Diseases and Disorders

What is Discitis? An Inevitable Problem of Ageing

Discitis (inflammation of the intervertebral disc) is a very rare disorder. Discitis can cause severe back pain, swelling, nausea, and weakness.

The term discitis is used to refer to an infection of the intervertebral discs, the spongy pads found between each of the vertebrae of the spine. It is a very rare disease and can be difficult to diagnose.

What is Discitis? In this article learn about Discitis symptoms, causes diagnosis, and treatment.

Discitis, An Inevitable Problem of Ageing

One of the inevitable problems of ageing is the aches and pains that we experience after doing things we used to do with no consequences. For example, sleeping on a very soft mattress now produces pain in our back, as does exercise and even lifting fairly light loads. There are a host of causes of low back pain that include muscle strain, arthritis, herniated disc, muscle spasm, spondylolisthesis (vertebral displacement), some cancers, and the list goes on and on. However, there is a back pain cause that I recently encountered that is rare, but requires an astute diagnostician and early treatment to control.

What is Discitis?

Discitis is a disease, as the “itis” would show, of infection of the discs between the vertebra of the spine. Like appendicitis, discitis is usually a bacterial infection but may be viral. The purpose of the disc is to allow some movement and shock absorption of the vertebra that the discs separate from the spinal column. A major issue for the discs is that they do not have a good blood supply and so if bacteria or viruses are there, the body’s immune cells, as well as a physician’s antibiotics, have great difficulty getting to the infection since they are conveyed there by the bloodstream.

Thus, if infection of the disc occurs, it is very difficult to treat, and therefore discitis is such a big problem for those who contract it.

What are the Causes for Discitis?

There are two types of discitis. One results from an intervention at the site of the infection by a surgical, diagnostic, or therapeutic procedure. For example, surgery on the back of a needle placed in the back for a diagnostic or treatment can introduce pathogens. The other form is “spontaneous” discitis that is caused by an infecting organism, either bacterial or viral that comes to the disc by the blood from the urinary tract (kidney or bladder), respiratory tract (nose, throat, lungs), intestine, gums (dental work), pelvic infections, or any other entry into the body.

This usually causes a generalized blood-borne attack that causes severe fever and chills about a week to ten days prior to the onset of severe back pain.

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What are the Discitis Symptoms?

Severe, almost unbearable back pain is usually the major symptom. Because, as mentioned at the outset, back pain is common and has a great number of causes, discitis is often misdiagnosed and that means it is late to be appropriately treated and the back pain remains. The pain is usually localized to the region of the infection and does not radiate (shoot) down the leg or other regions of the body as do some other back disorders (like sciatica).

How to do Discitis Diagnosis?

A very thorough history that elicits a fever and chill, indicative of a body-wide infection, is the first step in the diagnosis. The best and most sure diagnosis is to have an MRI (magnetic resonance imaging) scan of the region that will show the infection. Blood tests are not specific in the diagnosis but can show infection markers and this is not usually seen with other causes of back pain. After the infection is detected by imaging, a culture aspiration may “grow” out of the infectious organism. Fever is usually not present once the infection is localized in the disc.

What are the Discitis Risk Factors?

Discitis occurs in the young and then again in the elderly. The older one is, the greater the chance to have this rare (1 out of 100,000 people) disorder. Diabetes, any immune deficiency, and vascular disease predispose people to this problem. Drug abuse, particularly intravenous drug use and alcoholism, are also risk factors.

What is Discitis Treatment?

Discitis is treatable and usually results in an uncomplicated cure. However, it takes a very long course of antibiotic therapy that is usually given intravenously every day at an infusion center. The standard therapy requires six to eight weeks of this intravenous antibiotic therapy. Pain is treated with analgesics and patients learn to move as little as possible, but a brace may be prescribed to enforce this. The activity of parts of the body not affected, like arm exercises, should be done to prevent generalized weakness. Eating a healthy diet and responsible drinking are probably important.

The prolonged treatment course and the considerable pain and immobility can lead to situational depression that should be treated if present.

Conclusion

As we age, one of the rare problems that can occur after a systemic infection is a localized and very painful spinal infection of the disc. This is debilitation and often a late-diagnosed problem that requires immediate antibiotic treatment to get the cure that usually comes, but painfully long into the disease. 

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This article was originally published in Muschealth.org

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