It certainly appeared by the 1960s that humanity was leaving the so-called second epidemiologic tranistion. Ancient pathogens were being defeated at every turn as science went from triumph to triumph. And thus a whole generation of public health professionals committed themselves to combating man-made and degenerative diseases; by then believed to be the leading cause of human suffering.

It was sin that brought these afflictions. The sin of greed led owners to run factories demanding back-breaking work. The sin of gluttony led workers to pack on the pounds putting unnatural stresses on the back that wore it down too soon. Decades of litigation over sore backs followed and most were fought over the question of which sin was the greater. It wasn't until recently that some researchers began to wonder, and to investigate, whether or not something else was actually responsible for the epidemic of back pain that arose in the second half of the twentieth century.

That something else turns out to be an anaerobic bacteria and the proof of it would make Robert Koch proud. In more than 40% of all patients with low back pain who had signs on MRI of degenerative disc disease the bacteria was identified as being present. And when antibiotics targeted at that very bacteria were administered a big chunk of those cases resolved (versus placebo).

Not every case of lumbar pain was due to anaerobic bacteria and it also appears that sudden stress on the back may create an opportunity for the bug to exploit. Nevertheless, it's quite clear that antibiotics, rather than difficult surgery with its attendant permanent (though usually partial) disability, may be all it takes to restore sufferers of back pain to good health. The lesson here, as my colleague put it in a joint presentation we gave today, is that "we may forget to focus on germs but they never forget to focus on us."