Download Full Text (445 KB)

Document Type



Chronic lower back pain affects approximately eight percent of the American population, yet no treatment has been agreed upon universally. Studies suggest that between 20-30 percent of lower back pain cases are caused by a low-virulence bacterial infection of an intervertebral disc. • This scholarly project investigated: In patients with chronic lower back pain and Modic changes after disc herniation, what is the effect of antibiotic therapy on reducing pain symptoms compared to placebo. • The literature review used the following electronic databases: ClinicalKey, Cochrane Library, Embase, and PubMed. Keywords and mesh terms refined searches to the most recent and relevant literature. The articles were then analyzed and refined, revealing ten for critical review. The studies are peer-reviewed and include a double-blind randomized control trial, pilot study, systemic literature reviews, literature reviews, monocentric study, and cohort study. • Most of the research presented shows evidence that Cutibacterium acnes presence in intervertebral discs is not from contamination, but rather is an infectious process that occurs after disc herniation. Additional studies are required, but current research suggests that antibiotic therapy may be efficacious in reducing pain symptoms in those with chronic lower pain and Modic changes after disc herniation.


Physician Assistant Studies

Date of Work


Publication Date



Chronic lower back pain, low-virulence bacterial infection, Modic changes, disc herniation, antibiotic therapy, C. acnes


Medicine and Health Sciences

Antibiotic Efficacy in Lower Back Pain