Thoracic osteochondrosis is a chronic pathology in which the vertebrae of the bones and the intervertebral discs located between them undergo degenerative changes. Catastrophic damage in this zone is quite rare due to low mobility and good protection from the side frame. Osteochondrosis of the thoracic spine develops unnoticed, develops slowly but persistently and is also distinguished by a number of specific symptoms, masquerading as diseases of internal organs. In this regard, it is very important to seek medical help at the first, even mild, signs of back problems. Early treatment helps prevent serious complications.
Causes and precipitating factors
Degenerative-dystrophic processes in the thoracic parts of the spine occur in the context of endogenous disorders and under negative external influences. Their development is most often caused by the following factors:
- hereditary predisposition, the presence of a certain set of defective genes.
- excessive physical exercise, especially lifting and carrying various heavy objects.
- sedentary lifestyle, which causes congestion in the area of the vertebral bodies and intervertebral discs.
- congenital or acquired structural abnormalities, for example, accessory vertebrae, lordosis, kyphosis.
- back and/or chest injuries - fractures, prolonged compression.
- flat feet, club feet;
- impaired blood circulation in any, not only the thoracic region of the spine.
- frequent hypothermia;
- overweight;
- endocrine pathologies, metabolic disorders, such as diabetes, gout, hypothyroidism, hyperthyroidism.
- systemic diseases - rheumatoid arthritis, systemic lupus erythematosus, scleroderma.
- ankylosing spondylitis.
The strength and mobility of the spine as a whole directly depends on the condition of each segment. The disease can be a consequence of untreated, severe lumbar or cervical osteochondrosis.
Smoking, alcohol addiction and drunkenness, including occupational hazards, predispose to the destruction of intervertebral joints with discs composed mainly of cartilage. Thoracic osteochondrosis is diagnosed more often in the elderly than in the young and middle-aged. This is due to the natural aging of the body, the slowing down of recovery processes and the presence of one or more physical pathologies.
Symptoms and signs of the disease
The main symptom of the degenerative process is pain. Unlike cervical and lumbar osteochondrosis, acute, caustic, perforation is extremely rare. Patients usually describe the discomfort as dullness, pain, or pressure. The pain syndrome may intensify during bending/turning of the body, sudden uncomfortable movements, during a coughing fit or during temperature changes. Its radiation is noted — it spreads beyond the affected area. Osteochondrosis of the thoracic spine also manifests itself as follows:
- stiffness, feeling of restriction.
- specific clicks, creaking when changing the position of the body.
- loss of sensitivity, paresis in the form of a "goosebumps" sensation, burning, numbness.
- muscle spasms, further limiting range of motion.
- adoption of a forced position in which discomfort does not appear or is weakly expressed.
- pathological changes in posture, in later stages - gait.
- a slight decrease in growth as a result of the destruction of the intervertebral joints and the convergence of the vertebral bodies.
Due to the constant tension of the back muscles, the muscles of the neck and back also break, which is expressed in the pain of these parts.
The clinical picture of thoracic osteochondrosis is a combination of pain syndromes. The fact is that the affected parts are located in a common zone of innervation with many internal organs. If a displaced disc has pinched a nerve root located near the spine, then pain can be felt in them, simulating common pathologies:
- severe heart pain resembles angina and even myocardial infarction.
- pain in the mammary glands becomes the reason for an urgent differential diagnosis to exclude tumor processes.
- Constant or periodic pain in the right hypochondrium, stomach or intestine, similar to those characteristic of gastritis, cholecystitis and ulcerative lesions.
When osteochondrosis worsens, the lower back or abdomen may hurt. Patients confuse discomfort with signs of kidney pathology or gynecological disease. They refer to specialized specialists, who then refer patients to a neurologist or spondylologist after an examination.
Classification, main types
The common classification of osteochondrosis of the thoracic spine is based on the nature of the pain syndrome. There are two types of it:
- dorsal spine - sharp sharp pain in the sternum, which occurs mainly during a prolonged stay in one position of the body, often complicated by a feeling of lack of air during inhalation.
- dorsal in the form of mild painful sensations in the back, which appear periodically and subside after rest.
This division of pathology into groups allows the doctor to quickly decide on the choice of analgesic.
Gradual development of thoracic osteochondrosis
In its development, the osteochondrosis of the thoracic spine passes through four stages. Each has its own symptoms and radiographic markers. The more severe the deformation of the discs and vertebrae, the more severe the pain, stiffness of movement and paresthesia. The stage of the disease determines the therapeutic tactics.
Stage I
No changes in X-ray yet. However, the intervertebral disc no longer retains moisture well, without which its timely restoration is impossible. It gradually begins to thin, lose strength and elasticity. Only in some cases mild discomfort occurs in the chest area. A person perceives it as muscle fatigue and does not consult a doctor. Therefore, disease at this stage is usually an incidental diagnostic finding during workup for another reason.
Stage II
The structure of the annulus fibrosus becomes loose and fibrous. An enlargement of a fissure in the disc occurs with the protrusion of the nucleus pulposus in that direction. The distance between adjacent vertebrae decreases as the disc height decreases, which is clearly visible on radiographic images. To compensate for the distribution of loads, the muscle tissue is constantly tense. Stiffness increases, pain severity is still moderate.
Stage III
The annulus fibrosus ruptures with the nucleus pulposus being compressed beyond its limits. A herniated disc occurs, which causes severe symptoms and serious complications. Significant deformation of the vertebral bodies and formation of individual osteophytes (compensatory bone growths) is observed. The pain syndrome becomes stable, movements in the back are significantly limited.
IV stage
At this stage, the diagnosis of thoracic osteochondrosis is not difficult. Connective tissues have developed and multiple osteophytes have formed. Adjacent vertebrae in the segment are blocked, completely or partially immobilized. Nerve roots are often compressed by inflammatory swelling, bony growths, and muscle spasms. This manifests as a burning pain. The patient copes poorly with housework and has difficulty moving.
Complications
The development of disc myelopathy, a dystrophic disease of the spinal cord resulting mainly from compression by a herniated disc, is dangerous. It is worth noting that with osteochondrosis of the thoracic spine, such a complication is rare. Nevertheless, in clinical practice there have been cases of localization of discoid myelopathy in one of the lower segments. Due to a gradually increasing neurological deficit, muscle strength is reduced and tendon reflexes are altered. Ischemic areas are created and nerve cells die (spinal cord infarction). This is characterized by movement disorders, loss of sensation and eating disorders.
Diagnostic measures
At the first visit, the doctor listens to the patient's complaints, examines him, assesses the level of sensitivity, checks tendon reflexes, studies the medical history and the history of spinal injuries. Its diagnosis is confirmed by laboratory and organic studies:
- x-ray in two views, according to indications - targeted image of a specific part.
- magnetic resonance imaging?
- evoked potentials.
- electroneurography;
- electromyography?
- general clinical blood and urine tests.
To identify the cause of specific symptoms and exclude physical diseases with similar clinical manifestations, electrocardiography, ultrasound of cardiac structures, and electroencephalography may be prescribed.
Methods of treatment of thoracic osteochondrosis
The treatment is comprehensive, aimed at eliminating the symptoms and preventing the spread of the pathological process to other parts of the spine. In the acute stage, unbearable burning pain is eliminated by injecting drugs, including directly into the affected area. The use of glucocorticosteroids in combination with anesthetics (drug blocks) is usually applied. In other cases, drug treatment consists of taking tablets, capsules, rubbing in ointments and balms. The use of drugs from the following groups has proven effective:
- muscle relaxants to relieve muscle spasms.
- non-steroidal anti-inflammatory drugs with a strong analgesic effect.
- antispasmodics for pinched nerves.
- means to improve blood circulation.
- preparations with vitamin B6, which improve the transmission of nerve impulses and activate regeneration.
If a root syndrome has been created and other complications have arisen, then the person constantly lives in fear of experiencing excruciating pain again, and this can cause mental disorders. Prescribing sedatives and antidepressants can prevent such developments. In addition to drugs, the following methods are used in the treatment of osteochondrosis of the thoracic spine:
- therapeutic massage, including vacuum and acupuncture;
- physiotherapeutic procedures - electrophoresis/ultraphonophoresis, magnetic therapy, pulsed currents, UHF therapy, applications with ozokerite or paraffin, acupuncture, irudotherapy.
- Physiotherapy and gymnastics.
- spinal traction.
In cases of significant damage to the vertebral discs and myelopathy, surgical treatment is always prescribed immediately. A herniated disc is removed, a microdiscectomy is performed, a puncture or laser disc reconstruction is used, an implant is placed, or the spinal segment is stabilized.
Prevention of thoracic osteochondrosis
The main goal of primary prevention of thoracic osteochondrosis is to eliminate the factors that can cause thinning and bursting of the intervertebral disc. What doctors recommend:
- avoid excessive stress on the back.
- timely treat all diseases - infectious, endocrine, inflammatory.
- seek immediate medical attention for back injuries, even those that seem minor at first glance.
- stop alcohol and smoking or at least limit them.
- refresh your diet with oily fish, fresh vegetables, fruits and dairy products.
- avoid hypothermia.
- Do physical therapy for at least 15 minutes every day.
Such preventive measures are effective for already diagnosed diseases of the thoracic, cervical or lumbar spine. With their help, it will be possible to avoid exacerbations and the progression of the degenerative-dystrophic process.
If you have signs of osteochondrosis of the thoracic spine and want to get rid of it, contact the clinic for full, competent treatment.
Question answer
What is the difference between intercostal neuralgia and thoracic osteochondrosis?
In fact, intercostal neuralgia is a lesion of the intercostal nerves, which can complicate the course of osteochondrosis. There are two main differences between these pathological processes. Neuralgia is characterized by paroxysmal shooting or burning pain, which intensifies even with inhalation. Thoracic osteochondrosis without involvement of sensitive nerve endings is manifested by a dull, distant pain.
And the second difference is prediction. After eliminating the cause of intercostal neuralgia, it disappears without a trace. Osteochondrosis responds well to treatment only in the early stages of development.