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Suggest Treatment For Fever And Back Pain When Having Spine TB
Question: Hello Doctor,
She is my friend's mother and her age is 55.
She was having back ache and fever off and on for few days.
As usual, they initially thought it because of daily home work. But when they went to doctor and after tests, it was found to be spine tb.Now they had paid a visit to Orthopaedic doctor in the month of NOv 2014 and taking the medicines as prescriber by him.
It is been 2 months, there is hardly any improvement in the health of the patient.
She is having severe back ache, unable to bend and having fever on-off.
From last 2 months , even after taking medicines a very minute improvement has been seen.
She is using the belt on her back too and is on complete back rest.
As the doctor is known to them , so they were hesitant to move on any other doctor.
I just saw your experience and you had suggested good opinions to other patients here.
So by just looking at it, though to share the detail with you.
Please help us in the same.
She is my friend's mother and her age is 55.
She was having back ache and fever off and on for few days.
As usual, they initially thought it because of daily home work. But when they went to doctor and after tests, it was found to be spine tb.Now they had paid a visit to Orthopaedic doctor in the month of NOv 2014 and taking the medicines as prescriber by him.
It is been 2 months, there is hardly any improvement in the health of the patient.
She is having severe back ache, unable to bend and having fever on-off.
From last 2 months , even after taking medicines a very minute improvement has been seen.
She is using the belt on her back too and is on complete back rest.
As the doctor is known to them , so they were hesitant to move on any other doctor.
I just saw your experience and you had suggested good opinions to other patients here.
So by just looking at it, though to share the detail with you.
Please help us in the same.
Brief Answer:
Treatment is going along correct lines.
Detailed Answer:
Hi,
Thank you for posting your query.
I have noted your friend's mother's symptoms as well as reports attached here.
I would like to assure you that the reports are suggestive of spine TB, and the medications are going along correct lines.
We need to repeat the MRI scan of spine after three months of treatment to look for signs of improvement.
As told by the doctor, treatment should be continued for 18 months.
Only if the repeat MRI after three months does not show any improvement, then, we need to do a biopsy (minor surgery) from the affected area to confirm the diagnosis. Also, in some cases, the TB bacteria may be resistant to the current medications. Then, the medications may need to be changed.
I hope it helps.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
Treatment is going along correct lines.
Detailed Answer:
Hi,
Thank you for posting your query.
I have noted your friend's mother's symptoms as well as reports attached here.
I would like to assure you that the reports are suggestive of spine TB, and the medications are going along correct lines.
We need to repeat the MRI scan of spine after three months of treatment to look for signs of improvement.
As told by the doctor, treatment should be continued for 18 months.
Only if the repeat MRI after three months does not show any improvement, then, we need to do a biopsy (minor surgery) from the affected area to confirm the diagnosis. Also, in some cases, the TB bacteria may be resistant to the current medications. Then, the medications may need to be changed.
I hope it helps.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Hello Sir,
Thanks for your reply.
I have seen your recent posts, in which you quoted that a spine tb patient do see some relief in their back pain after 1-2 month of treatment.
As we have not seen any significant improvement till now, do we need to change the medications or we can continue with the same. and over above, as condition of the patient is still the same, is there any thing to worry that why no improvement in the health of patient even after being on complete bed rest and following the medicine schedule as prescribed.
One more thing sir, as we are from north XXXXXXX and its winters here.
So is it advisable to sit on chair from 3-4 hours and have the sun shine to get VitaminD.
Sir, one important question: a spine TB patient generally takes how much time to return to their normal routine, like bending their body and doing physical work (e.g. routine home tasks of a home maker.).As bye the time they have been diagnosed with it, my friend's mother is taking full bed rest and she is taking care of her mother.
Please confirm sir.
Thanks for your reply.
I have seen your recent posts, in which you quoted that a spine tb patient do see some relief in their back pain after 1-2 month of treatment.
As we have not seen any significant improvement till now, do we need to change the medications or we can continue with the same. and over above, as condition of the patient is still the same, is there any thing to worry that why no improvement in the health of patient even after being on complete bed rest and following the medicine schedule as prescribed.
One more thing sir, as we are from north XXXXXXX and its winters here.
So is it advisable to sit on chair from 3-4 hours and have the sun shine to get VitaminD.
Sir, one important question: a spine TB patient generally takes how much time to return to their normal routine, like bending their body and doing physical work (e.g. routine home tasks of a home maker.).As bye the time they have been diagnosed with it, my friend's mother is taking full bed rest and she is taking care of her mother.
Please confirm sir.
Brief Answer:
Initial improvement may range from 1-3 months
Detailed Answer:
Thank you for getting back.
I agree with you that most people show some improvement within one month, but occasional patients may take upto three months.
We need to be sure that absolutely there is no improvement (mainly we expect reduction in back pain and absence of fever). If she still has severe back pain or if fever is coming daily, then, instead of waiting for three months, we can do the MRI scan of spine earlier also.
Medicines may be changed only after repeat MRI spine and/or biopsy of the affected area.
It is safer not to move around too much or to return to normal activities for upto there months. I hope she is wearing the thoracic spine corset to keep the spine stable, while sitting or standing.
Sitting in sunlight is alright.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Initial improvement may range from 1-3 months
Detailed Answer:
Thank you for getting back.
I agree with you that most people show some improvement within one month, but occasional patients may take upto three months.
We need to be sure that absolutely there is no improvement (mainly we expect reduction in back pain and absence of fever). If she still has severe back pain or if fever is coming daily, then, instead of waiting for three months, we can do the MRI scan of spine earlier also.
Medicines may be changed only after repeat MRI spine and/or biopsy of the affected area.
It is safer not to move around too much or to return to normal activities for upto there months. I hope she is wearing the thoracic spine corset to keep the spine stable, while sitting or standing.
Sitting in sunlight is alright.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
Thanks for quick reply.
One or two more questions I have, like the improvements observed in few days is like fever does not come in the day time, but it comes in the night time around 99 to 101, but that is not on daily basis.
And pain is still there in the back, a mild improvement has been observed.
As she is on bed rest, what happens because of not moving our body parts like Feet and hand etc, they goes into sleep mode kind of.
So is it expected?
Requesting you to suggest on the same.
Is it ok, if she attend any urgent function for 2 -3 hours and can sit there on chair or so??
or it could be dangerous , please suggest sir.
Thanks..
Thanks for quick reply.
One or two more questions I have, like the improvements observed in few days is like fever does not come in the day time, but it comes in the night time around 99 to 101, but that is not on daily basis.
And pain is still there in the back, a mild improvement has been observed.
As she is on bed rest, what happens because of not moving our body parts like Feet and hand etc, they goes into sleep mode kind of.
So is it expected?
Requesting you to suggest on the same.
Is it ok, if she attend any urgent function for 2 -3 hours and can sit there on chair or so??
or it could be dangerous , please suggest sir.
Thanks..
Brief Answer:
These findings suggest improvement.
Detailed Answer:
Thank you for getting back with more information.
These observations suggest improvement, such as absence of fever during day time and reduction in the intensity of back pain.
It is better not to mobilize her, as sitting can cause instability of spine and pressure over the spinal cord. Immobilization of spine in a corset should be continued now.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
These findings suggest improvement.
Detailed Answer:
Thank you for getting back with more information.
These observations suggest improvement, such as absence of fever during day time and reduction in the intensity of back pain.
It is better not to mobilize her, as sitting can cause instability of spine and pressure over the spinal cord. Immobilization of spine in a corset should be continued now.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Hello Doctor,
One more question, we have seen improvement as mentioned earlier in the back ache and fever front.
But Liver is getting affected in a bing manner and their readings have touched the highest panel.The doctor had suggested to reduce the dosage for TB, but once consulted with the other doctor , they asked to continue with the same routine for one more month as after that their may be good improvement shown.
it is been 2 months today, so going forward in 1 month time can we expect her to be like walking properly or sit properly at her own without being spine getting impacted.
Normally in how many months in this case, doctor we can expect her to at least walk or sit properly, not doing any physical work though.
How long it will take for back pain to reduce to zero and fever also stop coming in? and wen we can stop using that back belt.
Or being so fit that she can attend any small gathering or function.
And how long it take for the person to be TB free?? and is this transferable from one person to another, any additional precautions that need to be taken.
Requesting you to please answer the questions that have come across me as the patient is really in vain.
Could you please update on the same?
Thanks in advance sir for your on time and good consultancy..
One more question, we have seen improvement as mentioned earlier in the back ache and fever front.
But Liver is getting affected in a bing manner and their readings have touched the highest panel.The doctor had suggested to reduce the dosage for TB, but once consulted with the other doctor , they asked to continue with the same routine for one more month as after that their may be good improvement shown.
it is been 2 months today, so going forward in 1 month time can we expect her to be like walking properly or sit properly at her own without being spine getting impacted.
Normally in how many months in this case, doctor we can expect her to at least walk or sit properly, not doing any physical work though.
How long it will take for back pain to reduce to zero and fever also stop coming in? and wen we can stop using that back belt.
Or being so fit that she can attend any small gathering or function.
And how long it take for the person to be TB free?? and is this transferable from one person to another, any additional precautions that need to be taken.
Requesting you to please answer the questions that have come across me as the patient is really in vain.
Could you please update on the same?
Thanks in advance sir for your on time and good consultancy..
Brief Answer:
Answers are below.
Detailed Answer:
Thank you for getting back and asking more questions. My replies are below:
1. There is no need to reduce the dosage of TB medications as per the LFT reports.
2. Yes, we can expect improvement in the next one month.
3. It takes 3-6 months time for a person like her to sit or walk properly.
4. Back pain may take 3-6 months to reduce to zero, and fever should settle in 3 months.
5. She can attend functions after 3-6 months.
6. 18 months of treatment is needed to cure the TB.
7. Spine TB is not transferable to another person.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Answers are below.
Detailed Answer:
Thank you for getting back and asking more questions. My replies are below:
1. There is no need to reduce the dosage of TB medications as per the LFT reports.
2. Yes, we can expect improvement in the next one month.
3. It takes 3-6 months time for a person like her to sit or walk properly.
4. Back pain may take 3-6 months to reduce to zero, and fever should settle in 3 months.
5. She can attend functions after 3-6 months.
6. 18 months of treatment is needed to cure the TB.
7. Spine TB is not transferable to another person.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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