TB or Tuberculosis might sound like a thing of the past to many, but it is still very much in existent and has also been claiming lives due to negligence and unawareness. Tuberculosis is amongst the top ten causes of death in India. Tuberculosis or TB is an airborne, contagious disease caused by a bacterium known as Mycobacterium tuberculosis, which primarily affects the lungs but has potential to spread to other organs and parts of the body such as bones and joints. When tuberculosis spreads to other organs, it is referred to as extrapulmonary tuberculosis (EPTB). Bone TB is a form of extrapulmonary tuberculosis and mostly affects the spine, long bones and joints; however, it can affect any other bone in the body too.
Bone tuberculosis is caused when a person is affected with tuberculosis, and the infection spreads outside the lungs to other organs of the body such as the bones. Tuberculosis is an airborne, contagious disease is spread from person-to-person through the air via means of tiny droplets of cough, sneeze, laugh, etc. That said, tuberculosis is not that easily transferrable until a person spends a lot of time in close proximity to the affected person. Tuberculosis destroys the body tissue, and once a person contracts tuberculosis in the lungs, it spread through blood from the lungs into the bones, joints and spine. Bone tuberculosis is essentially caused to excessive vascular supply in the centre of the long bones and the vertebrae.
Bone tuberculosis is rare, but over recent years due to the spread of AIDS in developing countries, this form of tuberculosis has gained momentum. Bone tuberculosis is complicated to diagnose and can cause severe problems, if not treated within time. Bone tuberculosis becomes even more difficult to diagnose because it does not often cause any symptoms until it reaches an advanced stage; moreover, bone TB is particularly painless in its early stages. In most people, the time when the bone TB is diagnosed, the stage of tuberculosis has already advanced quite further.
However, some symptoms that can help with diagnosis are:
- Intense and consistent back pain
- Swelling in joints
- Stiffness in back and joints
These symptoms are produced when the stage of bone tuberculosis has not advanced too much; however, cases where the bones tuberculosis has grown too much, dangerous symptoms such as below can occur:
- Neurological problems
- Shortening of limb in children
- Deformities in bones
It is also important to know that a person suffering from bone tuberculosis may or may not experience typical tuberculosis symptoms, such as:
- A dense cough lasting more than three weeks
- Acute chest pain
- Pain in breathing or coughing
- Blood in cough
- Constant fatigue and extreme tiredness
- Night sweats
- Severe chills
- Consistent fever especially low-grade
- Loss of appetite
- Unexplained weight loss
These symptoms may or may not accompany bone tuberculosis symptoms. While tuberculosis is communicable, it is possible to be infected with tuberculosis only if a person is in close contact with the infected person for a prolonged period. It is not possible to be infected with tuberculosis by simple shaking of hand or sharing of food. Some people who are at more risk of being infected with tuberculosis are:
- Family of the infected person
- Close friends of the infected person
- Co-workers of the infected person
- People who have travelled to Russia, Asia and Eastern Europe
- People who live in a hospital or a nursing home
Moreover, people with a weak immune system are in more danger of being infected with bone tuberculosis; these include:
- Babies and young children – with developing immune systems
- People who have diabetes or kidney disease
- HIV/ AIDS patient
- Organ transplant patients
- Cancer patients
- People with auto-immune disorders
- Malnourished or underweight people
- Chain smokers
- Substance users (alcohol and drugs)
It is very critical to understand what puts some people at more risk than others and how to identify bone tuberculosis symptoms so that adequate medical help can be obtained timely. If bone tuberculosis is not diagnosed and treated timely, it can cause severe complications and can also lead to death in some cases.
The damage caused by bone tuberculosis is irreversible unless it is detected and treated early on with the right medications. In some cases, patients might have to undergo spinal surgeries such as laminectomy, in which a part of the vertebrae is removed to treat the patient. However, medications are the first form of treatment, and the duration of treatment of bone tuberculosis can last for as long as 18 months. Along with treatment, the patient will also be asked to make many lifestyle changes and modify habits. A person being treated for bone tuberculosis will be asked to refrain from alcohol consumption, use of tobacco products, caffeine, refined products, greasy food, etc. The treatment will also be focused on fibre and protein-rich diet, as well as green leafy vegetables that would provide iron and necessary nutrients to the body.
With more than a million cases of tuberculosis in India, reported every year, it is critical to understand the symptoms and get the right treatment so that it does not spread outside the lungs and affects bones and joints, making it more intense and difficult to treat.