Doctor Warns About Chronic Back Pain: It May Not Be Just Muscle Inflammation
20 Jul 2024 at 13:47
Dr. Arak Wongworachat, Director of Walailak University Medical Center Hospital, has issued a warning regarding chronic back pain. In a recent Facebook post, he emphasized that the common assumption of muscle inflammation may not always be the case, using a real-life example to illustrate the potential dangers.
A patient, over 50 years old, presented with back pain regarding a palm’s width above his tailbone. The pain radiated outwards, but the patient had no fever, tingling, or numbness in his feet. Despite the discomfort, he might still work and carry out his daily activities. However, six months later, his condition worsened. He experienced weakness, loss of appetite, and weight loss, alongside an increase in back pain. Moreover, he developed tingling and numbness in both legs.
According to Dr. Arak, the patient initially self-medicated and subsequently sought treatment at a nearby hospital. The doctor at that facility initially suspected muscle inflammation and a herniated disc pressing on a nerve, recommending a visit to Walailak University Hospital.
Upon arrival at Walailak University Hospital, the patient’s weakness in the legs raised a red flag. A team of neurosurgeons and brain surgeons investigated the situation, suspecting a possible compression on the spinal cord. Medical imaging, including X-rays, was performed, leading to the diagnosis of spinal tuberculosis.
Immediate surgery was necessary. The surgery revealed an infection at the L1-2 vertebrae, with a large pus-filled mass pressing on the spinal cord and nerves. Bone fragments at both levels were extensively destroyed. The surgical procedure involved draining the pus, removing the fragments, and examining them for the presence of infection.
Three days following the surgery, the patient started to recover. His leg weakness improved, and he began walking exercises, eventually regaining almost complete mobility.
Dr. Arak highlighted the importance of seeking a proper medical diagnosis for chronic back pain, emphasizing that it shouldn’t be dismissed as simple muscle inflammation. His case study demonstrates the seriousness of spinal tuberculosis, which can lead to significant neurological complications, including paralysis.
Spinal tuberculosis is a bacterial infection that often originates in the lungs before spreading to the spine through the bloodstream. It can cause back pain, fever, and abscesses in the spine or hip muscles. In severe cases, it can lead to neurological abnormalities such as muscle weakness and paralysis.
The condition often affects the lower thoracic and upper lumbar spine. Individuals with weakened immune systems, poor health, or poor nutrition are more susceptible to tuberculosis infection. This includes people infected with HIV, those with a history of tuberculosis, or those who have had close contact with someone with tuberculosis.
Don’t Dismiss Chronic Back Pain: Spinal Tuberculosis – A Case Study
20 Jul 2024 at 13:47
Dr. Arak Wongworachat, Director of Walailak University Medical Center Hospital, recently shared a case study on his personal Facebook page to raise awareness regarding the seriousness of chronic back pain. The case highlights the importance of seeking medical attention promptly, as neglecting back pain can lead to serious complications like spinal tuberculosis.
The Case of a 50-Year-Old Patient
A patient in his 50s presented with back pain for approximately a year. His pain, located one palm’s width above the tailbone, radiated outwards. He experienced no fever, tingling, or numbness in his feet, and was still able to work and carry out daily activities. However, six months later, the patient’s condition worsened. He felt weak, lost his appetite, and experienced weight loss. His back pain intensified, and he began experiencing tingling and numbness in both legs.
The patient had previously self-medicated with over-the-counter pain relief medications. He later sought medical attention at a nearby hospital, where he was initially diagnosed with muscle inflammation and a suspected herniated disc. He was referred to Walailak University Hospital for further evaluation and treatment.
Discovering Spinal Tuberculosis
Upon arrival at Walailak University Hospital, the patient’s weak legs prompted immediate consultation with a neurosurgeon and brain surgeon. The physical examination raised suspicions regarding a potential issue compressing the spinal cord. The patient underwent X-ray imaging, which revealed a high likelihood of spinal tuberculosis. A surgical intervention was deemed necessary.
During surgery, the surgeon discovered that the patient’s L1-2 vertebrae were severely swollen, with a large pus-filled mass compressing the spinal cord and nerves. Extensive bone destruction was noted at both levels. The surgeon drained the pus, removed bone fragments for infection testing, and performed a standard surgical procedure.
Three days post-surgery, the patient’s condition improved significantly. His leg strength returned, and he began walking exercises, eventually regaining near-normal mobility.
The patient’s case highlights the crucial need for timely and proper medical evaluation in cases of chronic back pain. Self-medication and delaying professional care can have serious consequences, as illustrated by this patient’s delayed diagnosis and the associated complications.
Spinal Tuberculosis: A Closer Look
Spinal tuberculosis, also known as Pott’s disease, is a bacterial infection that affects the spine. The infection typically originates in the lungs and spreads to the spine through the bloodstream. This infection can lead to various symptoms, including:
- Back pain
- Fever
- Abscesses in the spine or hip muscles
- Muscle weakness or paralysis
Spinal tuberculosis often affects the lower thoracic spine and upper lumbar spine. Individuals with weakened immune systems, poor health, or malnutrition are at higher risk of contracting tuberculosis infections. These risk factors include:
- HIV-infected individuals
- Individuals with a history of tuberculosis
- Individuals who have had close contact with individuals with tuberculosis
Don’t Ignore the Warning Signs
Dr. Arak’s case study serves as a powerful reminder that persistent back pain should never be disregarded. It is essential to consult a healthcare professional for a thorough evaluation and diagnosis. Early detection and appropriate treatment can significantly improve outcomes and prevent debilitating complications.
If you experience chronic back pain, seeking immediate medical attention is crucial. Delaying treatment can lead to irreversible damage, making it essential to prioritize your health and seek expert medical guidance.
