Illustration of bacteria around spinal discs with Modic change.

Is Hidden Bacteria Sabotaging Your Back?

Lena Voss in Health & Wellness December 2025 • 4 min read.

"Research links low-grade infections to disc degeneration and chronic back pain. Uncover the potential connection and what it means for your spine health."

Chronic back pain is a widespread problem, often attributed to disc degeneration – a process where the intervertebral discs break down, leading to pain and functional limitations. While imaging techniques can reveal disc degeneration, there's often a disconnect between what's seen on scans and the actual pain experienced. This has led researchers to investigate other potential factors contributing to back pain, including the intriguing possibility of low-grade bacterial infections.

For years, the idea that bacteria could play a role in disc degeneration has been controversial. However, emerging evidence suggests that certain low-virulence anaerobic bacteria, those that thrive in the absence of oxygen, might be more involved than previously thought. These bacteria, often difficult to detect, could be contributing to inflammation and other processes that accelerate disc breakdown.

A recent study delved into this question, examining the presence of these bacteria in degenerated intervertebral discs and exploring their connection to Modic changes – alterations in the vertebral bone marrow seen on MRI, often associated with back pain. The findings shed light on the potential role of these hidden infections and open new avenues for understanding and managing chronic back pain.

The Hidden Culprit: Low-Virulence Anaerobic Bacteria

Illustration of bacteria around spinal discs with Modic change.

The research, published in BMC Musculoskeletal Disorders, investigated 80 patients undergoing discectomy (surgical removal of a damaged disc) for disc herniation. Researchers carefully collected disc samples during surgery, ensuring sterile conditions to avoid contamination. These samples were then analyzed to identify any bacteria present, with additional tissue samples taken from surrounding muscles and ligaments as contamination markers.

The study revealed that a significant portion of the degenerated discs, 32.5%, showed the presence of bacteria. After excluding potential contaminations, the absolute bacteria-positive rate was 28.75%. The most common culprit was Propionibacterium acnes (P. acnes), found in 26.25% of the samples, followed by coagulase-negative staphylococci (CNS) at 6.25%.

Propionibacterium acnes (P. acnes): This bacterium, commonly found on the skin, was the most prevalent type identified in the study.
Coagulase-negative staphylococci (CNS): While less common than P. acnes, CNS was also detected in some of the degenerated discs.

Interestingly, the study also found a significant association between the presence of bacteria and Modic changes in the adjacent vertebrae, as detected by MRI. This suggests that these bacterial infections may contribute to the inflammatory processes leading to these bone marrow changes. However, there was no direct correlation between bacterial infection and the overall severity of disc degeneration.

What Does This Mean for Your Back Pain?

This research adds to the growing body of evidence suggesting a potential link between low-grade bacterial infections and disc degeneration. While more research is needed to fully understand the mechanisms involved, these findings open new possibilities for diagnosing and treating chronic back pain.

If you're experiencing persistent back pain, especially if accompanied by Modic changes on an MRI, it's worth discussing these findings with your doctor. While antibiotics aren't a guaranteed solution, understanding the potential role of bacterial infections could lead to more targeted and effective treatment strategies.

The study authors suggest that these infections might play a crucial role in the pathophysiology of Modic changes and disc herniation. Further research could explore new therapeutic strategies that target these infections, potentially offering relief to those suffering from chronic back pain.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1186/s12891-018-2373-3, Alternate LINK

Title: Latent Infection Of Low-Virulence Anaerobic Bacteria In Degenerated Lumbar Intervertebral Discs

Subject: Orthopedics and Sports Medicine

Journal: BMC Musculoskeletal Disorders

Publisher: Springer Science and Business Media LLC

Authors: Guoqing Tang, Zhuo Wang, Ji Chen, Zhengshi Zhang, Hongbin Qian, Yong Chen

Published: 2018-12-01

Everything You Need To Know

Could bacteria actually be contributing to my chronic back pain?

The research indicates a potential connection between specific low-virulence anaerobic bacteria, particularly Propionibacterium acnes (P. acnes) and coagulase-negative staphylococci (CNS), and the process of disc degeneration. These bacteria, when present in the intervertebral discs, may contribute to inflammation and accelerate disc breakdown. The presence of these bacteria was also associated with Modic changes in the adjacent vertebrae, suggesting a link to inflammatory processes affecting bone marrow. While a direct correlation between infection and severity of disc degeneration wasn't found, the study highlights a potential role for bacterial infections in some cases of chronic back pain.

What specific types of bacteria were found in the degenerated discs?

The study specifically identified Propionibacterium acnes (P. acnes) as the most prevalent bacterium found in degenerated discs, present in 26.25% of the samples. Coagulase-negative staphylococci (CNS) were also detected, though less frequently, at 6.25%. These bacteria are anaerobic, meaning they thrive in the absence of oxygen, making them difficult to detect through traditional methods.

What are Modic changes, and how are they related to bacterial infections in the spine?

Modic changes are alterations observed in the vertebral bone marrow on MRI scans. They are often associated with inflammation and back pain. This research found a significant association between the presence of bacteria like Propionibacterium acnes (P. acnes) and coagulase-negative staphylococci (CNS) in degenerated discs and Modic changes in the adjacent vertebrae. This suggests that the bacterial infections may contribute to the inflammatory processes that lead to these bone marrow changes.

What are the potential treatment options if my back pain is linked to a bacterial infection?

The study mentioned discectomy, which is the surgical removal of a damaged disc, was performed on the study participants for disc herniation. The researchers collected samples from the extracted discs to examine them for presence of bacteria. Future treatments based on these findings could potentially involve targeted antibiotics to address these low-grade infections in specific cases of chronic back pain where bacteria like Propionibacterium acnes (P. acnes) or coagulase-negative staphylococci (CNS) are implicated. Further research is needed to determine the effectiveness and safety of such interventions.

Does this mean that bacteria are definitely the cause of disc degeneration and back pain?

While the study identifies a potential link between bacteria, such as Propionibacterium acnes (P. acnes) and coagulase-negative staphylococci (CNS), and disc degeneration, it does not establish a causal relationship. The research suggests that bacterial infections may contribute to inflammation and accelerate disc breakdown, but it doesn't definitively prove that these bacteria are the primary cause of disc degeneration or chronic back pain. More research is needed to understand the precise mechanisms involved and to determine the extent to which these infections play a role in different individuals experiencing back pain. Further research is also needed to explore additional factors, such as genetics, lifestyle, and other underlying conditions, that may contribute to disc degeneration.