Much like greying hair and forgetfulness, back pain is often seen as a common side effect of ageing. But when back pain comes on suddenly and without an obvious cause, it could be a symptom of a much bigger problem than just old age – discitis.
What is discitis?
Discitis is where a spinal disc becomes inflamed due to infection. The swelling puts pressure on the spine segment above or below, causing severe pain.
The cause of discitis is most commonly a bacterial infection, but it can also be viral. Usually, the infection travels to the spinal disc from elsewhere in the body, such as a UTI, ear infection, infected tooth, or respiratory infection like pneumonia. However, the infection can be spread by surgery or injection to the spine, i.e., lumbar puncture or epidural. In rarer cases, it can be caused by an autoimmune disorder.
Whatever the cause, if the infection is not treated in a timely manner, it can permanently destroy the disc tissue which acts as a shock absorber between the bones in the spine. Injury to the spine, spinal cord or nerves can also have neurological consequences for a patient leading to permanent disability and in worst case scenarios it can be fatal.
What are the symptoms of discitis?
The main symptom of discitis is severe, unbearable back pain without an obvious cause such as trauma or injury. Pain is usually localised to the spine, meaning it doesn’t radiate down the legs or to other parts of the body like sciatica or other spinal conditions would. Pain is most commonly experienced in the lumbar spine (lower back), but it can also be in the cervical spine (neck area) or thoracic (mid-back), depending on which disc is inflamed or infected.
Other warning signs can be weakness in the legs, loss of sensation in the bladder/bowel, stiffness in the back, change to posture, difficultly with mobility, abdominal pain, and fever with back pain.
Medical negligence and discitis
Contracting an infection which leads to discitis is not in itself negligent; even if the infection develops after spinal surgery, it is still a known risk and patients should be informed about this in their pre-operative assessment as part of the consent process.
However, as the main symptom is back pain which can have many causes, including old age, it means discitis is frequently misdiagnosed or overlooked. Diagnosis of discitis is often delayed by between two and six months from the first symptom which can be catastrophic for the long-term prognosis of a patient.
Diagnosis of discitis requires a shrewd judgement to look for signs of infection or inflammation. If suspected, tests should be requested to rule out discitis. The gold standard test is an MRI as it can pick up inflammation throughout the body, but other tests might include a blood test, bone scan or tissue analysis by way of a biopsy.
Treatment usually involves between six and eight weeks of IV antibiotics to clear the infection and immobilisation to prevent further damage to the spine. Anti-inflammatory medication or steroids may be needed and in more severe cases surgery is needed to repair the disc. So, any additional delays to treatment can lead to morbidity and mortality.
The three main reasons someone might bring a medical negligence case for discitis are:
- Failure to investigate symptoms
- Failure to administer the right treatment
- Failure to act on signs of paralysis
Examples of discitis medical negligence cases
One of our specialist medical negligence solicitors, Miriam Bi, has recently handled two discitis case here at Medical Solicitors, both of which had different causes and outcomes.
Delayed diagnosis of discitis case settles for £530,000 compensation
Miriam settled this case in February 2022 which involved a 48-year-old man who developed discitis after spinal surgery in 2015 that went undiagnosed and untreated for almost nine months, despite having had three MRI scans which noted inflammation and disc depreciation.
The Claimant ‘C’ had a slipped disc and was experiencing pain in his leg and back due to the herniated disc pressing on two different nerves. He underwent a successful microdiscectomy in August 2015 and noticed immediate improvement in his pain.
However, by his six-week check-up, he was experiencing severe lower back pain, stiffness and was struggling to walk. A routine MRI was requested by the surgeon. Before the scheduled scan appointment, C fell at home and was unable to get up off the floor for five hours, resulting in him being admitted to hospital after his partner found him in this condition. Junior doctors questioned whether it could be discitis and the MRI scan results showed inflammation. The report concluded that a post-operative infection was very possible. But no biopsy was done to confirm or rule out infection.
As the weeks went by, C was still in severe pain and a second MRI scan was requested which showed the disc height had reduced and there was an increase in fluid around the disc, indicating the disc tissue was disintegrating.
By the beginning of 2016, a biopsy was discussed but C had a fear of needles so requested it be done under general anaesthetic which was declined on safety grounds but C was offered the option of local anaesthetic or another MRI. He opted for the latter which was performed at the end of March 2016 and showed bone on bone impaction as a result of another disc slipping. The infected disc had been completely destroyed.
After eight months of severe pain without a diagnosis, C started a 12-week antibiotic course in May 2016 that ended in September without an improvement in pain. He was sent for a fourth MRI scan then referred for pain management and discharged in November 2016 by his consultant after being told nothing more could be done from a surgical point of view.
Before the initial spinal surgery, C was a self-confessed workaholic who loved his job as an electrical contractor. He has been unable to work since and can’t enjoy his previous hobbies. The pain is affecting his quality of life, impacting relationships with his partner and teenage daughter.
In his witness statement, C said: “I’m in agony every minute of the day and medication is not helping. I wish I’d never had the operation as at least I could work before and manage to control the pain but now it’s so debilitating I’ve been left feeling down and depressed. It’s turned my life upside down and I can’t see things improving.”
Throughout the case, the defendant trust denied liability, repeating their stance that antibiotics were not given earlier because there was never a confirmed diagnosis of discitis. However, Miriam worked with a panel of seven medical experts who refuted this, stating that the first request for an MRI by the surgeon indicated they likely suspected an infection so C should have been admitted to hospital and had the scan immediately. Each subsequent MRI scan showed signs of infection, yet nothing was done to escalate this. If a medic is not certain whether an infection is present or not, they should seek the advice of a microbiologist to further investigate.
After seeing C’s expert evidence after parties formally exchanged their expert reports, the Defendant invited C to a Joint Settlement Meeting. This was arranged where an out-of-court settlement of £530,000 was reached on Valentine’s Day 2022. As well as general damages, this included claims for loss of congenial employment, care costs, pain rehabilitation, psychiatric therapy, and adaptations to his home, car and mobility aids.
Miriam said: “This was one of the most difficult claims I’ve had to investigate but my client was so lovely and we built up a good rapport. During the JSM, he finally received an apology and physically broke down and had to leave the room. It’s been an emotional rollercoaster for him and his injuries have affected him terribly; he’s still in a lot of pain and can’t get out of bed without first taking painkillers. With the compensation, he has access treatment to control his permanent symptoms including spinal cord stimulation that was recommended by his expert.”
Ongoing case for deceased man who was left paralysed due to discitis diagnosis delays
Miriam is also currently investigating the case of a widow whose late husband became paralysed from the waist down after medics scanned the wrong part of his back.
He experienced a sudden, sharp pain in his upper back and sought medical advice but was told it was muscular. At first, the lower back was scanned only, which led to a delay in diagnosis. His leg then began to feel numb and his GP admitted him to hospital. He showed all signs of discitis but due to errors with the MRI scan, the infection went undetected. His neurology deteriorated resulting in permanent loss of movement in his legs.
Have you got a discitis negligence claim?
The spine is a delicate area and delays to diagnosing or treating an infection like discitis could result in a serious loss of function and mobility, paralysis and even death. If you believe that you have experienced negligent care by a GP, surgeon, consultant, nurse or other healthcare provider, you may be entitled to make a claim for compensation.
At Medical Solicitors, our niche law firm only handles clinical negligence claims for patients. As your legal partner, we’ll always keep you at the centre, supporting you and guiding you through the process. Our specialist solicitors are compassionate and knowledgeable. We go to great lengths to fully understand a case and we offer no-obligation advice about whether there is a chance of success. If we recommend going further, we will then offer a no win, no fee agreement.
Compensation for discitis claims
A misdiagnosed spinal infection like discitis could result in serious complications that impact a person’s ability to work or lead a fulfilled life. Along with compensation for the injuries sustained, there can also be a claim for special damages (financial losses) to account for such things as life-long private care needs, adapted accommodation or vehicle costs and loss of earnings. It can also include claims for any future treatment, rehabilitation, disability aids, and transport to medical appointments.
All cases are handled on a personal basis and we strive to do everything we can to achieve the maximum compensation to ensure the best possible quality of life for all clients.
If you’re considering making a claim for discitis, you may be thinking about how you’ll fund the legal costs. We offer Conditional Fee Agreements (No Win, No Fee) so there is nothing to lose in speaking to us about a claim.