In cases of chronic refractory osteomyelitis, HBOT has an 81 to 85 percent remission rate and is FDA-approved. With HBOT, or hyperbaric oxygen therapy, a patient relaxes in a hyperbaric chamber and receives 100 percent oxygen at increased atmospheric pressure. This floods the body with oxygen, including areas such as a bone infection where poor blood supply limits the oxygen levels. Most bacteria and fungi thrive in low oxygen, so the addition of oxygen is often enough to stop the spread of the infection. The increased oxygen stimulates the immune system to fight off the infection, as well as stimulates diseased tissue and blood vessels to repair and grow. HBOT, or hyperbaric oxygen therapy, also reduces swelling in the bone and surrounding tissue associated with osteomyelitis.

Studies on HBOT and Osteomyelitis

Numerous studies looked at the use of HBOT, hyperbaric oxygen, and chronic refractory osteomyelitis. A study in 2003 looked at 14 patients with chronic refractory osteomyelitis on the tibia. Previously, the patients received antibiotic treatment and surgical intervention with no success, having an average number of 5.4 operations before HBOT treatment. However, once treated with an average of 33.6 HBOT treatments, the infection healed and 11 patients saw no recurrence of infection.

Another report from 2013 looked at a patient with a bone infection as a complication from a closed fracture. The patient had several comorbidities and did not respond well to surgical intervention or antibiotic therapies. The patient started on 30 hyperbaric oxygen sessions at two atmospheres and they noted a rapid improvement in his condition. As a result, the patient showed no symptoms at a 10-month follow-up appointment.

What is Osteomyelitis?

In most cases of osteomyelitis, the organism responsible for 90 percent of the cases is Staphylococcus, while others include Haemophilus influenzae and salmonella. The bacteria travel through the bloodstream to the bone or spread from nearby infected tissue or open wound. Once the bacteria infect the bone, it causes swelling. The swollen tissue and pus place pressure on the outer wall of the bone, thus compressing the blood vessels in the bone and reducing the oxygen supply. This leads to bone death if left untreated. In chronic cases, this blood supply often becomes blocked and no longer allows blood flow. When blood flow is disrupted, white blood cells that fight infection can no longer travel to the site, nor can the antibiotics used to kill the infection.

Causes of Osteomyelitis

Your bones are usually well-protected from infection, but it can happen. Typical modes of entry for infection include:

• Bloodstream – Staphylococcus is the most common bacteria to spread through the bloodstream, though other bacteria and fungi can spread in the same manner. Bone infections through the bloodstream typically infect the ends of the leg and arm bones or the vertebrae.
• Direct Contact – In this form, the bacteria or fungi enter through direct contact with the bone. This can occur in open fractures, surgical procedures on the bone, or any type of injury where something pierces the bone. Osteomyelitis can also occur when surgeons use artificial joints or metal clips during a bone during surgery.
• Spread from Nearby Infected Tissue – When an infection occurs in the soft tissue, it can spread to the bone within a few days or weeks if left untreated. Infections due to radiation therapy, cancer, skin ulcers (such as diabetic foot ulcers), sinus infections, and tooth infections are also common causes of bone infections.

Increased Risk Factors for Osteomyelitis

Osteomyelitis can affect people of all ages, though the locations of infection can be different. Adults typically have infections in the vertebrae and pelvis while children see more cases at the end of the long bones of the arms and legs. While anyone can contract osteomyelitis, there are some factors that can increase your risk of infection. These include:

• Diabetes
• Patients receiving hemodialysis
• Weakened Immune systems
• Sickle Cell Disease
• Intravenous drug use
• Elderly patients
• Surgical patients where surgery involved bone
• Traumatic bone injuries

Symptoms of Osteomyelitis

Symptoms of osteomyelitis can vary based on the type and locality of the infection. In some cases, no symptoms appear or can take days, weeks, or months to surface and are often mistaken for other possible conditions. Symptoms of osteomyelitis include:

• Pain or tenderness in the infected area – this can include pain in the surrounding soft tissue or deep bone pain
• Swelling – with most bone infections, the soft tissue surrounding the bone will swell, can appear red in color, and warm to the touch
• Fever
• Nausea
• Drainage of pus – this occurs when a sinus tract forms from the bone to the surface of the skin, allowing for drainage.
• General discomfort or ill feeling
• Excessive sweating or chills
• Lower back pain – this occurs with an infection of the spine
• Loss or decrease of motion in a joint
• Changes in gait – this is often seen in children with an infection of the leg bones. Due to the infection, they may limp or refuse to put weight on a leg.

Traditional Treatments of Osteomyelitis

Traditional treatments for osteomyelitis target the bacteria or fungi with antibiotics or anti-fungal medications. These medications can be prescribed for months, depending on the severity of the infection. In some cases, surgical intervention is necessary. Surgeons will go in to remove dead bone tissue, drain the infected area, remove diseased tissue and bone, restore blood flow, or remove any foreign material in the bone.

In cases of chronic refractory osteomyelitis, surgical intervention is often not enough to stop the infection, and, in severe cases, amputation is often necessary. This is where HBOT treatments have proven very effective.

Call our office today for more information on HBOT, hyperbaric oxygen, and osteomyelitis. You can also schedule an initial consultation with Dr. Spiegel and his team. Additionally, visit HERE and fill out a contact form and someone will be in contact with you. Take the next step in your healing process and see how HBOT can benefit you!