Tuberculosis is a communicable disease caused by mycobacterium tuberculosis bacteria. Primarily tuberculosis affects the pulmonary system and gastrointestinal system, but it can also spread through blood to other organs. It is then labeled as extrapulmonary tuberculosis. Tuberculosis of bone is most common form of extrapulmonary tuberculosis.
The main sites of bone tuberculosis are weight bearing joints and spinal vertebra. In spinal tuberculosis the thoracic vertebra are mainly affected. Spinal bone TB is considered serious because it destroys the thoracic or lumbar vertebra leading to bony deformity and in worst situation paralysis of the lower limbs.Bone pain, swelling at the affected site, fever, weight loss, night sweats are other general manifestations of bone tuberculosis.
Tuberculosis of bone is curable condition. The cornerstone treatment of bone TB is a long course of anti-tuberculosis drugs. Along with medications maintaining healthy lifestyle, eating nutritious diet, rest and sleep are effective complimentary natural measures for the cure of bone tuberculosis.
What Causes Tuberculosis Of The Bone?
Tuberculosis of bone is extrapulmonary tuberculosis, caused by bacterium mycobacterium tuberculosis. At least 35 percent of tuberculosis other than lung and intestinal TB accounts for bone tuberculosis.The disease spreads through bloodstream to the ends of long bones and vertebra. It can also spread from nearby tuberculous lymph nodes.
The primary infection occurs in the lungs, but it is subclinical infection. Patient does not suffer from the disease, but the organism may have reached to the bone through bloodstream. Under favorable circumstances there may be reactivation of infection which progresses to full blown disease affecting the bones.
The clinical symptoms appear when the immune system fails to control the infection. Certain factors such as poverty, overcrowding, old age, malnourishment, drug abuse, diabetes mellitus, HIV infection can predispose tuberculosis of bone.
Signs And Symptoms Of Tuberculosis Of The Bone
The disease can affect any bone or the joint, but most common bones affected are spinal vertebra, knee, hip, shoulder and elbow bones and joints. Following are the main clinical manifestations of tuberculosis of bone:
- Pain: Mainly the weight bearing bones are affected. Pain may occur at the site of involvement. Usually thoracic spine is more affected than any other bones. Patient may complain of backache. Pain may travel to the front of the ribs in some cases. Tuberculosis of joints can cause pain and swelling in the joint along with stiffness. It restricts patient’s activities.
- Arthritis: Tuberculosis of joints gradually destroys the synovial tissue and the bones of a joint, mainly the hip and knee joint. There is swelling, redness and stiffness of the affected joint.
- Spinal deformity: Tuberculosis of spine if not treated on time can progress to formation of a hump on the back. This deformity results due to gradual destruction of the spinal vertebra. The vertebral bone due to destruction may become displaced and lose its alignment. It may appear as a hump or a gibbus at the back.
- Paraplegia: Due to destruction, the vertebra may collapse on other vertebra. This may injure the spinal cord leading to paralysis of lower limbs.
- Constitutional symptoms: Patient may also suffer from other general symptoms such as mild fever, night sweats, loss of weight, reduced appetite, fatigue, etc.
Treatment Options For Tuberculosis Of The Bone
Tuberculosis of bone can be completely cured if treatment is started as soon as possible. The main goal of treatment is to kill and eradicate the germs, and reinstate normal function of bone and joint. The mainstay treatment of tuberculosis of bone is anti tubercular medications.
These antibacterial drugs are given in combination of three or four initially for few months. After two to three months the drugs are gradually reduced. Anti tuberculosis treatment continues for 6 to 9 months or in some cases it may extend few more months.
Along with mainstay treatment, certain home remedies play vital role for cure of the disease.
- Person should eat healthy diet which consists of protein and other nutrients. Egg, fish, cereals, vegetables, fruits, has to be incorporated in daily diet.
- He should avoid crowded places.
- Rest is essential for few months, especially in tuberculosis of spine.
- Person should quit alcohol and smoking.
- Avoid carbonated drinks and too much of coffee and tea.
Surgery has limited role in treatment of tuberculosis of bone.