Sunday 11 April 2010

Back pain?! Could be Spinal TB

Are you suffering from chronic back pain? It could be spinal TB, also known as Pott's disease.

I was recently diagnosed with Spinal TB. I had a very severe case of infection and it had progressed to such a level that I began to have neurological side-effects. This is my experience.

The beginning: I'm an Indian in his early 30s. I started experiencing back pain when I had to relocate to a newer city for work. The company I worked for had arranged for my accommodation in the new place. I was using the bed available at the accommodation provided. I suspected that the bed I was using to be the cause of pain (it was a very soft foam bed). I started sleeping on the carpet which seemed to help. This went on for about 6 months.

The Progression: I had slowly turned lethargic and weak. I had to go out for some physical excerise to keep the back pain away. The physical exercise could be as simple as taking a 15 minute walk. I would feel good immediately after the walk.
I started using carpet instead of bed for sleeping all the time. In general, I started preferring harder surface for lying down compared to any softer ones. This went on for about 5 months.

The Final phase: It has been about 11 months since I started having back pains. I started experiencing occupational back spasm. As it was winter and the city was filled with snow, I couldn't go out for walks often.
One day, at home, I tripped over the carpet and fell. I experienced excruciating pain on my lower back. I had difficulty getting up and walking. I had to call emergency. At A&E, the doctor believed I have some kind of muscle problem. She gave me some pain killers and helped me get up and walk. I still had difficulty walking. I felt weak. But, I hoped it would get alright in couple of days time.
Two days later, when I woke-up early in the morning, I noticed that both my legs had gone numb. When I tried to extend my arm and reach for a switch I experienced a sharp pain in my chest. I had to call the emergency again.

The diagnosis: The doctor who was at A&E, ordered for an X-Ray of my lower back. They found a compression fracture at L4 and I was immediately admitted. The doctors (orthopaedics) had ordered for complete bed rest till neurosurgeons could review my case. By this time, I started loosing sensation on my right leg. The right leg had become very week compared to my left leg. I couldn't pull my feet up (I later learnt that this was called foot-drop). The doctors couldn't identify any reason why I should be experiencing chest pain. They believed I had some muscle problem which should fix itself with rest.

The neurosurgeon recommended that I undergo decompression laminectomy to relieve my spinal cord and nerves connecting legs (Sciatic nerves). He also recommended a bone biopsy as he suspected TB of spine.

Post surgery: Immediately after laminectomy, most of the sensations on my right leg returned. I slowly started regaining strength. But, it took me about 5 days to just get out of the bed and sit in a chair. My legs were so weak, I was unable to walk. It took me another ten days before I could walk with a zimmer frame.

Histology reports from biopsy suggested TB. As the culture of TB from biopsy would take more than 4 weeks, the doctors suggested I start on anti-TB medication. A month later, fully sensitive TB was cultured from my biopsy sample.

After 12 days, I was given a body brace to keep my spine straight. I was ordered to keep the brace on all the time, unless I'm on bed lying down. I was discharged.

The return to hospital: When I left hospital, I was barely walking crutches. I had another fall on the day I left hospital. This time I started experiencing extreme chest pain. I had to call emergency again. The doctor at A&E took x-ray of my thoracic spine and found a compression fracture in T4. During the fall, the body brace broke. I was ordered bed rest till the brace could be fixed.

After about 10 days, I was mobilised again by physiotherapists. The neurosurgeons recommended that conservative treatment for the chest pain I was experiencing. The 10 day rest had made me so weak, I had difficulty even getting out of bed. I started experiencing pain in my left leg and knees. The next couple of weeks were the most difficult period of my life. I had to take a cocktail of painkillers regularly to fight the pain. I was on regular doses of paracetamol, tramadol, amitriptyline and oramorph. I had to fight the pain to get out the bed and move around. But, slowly I gained strength. The more I mobilised, the better I felt the next day.

I was finally discharged from the hospital eventually. I had spent about four weeks in the hospital this time. I was still on crutches. But, I was confident I would be able to handle basic mobility.

I'm at home now, undergoing rehabilitation. The strength and sensation in my legs are slowly returning.

6 comments:

  1. Hello,

    I'm exactly in the same situation. I live in UK and has been frequently visiting Osteopath for my back pain. It is only when I went to India last week I came to know from MRI that I have Spinal TB. It is now in serious stage with my L4 completely damaged and spreading to L5. I came back to UK and in a dilemma about the treatment. Do you prefer Indian or UK treatment? Please suggest.

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  2. Thanks have not ever thought in this direction.There are so many kinds of pain and there could be so many meanings from it.There are so many kinds of Tuberculosis infections unheard of.

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  3. My mother is exactly in the same situation.she underwent surgery in india lastmonth she is in bedrest.please suggest how long she should wear that body brace and when she is able to mobilise inside the house.

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  4. Methuen High School had 160 students and staff tested for tuberculosis this week after a student was diagnosed with the infectious and potentially fatal disease early last month.

    Tuberculosis is an infectious disease that affects the lungs. Symptoms include coughing, chest pain, shortness of breath, fever and night sweats, poor appetite and weight loss. Complications are fluid or air between the lungs and chest wall, and, in some rare cases, death can result if an infected person goes without proper treatment.
    TB spreads through the air, according to the Centers for Disease Control and Prevention. Also mentions findrxonline on his website that the pain is natural product of the symptoms.

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  5. I had the exact same problem. One fine day got up in the morning to feel the right leg numb. Been 6 years now but some remnant or the other still prevails. Hope you still check this space. Would be great to share notes. Very few first hand experiences of this online.

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  6. My Girlfriend is also suffering this spine pain I recommended her to visit Chiropractor for complete checkup.

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