Do bacterial infections in the spine contribute to disc degeneration and lower back pain?

Disease – Back pain

Lead applicant – Professor Frances Williams

Organisation – King’s College London

Type of grant – Pain Challenge Full 2019

Status of grant – Active from 1 October 2020

Amount of the original award – £577,255.70

Start date – 01 August 2020

Reference – 22467

Public Summary

What are the aims of this research?

There are 24 bones (vertebrae) in the spine with cartilage-like discs in between them, which can degenerate over time causing lower back pain. This research aims to investigate if bacteria coming from other parts of the body enter the spine and contribute to disc degeneration. Researchers will test if bacteria are present in discs removed during routine spine surgery, if the same bacteria are present elsewhere in the body, and if the blood shows chemical signs of bacterial inflammation. This could aid our understanding of lower back pain and determine if disc degeneration is more than just an age-related phenomenon.

Why is this research important?    

Lower back pain is the leading cause of disability globally, and disc degeneration is a major contributor to this. While degenerative conditions are not generally considered to be caused by infection, there is some evidence that some forms of disc degeneration are caused by low grade infection of the spine.

The process of disc degeneration is complex, but it has recently been shown that the damage and associated inflammation may allow the passage of bacteria into the disc. This project aims to use newly available techniques to identify the bacteria responsible inflammation in degenerating discs, and where the bacteria is coming from in the body.

How will the findings benefit patients? 

This work will improve our understanding of the causes of lower back pain and how the body’s bacteria contribute. If results from this research identify key bacteria involved in disc degeneration, this could lead to development of new treatments for back pain in the future.