Thoracic osteochondrosis is rare in clinical practice. Previously, it was diagnosed mainly in the elderly, but now it is often detected in patients under 35 years of age. More often, 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 confused with 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 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 code - M42. Thoracic osteochondrosis is much less common than cervical or sacral. This is no 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 may develop. At first, there are signs of damage to one disc, but in the future, other elements may be involved in the pathological process. As the disease progresses, bone elements are damaged, as well as the ligaments and muscles that support the spinal column.
Degenerative-dystrophic processes in the thoracic region grow more slowly. It often takes years before the fibrous rings of damaged discs are destroyed so much that protrusions and hernias appear.
Severe clinical manifestations occur after a critical decrease in the height of the discs and entrapment of the roots. This can lead not only to dorsago, that is, short-term attacks of pain in the thoracic region, but also to a violation of the innervation of internal organs. It is much more difficult to treat pinched nerve roots extending in this area.
In most cases, spinal 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. The factors that can provoke the appearance of osteochondrosis of the thoracic spine include:
- congenital or acquired deformities of the spine;
- overload of the spine during pregnancy;
- infectious diseases;
- metabolic disorders;
- hormonal disruptions;
- chronic stress;
- bad habits;
- connective tissue diseases;
- dysplastic changes;
- posture disorders;
- unhealthy diet;
Detraining negatively affects the condition of the spinal column. People who lead a sedentary lifestyle are more likely to suffer from chest osteochondrosis. In addition, age-related changes and a slowdown in metabolism, which are observed in patients over 55 years of age, contribute to the appearance of these disorders.
Genetic predisposition may be a factor that can provoke the development of pathology. 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 lesion of the intervertebral disc 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 initial phases of development, the disease manifests itself only with the onset of cold weather or after physical overstrain. The initial manifestations of the development of osteochondrosis of the thoracic region include:
- back aches and pressure;
- muscle spasms;
- cold extremities.
As the disease progresses, the patient's condition worsens. Aching chest pains appear. They especially often occur against the background of prolonged stay in one position or with sudden movements. In addition, severe pain syndrome can appear when lifting weights. 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 bend. In severe cases, the patient may develop a hump. In addition, 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 skin of the upper body. Due to the violation of innervation and blood circulation, a feeling of goose bumps appears on the skin. Feet and hands are always cold. Sensory impairment 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 last stages of the process, it is possible that:
- intercostal neuralgia;
- stool disorders;
- heartburn and nausea;
- itching and burning in the feet;
- violations of the reproductive system;
- asthma attacks.
As the pathology progresses, a person's working capacity decreases. Physical activity is minimized. In the future, this disorder can create preconditions for the development of severe complications. The risk of pathological fractures increases. Curvature of the spine leads to compression of the organs located in the chest.
With an unfavorable course, the disease proceeds with infringement of the heart muscle and a decrease in lung volume. Most often, such severe complications are accompanied by widespread osteochondrosis, in which several intervertebral discs are affected at once.
Grades of thoracic osteochondrosis
The existing classification subdivides 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.
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 comprehensive diagnosis. The fibrous ring, which lacks moisture and nutrients, gradually loses its elasticity. Microcracks often form on the tissues, into which the nucleus pulposus is squeezed out. Displacement of discs into the spinal canal is possible. Protrusions are formed. There are no signs of rupture of the annulus fibrosus.
With the transition 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, signs of a decrease in the elasticity of the tissues that form the annulus fibrosus can be detected. The cartilage becomes very thin, which leads to an increased risk of developing hernias. There is a decrease in the height of the intervertebral discs, due to which the structures of the spinal column acquire abnormal mobility.
At the third stage, 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 stage of the process, the damaged annulus fibrosus ruptures. This phenomenon is accompanied by the exit of the nucleus pulposus 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, which creates conditions for injuries and fractures.
With the transition of pathology to the fourth degree of development, the structure of the intervertebral discs is disturbed so much that they cease to perform the amortization function. The annulus fibrosus and nucleus pulposus 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, that is, bone growths, begin to grow rapidly. The surrounding ligaments are involved in the pathological process. They lose elasticity and no longer support the spinal column properly. In addition, 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 conducts an external examination and collects an anamnesis. Laboratory tests often prescribed in the diagnosis of this disease include blood and urine tests. X-rays are taken to obtain information about the presence of defects in the structure of the spine. This research reveals:
- lowering the disc height;
- jagged edges of elements;
- change of vertebral bodies;
- forming osteophytes and so on.
To clarify the defects in the structure of the disc, a discography is assigned. This study allows you to identify the uneven contours of the nucleus pulposus, assess the degree of disc destruction and decrease in tissue density. CT and MRI are often done for better visualization. Given that the clinical manifestations of thoracic osteochondrosis are similar to the symptoms of ischemic heart disease, electrocardiography is often prescribed to differentiate these conditions.
This pathological condition requires complex treatment. First of all, patients are selected drugs that help 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 some folk remedies. In addition, it is recommended that you follow a specific diet.
In case of severe pain syndrome, the patient is advised to adhere to bed rest. This will reduce the intensity of the pain. To eliminate discomfort, analgesics and NSAIDs are often prescribed. If the pain syndrome manifests itself too intensely, blockages may be required. 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 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 subjected to compression, the patient needs B vitamins.
Physiotherapy and massage
Physiotherapy and massage are the most important components of the treatment of osteochondrosis, but they can only be used after drug suppression of symptoms. Correctly selected exercises help to improve lung ventilation and strengthen the muscular corset that supports the spinal column.
First, all the necessary exercises must be learned under the supervision of an exercise therapy instructor. In the future, the patient can do exercises at home. People with this condition may be advised to take classes in the pool.
Massage helps to eliminate muscle hypertonicity and improve soft tissue nutrition. So that the procedures do not cause harm, they must be carried out by a specialist. In most cases, a classic massage is performed, which involves successive rubbing, smoothing and pinching of the problem area. Acupressure and segmental massage can be of great benefit. These techniques involve the impact on pain points. They help improve blood circulation and lymphatic drainage. In most cases, it is enough for patients to do procedures 2-3 times a week.
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 carried out 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 treating osteochondrosis in the presence of severe inflammatory processes.
Manual therapy helps to 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 to restore the ligamentous apparatus. Such procedures can slow down the development of this pathological condition. The duration of the course of manual therapy is selected individually for the patient.
Post-isometric relaxation technique
Post-isometric relaxation procedures are a special technique that involves 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 the movements and the severity of muscle tension. This method allows you to quickly eliminate pain and restore normal muscle and ligament function.
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 best to use various formulations based on herbs and other natural ingredients as an adjunct to traditional therapies. You should get a doctor's recommendation on the advisability of using this or that folk remedy before starting its use.
Properly cooked celery root is believed to help saturate cartilage tissue with nutrients and water. To prepare this product, 1 root should be thoroughly chopped and pour 1 liter of boiling water. You need to insist the composition for at least 8 hours. After this time, you need to strain the product and take 1 tsp. 3 times daily before meals.
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 cup of chopped plant ingredient, pour 3 liters of water. The mixture needs to 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 better to store the rest of the medicinal product in a thermos.
A simple homemade ointment can be used for rubbing with osteochondrosis. To prepare this product, you need to melt about 150 g of pork fat in a water bath. After that, 2 tbsp should be entered into it. l. natural wax.
The composition must be boiled for at least 20 minutes. After that, 1 tbsp should be added to the heated mixture. l. fir oil. The product needs to be boiled for another 20 minutes. Lastly, 2-3 minutes before removing the container from the heat, 1 tbsp is introduced into the mixture. l. ammonia. The finished composition must be distributed in jars. Store homemade ointment in the refrigerator.
Nutrition for chest osteochondrosis
Patients suffering from osteochondrosis of the thoracic region need a balanced diet. A sufficient amount of protein-rich food should be introduced into the diet. It is advisable to regularly consume dishes containing a large amount of chondroitin, including aspic from fish, jellied meat, and so on. It is imperative to introduce fermented milk products, vegetables and fruits into the diet. Dishes need to be steamed or baked. Fatty and fried foods should be avoided. It is advisable to take food in small portions, but often. This will help avoid overeating.
Aggravation: what to do?
In the acute period of the course of the disease, it is desirable to reduce activity to a minimum. 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 advisable to follow a sparing diet during this period. Only after eliminating the symptoms can you start exercise therapy and physiotherapy.
Now this disease can be cured only 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.
To prevent the development of this pathological condition, it is recommended to avoid sudden weight 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 right and carefully monitor your weight.