Infection of hair follicle or sweat gland is known as boil. Boil is common over scalp and axilla. Boil is an infection of hair follicle or sweat gland caused by staphylococcal bacteria.(1) Boil is most often observed in neck and lower back than mid back. Boil resulting in back pain is common in obese patient who may be sweating a lot. Boil is also observed in elderly patient with history of diabetes. Boil in younger patient is associated with immunosuppressant diseases. The boil is classified as furuncle and carbuncle.
Furuncle- Localized infection of sweat gland and hair follicle is known as furuncle. The furuncle type of boil is not associated with wide spread of disease. The local infection of sweat gland and hair follicle causes pain, tenderness and local abscess formation.
Carbuncle- Carbuncle is wide spread infection of hair follicle and sweat gland. Carbuncle is observed in individuals who maintain poor daily self-hygiene and live in humid crowded unhyegenic surroundings. Infection is associated with wide spread subcutaneous abscess and inflammation. The infection involves several sweat gland and hair follicle. The treatment involves intravenous antibiotics to prevent complications. Inflammation and infection may spread into deeper tissue like muscles and tendons.
Symptoms And Signs Of Boils On Back-
- Pain- Back pain caused by boil is observed over the infected skin of the neck, thorax and lower back. Boil is more often seen in neck and lower back. Pain in the back caused by boil is often mild to moderate in severity and lasts for less than 6 months. Chronic pain in the back lasting beyond 6 months is often caused by carbuncle. The skin and subcutaneous tissue is tender to palpation. Pain is severe and continuous. Type of pain in the back caused by boil is burning and stabbing in character.
- Swelling- The warm and tender swelling in the back suggests infection and possible abscess under the skin. Swelling of less than 1 to 2 cm is observed when skin infection is caused by furuncle. The swelling of larger diameter is caused by carbuncle, which is infection of multiple sweat gland and hair follicle. Swollen skin is tender and soft to firm in consistency. The underlying active inflammation of subcutaneous tissue results in red and warm skin. Underlying subcutaneous abscess causes the soft to firm swelling.
- Purulent Discharge- In few cases of carbuncle, the tender swelling in the back breaks open through the skin and purulent discharge oozes out through the open skin wound.
Investigations Of Boils On Back
- High white blood cell count observed in patients suffering with carbuncle and furuncle.
- Boil- Skin biopsy of the boil suggests infection and bacterial growth around the sweat gland.
Treatment Of Boils On Back –
Local Treatment For Boils on Back-
- Wound Isolation- Wound is covered with sterile dressing.
- Cold Therapy- Pain is treated with cold pad or bag applied over sterile dressing.
Medications For Boils on Back-
- Anti-inflammatory Medications- Inflammation is treated with anti-inflammatory medications like Tylenol or Advil.
- Antibiotics- Doctors usually prescribe an antibiotic that is effective in the treatment of boil.(2) Infection is treated with amoxicillin, clindamycin and cephalosporin.
Surgery For Boils on Back-
The enclosed abscess under the skin is exposed with skin incision. The infection caused by boil responds better to antibiotic treatment when abscess is surgically drained.