Osteomyelitis is a bone infection, which can occur in practically any bone in
the body. Bacteria usually cause the infection, but fungi can occasionally have
the same effect. Osteomyelitis is rare in the U.S. and it affects children more
The disease takes several forms, depending on the way the infection traveled
to the bone and the type of bone infected. Infections can reach the bone via
open fractures or surgery on fractures, from body tissues next to the bone, from
artificial joints, and from ulcers in the foot. People who inject street drugs
and patients who receive kidney dialysis are particularly vulnerable to
Signs and Symptoms
The symptoms of osteomyelitis include the following.
Intense pain and a sensation of heat at the site of the affected
Small areas of tenderness and swelling
Persistent back pain that is not relieved by rest, heat, or pain
Abscesses containing pus in tissue surrounding the painful
Fever, in some cases
What Causes It?
Several different types of bacteria or fungi can infect bones, often after a
fracture or other injury, or as the result of a joint replacement. The infection
can also spread beyond the bone, creating abscesses in muscles and other tissues
outside the bone.
What to Expect at Your Provider's Office
After you describe your symptoms, your health care provider will feel your
skin above the affected bone, to check for tenderness. He or she will take blood
samples to check for osteomyelitis and the type of bacterium or fungus
responsible. Your provider may also want to sample the bone itself. This will
involve inserting a needle through the skin and into the bone, and snipping off
a small piece of the bone for testing. Your provider may also want you to have a
bone scan, which uses a mildly radioactive compound to highlight infected areas
in the bones. You may also need a computed tomography scan or magnetic resonance
imaging, two types of imaging tests that produce more detailed information than
conventional X rays.
In addition to prescribing medications, your health care provider may
recommend bed rest, particularly if the infection affects your back, and he or
she may put you in a cast or splint to immobilize the affected bones and
Taking medication should clear up an infection that is found early. The type
of medication you need depends on the type of bacteria or fungi that caused your
osteomyelitis. Courses of antibiotics lasting several weeks should clear up
infections identified early. Antimicrobials are recommended for chronic
osteomyelitis and forms of the condition caused by fractures or infections in
sites adjacent to the bone.
In children, intravenous medications may be given initially when the cause of
the infection is not clear. The patient may then be switched to oral
In cases of osteomyelitis that result from foot ulcers or diabetes, medical
treatment should include antimicrobial agents.
Surgery may be necessary when osteomyelitis is identified late or in cases of
chronic osteomyelitis, osteomyelitis caused by fractures and infections in soft
tissue contiguous to the bone, and that originating in foot ulcers. Surgery can
drain abscesses adjacent to the infected bone and remove all dead tissue and
bone. Antimicrobial or antibiotic therapy should follow all cases of
Infected prostheses should be surgically removed, following several weeks of
antibiotic treatment, to permit a new prostheses to be implanted at the same
Complementary and Alternative Therapies
Alternative therapies can be used along with medical treatment to strengthen
your immune system and help you recover.
For overall immune support and help with healing, use the
Vitamin C (250 to 500 mg two times a day)
Zinc (30 to 50 mg per day, then reduce to 25 mg per day)
Vitamin E (400 to 800 IU per day)
Vitamin A (10,000 to 15,000 IU per day). Do not use if you are, or
may become, pregnant.
Acidophilus (1 to 3 capsules per day, or 1 to 5 million organisms per
day)—to prevent antibiotic-induced diarrhea and yeast
Herbs are generally a safe way to strengthen and tone the body's systems. As
with any therapy, it is important to work with your provider on getting your
problem diagnosed before you start any treatment. Herbs may be used as dried
extracts (capsules, powders, teas), glycerites (glycerine extracts), or
tinctures (alcohol extracts). Unless otherwise indicated, teas should be made
with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or
flowers, and 10 to 20 minutes for roots. Drink two to four cups per day.
Use one or more herbs from each category. Make a tincture using equal parts.
Take 15 to 20 drops three to four times a day.
To relieve pain: valerian (Valeriana officinalis), St. John's
wort (Hypericum perforatum)
For improved circulation: Ginkgo biloba, 120 mg twice a
Herbs called alteratives are traditionally known as blood cleansers. Use an
infusion of red clover (Trifolium pratense), burdock root (Arctium
lappa), yellowdock (Rumex crispus), yarrow (Achillea millefolium),
cleavers (Galium aparine), and licorice root (Glycyrrhiza
glabra). Drink two to three cups a day. Do not use licorice if you have
To help with the healing of abscesses, make a paste from the powders of
goldenseal root (Hydrastis canadensis) and slippery elm (Ulmus fulva).
Apply as needed.
Although very few studies have examined the effectiveness of specific
homeopathic therapies, professional homeopaths may consider the following
remedies for the treatment of osteomyelitis because they are commonly used to
treat joint disorders, bone injuries, and wound infections. Before prescribing a
remedy, homeopaths take into account a person's constitutional type. A
constitutional type is defined as a person's physical, emotional, and
psychological makeup. An experienced homeopath assesses all of these factors
when determining the most appropriate treatment for each
ArnicaMontana -- used after trauma or injury,
especially when accompanied by a bruised, "beat up" feeling
Ledum -- for puncture wounds that lead to an accumulation of
pus, especially if they feel better with cold applications
Silicea -- for enlarged, pus-filled glands, especially in
individuals who are run-down or
May help stimulate immune response, reducing inflammation, pain, swelling,
Massage should be avoided because it could spread the
Expect your health care provider to monitor you carefully during your
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Review Date: August 1999
Reviewed By: Participants in the review process include: Jacqueline A. Hart, MD,
Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University
and Senior Medical Editor Integrative Medicine, Boston, MA; Scott Shannon, MD,
Integrative Psychiatry, Medical Director, McKee Hospital Center for Holistic
Medicine, Fort Collins, CO; Pamela Stratton, MD, Chief, Gynecology Consult
Service, National Institute of Child Health and Human Development, National
Institutes of Health, Bethesda, MD; Elizabeth Wotton, ND, private practice,
Sausalito, CA; David Zeiger, DO, ABFP, HealthWorks/Integrative Medical Clinic,
Chicago, IL.October 2001
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