Methods for treating degenerative disc disease and chronic lower back pain

1. A method for treating degenerative disc disease or chronic lower back pain, comprising: administering to a patient having degenerative disc disease or chronic lower back pain, and suspected of having a low-virulence infection, an antibiotic and an inhibitor of Nerve Growth Factor (NGF), wherein the inhibitor of NGF is tanezumab, fulranumab, TrkAd5, AMG 403, Appha-D11, MNAC13, ALE0540, PD90780, or PPC-1807.

2. The method of claim 1 , wherein the patient is suspected of having a low-virulence infection based on the detection of a commensal pathogen in intervertebral disc tissue.

3. The method of claim 2 , wherein the presence of the commensal pathogen is detected in intervertebral disc tissue by one or more of: the presence of microbial nucleic acid, host cell RNA profile, immunohistochemistry of disc tissue, and microbial-specific staining of disc tissue.

4. The method of claim 3 , wherein the commensal pathogen is one or more of Propionibacterium sp., Staphylococcus sp., Corynebacterium sp., Lactobacillus sp., Pseudomonas sp., Enterococcus sp., Streptococcus sp., Bacillus sp., Citrobacter sp., E. coli, Moraxella sp., Haemophilus sp., Neisseria sp., Clostridium sp., Enterobacter sp., and Klebsiella sp.

5. The method of claim 4 , wherein the commensal pathogen is Propionibacterium acnes.

6. The method of claim 5 , wherein the low-virulence infection is identified by the presence of one or more virulence factors in the patient's disc tissue.

7. The method of claim 1 , wherein the antibiotic is selected from benzylpenicillin, amoxicillin, ampicillin, dicloxacillin, methicillin, nafcillin, oxacillin, penicillin G, cephalexin, cefoxitin, cephalolothin, ceftriaxone, ciprofloxacin, chloramphenicol, erythromycin, tetracycline, vancomycin, clindamycin, fusidic acid, doxycycline, moxifloxacin, linezolid, rifampicin, ertapenem, taurolidine, or a combination thereof.

8. The method of claim 1 , wherein the antibiotic is administered systemically or locally.

9. The method of claim 8 , wherein the antibiotic is administered by a route selected from oral, parenteral, and transdermal.

10. The method of claim 1 , wherein the inhibitor of NGF is administered by a route selected from parenteral, oral, and transdermal.

11. The method of claim 10 , wherein the parenteral administration is subcutaneous injection, intramuscular injection, intravenous injection, or local injection to intervertebral disc tissue.

12. The method of claim 1 , wherein antibiotic, and the inhibitor of Nerve Growth Factor (NGF) are co-administered.

13. The method of claim 1 , wherein the antibiotic, and inhibitor of Nerve Growth Factor (NGF) are administered prior to surgery.

14. The method of claim 1 , wherein the antibiotic, and inhibitor of Nerve Growth Factor (NGF) are administered following surgery.