Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.



Osteomyelitis is a bone infection. It is caused by bacteria or a fungus. Different bones are affected in children and adults:

  • In children, infection usually occurs in the long leg or arm bones.
  • In adults, the spine, hips (pelvis), or feet are most often affected.

A bone infection can start:

  • After an injury or surgery.
  • As a result of infection in a skin sore or wound. People with diabetes are at higher risk if they have foot ulcers.

It’s important to diagnosis osteomyelitis early and treat it with antibiotics. This helps:

  • Lower the risk of infection spreading to other bones or tissues.
  • Prevent chronic osteomyelitis problems.

When osteomyelitis is serious or chronic, we often need to the infected bone with a cast or perform surgery.


A bone infection is a serious health condition. Call us immediately if you are worried that you may have osteomyelitis. Common symptoms include:

  • Bone pain
  • Fever or chills
  • Flu-like symptoms or general discomfort
  • Swelling, redness, or tenderness of the skin that covers the infected bone

Some people also experience:

  • Excessive sweating
  • Nausea
  • Swelling in the ankles, legs, and feet.
  • Back pain, if the infection affects the spine

Many other conditions can cause these symptoms. We base your diagnosis on your physical exam and test results as well as symptoms.


Your immune system usually stops infection from spreading. But if your system is weakened for any reason, an infection can:

  • Start in your skin or muscle
  • Get into your bloodstream
  • Spread to a bone

Bacteria called Staphylococcus is the most common cause of osteomyelitis. Less often, it’s caused by another bacterial or fungal infection.

An infection deep in the body can be more difficult to diagnose and treat. Sometimes an infection spreads beyond the bone. The infection can be resistant to the drugs we use for treatment.

Tests and Diagnosis

We will ask you about symptoms. We’ll check the wounded area for tenderness, swelling, and redness. Often we’ll ask you:

  • When and how your problem started.
  • What, if anything, makes your symptoms better or worse.
  • Whether you’ve recently had surgery or an injury.

If we think you may have an infection, we’ll begin treatment. We may also order one or more tests.

Blood tests. We use a blood culture test to detect a bacterial or fungal infection. Other tests show the level of inflammation in your body caused by infection:

  • Complete blood count (CBC)
  • Erythrocyte sedimentation rate (ESR), or C-reactive protein (CRP)

Imaging scans tell us about the health of your bone. We may order one or more of these:

  • X-ray
  • MRI
  • CT scan
  • Bone scan

We may take a tissue or bone biopsy (small sample) for testing.

Tissue biopsy: We may remove some fluid or a small piece of tissue from the problem area, using a thin needle. Then a laboratory checks the sample for osteomyelitis.

Bone biopsy. This test tells us about the affected bone. We will:

  • Give you instructions on how to prepare for this procedure.
  • Numb the area with a local anesthetic.
  • Use a needle to obtain a bone sample.

Sometimes, it’s better to have a surgeon remove a piece of bone. In either case, the sample is checked for osteomyelitis by a laboratory.

Risk Factors

Injury or trauma. Infection is more likely if you have a fractured bone or deep skin wound that heals slowly.

Surgery to repair a broken bone or replace a joint can bring bacteria into the body. Spleen removal also increases risk.

Circulation problems make it harder for your body to deliver infection-fighting cells. This slows your healing response. Blood circulation problems can be caused by:

  • Sickle cell disease
  • Diabetes
  • Cancer
  • Peripheral artery disease.

Medical procedures can allow infection to enter your body. Procedures include:

  • Kidney dialysis
  • Chemotherapy
  • Intravenous catheter

Substance abuse increases risk when users:

  • Share needles
  • Use unsterilized needles
  • Don’t sterilize their skin before injections

Please tell your care practitioner if you’re using street drugs, so we can connect you with help.


We can usually cure early or acute-stage osteomyelitis using antibiotics. Your overall health and the infection type also affect treatment success.

Early osteomyelitis is a bone infection of 4 weeks or less. Longer infections are called chronic. They may take longer to treat and require surgery. Even when treated, chronic osteomyelitis can recur years or decades later.

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.