Diagnostics and treatment of osteochondrosis of the thoracic spine

Chest osteochondrosis is a common degenerative disease. There are specific symptoms of thoracic osteochondrosis, indicating the onset of pathology. At the initial stages, discomfort does not bother the patient much, so he is in no hurry to seek help from a specialist. Over time, the symptoms intensify, which forces 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 what treatment methods are most effective.

What is thoracic osteochondrosis and how does it arise

Osteochondrosis of the thoracic region is characterized by the occurrence of destructive-dystrophic processes in the middle section of the ridge. The destruction is located between the 8th and 19th vertebra. 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 a circulatory disorder or age-related wear of the joints, the fibrous ring located in the cavity of the intervertebral disc begins to collapse, losing its normal structure. Since the destruction is slow, then at the initial stages microcracks appear, through which the nucleus pulposus seeps.

As the internal component seeps out, the annulus fibrosus 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. 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 discomfort, therefore, at this stage, the disease can only be detected by chance. The disease has many symptoms that can be disguised as other pathologies.

Symptoms of chest 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 feeling in the heart, 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 deteriorating 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 more strongly on the left or right side of the affected area.
6. Discomfort in the throat and trouble swallowing. If there is irritation of the nerve endings in the upper part of the 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. Herpes zoster occurs less frequently.
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 onset 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. Feels nausea, heaviness in the stomach.
16. In men, a few 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 can radiate to the neck or lower back.

If you find in the aggregate thoracic osteochondrosis and its signs or some of them, it is necessary to urgently consult a therapist, neurologist, orthopedist. Also, 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 that deprives the patient of working capacity, and he can only observe bed rest, then the subacute course is sluggish and does not significantly limit the patient's motor activity.

A clear sign of a sluggish lesion - there is no acute pain. Symptoms in the subacute stage are erased. 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.

So that the subacute course of the disease does not worsen and go into remission, important rules must be observed:

1. It is forbidden to lift weights.
2. You cannot bend over sharply.
3. It is forbidden to be in a sitting or standing position 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 proven that non-observance of a comfortable temperature regime for the body turns into an exacerbation of the inflammatory process. Dampness is also harmful to joints.

The duration of the subacute course is individual. If you follow medical recommendations, the patient will completely get rid of discomfort within 2-3 weeks. If conservative treatment and rest do not help, and the patient begins to suffer from nausea, dizziness and weakness, an urgent need 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 the onset of 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 the cartilage and bone tissue. In the first stage, there is also no rupture or stretching of the fibrous ring, so there are no hernias either. They can detect protrusion at the initial stage 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 promptly detected. Persons who do not want to visit a specialist can still endure the second stage, using available remedies, but self-medication will not be enough for a long time. At this stage, the most common neurological symptoms may appear, including headache, burning in the interscapular zone, pain in the neck, and blood pressure surges. Also at this stage, there is an increase in degenerative destruction in 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 aches. Disguised cardiac, gastroenterological, or pulmonary 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 injury.
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 cartilaginous 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 run the body to 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 medications and performing daily gymnastics. The later the patient turns to the doctor, the harder it is to stop the severe pain syndrome associated with 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 individuals suffering from physical inactivity are more likely to have problems with the ridge than those who regularly exercise. Also, excessive physical activity can provoke the destruction of cartilage at an early age.

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, the destruction of cartilage tissue occurs.

What reasons can cause osteochondrosis:

1. Obesity. When you are overweight, there is strong weight pressure on the spine. As a result, premature destruction of bone tissue occurs.
2. The presence of anomalies in the structure of bones and cartilage. Such problems are laid even during the period of intrauterine development.
3. Congenital asymmetry of the intra-articular gaps in the intervertebral joints of the type of tropism anomaly, contributing 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 vibration on the spine in a sitting position. An example of work is a minibus or bus driver.
6. Frequent physical strain 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, an accelerated leaching of calcium occurs, which is associated with poor metabolic processes. As a result, bones become brittle. Also, muscle tissue atrophies, due to which the load on the spine increases greatly. 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, vital moisture from the joints is lost. This leads to discomfort, decreased mobility in the spine.

Risk factors for breast osteochondrosis include:

1. Advanced age. In older people, natural degeneration occurs, therefore, after 40 years, the disease is found 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, spinal diseases are prone to occur.
3. The presence of hormonal disorders, endocrinological diseases. If the patient has diabetes mellitus or uncompensated hypothyroidism, intervertebral disc degeneration 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 causes 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 provokes serious spinal problems, including osteochondrosis and hernia.

Diagnostics of the 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 there is a suspicion of a neurological problem, the patient is referred to a narrow specialist - a traumatologist, neurologist or orthopedist.

At the reception with a specialized specialist, they also ask about complaints, conduct an initial diagnosis of the patient. Based on a visual examination, a set of diagnostic measures is prescribed, including:

1. Radiography. 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 can be noticed - the distance between the intervertebral discs will be reduced, and darkening is sometimes noticed at the site of the alleged hernia. If the results of the image do not suit the specialist, you have 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 picture. A more detailed image can be seen on MRI, but if there are contraindications (the presence of a pacemaker or prostheses in the joints), computed tomography is prescribed. CT is an improved X-ray that allows you to see in detail the bone, tendon and ligament. 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. Analytical data are necessary to assess the patient's health status. If an increase in leukocytes, ESR is found, 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. Spine scintigraphy. The research method reveals 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, you need to get to an experienced specialist. For the final diagnosis, a complete clinical picture is needed, taking into account several laboratory research methods.

Thoracic osteochondrosis of the spinal column requires differentiation along with such pathologies:

1. Dyshormonal spondylopathy.
2. Pathologies of the urinary system, 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, stomach and duodenal ulcers, irritable bowel syndrome.
5. Previous injuries, fractures.
6. Tumors in the chest, including a malignant course.
7. Rheumatoid arthritis (determined by a blood test for C-reactive protein, rheumatic test and ESR).
8. Osteomyelitis of the spine.
9. Acute inflammatory process.
10. Ankylosing spondylitis.
11. Spondylolisthesis.

Treatment of osteochondrosis of the thoracic spine

To slow down the progression of the disease, an integrated approach to therapy is needed. At the initial stages, only conservative therapy is shown, consisting of the use of medicines and physiotherapy 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 what cases is surgery performed?

Launched osteochondrosis of the thoracic region negatively affects the patient's quality of life. If a patient has constant discomfort that interferes with normal life, taking into account the lack of effect of medication treatment, then a surgical solution to the problem may be offered.

Absolute indications for surgery include:

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

In other cases, the patient makes the decision to remove the hernial formation independently. If the disease really brings severe anguish 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 medications:

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 medication from the NSAID group is accompanied by side effects with prolonged use, therefore, experts recommend limiting the use of drugs to the minimum period of use, no more than 1-2 weeks. Painkillers are most detrimental to the gastric mucosa, causing gastropathy and inflammation. Patients at risk are given certain medications designed to protect the gastrointestinal mucosa. Examples are proton pump inhibitors, H2 histamine receptor blockers, antacids. Persons 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. Relieve pain associated with muscle tension. They act on trigger points located in the pinched muscle tissue. The more a person overstrains, the higher their number. Muscle relaxants well remove tightness in the muscles, and therefore exhibit an analgesic effect. You need to take medications in a 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 length of one 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 in the gels for up to 4 weeks, after which they take a break. The scheme and duration of therapy is determined by the attending physician.
5. Honroprotectors. 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 break of 2-3 months and the course of therapy is repeated. Within 2-3 months, injectable forms of release are used, as they are better absorbed. Then they switch to supportive treatment, including the use of tablets. It is important to understand that medication does 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 residents of northern latitudes do not receive enough vitamin D3, because solar activity in this region is low all year round. To get rid of 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 tissue thinning occurs over time, so a person suffers from osteochondrosis and other complications. Calcium and D3 are better absorbed in combination, therefore, complex preparations are prescribed. The dose and course of administration should be prescribed by the attending physician.

As an adjunct to treatment, homeopathy, antispasmodics and complex multivitamins can be prescribed.

Conservative therapy of thoracic osteochondrosis

During the recovery period, the patient should pay sufficient attention to rehabilitation. The more carefully the patient maintains health, the less frequent 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 his 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. Begin execution gradually, spending at first 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. Supporting 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 pattern of wearing is assigned individually. You cannot wear a corset around the clock, otherwise your back muscles will become even weaker.
3. Massage. In medical practice, massages are 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 temporarily improves and overextended muscles are unclenched using the right technique. You need to attend specialist sessions several times a year in courses.
4. Physiotherapy. Physiotherapy 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 are warmed 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 it is started. To prevent the disease from proceeding acutely, it is necessary to comprehensively treat the pathology.