Osteomyelitis in the vertebrae: what to know

The infection affects one or more vertebrae and may also involve the nearby disc or soft tissues. Pain is often deep, persistent, and worse with movement, but the symptoms can resemble muscle strain. Fever is not always present. Some people have tenderness, reduced mobility, or pain that continues during rest.

Assessment can include a neurological examination, blood tests, and imaging such as magnetic resonance imaging. A sample may be taken when the diagnosis or organism is uncertain. The clinician also looks for a source, such as a bloodstream infection, urinary infection, skin wound, or recent procedure.

Seek a medical appointment for back pain that persists, especially when it occurs with chills, weight loss, fatigue, or a recent infection or procedure. Avoid heavy lifting until assessed, but follow the movement plan given by the treating team. Do not self-treat with leftover antibiotics or prolonged bed rest.

Treatment commonly involves targeted antibiotics and monitoring of pain, blood tests, and neurological function. A brace or activity adjustment may be used in selected cases. If infection has damaged bone and reconstruction is needed, a specialist may discuss [Bone Grafting](/treatments/trauma-and-fracture-care/bone-grafting/).

Go to urgent care immediately for new leg weakness, numbness, difficulty walking, loss of bladder or bowel control, severe escalating back pain, confusion, fainting, or breathing difficulty. These symptoms can signal pressure or spread affecting structures around the spine.

Ask which spinal level is involved, whether the spinal cord or nerves are affected, what imaging is needed, how long treatment may take, and which activities are safe while healing.