Chronic lower back pain is a common problem. A type of lower back pain includes signal changes int eh vertebral bone marrow (Modic changes). Recent evidence suggests that lower back pain due to Modic changes can be treated with antibiotic treatment. This study aims to analyze the efficacy of antibiotic treatment in patients with chronic lower back pain.

This is a double-blind, parallel-group, placebo-controlled, multicenter trial conducted across six outpatient clinics in Norway. The study included a total of 180 patients with chronic lower back changes with type-1 (n=118) or type-2 (n=62) Modic changes. Patients were randomly assigned to a three-month treatment of 750 mg oral amoxicillin or placebo three times a day. 

The primary outcome was the reduction in lower back pain indicated by the Roland-Morris Disability Questionnaire (RMDQ) score.

The difference is the mean RMDQ score between the amoxicillin and placebo groups was -1.6 in the primary analysis and -2.3 in the secondary analysis. 56% of the participants in the amoxicillin group experienced at least one drug-related adverse event than 34% in the placebo group.

Ther research concluded that three months of amoxicillin (antibiotic) treatment did not provide any clinical benefits to patients with chronic lower back pain with Modic changes.