Thoracic osteochondrosis is rare in clinical practice. Previously, it was mainly diagnosed in the elderly, but now it is 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, since severe symptoms appear only in the later stages.
In addition, the symptoms of this disorder can be easily mistaken for signs of impaired lung and heart function. This disease cannot be left without treatment, as it can cause curvature of the spine, the development of a persistent pain syndrome and other complications that can negatively affect the quality of human life.
What is thoracic osteochondrosis?
In the International Classification of Diseases, this pathological condition has an ICD-10 - M42 code. Thoracic osteochondrosis is much less common than cervical or sacral osteochondrosis. It 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 lower back, 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, osteochondrosis can develop when exposed to a number of unwanted factors. 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, bone components are damaged, along with the ligaments and muscles that support the spine.
Degenerative-dystrophic processes in the thoracic region develop more slowly. It often takes years before the fibrous rings of damaged discs are so destroyed 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, to short-term attacks of pain in the thoracic region, but also to a violation of the innervation of internal organs. Pinched nerve roots extending into this area are much more difficult to treat.
Development reasons
In most cases, spine problems do not come on suddenly. A disease such as osteochondrosis is no exception in this regard. This pathology, affecting 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 cause osteochondrosis of the thoracic spine to develop include:
- congenital or acquired deformities of the spine;
- overweight;
- overload of the spine during pregnancy;
- infectious diseases;
- hypothermia;
- metabolic disorders;
- hormonal disturbances;
- chronic stress;
- bad habits;
- connective tissue diseases;
- dysplastic changes;
- postural disturbances;
- unhealthy diet;
- injuries.
Decontamination negatively affects the condition of the spine. People who lead a sedentary lifestyle are more likely to suffer from chest osteochondrosis. In addition, age-related changes and slower metabolism, seen in patients over 55, contribute to the onset of these disorders.
Genetic predisposition can be a factor that can cause the development of a pathology. The genes that create the conditions for the onset 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 injury to the intervertebral disc occurred and the age of the patient. In the early stages of development there are no specific signs, but general symptoms may periodically occur. Often, in the initial stages of development, the disease does not manifest itself until the onset of cold weather or after physical overload. The initial manifestations of the development of osteochondrosis of the thoracic region include:
- fatigue;
- stiffness and pressure in the back;
- muscle spasms;
- cold ends.
As the disease progresses, the patient's condition worsens. Painful chest pains appear. Especially often they occur against the background of a prolonged stay in one position or sudden movements. In addition, severe pain syndrome may appear when lifting weights. Turning the torso can increase pain. The presence of osteochondrosis is also indicated by the appearance of a dull pain in the shoulder blades.
Often, osteochondrosis of the thoracic region is accompanied by the appearance of an abnormal curvature. In severe cases, the patient may develop a lump. In addition, this disease can cause 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 feeling of goosebumps appears on the skin. The feet and hands are always cold. Sensory disturbances in the extremities 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 final stages of the process, it is possible that:
- intercostal neuralgia;
- stool disorders;
- bloating;
- heartburn and nausea;
- itching and burning in the feet;
- violations of the reproductive system;
- asthma attacks.
As the pathology progresses, a person's ability to work decreases. Physical activity is minimized. In the future, this disorder may create prerequisites for the development of serious complications. The risk of pathological fractures increases. The curvature of the spine causes compression of the organs located in the chest.
With an unfavorable course, the disease continues with damage to the heart muscle and a decrease in lung volume. Most often, these serious complications are accompanied by generalized osteochondrosis, in which several intervertebral discs are affected at once.
Degrees of thoracic osteochondrosis
The existing classification subdivides the development of this pathology 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
At the first degree of pathology there are no pronounced clinical manifestations, but specific changes in the structure of the intervertebral discs can already be revealed with a full diagnosis. The fibrous ring, which receives less moisture and nutrients, gradually loses its elasticity. Microcracks often form on the tissues, into which the nucleus pulposus is expelled. Displacement of the discs in the spinal canal is possible. Protuberances form. There is no sign of a ruptured fibrous ring.
Second degree
With the passage of the disease to the second degree, the first clinical manifestations are observed. Patients sometimes experience pain and other neurological signs. When making a specific diagnosis, signs of a decrease in the elasticity of the tissues that form the annulus fibrosus can be detected. The cartilage becomes very thin, which increases the risk of developing hernias. There is a decrease in the height of the intervertebral discs, due to which the structures of the spine acquire abnormal mobility.
Third degree
In the third stage, the changes in the structure of the discs become so pronounced that the first signs of the development of kyphosis or scoliosis appear. Often at this point in the process, the damaged fibrous ring ruptures. This phenomenon is accompanied by the exit of the nucleus pulposus beyond the disc. A developing 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, which creates conditions conducive to injuries and fractures.
Fourth degree
With the passage of pathology to the fourth degree of development, the structure of the intervertebral discs is so disturbed that they cease to perform the function of damping. The annulus fibrosus and the nucleus pulposus lose their elasticity. These elements begin to ossify. Due to a violation of the damping function of the discs, the vertebrae suffer, which bear too much load.
On the edges of the vertebrae adjacent to the damaged disc, osteophytes, that is, bony growths, begin to grow rapidly. The surrounding ligaments are involved in the pathological process. They lose their elasticity and cease to properly support the spine. In addition, at this stage of the development of the pathological process, the work of the muscular apparatus is disturbed.
Make a diagnosis
When signs of the development of this disorder appear, the patient needs a consultation with a neurologist and an orthopedic surgeon. First of all, the doctor conducts an external examination and collects a history. Laboratory tests that are often ordered to diagnose this disease include blood and urine tests. To get information about the presence of defects in the structure of the spine, an x-ray is taken. This research reveals:
- lowering the height of the disc;
- jagged edges of the elements; hernia
- ;
- change of vertebral bodies;
- forming osteophytes and so on.
To clarify the flaws in the structure of the disc, a discography is assigned. This study allows you to identify uneven contours of the nucleus pulposus, assess the degree of destruction of the disc and decrease tissue density. Computed tomography and MRI scans are often done for better visualization. Whereas the clinical manifestations of thoracic osteochondrosis are similar to the symptoms of coronary heart 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 to eliminate symptomatic manifestations and improve the nutrition of the intervertebral discs. Drug treatment should be supplemented with physiotherapy and exercise therapy. As a supplement, you can use 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 the discomfort, pain relievers and NSAIDs are often prescribed. If the pain syndrome manifests itself too intensely, blockages may be necessary. Often, glucocorticosteroids are prescribed to eliminate pain in this disease.
Chondroprotectors are prescribed to improve the nutrient and water saturation of the intervertebral discs. In some cases, antispasmodics and muscle relaxants are prescribed as a short course. These drugs help relieve muscle spasms. If necessary, diuretics are prescribed to remove soft tissue edema. To improve the condition of the nerve endings subjected to compression, the patient needs B vitamins.
Physiotherapy and massage
Physiotherapy and massage are the most important parts of the treatment for osteochondrosis, but they can only be used after the symptoms have been medically suppressed. Properly selected exercises help improve ventilation of the lungs and strengthen the muscle corset that supports the spine.
First of all, all the necessary exercises should be learned under the supervision of an exercise therapy instructor. In the future, the patient will be able to do home exercises. People with this disease may be invited to take swimming pool lessons.
massage helps to eliminate muscle hypertonicity and improve soft tissue nutrition. In order for the procedures not to cause damage, they should be carried out by a specialist. In most cases, a classic massage is performed, which consists of successively rubbing, smoothing and pinching the problem area. Acupressure and segmental massage can be very helpful. 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 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 eliminate muscle spasms and pain. Acupuncture procedures should be performed by a professional in this field. 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 treating 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 reduce the intensity of pain and muscle spasms. This effect helps to restore the ligamentous 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 involves tightening all the muscles around the spine and then relaxing them.
These 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 provoke a worsening of the course of the disease. It is best 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, 1 root must be carefully chopped and pour 1 liter of boiling water. You need to insist on the composition for at least 8 hours. After this time you need to strain the product and take 1 tbsp. 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 should be boiled for 3-5 minutes. After that, the agent should be cooled and taken in the form of tea for several days. To improve the taste of the drink, you can add honey to it. It is best to keep the rest of the medicine in a thermos.
Homemade ointment
A simple homemade ointment can be used to rub in osteochondrosis. To prepare this product, you need to melt about 150 g of pork fat in a water bath. After that, 2 tablespoons should go into it. l. natural wax.
The composition should be boiled for at least 20 minutes. After that, 1 tbsp should be added to the heated mixture. l. fir oil. The product should be boiled for another 20 minutes. Finally, 2-3 minutes before removing the container from the heat, 1 tablespoon is introduced into the mixture. l. ammonia. The finished composition should be distributed in jars. Store the homemade ointment in the refrigerator.
Nutrition for thoracic osteochondrosis
Patients with osteochondrosis of the thoracic region need a balanced diet. A sufficient amount of protein rich foods should be introduced into the diet. It is advisable to regularly consume dishes containing a large amount of chondroitin, including fish aspic, jellied meat, etc. It is imperative to introduce fermented dairy products, vegetables and fruits in the diet. Dishes should be steamed or baked. Fatty and fried foods should be avoided. It is advisable to take food in small portions, but often. This will prevent overeating.
Aggravation: what to do?
In the acute period of the course of the disease, it is desirable to reduce the activity to a minimum. If possible, you should avoid poses in which the pain syndrome intensifies. 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 advisable to follow a gentle diet during this period. Only after eliminating the symptoms can you start exercise therapy and physiotherapy.
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 necessary. With an integrated approach to therapy, a person suffering from this pathology can lead a full-fledged life without experiencing pain and other neurological disorders.
Prevention
To avoid the development of this pathological condition, it is recommended to avoid suddenly lifting heavy objects. You should always dress for the weather, avoiding hypothermia. In addition, to prevent osteochondrosis, it is necessary to fight against hypodynamia and monitor posture. As part of the prevention of this pathology, it is recommended to eat well and carefully monitor your weight.