Hanne Albert

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Hanne Albert is a Danish physiotherapist with a Ph.D. in medical science.[1] Her main research interest is in lower back pain and pelvic girdle pain.[2] Albert's studies have revealed that bone œdema (Modic changes) could be caused by a bacterial infection and treated with antibiotics.[3][4]

Career and education[edit]

Albert was recognized and authorized as a physiotherapist by Metropolitan University College in Copenhagen. In 2000, she was awarded a Master of Public Health from the Nordic College for Public Health in Gothenburg, Sweden. The subject of her Master's thesis was Group Treatment of Women With Chronic Pelvic Pain.

Based on her thesis on Non-Surgical Treatment of Patients With Sciatica - A randomized clinical controlled trial [5], she was awarded a Ph.D. degree in 2004 from the faculty of health sciences, University of Southern Denmark.

Albert started her career as a physiotherapist at Odense University Hospital, where she later went on to become a clinical lecturer. In 2000, she was employed as a researcher in the research department of The Back Center in Ringe, Denmark.[6] Between 2010 and 2013 she held the title of Associate Professor at the Faculty of Health Sciences, University of Southern Denmark. In 2013, she became the Medical Director at the Modicklinikken, Odense, Denmark.[7]

Research and publications[edit]

Albert has led or has been a part of several teams that have explored the area of back pain.[8][9][10][11][12][13]

Her career in research began in the field of gynecology and obstetrics at the gynecology ward of Odense University Hospital, where she worked with women experiencing chronic pelvic pain. She partnered with another physiotherapist, Tove Boe, to develop a new treatment for women with chronic pelvic pain using a psychosomatic approach. They combined qualitative action research methods with quantitative measurements of improvement. The results showed that the patients improved significantly. This research was published in her Master's thesis and as a scientific paper.[14]

Working with another physiotherapist, Mona Godskesen, Albert attempted to classify the different groups of pelvic girdle pain into subgroups that required different treatments. The study, which was the largest in the world, included 2269 pregnant women, all of whom were examined in the twentieth week of their pregnancy. The women who suffered from pelvic pain were followed at 1, 3, 6, 12, and 24 months post-partum, or until their pelvic pain subsided. The study found that there were most likely four different subgroups of pelvic girdle pain. Furthermore, the different groups have different incidences, and there are different clinical characteristics, pain patterns, and prognosis. The study also found that 5% of the pregnant women fell into the most important subgroup of Pelvic Girdle Syndrome. Unfortunately, these women have a poor prognosis and 20% of them will suffer from pain two years after the delivery of their child.

This research resulted in five scientific papers and three summaries.[15][16][17][18][19][20][21] For this scientific work, she was given two awards and a seat in the European Guideline Group.[22]

Disc herniation[edit]

In 2000, Albert was employed as a researcher and a Ph.D. student at The Back Center in Ringe, Denmark. The aim of her Ph.D. was to evaluate the possibility of treating patients with severe lumbar disc herniation via exercises. Normally, such patients would have been offered surgical intervention for treatment. The PhD study demonstrated that there was a significant improvement in patients receiving this kind of treatment. It also demonstrated that different symptoms would react to different treatments, i.e., specific exercises and positioning, as well as noting that patients with different types of herniation and different personality traits would require different treatments.[23][24][25][26][27][28]

Modic changes[edit]

The Ph.D. study revealed that about 50% of the patients developed Modic changes in the vertebrae adjacent to the one previously herniated - this was visible one year after their disc herniation. These patients also developed back pain, whereas the main problem that they presented while having the lumbar disc herniation was pain radiating into one or both legs. Albert was the first to describe this connection between a previous herniation and new Modic changes in the adjacent vertebra.[29] In 2007, she and radiologist Joan Solgård Sørensen published their ideas of three theories of the pathogenesis behind Modic changes: a bacterial cause, a mechanical cause, and a rheumatological cause.[30]

Bacteria as a cause of back pain[edit]

The new idea that they presented suggested that, through a lesion in the herniated disc, the bacteria Propioni Acnes could invade the disc, and that Modic changes/bone edema was the edema surrounding the infected disc. Antibiotic treatment was a relevant treatment for an infection.

The first study of antibiotic treatment of Modic changes was published in 2008. In the study, 32 patients were treated with long-term antibiotics in a pilot study; 60% of this cohort showed significant improvement or had their back pain cured.[3]

In 2013, the first randomized, clinically controlled trial was published.[4] This study worked with 162 patients in a double-blind, placebo-controlled, and randomised clinical trial. It showed that an oral antibiotic treatment offered significant and clinically relevant improvement for these chronic low back pain patients by removing the bacterial infection.[31]

The results created international interest.[32][33][34][35] Previous opinions had been that back pain was either caused by mechanical problems in the tissue or the pain was psychosomatic. Now there was a third cause, demonstrating that back pain could be caused by bacterial infection.


Albert has been the head author or co-author of 55 scientific papers that were published in peer-reviewed papers.[2] She has been the co-author of three books[36][37][38] and was also an assistant editor of the European Spine Journal.[39]

Honours, awards, and distinctions[edit]

2003: Danish Physiotherapists Research Award for original and innovative research with immediate clinical relevance.[40]
2004: The Columna Prize from The Danish Society for Musculoskeletal Medicine. For comprehensive clinical research in women with pelvic pain related to pregnancy and after delivery, and the extensive education to implement this new knowledge in all groups of health professionals.
2005: Modic changes following lumbar disc herniation. The best scientific presentation at the European Spine conference in Barcelona.[41]
2017: The German Pain Prize for showing there was a third new cause of back pain due to a bacterial infection, instead of the early belief that back pain was either caused by mechanical problems in the tissue or the back pain was psychosomatic.[42][43]

Albert was invited to be a part of the group that wrote the European guidelines for the diagnosis and treatment of pelvic girdle pain, which was published in 2008.[44]


  1. ^ PT, Hanne B. Albert University of Southern Denmark; MPH.; Ph.D. "Hanne B Albert - PT., MPH., Ph.D. - University of Southern Denmark, Odense - SDU". ResearchGate. Retrieved 11 October 2018.
  2. ^ a b PT, Hanne B. Albert University of Southern Denmark; MPH.; Ph.D. "Hanne B Albert - PT., MPH., Ph.D. - University of Southern Denmark, Odense - SDU". ResearchGate. Retrieved 11 October 2018.
  3. ^ a b Albert, HB; Manniche, C; Sorensen, JS. Deleuran BW. (2008). "Antibiotic treatment in patients with low-back pain associated with Modic changes Type 1 (bone oedema): a pilot study". Br J Sports Med. 2008 (42): 969–73. doi:10.1136/bjsm.2008.050369. PMID 18718972. S2CID 966062.
  4. ^ a b Albert, HB; Sorensen, JS; Christensen, BS; Manniche, C (2013). "Antibiotic treatment in patients with chronic low back pain and vertebral bone edema (Modic Type 1 changes): a double-blind randomized clinical controlled trial of efficacy". Eur Spine J. 22 (4): 697–707. doi:10.1007/s00586-013-2675-y. PMC 3631045. PMID 23404353.
  5. ^ "Ikke-kirurgisk behandling af patienter med radiculære smerter til UE". Fysio.dk. Retrieved 11 October 2018.
  6. ^ "Archived copy". Archived from the original on 2017-02-06. Retrieved 2017-08-13.{{cite web}}: CS1 maint: archived copy as title (link)
  7. ^ "behandlerne i klinikken". Modicklinikken.dk. Retrieved 11 October 2018.
  8. ^ Albert HB, Lambert P, Rollason J, Sorensen JS, Worthington T, Pedersen MB, Nørgaard HS, Vernallis A, Busch F, Manniche S, Elliott T. Is nuclear tissue infected with bacteria following disc herniations which leads to Modic changes in the adjacent vertebrae? Eur Spine J 2013;22:690-6.
  9. ^ Rollason, J; McDowell, A; Albert, HB; Barnard, E; Worthington, T; Hilton, AC; Vernallis, A; Patrick, S; Elliott, T; Lambert, P (2013). "Genotypic and antimicrobial characterisation of Propionibacterium acnes isolates from surgically excised lumbar disc herniations". Biomed Res. Int. 2013: 530382. doi:10.1155/2013/530382. PMC 3771251. PMID 24066290.
  10. ^ "Rygsmerter, radiologi og endepladeforandringer ad modum Modic". Ugeskrift for læger. 168: 1668.
  11. ^ Albert H, Pedersen H, Manniche C, Høilund-Carlsen PF. "PET imaging in patients with Modic changes. Nuklearmedizin. 2009;48(3):110-2. Epub 2009 Mar 23.
  12. ^ Albert, HB; Briggs, AM; Kent, P; Byrhagen, A; Hansen, C; Kjaergaard, K (2011). "The prevalence of MRI-defined spinal pathoanatomies and their association with Modic changes in individuals seeking care for low back pain". Eur Spine J. 20 (8): 1355–62. doi:10.1007/s00586-011-1794-6. PMC 3175840. PMID 21544595.
  13. ^ Kent, P; Briggs, AM; Albert, HB; Byrhagen, A; Hansen, C; Kjaergaard, K; Jensen, TS (2011). "Inexperienced clinicians can extract pathoanatomic information from MRI narrative reports with high reproducibility for use in research/quality assurance". Chiropr Man Ther. 19 (1): 16. doi:10.1186/2045-709x-19-16. PMC 3154850. PMID 21774836.
  14. ^ Albert, H (1999). "Psychosomatic group treatment helps women with chronic pelvic pain". J Psychosom Obstet Gynecol. 20 (4): 216–25. doi:10.3109/01674829909075598. PMID 10656156.
  15. ^ Albert, H; Godskesen, M; Westergaard, JG; Chard, T; Gunn, L (1997). "Circulating levels of relaxin are normal in pregnant women with pelvic pain". Eur J Obstet Gynecol Reproductive Biology. 74 (1): 19–22. doi:10.1016/s0301-2115(97)00076-6. PMID 9243195.
  16. ^ Albert, H; Godskesen, M; Westergaard, JG (2000). "Evaluation of clinical tests used in classification procedures in pregnancy-related pelvic joint pain". Eur Spine J. 9 (2): 161–6. doi:10.1007/s005860050228. PMC 3611366. PMID 10823434.
  17. ^ Albert, HB; Godskesen, M; Westergaard, JG (2001). "Prognosis of four classification groups of pregnancy-related pelvic joint pain". Acta Obstet Gynecol Scand. 80: 505–10. doi:10.1034/j.1600-0412.2001.080006505.x. S2CID 26614475.
  18. ^ Albert, HB; Godskesen, M; Westergaard, JG (2002). "Incidence of four syndromes of pregnancy-related pelvic joint pain". Spine. 27 (24): 2831–4. doi:10.1097/00007632-200212150-00020. PMID 12486356. S2CID 28828788.
  19. ^ Albert, HB; Godskesen, M; Korsholm, L; Westergaard, JG (2006). "Risk Factors in developing Pregnancy-Related Pelvic Girdle Pain". Acta Obstetricia et Gynecologica Scandinavica. 85 (5): 539–44. doi:10.1080/00016340600578415. PMID 16752231. S2CID 24963131.
  20. ^ Albert, HB (2002). "Behandling af bækken - og lænderygsmerter hos gravide og post partum kvinder". Muskuloskelatalt Forum. 2: 16–21.
  21. ^ Albert, HB (2012). "Bækkensmerter i graviditeten - forekomst, prognose, risikofaktorer og diagnostisering". Best Practice. 6: 23–25.
  22. ^ "European guidelines for the diagnosis and treatment of pelvic girdle pain | European Spine Journal". europeanspinejournal.org. Retrieved 2023-05-15.
  23. ^ Albert HB. Conservative treatment of patients with sciatica- a randomized controlled trial. [Dissertation] Odense: Faculty of Health Sciences, University of Southern Denmark; 2004.[Danish]
  24. ^ Albert, HB; Manniche, C (2012). "The efficacy of systematic active conservative treatment for patients with severe sciatica. A single-blind randomized clinical controlled trial". Spine. 37 (7): 531–42. doi:10.1097/brs.0b013e31821ace7f. PMID 21494193. S2CID 25518989.
  25. ^ Albert, HB; Hauge, E; Manniche, C (2012). "Centralization in patients with sciatica: are pain responses to repeated movement and positioning associated with outcome or types of disc lesions?". Eur Spine J. 21 (4): 630–6. doi:10.1007/s00586-011-2018-9. PMC 3326129. PMID 21947819.
  26. ^ Jensen, TS; Albert, HB; Sorensen, JS; Manniche, C; Leboeuf-Yde, C (2007). "Magnetic Resonance Imaging Findings as Predictors of Clinical Outcome in Patients With Sciatica Receiving Active Conservative Treatment". J Manip Ther Phys. 30 (2): 98–108. doi:10.1016/j.jmpt.2006.12.004. PMID 17320730.
  27. ^ Løgtholt Andreasen, Marianne; Langhoff, Lotte; Secher Jensen, Tue; Albert, Hanne B. (2007). "Reproduction of the Lumbar Lordosis: A Comparison of Standing Radiographs versus Supine MRI obtained with Straightened Lower Extremities". J Manipulative Physiol Ther. 30 (1): 26–30. doi:10.1016/j.jmpt.2006.11.009. PMID 17224352.
  28. ^ Jensen, Tue S.; Albert, Hanne B.; Soerensen, Joan S.; Manniche, Claus; Leboeuf-Yde, Charlotte (2006). "Natural course of disc morphology in patients with sciatica: an MRI study using a standardized qualitative classification system". Spine. 31 (14): 1605–12. doi:10.1097/01.brs.0000221992.77779.37. PMID 16778696. S2CID 11759913.
  29. ^ Albert, HB; Manniche, C (2007). "Modic changes following lumbar disc herniation". Eur Spine J. 16 (7): 977–82. doi:10.1007/s00586-007-0336-8. PMC 2219661. PMID 17334791.
  30. ^ Albert, HB; Kjaer, P; Jensen, TS; Sorensen, JS; Bendix, T; Manniche, C (2008). "Modic changes, possible causes and relation to low back pain". Med Hypotheses. 70 (2): 361–8. doi:10.1016/j.mehy.2007.05.014. PMID 17624684.
  31. ^ World Congress LBPGP website
  32. ^ "Antibiotics could cure 40% of chronic back pain patients", The Guardian, Tuesday 7 May 2013. Retrieved Saturday 5 August 2017.
  33. ^ "Antibiotics may help ease chronic back pain", Wednesday 8 May 2013. Retrieved 5 August 2017.
  34. ^ Laurance, Jeremy. "The stuff of Nobel prizes: Half a million sufferers of back pain could be cured with antibiotics", The Independent, Tuesday 7 May 2013. Retrieved Saturday 5 August 2017.
  35. ^ Moore, Thomas. "Antibiotics 'Can Cure Back Pain', Study Finds", Sky NEWS, Wednesday 8 May 2013. Retrieved Saturday 5 August 2017.
  36. ^ Albert HB, Johansen S. Bækkensmerter s 607-622 i Klinisk reumatologi for ergo og fysioterapeuter. Red Danneskiold-Samsøe B, Lund H, Avlund K. Munksgård, København.
  37. ^ Albert HB, Lund H, Hovmand B, Winkel A. Case rapport. En grundbog i praksisformidling. Munksgaard, København.
  38. ^ Thomsen K, Albert H, Warren M, Groby L. Ortopædkirurgi for ergoterapeuter og fysioterapeuter; Ryg og bækken, 359-404. Munksgaard, København, 2009.
  39. ^ "The Editorial Board | European Spine Journal". Archived from the original on 2017-08-13. Retrieved 2017-08-13.
  40. ^ Weirsøe, Frank. "Pris til fynsk fysioterapeut", TV 2/Fyn, [DANISH] 19 November 2003. Retrieved 5 August 2017.
  41. ^ "Best podium presentation 2005: Modic Changes, the prevalence and relationship to lumbar disc herniation. A possible new pathogenesis of low back pain." EUROSPINE, Retrieved 5 August 2017.
  42. ^ Zeuner, Nicole. " 'Antibiotika helfen bei Rückenschmerzen' - Deutscher Schmerzpreis für revolutionäre Studien", [GERMAN], 26 March 2017. Retrieved 5 August 2017.
  43. ^ "Deutscher Schmerz- und Palliativtag 2017: Schmerzpreis für revolutionäre Studien zur Behandlung von Rückenschmerzen mit Antibiotika", [GERMAN] 26 March 2017. Retrieved 5 August 2017.
  44. ^ Vleeming A; Albert HB; Ostgaard HC; Stuge B; Sturesson B (June 2008). "European guidelines on the diagnosis and treatment of pelvic girdle pain". European Spine Journal. 17 (6). Epub: 794–819. doi:10.1007/s00586-008-0602-4. PMC 2518998. PMID 18259783.