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RESEARCH PROJECT: Is sciatica and related back pain an infection?
Progress Update - 10th June 2003
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Duration of Project: 2001 to 2003
(this may be extended depending upon findings)
Research Site:
- R&D department, Microbiology, UHB NHS Trust Birmingham.
- Biological Sciences, Aston University, Aston, Birmingham.
- Spinal Unit, Royal Orthopaedic Hospital, Northfield, Birmingham.
Researcher: Professor TSJ Elliott
Objective of Research:
To investigate if the inflammation associated with sciatica is linked with
a bacterial infection in or around the spinal discs.
Progress to date:
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Collection of samples from patients with sciatica(Royal Orthopaedic Hospital) |
Collection of samples from patients without sciatica |
Collection of samples from patients with sciatica(BUPA Hospital) |
Collection of skin swabs from patients with acne |
Identification of the bacteria |
| Target |
300 |
50 |
50 |
50 |
All bacteria |
| Achieved to date |
311 |
35 |
50 |
30
(now complete) |
All bacteria to date have been identified |
All of the bacteria that have been present in the spinal samples have been
identified by laboratory methods and the main bacterium that is present is
called Propionibacterium acnes (60% of total cultures). The other main organism grown
has been the coagulase negative staphylococci (CNS) that also lives on the skin.
We have looked at the various chemicals and toxins which Propionibacterium acnes produces
and the antibiotics the organisms are sensitive to. All of the bacteria produce
varying amounts and types of chemical that may help to cause disease, however the
majority are sensitive to a wide range of common antibiotics including tetracycline,
cephalosporin and amoxycillin.
Benefits to patients:
If it can be shown that bacteria are associated with some cases of sciatica, it may
be possible to treat some patients with sciatica with antibiotics. At present,
patients with severe sciatica undergo surgery to relieve their pain.
Next stage of research:
With regard to collection of clinical material, we have reached our target figures
in the majority of patient groups. The next stage of the research will follow various
routes:
We will continue to collect clinical samples from patients without sciatica (controls)
in an attempt to reach the target figure.
We will determine if strains of Propionibacterium acnes found in the skin, hair
follicles, soft tissue and surgical blades used to make the incision during surgery
are related in any way to those organisms grown from the spinal material in patients
with sciatica.
We will look more closely at Propionibacterium acnes recovered from patients' spinal
tissue. We will determine how the organisms may cause the inflammation associated
with sciatica, and also investigate for bacterial products which may be used to
potentially diagnose those patients with sciatica who may have Propionibacterium acnes
in their spinal tissue.
We will continue to seek funding through major grant applications to determine if
antibiotic treatment of patients with sciatica reduces symptoms.
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