Q: My 57 years old mother had lung tuberculosis 20 years back. She got treated for the problem. Her right lung is unable to function and is damaged. Recently, she fell at home and now has pain in her lower back. We consulted a doctor, who told us that there might be a possibility of bone tuberculosis. She is living in the Middle-East with a good living standard. Is bone tuberculosis curable? How can it be treated?

A:Tuberculosis is an infectious disease which may remain latent for prolonged period of time, and can reactivate after long period of latency. Reactivation of previously treated tuberculosis may be either recurrence of disease which might have remained hidden and untreated, and it might become manifest due to decrease in body’s immune function due to physiological changes (increasing age) or disease (e.g. malnutrition, HIV) or therapy (e.g. chemotherapy).

In some cases, recurrence of the disease is not due to relapse but a result of new infection with a new strain of the bacteria which causes tuberculosis. Reinfection or reactivation may affect any part of the body. It is not unusual for reactivated TB to affect bones, which is generally due to previous pulmonary TB. However, there are a number of other infective and non-infective causes of this bone pain, and an experienced physician based on signs and symptoms of the disease would be able to differentiate. Bone TB is treatable and curable just like any other forms of TB, however the duration of treatment is generally longer (may be up to a year or more).

The complications of bone TB depend on the site of infection, the stage of the disease at the time of initiation of treatment, general health of the person etc. In some cases surgery may be required in addition to medical treatment. Treatment of bone TB, just like any other forms of TB may be complicated by drug resistance issues, and side effects of TB treatment.