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How to manage pain after spinal tuberculosis?

Q: I am 27 years now. I had been treated for primary complex at the age of 3 with streptomycin injections. 2.5 years ago, I started to experience back pain for 6 months. In the duration I gained weight. I was Mantoux positive at that time and MRI on the spinal revealed shrunken space between L4 and L5. I was reported as spinal spondylitis and undergone TB drugs (H, R, Z, E max limited dose) for 12 months till one year ago. The pain during the period was fully controlled. Were the drugs consumed correct or not? Now I feel that I have some pain in back while after carrying a weight or even after a long walk. What might be the cause of this? Could the disease come back?

A:One year of treatment for spinal tuberculosis with an appropriate multi-drug regimen should eliminate the infection. Persistence or recurrence may need to be considered in a patient who was not compliant or in someone who has an impairment of immunity. However, the damage to the vertebral bones may lead to the development of osteoarthritis, and this could result in progressive pain. It may be advisable to determine if anti-arthritis treatment helps relieve the condition. If it does not, or if symptoms worsen, repeat MRI could help determine if there is a recurrence of TB. In any case avoiding back strain for a couple of weeks would be important since the problem may resolve in that time if there is no lingering infection present.

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