say the risks we too high, a risk of CDIFF and they are not willing to talented chance.

[Bananas5 in reply to katwilson04]

Can sort of understand but pain specialist is THE expert. He wouldn't have suggested ot if he thought risks were too high.

Even more so if he has sent all evidence of how it works etc to your GP.

As I said pain consultants chose treatment and meds and GP should just write the script.

Difficult call this one

x

[pump321 in reply to katwilson04]

Hi again, GP's are always reluctant to hand out long courses of antibiotics and I can see why for all the reasons but there are exceptional cases like yours and I have lots of friends who are on long term doses of antibiotics for deep seated and difficult infections that will not clear up. These prescriptions are usually given out by consultants or surgeons as in your case. Surgeons are more senior and qualified to make decisions than GP's so please do not give up, I know how hard it is to fight the system but have courage and persevere x

[katwilson04 in reply to pump321]

Thank you! I just wish they would make the decision soon, I've been waiting for 2 months now!!

[Boozybird in reply to katwilson04]

They are happy enough to prescribe ABs for acne - surely suffering pain is arguably just as soul destroying ! Plus consultants can def prescribe... Is it a private consultation?

[pump321 in reply to katwilson04]

Hi katwilson04, I'm really sorry to hear of your pain and struggle to get some long term antibiotics for your disc infection. If your Surgeon has prescribed 100 days of antibiotics for you I think your GP should be obliged to give them to you. Could you contact the Surgeon again (or his secretary) and tell them of your predicament with your GP. Has the surgeon written a letter to your GP, if not perhaps he could do so stating that he wishes you to take this 100 day course of antibiotics. You could always ring your local PALS helpline, there is usually a leaflet in hospital or surgeries about them, they help with problems. It may lead to a bit of conflict with your GP if he is difficult about prescribing these antibiotics but I honestly think it's worth you pursuing this as you must get the medication you need. No GP should refuse to carry out a Consultant or Surgeons instructions. I really hope you are able to obtain your medication. Keep fighting as it's your right. Good luck.

[katwilson04 in reply to pump321]

Well my GP sent my surgeon a letter last Wednesday saying the will not prescribe them, he has to if he wants me on them. So tomorrow I have to call My GO and get an update as to what is going on now.

[pump321 in reply to Bananas5]

I have always thought that these chronic flare ups of pain are caused by inflammation caused by infection but GP's are so reluctant to acknowledge this as they don't want to have to prescribe antibiotics unless it's really necessary as their guidelines won't allow it. I'm glad that research has now brought this to the attention of the public and that GP's will now perhaps be encouraged to prescribe antibiotics to help ease the pain of so many sufferers. Could take awhile I fear!

[Bananas5 in reply to pump321]

Mighty Oaks from little acorns grow

x

[katwilson04 in reply to pump321]

Yes you are right, I think this may be a long term thing and not any time soon. I mean it's new and I get that, but there is evidence, research and findings, but my GP says it's not enough. The pharmacist advised the GP not to prescribe them.

[pump321 in reply to katwilson04]

I'm so sorry that you are having such difficulties, it's a real conundrum with the surgeon, your GP and the pharmacist all involved and having different points of view. I do hope you are able to get it sorted very soon as chronic pain is awful to bear and you certainly need some help. Would a compromise be that you try the antibiotics for 25-50 days to see if there is any improvement, I wonder if that would be worth mentioning. All best wishes and hope you get some help soon.

[lowlife]

Hi kat, i can understand why your docter doesn't want to prescribe something that hasn't been tested properly yet as he/she is thinking of your safety. Isn't there another antibiotic he could give you? You could always ask your GP to email your specialist so that they can work together to help you. If your in pain they need to sort it sooner rather than later. Good luck x

[katwilson04 in reply to lowlife]

Yeah they are currently arguing between them just now, said that they won't prescribe but if he wants me on them m, then he has to give me them, and I'd be under his care and not theirs. Which is bad because of something goes wrong, he's 1.5hrs drive away and a month wait to see him! I understand the concern, just hope hey can work out a way forward. They seem to have forgotten the patient - aka ME in all this and have just left me alone!

[Lovecooking]

Frankly, I have never heard of disc infection...and have never heard of staying on antibiotics for 100 days, and would be afraid of building a resistance to antibiotics, which I read is on the increase, but the concept of it helping back pain intrigues me

Believe there are many types of antibiotics.

Do you know which type of antibiotic? Is it of the penicillin type?

I have been suffering lower back pain for 9 months now and hate taking pain killers. Am afraid I will trade the pain, for a trashed liver. Am scheduled for an MRI next month, so hope to know more

Hang in there, know how debilitating it is.

[katwilson04 in reply to Lovecooking]

Hi! It's something called Augmentin, which yes I think does have penicillin in it, not sure if that he reason for it? 100 days is a long time, and I'm not 100% sure I want to be on them, but as this is my last option and nothing more can be done for me, maybe I have try them? Good luck with your MRI!

[Bananas5]

I can see a few problems Dan. Distance from home to consultant may be a fair way to travel.

If you become unwell or ill, who is responsible? Consultant for prescribed and monitoring that drug or GP for one he has given you? Could be a conflict of interests.

x

[katwilson04]

Well that appears what is going to happen, just being under my specialists care is not going to be easy. He's 1.5hr drive away and you can't see him instantly, usually a months wait. How is that going to work!?

[katwilson04]

Wouldn't that be great - a reasonable GP!!

[RAYJAYC]

Hi kat

I had a pain clinic appointment today and I asked about the 'antibiotics theory' - the response was that it was only one trial and there were no real results from it and it didn't get taken any further!

Obviously, there'll be counter claims but it's worth getting views of other doctors.......

RAY

[katwilson04 in reply to RAYJAYC]

Thanks for this information, that's good to know. I thought there was a lot more results!

[Boozybird]

My consultant said I had specific type 'modic' changes on my MRI and therefore I would be a candidate for the same treatment protocol as you are talking about. This protocol came from an evidence-based study in Scandinavia but it needs to be repeated he said to become an accepted treatment for this type of back pain (modic changes on MRI - infection in discs) one trial does not quite cut the mustard! Anyway, he wanted to pursue the usual treatment plans (injections etc) before we got to the end of the road. We got to the end of the road and I reminded him of the AB regimen. He then said no... (I wonder whether there has been some behind the scene scandal related to this study as it seems strange he changed his mind!) but it was controversial that the British surgeon who brought attention to this study to the uk then opened a clinic in London and started charging a fortune for treatment.... Ho hum!

[linlow]

Any progress on what is happening Kat?  I was just last night telling someone else to question this treatment (whether it was available).

[katwilson04 in reply to linlow]

Kind of.  He decided that he would put me on the course of antibiotics even bough there was no high evidence of infection.  Wrote to my GP to get them prescribed and the GP said no.  After battles and arguments, he called me to say that he wouldn't put me on them, and to see how I was in 3 months time and will review me again.  So basically that was the end of that!  Just left as I am! 

[linlow in reply to katwilson04]

That is terrible and, probably, extremely bad timing given the government's recent campaign to stop the prescribing of antibiotics gov.uk/government/news/unne....  And it does have to be said that antibiotic destruction of the microbiome can leave you permanently disabled hormonesmatter.com/harmful-....  None of which helps you or relieves your pain so I was wondering if you had ever heard of kefir?  It is a very powerful (or it is when you make it at home) probiotic that can work wonders all through the body and, in a lot of instances, clear up infections.  Tests have seen it neutralise other bacteria.  ncbi.nlm.nih.gov/pmc/articl...  I am not guaranteeing that it would work but it might be worth a try for an out lay of less than a tenner.

[katwilson04 in reply to linlow]

Haven't heard of Kefir before, but as he can't diagnose me with an infection, I don't think I know where to turn to next.  He was only going to give me the antibiotics as a "last resort" because he's tried everything else!?

[linlow in reply to katwilson04]

Well kefir is antibacterial and there are a lot of benefits associated with it

authoritynutrition.com/9-he...

regenerate-wellness.com/kef...

ebay is cheaper than amazon but it is available on both ebay.co.uk/sch/sis.html?_nk...

there is lots of information on the net, and videos on youtube on how to make it and what to do with it when you have culturesforhealth.com/kefir

Coconut oil and grass fed ghee also have healing properties (both inside and out) as do many herbs and spices.

You might also look at changes to your diet.  I cured my arthritis more than half a lifetime ago by changing mine.  Take a look at the 'healing' powers of the LCHF diet, Dr Terry Wahls' diet or Karen Lamphere on the anti-inflammatory diet