My perspective on this important piece of research is that we should pause and plan how we can identify those with chronic low back pain who are likely to have the modic type 1 changes. 
In the first instance, clinical groups who are responsible for developing guidelines and clinical pathways will need to address the guidelines for requesting an MRI scan when the individual has simple back pain. It will need to be understood what are the likely patterns of dysfunction and pain that we can attribute to modic type 1 changes. Family doctor groups will also need to agree on the validity of this study and address the implications of more widely prescribed antibiotics. My view is that in practice (my practice, and that of my colleagues) we find that the frequency of modic type 1 changes in our patient population is somewhat less than 40% of our MRI scan findings. However, modic type 2 changes are more commonly found, and the paper proposes that this cohort should be researched in a similar way. If there is an opportunity to fundamentally improve the quality of life and the recovery prospects of chronic low back pain sufferers, then this is truly an important piece of work.