In Rare Cases, Infection May Be at Root of Back Pain

New guidelines alert doctors to this possibility

By Robert Preidt

Thursday, July 30, 2015

THURSDAY, July 30, 2015 (HealthDay News) -- People with back pain that doesn't improve with treatment could have a rare type of spine infection, new guidelines suggest.

The infection -- called vertebral osteomyelitis -- could lead to paralysis or death if it's not diagnosed and treated correctly.

The condition is often overlooked because it causes back pain, a common problem typically caused by a pulled muscle or back injury, according to the guidelines published July 30 in the journal Clinical Infectious Diseases.

"Back pain is so common -- and usually not caused by infection -- that diagnosis often is missed or delayed," guidelines lead author Dr. Elie Berbari, associate chair of education, division of infectious disease, Mayo Clinic College of Medicine in Rochester, Minn., said in a news release from the Infectious Diseases Society of America.

Vertebral osteomyelitis affects two to six out of 100,000 people a year. The condition develops when bacteria enter the blood stream and lodge in a spinal disc. The infection is most common in older people.

"The infection causes severe pain that often wakes the person at night and does not go away after pain management or rest. If that's the case, the doctor needs to start considering that something else is going on, especially if the patient has a fever," Berbari said.

A simple blood test can alert a doctor that a patient may have vertebral osteomyelitis, and an MRI and biopsy can confirm it. Treatment typically involves six weeks of intravenous antibiotics. However, about half of patients may have to undergo surgery to remove the infection, Berbari said.

SOURCE: Infectious Diseases Society of America, news release, July 30, 2015

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