Thoracic osteochondrosis is a chronic disease of the spine, during which degenerative-dystrophic changes occur in the intervertebral discs.
The thoracic spine is less often affected by osteochondrosis compared to the cervical and lumbar spine. This is explained by the fact that it is relatively inactive, stable and well reinforced by a muscular corset. Its complications are even rarer - protrusion and disc herniation.
However, this disease is manifested by extensive symptoms, which significantly reduce the quality of life and, therefore, require treatment. The use of medicines only suppresses the symptoms and gives a temporary effect that does not affect the development of the disease.
To reliably eliminate the symptoms, you need to act on the cause of the development of degenerative processes in the discs. For this purpose, complex therapy is used in the clinic, which gives positive results in more than 90% of cases. It includes oriental reflexology and physiotherapy methods - acupressure, acupuncture, moxa therapy and other medical procedures.
Symptoms, signs
During osteochondrosis, there is a flattening of the intervertebral discs and fusion of the vertebrae, which causes stretching of the spinal nerve roots. This causes pain between the shoulder blades (usually described as a sticking stick).
Pain syndrome during thoracic osteochondrosis can be acute, intense or chronic, moderate.
In the first case, acute pain appears suddenly and is called dorsago. In the second case, the pain is constantly felt, has a painful character and is called dorsalgia.
Irritation from the pinched root spreads along the nerve, radiates into the chest and becomes the cause of intercostal neuralgia - cutting, cutting or burning pain in the chest, which is aggravated by inhaling, moving, coughing, sneezing, laughing.
Another characteristic symptom of thoracic osteochondrosis is pain in the heart area, accompanied by signs of cardioneurosis - palpitations, palpitations, increased heart rate.
A pinched nerve root causes innervation disturbances, numbness, weakness of the hand, coldness of the hand, cyanosis (blue color) or whiteness of the skin. These symptoms are usually unilateral.
With osteochondrosis, pain can also spread to the shoulder, under the shoulder blade and to the forearm.
Other symptoms of the disease are stiffness, tension in the back, numbness in the paravertebral area, in the shoulders, in the cervical area, difficulty in breathing, feeling of a lump in the chest.
The nerves that originate from the spinal cord in the thoracic region play an important role in the innervation of the entire body. Therefore, the symptoms of osteochondrosis can appear in places that are not connected to the spine at first glance. For this reason it is called "chameleon disease".
These symptoms include:
- heartburn, bloating,
- loss of appetite, nausea,
- Indigestion (dyspepsia),
- cough
- cold feet
- body numbness
- pain in the right hypochondrium,
- discomfort in the abdomen,
- Sweating
In addition, thoracic osteochondrosis is manifested by impaired blood supply to the brain - headache, pressure instability, dizziness, gait instability and decreased coordination.
Causes of development, stages
The main role in the development of the disease is played by muscle spasm and tension of the back muscles (hypertonicity). These spasms are caused by a sedentary lifestyle, poor posture, or prolonged sitting in a static, uncomfortable position (for example, sitting at an office desk or driving a car).
On the other hand, monotonous, hard physical work also leads to the formation of permanent spasm of the back muscles (for example, working with raised arms).
Muscle spasm inhibits circulation and prevents blood flow to the spine. Due to this, nutrition of the intervertebral discs deteriorates.
Intervertebral discs are absorbent cushions of connective tissue found between vertebrae. At the center of each disc is a pulpy, semi-liquid core that contains a lot of moisture. Water provides load resistance and compression resistance.
Along the outer perimeter of each disc is reinforced with a rigid fiber ring. The connective tissues of the discs are mainly composed of collagen - this substance is synthesized in the body and must be constantly supplied to the joints, intervertebral discs and other connective, cartilaginous tissues for their continuous regeneration.
Muscle spasm prevents blood flow, resulting in insufficient collagen reaching the discs for normal tissue repair. Lack of oxygen leads to slowing down of metabolic processes.
As a result of metabolic disorders, tissue renewal of intervertebral discs slows down and their wear accelerates. This leads to dystrophy and degenerative changes – the discs are dehydrated, cracked, dry, flattened and lose shock absorbing properties and elasticity.
Spasm of the back muscles is the main cause of excessive stress on the spine in the thoracic region. If the intervertebral disks in the cervical region are pressed by the weight of the head, which increases during incorrect posture, and the body weight in the lumbar region is pressed, which increases with excess weight, then muscle spasm in the chest area plays a special role. in the development of the disease. These spasms not only impede blood circulation, but also stretch the spine and compress the intervertebral discs both day and night. Intervertebral discs are practically deprived not only of cellular renewal, but also of easy rest and recovery. Therefore, the first thing a doctor should do in the treatment of thoracic osteochondrosis is to relax tense back muscles, eliminate muscle spasms and hypertonicity. Without it, effective treatment of the disease is impossible.
Flattening of the intervertebral discs leads to the reduction of the gaps between the vertebrae, bringing the vertebrae closer together and stretching the nerve roots. This causes pain, which causes reflex muscle spasm and further increases the pressure on the discs. Therefore, with the appearance of pain, the development of the disease, as a rule, accelerates.
These degenerative-dystrophic changes correspond to the first stage of osteochondrosis.
Important!
In old age, thoracic osteochondrosis usually develops against the background of general dehydration and metabolic disorders in the body. This is manifested, in particular, by a decrease in height in the elderly, which occurs due to the thinning of the intervertebral discs.
In the second stage, the outer fibrous ring becomes fiberless. Its fabric becomes loose, weakens and cannot cope with maintaining the internal load. As a result, disc protrusion occurs as a (usually local) protrusion.
The protrusion directed towards the spinal cord is called dorsal. Eruptions directed to the side are called lateral. The rarest case is a uniform protrusion of the disc around the entire perimeter.
The appearance of a protrusion usually causes pain. The X-ray image clearly shows a decrease in the height of the gap between the vertebrae, as well as the development of osteophytes - bone growths. They are formed along the edges of the spine to compensate for the load on the spine, as the intervertebral discs cope with them less and less.
In the third stage of the disease, the fibrous ring of the disc cannot withstand the internal pressure and ruptures. A part of the core of the disc pulposus is compressed from the resulting gap - an intervertebral hernia appears.
In the fourth stage of the disease, the range of motion in the back is sharply reduced, the pain syndrome becomes constant, and a wide picture of neurological disorders develops.
diagnosis
During the first visit, the doctor asks the patient about the symptoms, the circumstances of their origin, studies the medical history, conducts an external examination, pays attention to the posture, the presence or absence of spinal deformities (scoliosis, kyphosis).
The cause of pain syndrome (dorsago, dorsalgia) can be both osteochondrosis and displacement of the spine (spondylolisthesis), ankylosing spondylarthrosis, ankylosing spondyloarthrosis.
Osteochondrosis of the thoracic region is usually accompanied by tension in the back muscles and hypertonicity of the back muscles. The doctor palpates and uses consistent pressure to find pain (trigger) points that correspond to muscle spasm centers.
To get more detailed information, the doctor will prescribe an X-ray or MRI.
X-ray of thoracic osteochondrosis provides the most general information - it helps to differentiate the disease from spondylolisthesis, to see osteophytes and to narrow the gaps between the vertebrae.
Magnetic resonance imaging better shows soft, connective tissue. With its help, the doctor can study in detail the structure of the intervertebral discs, see a protrusion, hernia (its size, location, shape), as well as the condition of ligaments, intervertebral joints, blood vessels, nerve roots, and see spinal cord stenosis (or its danger).
Based on the MRI data, the doctor makes a diagnosis and establishes an individual treatment plan.
Treatment of osteochondrosis of the chest region
drug treatment
Non-steroidal anti-inflammatory drugs in the form of ointments, tablets or injections can be used to relieve the pain of back and intercostal neuralgia during thoracic osteochondrosis. The main effect of these drugs is anti-inflammatory, so their use is justified in cases where a stretched nerve root is accompanied by its inflammation, i. e. thoracic sciatica. Nonsteroidal anti-inflammatory drugs also reduce inflammation of muscle tissue against the background of spasms and persistent hypertension.
In case of acute pain syndrome, we can use paravertebral or epidural block - injection of painkiller. In the first case, the injection is made in the place where the nerve root folds, in the second case, between the periosteum of the spine and the spinal cord sheath.
Myorelaxants and antispasmodics are used to relieve muscle tension and reduce pressure on nerve roots, blood vessels and intervertebral discs.
Vitamin complexes are prescribed to nourish nerve tissues and prevent their atrophy.
To slow down the process of destruction of connective tissues, chondroprotectors can be prescribed.
These drugs have a symptomatic effect and can somewhat slow down the development of the disease, but in general they have almost no effect on the process of degenerative changes of the intervertebral discs.
Non-drug treatment
Non-narcotic treatment of thoracic osteochondrosis includes methods of physiotherapy, reflexology and physiotherapy.
The main goals of the treatment are to alleviate the inflammatory process, improve blood circulation and restore metabolic processes in the spinal discs, stimulate cellular renewal of connective tissues. For this purpose, the clinic uses complex therapy using oriental medicine methods.
Important!
Physiotherapy exercises help to form and strengthen the muscle corset, eliminate irrational loads on the spine, and serve to reduce swelling and muscle spasms.
surgery
For a large hernia, especially dorsal, with the danger of stenosis of the spinal cord and especially if it exists, a surgical operation - discectomy - may be indicated.
Part of the disc is removed or the entire disc is removed and replaced with a prosthesis. Although discectomy is a common type of surgery, chest surgery is very rare.
treatment in the clinic
Treatment of thoracic osteochondrosis in the clinic is carried out in complex sessions, which include several procedures - acupuncture, acupressure, moxa therapy, stone therapy, vacuum therapy, hirudotherapy with individual indications.
High efficiency is achieved due to the synergy of individual methods and elimination of the cause of the disease.
- Acupressure. By pressing hard on trigger points on the spine, the doctor will eliminate muscle spasms, tension, swelling, improve blood circulation and restore smooth blood flow to the spine. Thanks to this, the load on the intervertebral discs is reduced, with the influx of oxygen and collagen, the processes of metabolism and tissue regeneration are accelerated.
- Acupuncture. Inserting needles into the bioactive points of the back, legs, arms, head, chest eliminates symptoms related to innervation disorders - numbness, arm weakness. This procedure relieves intercostal neuralgia and other spinal pain. In addition, acupuncture enhances the effect of acupressure and has anti-inflammatory and anti-edema effects.
- Moxibustion therapy. Warming of bioactive points in the area of the spine is carried out with a cigar of boiled worm. This procedure activates metabolic processes, increases blood flow to the intervertebral discs, stimulates and accelerates their recovery.
- Vacuum therapy. Massage the strap and the strap creates blood flow and helps improve blood circulation.
- manual therapy. Using gentle traction on the spine, the doctor unloads the intervertebral discs, increases the distance between the vertebrae, relieves compressed nerve roots, relieves pain and increases the range of motion of the spine.
Gentle traction, or traction, is the only manual therapy technique indicated for thoracic osteochondrosis. Before starting, the doctor should thoroughly relax the back muscles, eliminate spasms and release the spine. For this, the muscles are well warmed up and relaxed through massage. If this is not done, the use of physical effort can cause damage - rupture, sprain or fracture. During osteochondrosis, the methods of traction of the spine are ineffective and even dangerous, so they are not used in the clinic.
Hirudotherapy
Placement of healing leeches improves local blood circulation, blood supply of intervertebral discs and has an anti-inflammatory effect.
stone therapy
Smooth stones heated to a certain temperature are placed along the spine to deeply warm and relax the back muscles, improve blood circulation and stimulate blood flow.
The duration of the treatment session in the clinic is 1-1. 5 hours, depending on individual indications. The course of treatment usually includes 10-15 complex sessions. After completion, a follow-up MRI is performed to evaluate the results achieved by the treatment.
Complications
The main complication of thoracic osteochondrosis is spinal cord stenosis, which is caused by the development of paralysis of the body due to disc herniation.
Other possible complications are related to the disturbance of innervation of the body due to compression of spinal nerve roots: the development of diseases of the gastrointestinal tract, kidneys, heart and reproductive system.
Prevention
To prevent the development of thoracic osteochondrosis, you should avoid a sedentary lifestyle and control your posture.
Important!
If a child or teenager has scoliosis, it is advisable to treat this disease without hoping that it will go away by itself. Lateral curvature of the spine occurs as a growing pain, but can last a lifetime.
In this case, constant muscle tension and spasm will be inevitable, which in turn will lead to the development of osteochondrosis and, possibly, its complications. And this is in addition to the fact that scoliosis itself is full of complications of the respiratory, digestive and cardiovascular systems.