6 Min Read
Spinal infections are serious medical conditions that can lead to permanent damage if not diagnosed and treated promptly. Although relatively rare, their consequences can be severe-ranging from chronic pain to paralysis or even death. Early detection is key, but that requires awareness. Unfortunately, many of the early symptoms of spinal infection can be mistaken for less serious issues, such as a pulled muscle or simple backache.
In this blog, we’ll explore what spinal infections are, what causes them, and—most importantly—the early warning signs that you must not ignore.
Synopsis
What Is a Spinal Infection?
A spinal infection, also known as spinal osteomyelitis, refers to an infection that occurs in the spine’s vertebrae, intervertebral discs, spinal canal, or surrounding tissues. Common types include:
-
Vertebral osteomyelitis – infection in the bones of the spine
-
Discitis – infection in the intervertebral disc space
-
Epidural abscess – accumulation of pus between the spinal bones and protective membranes
-
Meningitis – infection of the membranes surrounding the brain and spinal cord
In the Indian subcontinent, the majority of spinal infections—over 80%—are caused by the Mycobacterium tuberculosis complex. The remaining cases are due to other pathogens, including bacteria, fungi, and, rarely, viruses. Among the most serious forms of spinal infection is the epidural abscess, which is most commonly caused by Staphylococcus aureus, including methicillin-resistant strains (MRSA).
More Reads: Spinal Cord Injury: Causes, Treatment, and Prevention
Common Causes and Risk Factors
Spinal infections can develop due to:
-
Blood spread: Spinal TB is usually secondary to blood spread from a primary site of infection (most commonly the lungs).
-
Spread from Other Infections: Bacteria or fungi from UTIs, dental issues, or skin infections can travel to the spine via the bloodstream.
-
IV Drug Use: Increases bloodstream infections, making spinal seeding more likely, and can compromise immunity.
-
Weakened Immunity: Conditions like HIV, diabetes, and cancer treatment impair the body's ability to fight off infections.
-
Chronic Illness/Malnutrition: Can weaken the immune system and overall health, increasing infection risk.
-
Elderly: Older age presents higher risk due to weakened immunity or surfaces for bacteria to attach.
Early Warning Signs of Spinal Infection
Here’s a quick-reference table summarising the early signs you should never ignore:
|
Symptom |
Description |
|
Persistent Back Pain |
Continuous, worsening pain unrelieved by rest |
|
Fever and Chills |
Unexplained high temperature, night sweats |
|
Neurological Changes |
Numbness, tingling, weakness, or loss of bowel/bladder control |
|
Fatigue and General Malaise |
Unusual tiredness, lack of energy |
|
Redness or Swelling |
Visible inflammation, warmth over spine (in some cases) |
When to See a Doctor
Immediate medical attention is crucial if you experience:
-
Unexplained severe back pain, especially nighttime pain or disturbing sleep
-
Fever with back discomfort
-
Numbness or tingling in the legs or arms
-
Weakness or bladder/bowel dysfunction
-
Signs of infection post spinal procedure
Spinal tuberculosis is the most common form of spinal infection and typically follows a slow-growing, slow-progressing course. In contrast, epidural infections—most often caused by Staphylococcus aureus—are rapidly progressive and potentially life-threatening. If left undiagnosed and untreated, they can present with a classic triad of severe back pain, fever, and neurological deficits (such as paralysis), and may quickly lead to sepsis, multi-organ failure, or even death. These symptoms warrant urgent medical evaluation to rule out or confirm a rapidly progressing spinal infection.
More Reads: All About Spinal Fusion Surgery
Diagnosis and Tests
To diagnose a spinal infection, your doctor may suggest:
-
MRI Scan: Crucial for spotting infection signs like inflammation and abscesses. Often the most accurate imaging tool.
-
Blood Tests: Check for general infection markers like ESR and CRP, indicating inflammation in the body but not specific to the spine. Helpful in supporting the diagnosis.
-
Blood Cultures: Aim to identify the specific bacteria or fungi causing the infection by detecting its presence in the bloodstream.
-
CT-Guided Biopsy: To obtain a tissue sample for direct identification of the pathogen. Offers the most definitive diagnosis.
Early detection helps ensure timely treatment and a better prognosis.
Treatment Options
Treatment may include:
-
For rifampicin-sensitive tuberculosis (TB) of the spine, the standard treatment involves first-line anti-tubercular therapy (ATT) with oral medications for 9 to 12 months. In cases of multidrug-resistant TB (MDR-TB), second-line ATT is required, typically administered for 18 months to 2 years. For non-tubercular spinal infections, treatment is guided by culture and drug sensitivity reports. This usually involves a 6-week course of intravenous antibiotics, followed by an additional 6 weeks of oral antibiotics.
-
Pain Management is Crucial: Strategies include medications (nerve pain relievers, muscle relaxants) and supportive measures like heat/cold therapy and physical therapy.
-
Immobilisation Aids Healing: Bracing helps reduce spinal stress and pain, promoting recovery in the affected area.
-
Surgery Addresses Severe Issues: It's reserved for cases with instability caused by destruction of bone, intervertebral disc and ligaments or causing spinal cord compression from abscesses, failure of non-operative treatment, or worsening neurological problems.
The earlier treatment begins, the more likely it is to avoid long-term complications.
Prevention Tips
You can reduce your risk by:
-
Managing chronic conditions (e.g., diabetes)
-
Avoiding IV drug use
-
Keeping surgical wounds clean
-
Practising good dental and personal hygiene
-
Seeking early care for any infections
Conclusion
If you or a loved one is experiencing signs of a spinal infection, don’t delay—timely diagnosis and expert care can prevent life-changing complications.
Manipal Hospitals Dwarka offers advanced spinal diagnostics, infectious disease care, and neurosurgical support under one roof. Our experienced team ensures rapid intervention and holistic treatment tailored to your needs.
Whether you're dealing with severe back pain, post-surgical symptoms, or unexplained neurological changes, trust Manipal Hospitals Dwarka to deliver compassionate and world-class care.
Book your appointment with a spine specialist at Manipal Hospitals Dwarka today. Your spine deserves the best.
FAQ's
Spinal infection pain is typically deep, localised, and persistent. It does not go away with rest and can worsen at night and often disturbs sleep.
While both may cause back pain, spinal infections often include fever, fatigue, and pain more at night time or on rest while patient with slip disc has pain more on standing, sitting(on exertion)
Yes, most spinal infections are curable with early diagnosis, antibiotics, and appropriate medical care. Delays can cause permanent damage.
For rifampicin-sensitive tuberculosis (TB) of the spine, the standard treatment involves first-line anti-tubercular therapy (ATT) with oral medications for 9 to 12 months. In cases of multi-drug resistant TB (MDR-TB), second-line ATT is required, typically administered for 18 months to 2 years.For non-tubercular spinal infections, treatment is guided by culture and drug sensitivity reports. This usually involves a 6-week course of intravenous antibiotics, followed by an additional 6 weeks of oral antibiotics.
Those with weakened immune systems, chronic illnesses, or recent surgery are at higher risk of developing spinal infections.
Share this article on:
-ks-brar-vsm.webp)
