Thoracic osteochondrosis is a chronic pathology in which the bone vertebrae and the intervertebral discs located between them undergo degenerative changes. Destructive injuries in this area are quite rare due to low mobility and good protection of the rib cage. Osteochondrosis of the thoracic spine develops imperceptibly, progresses slowly but persistently, and is also distinguished by a number of specific symptoms that masquerade as diseases of internal organs. In this regard, it is very important to seek medical help at the first, still mild signs of back problems. Timely treatment helps to avoid severe complications.
Causes and factors
Degenerative-dystrophic processes in the thoracic segments of the spine occur against the background of endogenous disorders and under negative external influences. Their development is most often provoked by the following factors:
- hereditary predisposition, the presence of a certain set of defective genes;
- excessive physical exertion, especially lifting and carrying various heavy objects;
- A sedentary lifestyle that causes swelling in the area of the vertebral bodies and intervertebral discs;
- Congenital or acquired structural anomalies, for example, accessory vertebrae, lordosis, kyphosis;
- Back and/or chest injuries - fractures, prolonged compression;
- flat feet, club feet;
- blood circulation disorder in any area, not only in the back of the chest;
- frequent hypothermia;
- Excess weight;
- Endocrine pathologies, metabolic disorders, such as diabetes, gout, hypothyroidism, hyperthyroidism;
- Systemic diseases - rheumatoid arthritis, systemic lupus erythematosus, scleroderma;
- Ankylosing spondylitis.
The strength and mobility of the spine as a whole directly depends on the condition of each section. The disease can be the result of untreated, severe lumbar or cervical osteochondrosis.
Smoking, alcohol addiction and intoxication, including occupational hazards, tend to destroy intervertebral joints with discs, which are mainly composed of cartilage. Osteochondrosis of the chest is diagnosed more often in the elderly than in young and middle-aged people. This is due to the natural aging of the body, slowing down of recovery processes and the presence of one or more somatic pathologies.
Symptoms and signs of the disease
The leading symptom of the degenerative process is pain. Unlike cervical and lumbar osteochondrosis, it is extremely rarely acute, burning, piercing. Patients usually describe the discomfort as dull, painful, or pressing. The pain syndrome may increase during body bending/turning, awkward sudden movements, coughing attacks or temperature changes. Its radiation is noted - spread beyond the damaged area. Osteochondrosis of the thoracic spine is also manifested as follows:
- stiffness, feeling of restriction;
- specific clicks, convulsions when changing body position;
- Loss of sensitivity, paresis in the form of "crawling goose" sensation, burning, numbness;
- muscle spasm, further limitation of range of motion;
- adopting a forced position in which discomfort does not arise or is weakly expressed;
- Pathological changes in posture, in later stages - walking;
- A slight decrease in growth as a result of destruction of intervertebral joints and convergence of vertebral bodies.
Due to the constant tension of the back muscles, the muscles of the neck and back also become spasm, which is expressed in the pain of these parts.
The clinical picture of thoracic osteochondrosis is a combination of pain syndromes. The fact is that the affected segments are located in the zone of common innervation with many internal organs. If the displaced disc catches the nerve root near the spine, then pain is felt in them, simulating common pathologies:
- Severe heart pain resembles angina pectoris and even myocardial infarction;
- Pain in the mammary glands becomes a reason for urgent differential diagnosis in order to exclude tumor processes;
- Constant or periodic pain in the right hypochondrium, stomach or intestines, similar to pains characteristic of gastritis, cholecystitis and ulcerative lesions.
When osteochondrosis worsens, the back or abdomen may be painful. Patients consider discomfort as a sign of kidney pathology or gynecological disease. They refer to specialized specialists who, after examination, refer patients to a neurologist or vertebrologist.
Classification, main types
The general classification of osteochondrosis of the thoracic spine is based on the nature of the pain syndrome. There are two types of it:
- Dorsago - sharp acute pain in the chest area, which appears mainly during a long stay in one position of the body, often complicated by a feeling of lack of air when inhaling;
- Dorsalgia in the form of mild painful sensations in the back, appears periodically and disappears after rest.
This division of pathology into groups allows the doctor to quickly decide on the choice of analgesics.
Gradual development of thoracic osteochondrosis
In its development, osteochondrosis of the thoracic spine goes through four stages. Each has its own symptoms and radiographic markers. The more pronounced the deformation of the discs and vertebrae, the stronger the pain, stiffness of movement and paresthesia. The stage of the disease determines the therapeutic tactics.
Stage I
There are no changes on the X-ray yet. However, the intervertebral disc no longer retains moisture well, without which it cannot be restored in time. It begins to gradually thin, lose strength and elasticity. Only in some cases mild discomfort occurs in the chest area. A person perceives this as muscle fatigue and does not consult a doctor. Therefore, the disease at this stage is usually an incidental diagnostic finding during examination for another reason.
II stage
The structure of the fibrous ring becomes loose and fibrous. One crack in the disc is enlarged by the protrusion of the nucleus pulposus in this direction. The distance between adjacent vertebrae decreases as the disc height decreases, which is clearly visible on radiographic images. In order to compensate for the distribution of loads, muscle tissue is constantly strained. Stiffness increases, pain intensity is still moderate.
III stage
The annulus fibrosus ruptures beyond the borders of the nucleus pulposus. A herniated disc occurs, causing severe symptoms and serious complications. There is a significant deformation of the vertebral bodies and the formation of individual osteophytes (compensatory bone formations). The pain syndrome becomes constant, movements in the back are significantly limited.
IV stage
At this stage, the diagnosis of thoracic osteochondrosis is not difficult. Connective tissues grew and many osteophytes formed. The adjacent vertebrae in the segment are blocked, completely or partially immobilized. Nerve roots are often pinched by inflammatory swelling, bone formations, and muscle spasms. It manifests itself as a burning, shooting pain. The patient copes poorly with household duties and has difficulty moving.
Complications
It is dangerous to develop discogenic myelopathy, a dystrophic disease of the spinal cord, which is mainly caused by compression by a hernia. It should be noted that with osteochondrosis of the thoracic spine, such a complication is rare. Nevertheless, cases of localization of discogenic myelopathy in one of the lower segments have been observed in clinical practice. Due to gradually increasing neurological deficit, muscle strength decreases and tendon reflexes change. Ischemic areas are formed and nerve cells die (spinal cord infarction). It is characterized by movement disorders, loss of sensitivity and trophic disorders.
Diagnostic measures
During the first consultation, the doctor listens to the patient's complaints, examines him, assesses the level of sensitivity, checks tendon reflexes, studies the medical history and the history of spinal injuries. Its diagnosis is confirmed by laboratory and instrumental studies:
- Radiography in two projections, according to the indication - targeted image of a certain segment;
- magnetic resonance imaging;
- induced potential;
- electroneurography;
- electromyography;
- General clinical blood and urine tests.
To clarify the cause of specific symptoms and to exclude somatic diseases with similar clinical manifestations, electrocardiography, ultrasound scanning of cardiac structures and electroencephalography can be prescribed.
Methods of treatment of thoracic osteochondrosis
The therapy is comprehensive, aimed at eliminating the symptoms and preventing the spread of the pathological process to other segments of the spine. In the acute stage, excruciating burning pain is eliminated by injecting drugs, including directly into the affected area. The use of glucocorticosteroids in combination with anesthetics (narcotic blockade) is commonly used. In other cases, drug therapy consists of taking tablets, capsules, rubbing in ointments and balms. The use of drugs from the following groups has proven to be effective:
- muscle relaxants to relieve muscle spasms;
- Non-steroidal anti-inflammatory drugs with a pronounced analgesic effect;
- antispasmodics for pinched nerves;
- means to improve blood circulation;
- Preparations with vitamin B6, which improve the transmission of nerve impulses and activate regeneration.
If a radicular syndrome is formed and other complications arise, then a person constantly lives in fear of experiencing excruciating pain again, and this can lead to mental disorders. The appointment of sedatives and antidepressants can prevent such development. In addition to medications, the following methods are used to treat thoracic osteochondrosis of the spine:
- therapeutic massage, including vacuum and acupuncture;
- Physiotherapy procedures - electrophoresis/ultraphonophoresis, magnetotherapy, pulsed currents, UHF therapy, use of ozokerite or paraffin, acupuncture, hirudotherapy;
- physiotherapy and gymnastics;
- Back traction.
In case of significant damage to the spinal discs and myelopathy, surgical treatment is always prescribed immediately. A herniated protrusion is removed, a microdiscectomy, puncture valorization or laser disc reconstruction is performed, an implant is placed, or a spinal segment is stabilized.
Prevention of thoracic osteochondrosis
The main goal of primary prevention of thoracic osteochondrosis is to eliminate the factors that can cause thinning and rupture of the intervertebral disc. What doctors recommend:
- avoid excessive stress on the back;
- timely treatment of all diseases - infectious, endocrine, inflammatory;
- Seek immediate medical attention for back injuries, even seemingly minor ones;
- give up alcohol and smoking or at least limit them;
- Fill your diet with fatty fish, fresh vegetables, fruits and dairy products;
- prevent hypothermia;
- Do physical therapy for at least 15 minutes every day.
Such preventive measures are effective in cases of already diagnosed diseases of the chest, cervical or lumbar spine. With their help, it will be possible to prevent the aggravation and progression of the degenerative-dystrophic process.
If you have signs of osteochondrosis of the thoracic spine and want to get rid of it, contact the clinic for complete, competent treatment.
Read the answer
What is the difference between intercostal neuralgia and thoracic osteochondrosis?
In fact, intercostal neuralgia is a damage to the intercostal nerves, which can complicate the course of osteochondrosis. There are two main differences between these pathological processes. Neuralgia is characterized by paroxysmal shooting or burning pain, which intensifies even during inhalation. Osteochondrosis of the chest without disturbance of sensitive nerve endings is manifested by dull, as if distant pain.
And the second difference is prediction. After eliminating the cause of intercostal neuralgia, it disappears without a trace. Osteochondrosis responds well to treatment only in the initial stages of development.