Thoracic osteochondrosis is rare in clinical practice. Previously, it was mainly diagnosed in the elderly, but is now often detected in patients under the age of 35. More often, the pathology develops in women than in men. This degenerative-dystrophic disease is difficult to diagnose, as severe symptoms appear only in the later stages.
Furthermore, the symptoms of this disorder can be easily confused with signs of reduced lung and heart function. This disease cannot be left without treatment, as it can cause curvature of the spine, the development of persistent pain syndrome and other complications that can adversely affect the quality of human life.
What is thoracic osteochondrosis?
In the international classification of diseases, this pathological condition has an ICD-10 code - M42. Thoracic osteochondrosis is much less common than cervical or sacral osteochondrosis. This is not a coincidence. Due to the presence of a rigid rib cage in this part of the body, this part of the spine is physiologically less mobile.
The thoracic region contains more vertebrae than the cervical and lumbar, but in this part of the spine the discs are thinner. These anatomical features contribute to a decrease in the mobility of this part of the spine, so it is less prone to injury.
However, when exposed to a number of adverse factors, osteochondrosis can develop. At first, there are signs of damage to a disc, but in the future, other elements may be involved in the pathological process. As the disease progresses, the bony elements are damaged, as are the ligaments and muscles that support the spine.
Degenerative-dystrophic processes in the thoracic region grow more slowly. It often takes years for the fibrous rings of damaged discs to be destroyed so much that protrusions and hernias appear.
Severe clinical manifestations occur after a critical decrease in disc height and root entrapment. This can lead not only to dorsago, that is, short-term pain attacks in the thoracic region, but also to a violation of the innervation of internal organs. It is much more difficult to treat the pinched nerve roots that extend into this area.
Reasons for development
In most cases, spinal problems do not come on suddenly. A disease such as osteochondrosis is no exception in this regard. This pathology, which affects the intervertebral discs, is the result of long-term degenerative-dystrophic processes. In most cases, it is impossible to determine exactly what triggered the development of the disorder. Factors that can provoke the appearance of osteochondrosis of the thoracic spine include:
- congenital or acquired deformities of the spine;
- overweight;
- overload of the spine during pregnancy;
- infectious diseases;
- hypothermia;
- metabolic disorders;
- hormonal disorders;
- chronic stress;
- bad habits;
- connective tissue diseases;
- dysplastic changes;
- posture disorders;
- unhealthy diet;
- injuries.
Training negatively affects the condition of the spine. People who lead a sedentary lifestyle are more likely to suffer from thoracic osteochondrosis. Furthermore, age-related changes and a slowing of metabolism, which are observed in patients over the age of 55, contribute to the appearance of these disorders.
The genetic predisposition can be a factor that can cause the development of pathologies. The genes that create the conditions for the appearance of breast osteochondrosis have not yet been identified, but in people with a family history of cases of this disease, it is more often diagnosed.
Symptoms and signs
The clinic of this pathological condition depends on the stage of neglect of the process, the level at which the intervertebral disc injury occurred and the age of the patient. In the early stages of development, there are no specific signs, but general symptoms can occur periodically. Often, in the early stages of development, the disease manifests itself only with the onset of cold weather or after physical overload. The initial manifestations of the development of osteochondrosis of the thoracic region include:
- fast fatigue;
- back pain and pressure;
- muscle spasms;
- cold extremities.
As the disease progresses, the patient's condition worsens. Aching chest pains appear. Especially often they occur against the background of a prolonged stay in one position or with sudden movements. In addition, severe pain syndrome may appear during weight lifting. Turning the torso can cause increased pain. The presence of osteochondrosis is also indicated by the occurrence of dull pain in the area of the shoulder blades.
Often, osteochondrosis of the thoracic region is accompanied by the appearance of an abnormal curve. In severe cases, the patient can develop a hump. Also, this disease can provoke the appearance of pain during deep breaths and exhalation.
When the nerve roots are pinched, there is often a feeling of numbness in the upper limbs and the skin of the upper body. Due to the violation of innervation and blood circulation, a sensation of goosebumps appears on the skin. The feet and hands are always cold. Limb sensitivity may be present. In advanced cases, this disease can lead to the appearance of symptoms of damage to other organs as a result of a violation of their innervation. In the latter stages of the process it is possible that:
- intercostal neuralgia;
- stool disorders;
- swelling;
- heartburn and nausea;
- itching and burning in the feet;
- violations of the reproductive system;
- asthma attacks.
As the disease progresses, a person's ability to work decreases. Physical activity is minimized. In the future, this disorder can create prerequisites for the development of serious complications. The risk of pathological fractures increases. The curvature of the spine leads to compression of the organs located in the chest.
With an unfavorable course, the disease proceeds with the violation of the heart muscle and a decrease in lung volume. Most often, such serious complications are accompanied by diffuse osteochondrosis, in which several intervertebral discs are affected at the same time.
Degrees of thoracic osteochondrosis
The existing classification divides the development process of this pathological condition into 4 degrees. Each of them is characterized by the presence of a number of changes in the structure of the intervertebral discs, vertebrae and other elements that form this part of the spine.
First degree
In the first degree of pathology, there are no pronounced clinical manifestations, but with a complete diagnosis, specific changes in the structure of the intervertebral discs can already be detected. The fibrous ring, which receives less moisture and nutrients, gradually loses its elasticity. Often microcracks are formed on the tissues, in which the pulpus nucleus is squeezed. Displacement of the discs in the spinal canal is possible. Protrusions are formed. There are no signs of rupture of the fibrous ring.
Second degree
With the passage of the disease to the second degree, the first clinical manifestations are observed. Patients occasionally experience pain and other neurological signs. When carrying out specific diagnostics, it is possible to detect signs of a decrease in the elasticity of the tissues that form the fibrous annulus. The cartilage becomes much thinner, which leads to an increased risk of hernias. There is a decrease in the height of the intervertebral discs, as a result of which the structures of the spinal column acquire abnormal mobility.
Third degree
In the third stage, the changes in the disc structure become so pronounced that the first signs of kyphosis or scoliosis appear. Often at this stage of the process, the damaged fibrous ring breaks. This phenomenon is accompanied by the exit of the pulpus nucleus beyond the disc. A forming hernia, depending on the direction of the protrusion, can compress the nerve roots or the spinal cord. Severe pain and neurological disorders occur. The mobility of the spine increases, creating conditions for injuries and fractures.
Fourth degree
With the passage of the pathology to the fourth degree of development, the structure of the intervertebral discs is so disturbed that they cease to perform the function of amortization. The fibrous ring and the pulpy nucleus lose elasticity. These elements begin to ossify. Due to the violation of the amortization function of the discs, the vertebrae suffer, which bear too much load.
At the edges of the vertebrae adjacent to the damaged disc, osteophytes, i. e. bone growths, begin to grow rapidly. The surrounding ligaments are involved in the pathological process. They lose elasticity and no longer adequately support the spine. Also, at this stage of the development of the pathological process, the work of the muscular apparatus is disrupted.
Making a diagnosis
When signs of the development of this disorder appear, the patient needs a consultation with a neurologist and an orthopedic surgeon. First, the doctor performs an external examination and collects an anamnesis. The laboratory tests that are often prescribed to diagnose this disease include blood and urine tests. To obtain information on the presence of defects in the structure of the spine, X-rays are performed. This research reveals:
- lowering the disc height;
- jagged edges of elements;
- hernia;
- change of the vertebral bodies;
- forming osteophytes and so on.
To clarify the defects in the structure of the disc, a discography is assigned. This study makes it possible to identify the irregular contours of the nucleus pulposus, evaluate the degree of destruction of the disc and decrease the density of the tissues. CT and MRI are often done for better visualization. Considering that the clinical manifestations of thoracic osteochondrosis are similar to the symptoms of coronary artery disease, electrocardiography is often prescribed to differentiate these conditions.
Treatment options
This pathological condition requires complex treatment. First of all, patients are selected drugs that help eliminate symptomatic manifestations and improve nutrition of the intervertebral discs. Pharmacological treatment must be supplemented with physiotherapy and physical therapy. As a supplement, you can use some folk remedies. In addition, it is recommended to follow a specific diet.
Drugs
In case of severe pain syndrome, the patient is advised to stay in bed. This will reduce the intensity of the pain. To eliminate discomfort, analgesics and NSAIDs are often prescribed. If the pain syndrome comes on too intensely, blockages may be needed. Often, glucocorticosteroids are prescribed to eliminate pain in this disease.
Chondroprotectors are prescribed to improve nutrient and water saturation of the intervertebral discs. In some cases, antispasmodics and muscle relaxants are prescribed in short courses. These drugs help relieve muscle spasm. If necessary, diuretics are prescribed to eliminate soft tissue edema. To improve the condition of the nerve endings under compression, the patient needs vitamins of group B.
Physiotherapy and massage
Therapeutic exercise and massage are the most important components of osteochondrosis treatment, but they can be used only after drug suppression of symptoms. Properly selected exercises help improve lung ventilation and strengthen the muscular corset that supports the spine.
First of all, all the necessary exercises must be learned under the supervision of a physical therapy instructor. In the future, the patient can do exercises at home. People with this condition may be advised to take lessons in the pool.
Massage helps eliminate muscle hypertonicity and improves soft tissue nutrition. In order for the procedures not to cause harm, they must be carried out by a specialist. In most cases, a classic massage is performed, which involves subsequent rubbing, smoothing and pinching of the problem area. Acupressure and segmental massage can be of great benefit. These techniques involve impact on sore spots. They help improve blood circulation and lymphatic drainage. In most cases, it is enough for patients to perform the procedures 2-3 times a week.
Acupuncture
This method involves placing needles on areas of the patient's body. This method allows you to quickly get rid of muscle spasms and pain. Acupuncture procedures should be performed by a professional in this matter. If a specialist does this, the procedure will be almost painless. Acupuncture is contraindicated for people suffering from oncological diseases, mental disorders. It is not recommended to use this method of treatment of osteochondrosis in the presence of severe inflammatory processes.
Manual therapy
Manual therapy helps restore the correct anatomical position of the vertebrae. In addition, this method helps to reduce the intensity of pain and muscle spasms. This effect helps restore the ligament apparatus. Such procedures can slow down the development of this pathological condition. The duration of the manual therapy course is selected individually for the patient.
Post-isometric relaxation technique
Post-isometric relaxation procedures are a special technique that consists of tensioning all the muscles surrounding the spine and then relaxing them.
Such exercises should be performed under the supervision of a specialist who can assess the correctness of movement and the severity of muscle tension. This method allows you to quickly eliminate pain and restore normal muscle and ligament function.
Folk remedies
It is impossible to treat osteochondrosis only with folk remedies, since this approach can cause an aggravation of the course of the disease. It is preferable to use various herbal formulations and other natural ingredients in addition to traditional therapies. You should get a doctor's recommendation on whether to use this or that folk remedy before you start using it.
Celery root
Properly cooked celery root is believed to help saturate the cartilage tissue with nutrients and water. To prepare this product, you need to carefully grind 1 root and pour 1 liter of boiling water. You need to insist on the composition for at least 8 hours. After this time, it is necessary to filter the product and take 1 tsp. 3 times a day before meals.
Sunflower root
For the treatment of osteochondrosis of the cervical spine, a decoction of sunflower root is often used. To prepare this product, you will need about 1 glass of chopped vegetable ingredient, pour 3 liters of water. The mixture must be boiled for 3-5 minutes. After that, the agent must be cooled and taken in the form of tea for several days. To improve the taste of the drink, you can add honey. It is best to store the rest of the medicine in a thermos.
Home ointment
A simple homemade ointment can be used for rubbing with osteochondrosis. To prepare this product, it is necessary to dissolve about 150 g of pork fat in a water bath. After that, 2 tbsp. Should be inserted. L. natural wax.
The composition must be boiled for at least 20 minutes. After that, add 1 tablespoon to the heated mixture. L. fir oil. The product must be boiled for another 20 minutes. Last but not least, 2-3 minutes before removing the container from the heat, 1 tablespoon is introduced into the mixture. L. ammonia. The finished composition must be distributed in jars. Store the homemade ointment in the refrigerator.
Nutrition for thoracic osteochondrosis
Patients suffering from osteochondrosis of the thoracic region need a balanced diet. A sufficient amount of protein-rich foods should be included in the diet. It is recommended to regularly consume dishes containing a large amount of chondroitin, including fish aspic, jellied meat, and so on. It is imperative to introduce fermented milk products, vegetables and fruits into the diet. Dishes should be steamed or baked. Fatty and fried foods should be avoided. It is recommended to take food in small portions, but often. This will avoid overeating.
Aggravation: what to do?
In the acute period of the course of the disease, it is desirable to minimize the activity. If possible, you should avoid poses in which the pain syndrome increases. First aid for exacerbation of osteochondrosis involves the use of drugs that reduce the severity of edema, inflammation and pain. The patient is advised to rest in bed. It is recommended that you follow a moderate diet during this period. Only after the symptoms have been eliminated can physical therapy and physiotherapy begin.
Forecast
Now this disease can only be cured in the early stages of development. With late diagnosis, therapy is aimed at eliminating symptoms and improving spinal mobility. In some cases, surgical treatment is required. With an integrated approach to therapy, a person suffering from this pathology can lead a full-fledged lifestyle without experiencing pain and other neurological disorders.
Prevention
To prevent the development of this pathological condition, it is recommended to avoid sudden heavy lifting. You should always dress for the weather, avoiding hypothermia. In addition, to prevent osteochondrosis, one should fight hypodynamia and monitor posture. As part of the prevention of this pathology, it is recommended to eat correctly and carefully monitor your weight.