Discitis
Discitis Overview
Discitis is a condition caused by infection, inflammation and irritation of the small spaces between the disks of the spine. Swelling in the spaces puts pressure on the disks, which causes pain. Discitis is fairly uncommon and mostly affects young children.
The condition typically involves the upper back (thoracic) and lower back (lumbar). Sometimes surrounding tissue, joints and vertebrae can become irritated and inflamed. It’s important that discitis is diagnosed as early as possible so that antibiotic treatment can be administered promptly to relieve pain and avoid more serious consequences including additional infection.
Discitis can be caused by a bacterial or viral infection, or another source of inflammation such as an autoimmune disease. These are conditions in which the body’s immune system mistakenly attacks cells in the body. Sometimes discitis can be the result of a medical or therapeutic procedure. For example, surgery on the back or a needle in the back can introduce pathogens, which can lead to infection. In other instances the bacteria or virus enters the body through the urinary tract, intestine or other means.
Because the symptoms of discitis can mimic those of conditions related to aging and wear and tear on the spine, expert diagnosis is essential. Your Wellstar neurologist will help rule out other causes of back pain and confirm a diagnosis of discitis.
Symptoms
Discitis can be difficult to treat. Because the area is not served by a good blood supply, it can be challenging to get medications (typically antibiotics) into the location.
Discitis is characterized by back severe pain, sometimes described as unbearable. Other symptoms include:
- Abdominal pain
- Difficulty getting up and standing
- Increased curvature of the back
- Loss of appetite
- Back stiffness
- Irritability
- Low-grade (under 102° F.) fever and chills
- Recent flu-like symptoms
- A refusal to sit up, stand or walk (in a young child)
- With discitis, back pain is usually localized in the area of the infection. Unlike some other causes of back pain, including sciatica, the pain from discitis does not radiate down the leg.
Risk Factors
Those most at risk for getting discitis include:
- Children under age 10 and the elderly
- Individuals with autoimmune disorders
- Individuals with weakened immune systems
- Individuals with an elevated risk of infection
- Patients who have had back surgery or other procedures
- Individuals who abuse drugs and alcohol
Discitis Prevention
There is nothing a patient can do to prevent discitis that is a result of a viral or bacterial infection. However, doctors performing surgical procedures on the back routinely use antibiotics to minimize the risks of discitis and other infections.
Discitis Diagnosis
The sooner discitis is diagnosed, the sooner it can be treated, usually with antibiotics and anti-inflammatory medications. Your Wellstar neurologist will ask questions about symptoms and will perform a physical examination to learn why they are occurring.
Tools and Tests
Diagnosing discitis can be challenging because there are many other possible causes of back pain. Your doctor may order tests to confirm a diagnosis including:
- X-ray to indicate the area of infection
- MRI (magnetic resonance imaging)
- Bone scan
- CBC (Complete Blood Count)
- ESR (A test that measures the blood’s sedimentation rate. When inflammation is present, red blood cells settle faster in a test tube.)
Discitis Treatment
Your Wellstar neurologist will discuss treatment options, with the goal of reducing inflammation and pain. A common approach for adults is a long course (four weeks or more) of daily antibiotics. These may be given orally and/or intravenously at either a Wellstar outpatient facility or via Home Health.
Treatment may also include anti-inflammatory medications and a brace to support the spine and make it easier to move without pain. Rest may also be recommended. Activity modification ranging bedrest to more active therapy may be recommended depending on the pathology.
In rare cases, severe cases of discitis may require surgery in order to clean out the infection.
Ongoing Care for Discitis
People who suffer from discitis usually make a complete recovery and require little ongoing care. A good prognosis is very likely with proper and consistent medical and surgical therapy.