Diagnosis and treatment of osteochondrosis of the thoracic spine

Thoracic osteochondrosis is a common degenerative disease. There are specific symptoms of thoracic osteochondrosis, indicating the onset of pathology. In the early stages, the discomfort does not bother the patient much, so there is no hurry to seek help from a specialist. Over time, the symptoms intensify, forcing the patient to go to the doctor, where there is a neglected pathology. 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 does it occur

Osteochondrosis of the thoracic region is characterized by the appearance of destructive-dystrophic processes in the middle part of the ridge. The destruction is between the 8th and 19th vertebrae. To find out which vertebra is affected, it is necessary to conduct precise diagnostic studies. Osteochondrosis of the thoracic region is often accompanied by serious 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 a circulatory disorder or age-related wear and tear on the joints, the fibrous ring in the intervertebral disc cavity begins to collapse, losing its normal structure. As the destruction is slow, microcracks appear at the beginning, through which the nucleus pulposus infiltrates.

As the internal component infiltrates, the fibrous ring begins to weaken, resulting in gradual stretching and breaking. When the nucleus pulposus protrudes, an intervertebral hernia occurs, which is the most common complication of osteochondrosis. Pathology involves damage to 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 any discomfort, therefore, at this stage the disease can be detected only by chance. The disease has many symptoms that can be disguised as other conditions.

Symptoms of thoracic osteochondrosis can be experienced 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 the spinal cord.
2. The main symptom is pain in the chest area. There is also a feeling of pressure in the heart, which is more like 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 coldness in the lower or upper extremities.
5. Pain in the chest against the background of emerging intervertebral hernias. Discomfort is often felt most strongly on the left or right side of the affected area.
6. Sore throat and difficulty swallowing. If there is irritation of the nerve endings in the upper part of the chest region, a cough appears.
7. Women may experience chest pain that is not related to cyclical changes or hormonal imbalances.
8. A tingling or burning sensation appears in the legs and feet.
9. Hair and nails become brittle, dull.
10. Shingles is less common.
11. Pain in the back and chest occurs at the same time.
12. Less commonly, there is discomfort in the stomach, liver or pancreas.
13. The appearance of stiff pain in the ribs, which indicates intercostal neuralgia.
14. There are signs of chest chondrosis and compression - a similar pathology.
15. There are problems in the work of the gastrointestinal tract. Sensation of nausea, heaviness in the stomach.
16. In men, some libido may drop. 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 may radiate to the neck or lower back.

If you find in the whole thoracic osteochondrosis and its signs or some of them, it is necessary 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 experiences severe pain, which deprives him of his ability to work, and he can only observe bed rest, the subacute course is slow and notnot significantly limit the motor activity of the patient.

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

In order for the subacute course of the disease not to worsen and go into remission, important rules must be observed:

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

The duration of the subacute course is individual. If you follow the medical recommendations, the patient will completely get rid of 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 a 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. At 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. At the first stage, there is also no rupture or stretching of the fibrous ring, so there are also no hernias. They can detect initial protrusion and signs of cartilage degeneration.
2. Stage two presents with minor pain or discomfort. An attentive patient seeks a doctor, therefore, osteochondrosis of the thoracic region is quickly detected. People who do not want to see a specialist can still endure the second stage, using the available remedies, but self-medication will not be enough for a long time. At this point, the most common neurological symptoms may appear, including headache, burns in the interscapular area, neck pain, and spikes 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 step 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 present with somatic and autonomic disorders, indicating a disturbance in the functioning of the nervous system. The patient is often tormented by nausea, incessant headache, dizziness, back pain. Disguised cardiac, gastroenterological or pulmonary signs of the disease may also appear. At this stage, there is active demineralization of bone and cartilage tissue. There is a tendency for injury.
4. The last step 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 long inflammation is replaced by osteophytes. To remove them, an operation is necessary.

In order not to lead the body to a state similar to stage 3 or 4, it is better to consult a doctor at the slightest sign. The sooner the disease is detected and treatment started, the sooner the patient will return to normal and learn to live with osteochondrosis. The process of pathological destruction cannot be completely stopped, but it can be slowed down by leading a healthy lifestyle, using drugs and doing 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 causing destructive changes in the spine. An important role in the appearance of pathology is attributed to a hereditary factor. It has been proven that people with physical inactivity are more likely to have problems with the ridge than those who exercise regularly. In addition, excessive physical activity can cause the destruction of cartilage at an early age.

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

What reasons can cause osteochondrosis:

1. Obesity. When you are overweight, there is a strong pressure of the weight on the spine. As a result, premature destruction of bone tissue occurs.
2. The presence of an abnormality in the structure of bones and cartilage. Such problems arise even during the period of intrauterine development.
3. Congenital asymmetry of intra-articular gaps in intervertebral joints of the tropism type of abnormality, contributing to the appearance of a degenerative-dystrophic process in the spine.
4. The presence of muscle spasms, 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 spinal vibration while seated. A working example is a minibus or 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 body and poor circulation, which leads to back problems.
8. Sedentary lifestyle. With insufficient physical activity, accelerated leaching of calcium occurs, associated with poor metabolic processes. As a result, the bones become brittle. In addition, muscle tissue atrophies, which significantly increases the load on the spine. 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 act as a shock absorber. With the development of osteochondrosis, an accelerated process of demineralization occurs, vital moisture in the joints is lost. This leads to discomfort, a decrease in the mobility of the spine.

Risk factors for breast osteochondrosis include:

1. Advanced 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 pharmacological support, diseases of the spine are likely to occur.
3. The presence of hormonal disorders, endocrinological diseases. If the patient suffers from diabetes mellitus or uncompensated hypothyroidism, degeneration of the intervertebral discs may 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 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 serious spine problems, including osteochondrosis and hernia.

Diagnosis of thoracic osteochondrosis

If the patient suspects back problems, it is necessary to consult a therapist. 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 restricted specialist - a traumatologist, a neurologist or an orthopedist.

During the appointment with a specialized specialist, they also ask about complaints, carry out an initial diagnosis of the patient. Based on a visual examination, a set of diagnostic measures is 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, signs of pathology can be noticed - the distance between the intervertebral discs will be reduced, and darkening is sometimes noticed at the site of the suspected hernia. If the results of the picture are not suitable for the specialist, you should continue to find 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 picture. A more detailed picture can be seen on the MRI, but if there are contraindications (the presence of a pacemaker or prostheses in the joints), a CT scan is prescribed. A CT scan is an enhanced x-ray that allows you to see bone, tendon, and ligament in detail. The image renders the image as a three-dimensional image, so that the details of the damage are clearly visible.
3. Biochemical and general blood test. These tests are necessary to assess the patient's state of health. If an increase in leukocytes, ESR is found, this indicates an active inflammatory process in the body. With the active destruction of bone tissue, reduced levels of calcium and cholecalciferol (vitamin D3) deficiency are found in the blood.
4. Spine scintigraphy. The research method reveals active destruction of bone tissue. Weak bone tissue is very susceptible to brittleness. The method will reveal the tendency and signs of degeneration.

To diagnose the disease, you need to turn to an experienced specialist. For the final diagnosis, a complete clinical picture is required, taking into account several laboratory research methods.

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

1. Dyshormonal spondylopathy.
2. Pathologies of the urinary system, in particular 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. Tumors in the chest, including a malignant course.
7. Rheumatoid arthritis (determined by blood test for C-reactive protein, rheumatic test, and SV).
8. Osteomyelitis of the spine.
9. Acute inflammatory process.
10. Ankylosing spondylitis.
11. Spondylolisthesis.

Treatment of osteochondrosis of the thoracic spine

To slow the progression of the disease, an integrated therapeutic approach is needed. In the initial stages, only conservative therapy is indicated, consisting in the use of drugs and physiotherapy treatment methods. 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?

The initiated osteochondrosis of the thoracic region negatively affects the quality of life of the patient. If the patient experiences constant discomfort that interferes with normal life, given the lack of effect of drug therapy, a surgical solution to the problem may be offered.

Absolute indications for surgery include:

1. Lack of tenderness in the bladder and bowels.
2. If the tenderness in the legs disappears, and the patient loses the ability to move independently.
3. Paralysis due to strong excessive growth of the hernia.

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

Drug treatment for osteochondrosis of the thoracic spine

During the period of exacerbation, the attending physician prescribes various drugs that are necessary for use 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. Nonsteroidal anti-inflammatory drugs, analgesics or analgesics. These drugs 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 during prolonged use. Therefore, experts recommend limiting the use of drugs to the minimum period, not more than 1-2 weeks. Pain relievers are the most harmful to the stomach lining, causing gastropathy and inflammation. Patients at risk are given certain drugs designed to protect the gastrointestinal lining. Examples are proton pump inhibitors, histamine H2 receptor blockers, antacids. It is better for people with ulcers and gastritis to avoid the use of NSAIDs or to take modern analogues with a selective effect.
2. Muscle relaxants. These drugs are very effective in treating muscle spasticity. Relieve pain related to muscle tension. They act on trigger points located in the pinched muscle tissue. The more a person overwork, the higher his number. Muscle relaxants relieve tension in the muscles well and therefore have an analgesic effect. You need to take medication during a course, the average duration of treatment 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 for achieving a therapeutic effect, therefore, they are prescribed in the form of drugs. The average duration of a cycle 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 deterioration of gastrointestinal or laboratory blood. Another advantage of outdoor products is the possibility of long-term use. You can apply the gels for up to 4 weeks, after which they take a break. The scheme and duration of treatment is determined by the attending physician.
5. Honroprotectors. These are complex substances used to nourish the cartilage tissue in the joints. It is necessary to use drugs for a long time, at least six months, after which they take a break of 2-3 months and the treatment 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 nutrition, which slows down the degenerative processes occurring in the bones and joints.
6. Complex preparations of calcium and vitamin D3. It has been proven that people in northern latitudes do not consume enough vitamin D3 because solar activity is low all year round in this region. To get rid of hypovitaminosis, it is necessary to take cholecalciferol supplements in winter and in autumn as a cure when solar activity is minimal. Without this vitamin, the assimilation of calcium and other minerals is impossible. Due to a long calcium deficiency, thinning of bone tissue occurs over time, so a person suffers from osteochondrosis and other complications. Calcium and D3 are better absorbed in combination, which is why complex preparations are prescribed. The dose and method of administration should be prescribed by the attending physician.

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

Conservative treatment of breast osteochondrosis

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

The most effective conservative treatments include:

1. Exercise therapy. With the help of exercises, the patient learns to keep the back straight, strengthens the muscle corset. Physiotherapy can be done 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 per 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 dressing depending on the size and type of appointment. The attending physician should select the appropriate model. The duration and mode of wearing are assigned individually. You cannot wear a corset 24 hours a day, otherwise your back muscles will become even weaker.
3. Massage. In medical practice, massage is one of the most popular and effective methods of conservative treatment in the presence of osteochondrosis of the thoracic region in a patient. During the recovery period, the muscles need extra support. It is useful when blood flow temporarily improves and over-stretched muscles are loosened using the right technique. You must attend specialized sessions several times a year in the courses.
4. Physiotherapy. Physiotherapy procedures are prevalent in trauma, orthopedic, and neurological practice. With the help of procedures, local blood flow is improved, systemic drugs are used externally, and the device acts on damaged tissue. As a result, the muscles are warmed up and the chronic inflammatory process is eliminated in the affected area. Examples of medical procedures - magnetotherapy, shock wave therapy, electrophoresis.

Less frequently, manual therapy and acupuncture are prescribed.

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