Background & Aims

Chronic low back pain is a common condition with various etiologies. While sexually transmitted infections like syphilis can cause back pain, particularly in cases of neurosyphilis, the relationship between syphilis treatment and resolution of chronic, idiopathic back pain remains unclear. This case report explores the outcome of syphilis treatment on long-standing low back pain, contributing to the ongoing discussion about antimicrobials’ role in treating chronic low back pain.

Case Description – A 28-year-old G4P3 female with a history of depression and PTSD was referred to a specialty pain clinic for evaluation and treatment of chronic low back pain persisting for over 5 years. She described bilateral lumbosacral junction pain with intermittent radiation to the right buttocks and anterior thigh, exacerbated by lumbar extension and relieved by rest. Recent testing revealed a positive syphilis diagnosis.

 

Methods

Single dose of IM Penicillin (2400000 Unit/4ML) and referral to physical therapy

Results

Persistent back pain despite syphilis treatment

Conclusions

This case highlights the need for further investigation into penicillin’s role in treating chronic back pain, including the potential impact of administration route (IM vs. PO). It also underscores the importance of exploring the connection between syphilis and back pain, which could provide valuable insights into pathogenesis, epidemiology, and inform future public health strategies and patient care approaches.

References

Hensley, C. P., & Courtney, C. A. (2014). Management of a patient with chronic low back pain and multiple health conditions using a pain mechanisms–based classification approach. Journal of Orthopaedic & Sports Physical Therapy, 44(11), 867-878.

Klauder, Joseph V. “Syphilitic Backache: A Symptom of Syphilis of the Spinal Cord, Lumbar Muscles and Vertebrae with Report of Cases.” Journal of the American Medical Association 72.9 (1919): 657-662.

Yin, R., Wang, L., Zhang, T., & Zhao, B. (2017). Syphilis of the lumbar spine: A case report and review of the literature. MD-Journal, 96(50), e9098. doi: 10.1097/MD.0000000000009098

Presenting Author

Christine Chilaka

Poster Authors

Christine Chilaka

OTHR

University of Washington

Lead Author

Topics

  • Assessment and Diagnosis