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Could Your Back Pain Be a Spinal Infection?

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Most chronic back pain has a common cause: muscle strain, a bulging disk or arthritis, for instance. But rarely, the culprit is a spinal infection called native vertebral osteomyelitis, a serious condition that affects mostly adults 50 and older. Because the infection is so rare, and back pain so common, a vertebral osteomyelitis diagnosis is often delayed—and the consequences can be dire. If left untreated, the infection can eventually lead to paralysis or even death.

Each year, up to six in 100,000 people are diagnosed with vertebral osteomyelitis (sometimes called discitis), in which bacteria—usually Staphylococcus aureus—enter the bloodstream and become lodged in a spinal disk, causing severe persistent pain that’s typically worse at night. Risk factors for vertebral osteomyelitis include degenerative spine disease, previous spine surgery, diabetes, steroid therapy, a compromised immune system, hemodialysis therapy, placement of an indwelling central catheter and intravenous drug use.

Detecting an infection

New clinical guidelines from the Infectious Diseases Society of America, published in the September 2015 issue of Clinical Infectious Diseases, outline symptoms that in combination could indicate vertebral osteomyelitis.

Signs of infection include new or worsening back pain, often with elevated levels of two inflammatory markers— erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). A fever or a blood or heart infection, such as sepsis or endocarditis, sometimes accompanies these symptoms. New neurological symptoms, such as radiating pain or numbness in the limbs or bladder or bowel dysfunction, and a fever, with or without back pain, may also indicate vertebral osteomyelitis. A biopsy is sometimes used to confirm the infection and identify the bacteria type, then oral or intravenous antimicrobial therapy can be tailored to the results.

Most people with vertebral osteomyelitis recover after six weeks of antimicrobial therapy. Some patients, such as those who show neurological deficits or symptoms of spinal cord compression, may need surgery to remove infected tissue or stabilize the spine.

Act quickly

Although back pain most always has a more typical cause than vertebral osteomyelitis, it’s important to have your symptoms assessed and diagnosed by a doctor so you can get started on treatment as soon as possible if it’s an infection. Although most patients’ back pain improves after treatment begins, the longer the wait between symptom onset and treatment, the more likely that back pain will persist even after the infection is cleared. 


Posted in Back Pain on March 22, 2016

Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Health After 50 Disclaimer

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