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 than adults.

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 osteomyelitis.

The symptoms of osteomyelitis include the following.

• Intense pain and a sensation of heat at the site of the affected bone
• Small areas of tenderness and swelling
• Persistent back pain that is not relieved by rest, heat, or pain killers
• Abscesses containing pus in tissue surrounding the painful bone
• Fever, in some cases
• Fatigue

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.

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 joints.

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 medications.

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 surgery.

Infected prostheses should be surgically removed, following several weeks of antibiotic treatment, to permit a new prostheses to be implanted at the same time.

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 following.

• 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 infections

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.

• For immune support: coneflower (Echinacea purpurea), lomatium (Lomatium dissectum), astragalus (Astragalus membranaceus)
• To fight infection: goldenseal (Hydrastis canadensis), barberry (Berberis vulgaris), garlic (Allium sativum)
• To relieve pain: valerian (Valeriana officinalis), St. John's wort (Hypericum perforatum)
• For improved circulation: Ginkgo biloba, 120 mg twice a day

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 hypertension.

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 individual.

• Arnica Montana -- 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 exhausted

May help stimulate immune response, reducing inflammation, pain, swelling, and fever.

Massage should be avoided because it could spread the infection.

Expect your health care provider to monitor you carefully during your treatment.

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