Discitis: Symptoms, Causes, Treatment

What are the symptoms of discitis?

Discitis is an infection or inflammation of the intervertebral discs in the spine. It can cause a range of symptoms, which often vary in severity depending on the location and extent of the infection.

Common Symptoms of Discitis:

Severe Back Pain:
Often localized to the infected area of the spine.
Pain may worsen with movement and improve with rest.
Limited Mobility:
Stiffness in the back or neck, making it difficult to move or bend.
Fever and Chills:
Often associated with infection.
May include sweating or flu-like symptoms.
Spinal Tenderness:
The affected area of the spine may be painful to the touch.
Muscle Spasms:
Involuntary muscle tightening around the infected area.
Neurological Symptoms (in severe cases):
Numbness, tingling, or weakness in the arms or legs if the infection spreads and compresses nearby nerves.
Fatigue and Malaise:
General feelings of weakness and exhaustion due to the body fighting the infection.
Difficulty Walking or Sitting:
Severe discomfort in performing basic movements due to pain and inflammation in the spine.

Symptoms in Children:

In children, discitis may present with difficulty walking, irritability, and an unwillingness to move or play due to pain.

If discitis is suspected, early diagnosis and treatment are important to prevent complications such as abscess formation or permanent neurological damage. Treatment usually involves antibiotics or anti-inflammatory medications, and in some cases, surgery.

What are the causes of discitis?

Discitis is typically caused by an infection or, less commonly, by an inflammatory condition affecting the intervertebral discs in the spine. The most common causes are as follows:

1. Bacterial Infection

The majority of discitis cases are due to bacterial infections. Staphylococcus aureus is the most common bacterium responsible, but other types of bacteria can also cause the infection.
The infection can occur when bacteria enter the bloodstream and travel to the spine, often from other parts of the body, like the skin, urinary tract, or lungs.
Infections can also develop after surgery or other invasive procedures on the spine.

2. Spinal Surgery or Invasive Procedures

Discitis can sometimes develop as a complication after spinal surgery, injections, or other medical procedures involving the spine.

3. Spread from Nearby Infections

Discitis can occur when an infection in another part of the body (such as the bloodstream, urinary tract, or skin) spreads to the spine through the blood.

4. Immunocompromised Conditions

People with weakened immune systems, such as those with diabetes, HIV/AIDS, cancer, or those on immunosuppressive medications, are at higher risk of developing discitis because their bodies may have difficulty fighting infections.

5. Viral or Fungal Infections

In rare cases, discitis can be caused by viral or fungal infections, especially in immunocompromised individuals.

6. Inflammatory Conditions

Although much less common, discitis can occur due to non-infectious causes, such as chronic inflammatory conditions like rheumatoid arthritis.

Risk Factors:

Recent surgery or spinal procedures
IV drug use
Chronic conditions that weaken the immune system
History of infections, such as UTIs or skin infections

Discitis requires prompt treatment, usually with antibiotics or antifungal medications, to prevent the infection from spreading to other parts of the spine or causing complications like abscesses or neurological damage.

What is the treatment for discitis?

The treatment for discitis focuses on addressing the underlying infection or inflammation and managing symptoms. The specific approach can vary based on the cause of the discitis, the severity of the condition, and the patient’s overall health.

Common Treatments for Discitis:

1. Antibiotic Therapy (if infection is bacterial)

Intravenous (IV) antibiotics are the main treatment if discitis is caused by a bacterial infection.
Treatment typically lasts for 4-6 weeks, but may extend depending on the severity of the infection.
Once the patient improves, they may transition to oral antibiotics to complete the course.

2. Antifungal or Antiviral Therapy (if infection is fungal or viral)

In rare cases where discitis is caused by a fungal or viral infection, antifungal or antiviral medications will be prescribed.
The duration and specific treatment depend on the type of infection.

3. Pain Management

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or stronger prescription painkillers may be used to manage pain and inflammation.
Muscle relaxants can help with spasms and stiffness around the affected area of the spine.
Steroids may sometimes be prescribed to reduce severe inflammation.

4. Immobilization

A back brace or other form of spinal support may be used to immobilize the spine, reduce pain, and allow the affected disc to heal.
Immobilization can help prevent further damage and reduce discomfort during movement.

5. Surgical Intervention (in severe cases)

Surgery may be required if there is an abscess, significant spinal instability, or neurological symptoms (such as nerve compression).
Surgery can involve drainage of abscesses, debridement (removal of infected tissue), or spinal fusion if structural stability is compromised.

6. Physical Therapy

After the infection is controlled, physical therapy can help improve mobility, strength, and flexibility.
Gradual rehabilitation is important to help restore function and reduce pain associated with inactivity or prolonged immobilization.

7. Treatment of Underlying Conditions

For patients with immune system disorders or other chronic conditions (e.g., diabetes or autoimmune diseases), managing these underlying health issues is key to preventing further complications or recurrence.

Recovery:

Rest and Monitoring: Patients are often advised to rest, and their response to treatment is closely monitored with regular blood tests and imaging (such as MRI) to ensure the infection is resolving.
Duration of Treatment: Treatment can last several weeks to months, depending on the severity of the infection and the patient’s response to therapy.

Timely diagnosis and appropriate treatment are crucial to prevent complications, such as chronic pain, spinal deformities, or neurological damage.