Danish researchers say they've found a link between many cases of back pain and infection from bacteria.
Some experts have questioned how many people are likely to benefit from this treatment. Others have cautioned that boosting antibiotic use in the face of growing resistance could be counterproductive and lead to more superbugs.
Back pain is a common condition, affecting about 4 out of 5 people at some point in their lives.
Recommended treatments include painkillers, hot or cold compresses, lifestyle changes, physical therapy, and keeping active. In extreme cases, when other treatments have failed, surgery may be carried out to remove part of a damaged disc.
The latest studies from the University of Southern Denmark build on previous research, which shows that between 7% and 53% of patients with herniated discs have a type of bacteria. In these patients the bacteria entered the disc at the time it was herniated, or "slipped."
In the first study of 61 patients who had spinal surgery for lower back pain, the researchers found bacteria in 46% of the slipped discs.
In a second study, the research team recruited 162 patients who had been living with low back pain for more than 6 months following a slipped disc. Half of the patients were given a 100-day course of antibiotic treatment, while the others received a placebo.
After a 1-year follow-up period, those who'd taken antibiotics were less likely to still have lower back pain and physical disability. They were also less likely to have leg pain and to have taken days off work because of their back.
The researchers estimate that about 35% to 40% of people with long-term back pain have excess fluid in the spinal vertebrae and might benefit from this type of treatment.
The findings are published in the European Spine Journal.
'Not a Cure'
Media reports that antibiotics could be a cure for back pain have alarmed John O'Dowd, a consultant spinal surgeon and president of the British Society for Back Pain Research.
"Unless you've had a disc herniation ... I don't think you should be getting too excited, and I don't think this is going to be a treatment for you," O'Dowd says. "I think this is another useful building block of evidence, but I don't think it's either a cure or the answer to back pain."
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