Table 1 Eligibility criteria
Inclusion criteria | Exclusion criteria |
|---|---|
- Aged between 18 and 60 years | - Static disorders of the spine |
- Low back pain with an inflammatory pattern (at least one of three characteristics: waking at night due to pain, morning stiffness for longer than 60 minutes, maximal pain on morning) | - Contraindication to pamidronate (hypocalcaemia, severe kidney failure or allergy) |
- Underage patients, patients subject to legal protections | |
- Previous treatment with bisphosphonates | |
- Pregnancy | |
- Daily pain for at least three months | |
- VAS for pain > 40/100 in the last 48 hours | - Local or general infection |
- Previous disc surgery | |
- Lack of efficacy, intolerance, or contraindication to NSAIDs | |
- Systemic corticosteroid therapy in the last month | |
- Lack of efficacy of a rigid or semi-rigid back brace | - Epidural or facet joint corticosteroid injection in the last month |
- Modic 1 disc disease (diagnosed on MRI and confirmed by a trained radiologist) | |
- History of septic spondylodiscitis | |
- Dental check-up within the last six months | - Ankylosing spondylitis |
- Low back pain associated with radiculalgia | |
- Signed informed consent form | - Active psychiatric disorder |
- Inability to read or understand French | |
- Body temperature greater than 38°C (fever) or erythrocyte sedimentation rate greater than 20 mm/hour |