Diagnosis and treatment of osteochondrosis of the thoracic spine

Thoracic osteochondrosis is a common degenerative disease. There are specific symptoms of thoracic osteochondrosis, which indicate the onset of pathology. In the initial stages, the discomfort does not bother the patient very much, so he is in no hurry to seek help from a specialist. Over time, the symptoms intensify, forcing the patient to go to the doctor, where a neglected pathology is found. You should find out by what early signs osteochondrosis is determined and which methods of treatment are most effective.

What is thoracic osteochondrosis and how it manifests itself

Osteochondrosis of the thoracic region is characterized by the occurrence of destructive-dystrophic processes in the central section of the crest. The destruction is located between the eighth and nineteenth vertebrae. To find out which vertebra is affected, it is necessary to conduct accurate diagnostic studies. Osteochondrosis of the thoracic region is often accompanied by formidable complications, including prolapse or hernia. Without complications, the disease is rare, since the destruction of cartilage tissue inevitably leads to the destruction of the entire vertebral frame.

When a patient develops circulatory disturbance or age-related joint wear, the fibrous ring located in the intervertebral disc cavity begins to collapse, losing its normal structure. Since the destruction is slow, microfractures appear in the initial stages, through which the nucleus pulposus filters.

As the internal component comes out, the fibrous ring begins to weaken, which leads to gradual stretching and rupture. When the nucleus pulposus protrudes, an intervertebral hernia occurs, which is the most common complication of osteochondrosis. The pathology involves damage to the cartilage tissue, which causes significant discomfort. Severe back pain is also associated with neurological syndromes that develop from pinching or irritation of the nerve roots.

Symptoms of breast osteochondrosis

At the initial stage, the patient does not feel discomfort, therefore, at this stage, the disease can only be detected by chance. The disease has many symptoms that can be masked by other pathologies.

Symptoms of thoracic osteochondrosis can be felt by the following manifestations:

1. Breathing is difficult. Problems arise, manifested by shortness of breath and a feeling of shortness of breath. This indicates damage to the thoracic vertebrae and spinal cord.
2. The main symptom is pain in the chest area. There is also a pressing sensation in the heart, which is rather reminiscent of an ischemic attack.
3. Discomfort occurs when the back bends. As the disease progresses, the pain in this position increases.
4. Against the background of the deterioration of blood circulation, there is a feeling of cold in the lower or upper limbs.
5. Chest pain against the background of emerging intervertebral hernias. Discomfort is often felt most strongly on the left or right side of the affected area.
6. Throat discomfort and difficulty swallowing. If there is irritation of the nerve endings in the upper thoracic region, a cough appears.
7. Women may experience chest pains that are not related to cyclical changes or hormonal imbalances.
8. Tingling or burning sensation appears in the area of the legs and feet.
9. Hair and nails become brittle, dull.
10. Shingles occurs less frequently.
11. Back and chest pain occur simultaneously.
12. Less commonly, there is discomfort in the stomach, liver, or pancreas.
13. The onset of stiff pain in the ribs, which indicates intercostal neuralgia.
14. There are signs of chondrosis and chest compression - a similar pathology.
15. There are problems in the work of the gastrointestinal tract. Feels nauseous, heaviness in the stomach.
16. In men, some libido can decrease. Problems arise in the genitourinary sphere.
17. When standing or sitting for a long time, severe discomfort occurs.
18. There is a severe headache accompanied by dizziness. Migraines with aura may appear.
19. The patient often develops intercostal neuralgia.
20. The pain can radiate to the neck or lower back.

If you find aggregate thoracic osteochondrosis and its signs or some of them, you need to urgently consult a therapist, neurologist, orthopedist. In addition, such symptoms should be alerted in the absence of problems with the gastrointestinal tract, cardiovascular system and lungs.

There are also acute and subacute symptoms. If, with an exacerbation of osteochondrosis of the thoracic region, the patient feels severe pain that deprives the patient of working capacity and can only observe bed rest, then the subacute course is slow and does not significantly limit the motor activity of the patient.

A clear sign of a slow injury: there is no sharp pain. Symptoms in the subacute stage are canceled. No discomfort with basic body movements, including inhaling, sneezing or turning. A person does not suffer from pain in a dream, so the process of falling asleep is facilitated.

In order for the subacute course of the disease not to worsen and go into remission, it is necessary to observe important rules:

1. It is forbidden to lift weights.
2. You cannot bend sharply.
3. It is forbidden to sit or stand for a long time. A person often unconsciously in this state assumes a posture that is harmful to the spine, so there is an excessive load on the ridge, which entails another exacerbation.
4. Avoid hypothermia. It has been proved that non-observance of a comfortable temperature regime for the body turns into an exacerbation of the inflammatory process. Moisture is also bad for the joints.

The duration of the subacute course is individual. If you follow the medical recommendations, the patient will completely eliminate the discomfort within 2-3 weeks. If conservative treatment and rest do not help and the patient begins to suffer from nausea, dizziness and weakness, it is urgent to consult a specialist. Such symptoms indicate re-exacerbation.

Degrees of development of osteochondrosis of the thoracic region

There are 4 clinical stages of the disease, during which the patient develops signs of pathology:

1. In the initial stage, there are no clinical symptoms. The first stage occurs against the background of the appearance of destructive processes in cartilage and bone tissue. Furthermore, in the first stage, there is no rupture or stretching of the fibrous ring, so there are no hernias either. They can detect the initial protrusion and signs of cartilage degeneration.
2. The second stage presents with minor pain or discomfort. An attentive patient seeks a doctor, then osteochondrosis of the thoracic region is readily detected. People who do not want to visit a specialist can still endure the second stage, using the available remedies, but self-medication will not be enough for a long time. The most common neurological symptoms may appear at this stage, including headache, burning in the interscapular area, neck pain, and sudden changes in blood pressure. Also at this stage, there is an increase in degenerative destruction of the spine - the fibrous ring protrudes, which leads to the appearance of an intervertebral hernia of the thoracic region.
3. The third stage is already difficult for the patient. Persistent neurological syndromes develop, including constant radiating pain in the shoulder blades, arms, collarbone, and lower back. The patient may show somatic and autonomic disorders, indicating a disturbance in the functioning of the nervous system. The patient is often tormented by nausea, incessant headaches, dizziness, back pain. Cardiac, gastroenterologist or pulmonary masked signs of the disease may also appear. At this stage, there is an active demineralization of bone and cartilage tissue. There is a tendency to prejudice.
4. The last stage is the fourth. Against the background of osteochondrosis and hernia, irreversible consequences arise: the mobility of the intervertebral discs is completely lost, and the cartilage tissue in the place of a long course of inflammation is replaced by osteophytes. To remove them, an operation is required.

In order not to bring the body into a state similar to stage 3 or 4, it is better to visit a doctor at the slightest sign. The sooner the disease is detected and therapy is started, the faster the patient will return to normal and learn to live with osteochondrosis. The pathological destructive process cannot be completely stopped, but it can be slowed down by leading a healthy lifestyle, using drugs and performing daily gymnastics. The later the patient turns to the doctor, the more difficult it is to stop the severe pain syndrome associated with the degeneration of cartilage tissue.

Risk factors and causes of the disease

There is no exact reason that causes destructive changes in the spine. An important role in the onset of pathology is attributed to a hereditary factor. People who suffer from physical inactivity have been shown to be more likely to have ridge problems than those who exercise regularly. Also, excessive physical activity can result in the destruction of cartilage at an early age.

Thinning and destruction of the intervertebral discs are closely related to spinal overload. If the muscles are not strong enough and the back is subjected to regular overload, the destruction of the cartilage tissue occurs.

What reasons can cause osteochondrosis:

1. Obesity. When you are overweight, there is a lot of weight pressure on the spine. As a result, premature destruction of bone tissue occurs.
2. The presence of an abnormality in the structure of the bones and cartilage. Such problems are also posed during the period of intrauterine development.
3. Congenital asymmetry of intra-articular spaces in the intervertebral joints of the anomaly type of tropism, which contributes to the occurrence of a degenerative-dystrophic process in the spine.
4. The presence of muscle spasm, spondylosis, chronically persistent trigger points and vascular disorders in the thoracic region. These pathologies also contribute to the appearance of osteochondrosis of the thoracic region.
5. Prolonged exposure to vibrations on the spine in a sitting position. An example of a job is a minibus or a bus driver.
6. Frequent physical exertion associated with heavy lifting. Examples are work as a loader or professional sports activities.
7. Smoking and alcohol abuse. People with unhealthy lifestyles are more likely to have a lack of minerals in their bodies and poor circulation, leading to back problems.
8. Sedentary lifestyle. With insufficient physical activity, accelerated leaching of calcium occurs, which is associated with poor metabolic processes. As a result, the bones become brittle. In addition, muscle tissue atrophies, as a result of which the load on the spine increases significantly. The result is pain, frequent discomfort with minimal physical exertion.

Due to the intervertebral discs, sufficient mobility of the ridge is provided. The intervertebral discs play a cushioning role. With the development of osteochondrosis, an accelerated process of demineralization occurs, the vital moisture of the joints is lost. This leads to discomfort, reduced mobility of the spine.

Risk factors for breast osteochondrosis include:

1. Old age. In older people, natural degeneration occurs, therefore, after 40 years, the disease is detected more often.
2. Female. In girls there are periods that contribute to the active leaching of calcium from the bones: pregnancy and menopause. Without adequate drug support, spinal diseases are likely to occur.
3. The presence of hormonal disorders, endocrinological diseases. If the patient has diabetes mellitus or uncompensated hypothyroidism, intervertebral disc degeneration can occur at an early age.
4. Prolonged immobilization. If the patient is sick and has to lie down for a long time, atrophic processes occur in the muscles, which cause back pain.
5. Previous back injuries. When the ligaments and tendons are stretched, the risk of osteochondrosis in the thoracic region increases.
6. The presence of scoliosis. Poor posture in the future causes severe spinal problems, including osteochondrosis and hernia.

Thoracic osteochondrosis diagnostics

If the patient suspects back problems, a therapist should be consulted. The doctor conducts a general examination of the patient, asks about complaints, measures blood pressure. If a neurological problem is suspected, the patient is referred to a narrow specialist: a traumatologist, a neurologist or an orthopedist.

At the appointment with a specialized specialist, they also ask for complaints, conduct an initial diagnosis of the patient. Based on a visual examination, a number of diagnostic measures are prescribed, including:

1. X-ray. With the help of an x-ray, you can assess the condition of the skeletal system in general terms. If the patient has a hernia or osteochondrosis, hints of pathology may be noted: the distance between the intervertebral discs will be reduced, and sometimes darkening will be noted at the site of the alleged hernia. If the results of the image do not satisfy the specialist, then you need to continue looking for the cause of the pain and discomfort.
2. CT or MRI. The most accurate diagnostic methods that allow you to accurately examine the state of the focus of inflammation in the image. A more detailed picture can be seen on MRI, but if there are contraindications (presence of pacemakers or prostheses in the joints), computed tomography is prescribed. CT is an improved X-ray that allows you to see the bone, tendon and ligament in detail. The image renders the image in the form of a three-dimensional image, so the details of the damage are clearly visible.
3. Biochemical and general blood test. These analyzes are necessary to assess the patient's health. If an increase in leukocytes, ESR, is detected, then this indicates an active inflammatory process in the body. With active destruction of bone tissue, reduced levels of calcium and a deficiency of cholecalciferol (vitamin D3) are found in the blood.
4. Spinal scan. The research method reveals the active destruction of bone tissue. Weak bone tissue is highly susceptible to fragility. The method will reveal the tendency and signs of degeneration.

To diagnose the disease, it is necessary to turn to an experienced specialist. A complete clinical picture is required for the final diagnosis, taking into account different laboratory research methods.

Thoracic osteochondrosis of the spine requires differentiation along with the following pathologies:

1. Dyshormonal spondylopathy.
2. Disorders of the urinary tract, including urolithiasis, cystitis or pyelonephritis.
3. Diseases of the cardiovascular system, excluding sinus arrhythmia, tachycardia and angina pectoris.
4. Diseases of the gastrointestinal tract, including chronic pancreatitis, gastric and duodenal ulcers, irritable bowel syndrome.
5. Previous injuries, fractures.
6. Chest tumors, including a malignant course.
7. Rheumatoid arthritis (determined by a blood test for C-reactive protein, rheumatic test and ESR).
8. Spinal osteomyelitis.
9. Acute inflammatory process.
10. Ankylosing spondylitis.
11. Spondylolisthesis.

Treatment of osteochondrosis of the thoracic spine

An integrated approach to therapy is required to slow the progression of the disease. In the initial stages, only conservative therapy is shown, consisting in the use of drugs and physiotherapeutic methods of treatment. In advanced cases, when the patient has large hernias and a pronounced degree of bone degeneration, an operation is prescribed. Do not self-medicate at home. Folk remedies do not eliminate osteochondrosis of the thoracic spine.

In which cases is surgery performed?

Initiated osteochondrosis of the thoracic region adversely affects the patient's quality of life. If the patient has constant discomfort that interferes with normal life, taking into account the lack of effect of drug treatment, a surgical solution to the problem can be offered.

Absolute indications for surgery include:

1. Lack of sensation in the bladder and intestines.
2. If the sensitivity in the legs disappears and the patient loses the ability to move independently.
3. Paralysis due to severe hernia overgrowth.

In other cases, the patient makes the decision to remove the hernial formation independently. If the disease really brings severe distress, and the patient's condition does not improve against the background of conservative treatment, doctors recommend surgery.

Drug treatment of osteochondrosis of the thoracic spine

During the period of exacerbation, the attending physician prescribes various drugs necessary for use in order to relieve the inflammatory process. The acute period is characterized by severe pain that can only be relieved with medication. If enough medication is taken, the patient gets better. Only an experienced specialist can prescribe drugs, self-medication is unacceptable.

Osteochondrosis of the thoracic spine is treated with the following drugs:

1. Non-steroidal anti-inflammatory drugs, pain relievers or analgesics. These medicines are designed to quickly relieve back pain associated with an active inflammatory process. The effect of taking pills or injections is felt the next day. Taking any drug from the NSAID group is accompanied by side effects with prolonged use, therefore, experts recommend limiting the use of drugs to the minimum period, no more than 1-2 weeks. Pain relievers are more harmful to the gastric mucosa, causing gastropathy and inflammation. At-risk patients are given certain drugs designed to protect the gastrointestinal mucosa. Examples are proton pump inhibitors, histamine H2 receptor blockers, antacids. People with ulcers and gastritis are better off avoiding the use of NSAIDs or taking modern analogues with a selective effect.
2. Muscle relaxants. These drugs are very effective in treating muscle spasticity. Relieves pain associated with muscle tension. They act on trigger points located in pinched muscle tissue. The more a person overloads himself, the higher their number. Muscle relaxants well remove tension in the muscles and thus show an analgesic effect. It is necessary to take drugs in one course, the average duration of therapy is at least 2-4 weeks.
3. Vitamins of group B. Assign B1, B6, B12 in the form of injections with a combined composition. In large doses, these substances have an analgesic effect and have a positive effect on the nervous system. Neurotrophic drugs are effective in treating pain associated with pinched nerve roots. With the help of nutrition, it is impossible to replenish the norm of these substances necessary to achieve a therapeutic effect, therefore they are prescribed in the form of medicines. The average duration of a course of injections is 2-3 weeks. Then, if necessary, they switch to tablets.
4. Anti-inflammatory ointments, gels. If the pain is tolerable and systemic forms of NSAIDs are contraindicated, external drugs are prescribed. The advantage of external remedies is that they do not cause side effects. In rare cases, skin allergies may appear, but the ointment will not cause gastrointestinal or laboratory blood deterioration. Another advantage of outdoor products is the possibility of long-term use. You can rub the gels for up to 4 weeks, after which they take a break. The scheme and duration of therapy are determined by the attending physician.
5. Onroprotectors. These are complex substances used to nourish the cartilage tissue of the joints. It is necessary to use medicines for a long course, at least six months, after which they take a 2-3 month break and the course of therapy is repeated. Within 2-3 months, injectable release forms are used, as they are better absorbed. Then they switch to supportive treatment, including the use of tablets. It is important to understand that drugs do not stop the destruction of cartilage tissue. They only create additional nourishment, which slows down the degenerative processes that occur in the bones and joints.
6. Complex preparations of calcium and vitamin D3. It has been shown that residents of northern latitudes do not get enough vitamin D3, because solar activity is low all year round in this region. To eliminate hypovitaminosis, it is necessary to take cholecalciferol supplements in winter and autumn in courses while solar activity is minimal. Without this vitamin, the assimilation of calcium and other minerals is impossible. Due to a long calcium deficiency, bone thinning occurs over time, so a person suffers from osteochondrosis and other complications. Calcium and D3 are better absorbed in combination, so complex preparations are prescribed. The dose and course of administration should be prescribed by the attending physician.

In addition to treatment, homeopathy, antispasmodics and complex multivitamins can be prescribed.

Conservative therapy for breast osteochondrosis

During the recovery period, the patient should pay sufficient attention to rehabilitation. The more carefully the patient maintains health, the less frequent the attacks of the disease will be.

The most effective conservative treatments include:

1. Physical therapy. With the help of exercises, the patient learns to keep his back straight, strengthens the muscle corset. Physiotherapy can be performed at any age, several times a week. The complex is selected individually, taking into account the anatomical features of the patient. Start running gradually, initially spending no more than 5 minutes a day. As physical qualities improve, the patient learns to do more difficult exercises over a longer period of time.
2. Support corset. Anatomical devices serve to support weakened muscles, if there are contraindications to their strengthening. The patient chooses a bandage depending on the height and type of appointment. The attending physician must select the appropriate model. The duration and the model of wearing are assigned individually. You cannot wear a corset all day, otherwise the back muscles will become even weaker.
3. Massage. In medical practice, massage is one of the most popular and at the same time effective methods of conservative treatment, in the presence of osteochondrosis of the thoracic region in a patient. During the recovery period, the muscles need additional support. It is useful when blood flow improves temporarily and excessively extended muscles are unblocked using the right technique. It is necessary to attend specialized sessions several times a year in the courses.
4. Physiotherapy. Physiotherapeutic procedures are widespread in trauma, orthopedic and neurological practice. With the help of procedures, local blood flow is improved, systemic drugs are used externally, and the apparatus acts on damaged tissues. As a result, the muscles warm up and the chronic inflammatory process is eliminated in the affected area. Examples of medical procedures: magnetotherapy, shock wave therapy, electrophoresis.

Less commonly, manual therapy and acupuncture are prescribed.

Osteochondrosis of the thoracic region is a serious disease if started. To prevent the disease from proceeding acutely, it is necessary to comprehensively treat the pathology.