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Tuberculosis is the most widespread and a concern disease caused by the bacteria “Mycobacterium tuberculosis” across world and is one of the top-10 causes of death. Tuberculosis is preventable and treatable if early diagnosed. Lung is the primary site, which is affected but other parts of the body are also affected.

When TB spreads, it’s referred to as extra-pulmonary tuberculosis (EPTB), which include bone and joint tuberculosis. Bone tuberculosis is a type of TB that affects long bones, spine and the joints. Bone Tb is rare occurring disease but from the past few decades, the incidence of this disease has been increased, especially in underdeveloped countries as shown in research. It is reported that only about 3 percent of all TB cases affect the musculoskeletal system in United States. Although it is rare, but if left untreated, it will get worsen. 

Reports suggest that bone Tb are suspected in patients having progressive history of back pain and in individuals from an endemic area.

Bone TB could mostly affect any type of bone in the body but the common site is spine. Research shows that people with bone TB, shows more likely its affect in spinal column.  A common form of spinal bone TB is known as Pott’s disease.

Causes of bone tuberculosis

The cause is generally when the person comes in contact with TB patient, where bacterial transmission occurs from person to person.  Bone TB generally arise when tuberculosis spread outside from the lungs, which travels from the lungs or lymph nodes to the bone, joints or spines by means of blood. Bone TB typically begins due to the rich vascular supply in the middle of the long bones and the vertebrae. This is rare occurring disease but from last few decades, its frequency increased in many countries. Mostly, it is difficult to diagnose this disease at initial level, as it is generally painless and does not show any symptoms, until reached to advanced stage, which leads to severity.  

Types of Bone TB

There are different forms of bone TB, having different mode of treatment for different types of bone TB. Some of them are as follows:

• Spine Tuberculosis
• Knee joint Tuberculosis
• Elbow Tuberculosis
• Hip joint Tuberculosis
• Ankle joint Tuberculosis

 Symptoms of Bone TB

The most common symptoms that occurs in Bone TB patients, are the pain in the extra-spinal skeleton, prosthetic joint, and stiffness in the affected joints, severely pain in the joints of the hips, back, and knees, Wrist pain, Soft tissue swelling. In advance cases, serious complication occurs like neurological complications, paralysis, limb-shortening and bone deformities. 

Treatment and Prevention from Bone TB

• Medicines - Prior therapy given is medicines which can last from 6–18 months, which include anti- tuberculosis medications like pyrazinamide or advised by the physicians. 
• Surgery – Surgery is required depends upon the severity of the disease. Laminectomy surgery, where a part of the vertebrae, is removed for treatment.
• MDR Therapy – This therapy includes the combination of anti-tubercular drug and is the most suitable method of treatment for bone TB.
• DOTS therapy – DOTS or “directly observed treatment short course” is a method that, which involves the list of all the drugs coming under the classification of anti-tubercular medication.

5 Foods which needs to be avoided while having bone TB

If bone TB has been detected, some foods needs to be avoided:

• Tobacco: Tobacco in any form should be strictly avoided as it increases the risk of contracting tuberculosis and also increase the chances recurrence of TB. Tobacco also reduces the effect of many medicines and thus rises the risk of relapse. 
• Alcohol: Too much alcohol consumption increase the risk of bone tuberculosis as it raises the burden of mycobacteria, which in turn impaired granuloma formation. It also reduces the effect of the Bacillus Calmette–Guérin (BCG) vaccine, which is mainly given to prevent tuberculosis. Hence, alcohol consumption should be strictly avoided by patients having bone TB.
• Refined products: Items like sugar, bread, white rice, sweetened drinks, refined cereals, should be avoided if a person is suffering from tuberculosis since they contain properties that activate bacterial action in TB patients.
• Greasy food: Foods like chicken, fried beef, onion chips and other fried foods that are high on saturated fat – should be avoided as it weakens the immune system, which act as a breeding ground for tuberculosis bacteria. 
• Caffeine: Drinks like carbonated drinks, coffee etc. should be avoided by a person having bone tuberculosis as caffeine present in these drinks increases the bacterial action causing conditions more severe. 

Patient suffering from any type of tuberculosis should take precautionary and preventive measures by avoiding such foods which can accelerate the bacterial action, and by taking nutritional diet which are rich in fiber, protein, iron and vitamin B, antioxidant-rich vegetables and unsaturated fat should be increases. If a person is diagnosed with this, treatment should be taken immediately, as delay will make it more painful and severe. 

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