Thoracic osteochondrosis is a chronic disease of the spine in which degenerative-dystrophic changes occur in the intervertebral discs.
The thoracic spine is less affected by osteochondrosis than the neck and back. This is explained by the fact that it is relatively immobile, stable and well reinforced by a muscular corset. Its complications are rarer - protrusion and disc herniation.
However, this disease manifests itself with a wide range of symptoms that significantly reduce the quality of life and therefore require treatment. The use of drugs only suppresses the symptoms and has a temporary effect that does not affect the development of the disease.
To reliably eliminate the symptoms, you need to affect the cause of the development of degenerative processes in the discs. For this purpose, complex therapy is applied 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 therapeutic procedures.
Symptoms, signs
During osteochondrosis, flattening of the intervertebral discs occurs and the vertebrae fuse, which causes compression of the spinal nerve roots. This causes pain between the shoulder blades (usually described as a sticking stake).
Pain syndrome in thoracic osteochondrosis can be acute, intense or chronic, moderate.
In the first case, sharp pain occurs suddenly and is called chest pain. In the second case, the pain is felt constantly, has a painful character and is called dorsalgia.
Irritation from the compressed root spreads along the nerve, spreads to the chest and becomes the cause of intercostal neuralgia - stabbing, cutting or burning pains in the chest, aggravated by inhalation, movement, coughing, sneezing, laughing.
Another characteristic symptom of thoracic osteochondrosis is pain in the heart area, which is accompanied by symptoms of cardioneurosis - palpitations, palpitations, increased heart rate.
Compression of the nerve root leads to disruption of innervation, numbness, weakness of the hand, feeling of coldness in the hand, cyanosis (blue discoloration) or whiteness of the skin. These symptoms are usually unilateral.
With osteochondrosis, pain can 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, shoulders, neck, difficulty in breathing, swelling in the chest.
Nerves arising from the spinal cord in the thoracic region play an important role in the innervation of the whole body. Therefore, symptoms of osteochondrosis can occur in places unrelated to the spine. 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,
- abdominal discomfort
- don't sweat
In addition, thoracic osteochondrosis is manifested by impaired blood supply to the brain - headaches, pressure instability, dizziness, gait instability, and loss of coordination.
Causes, stages of development
The main role in the development of the disease is played by muscle spasms and tension (hypertonicity) of the back muscles. These spasms are caused by a sedentary lifestyle, poor posture, or prolonged sitting in a static, uncomfortable position (such as sitting at an office desk or driving a car).
On the other hand, monotonous, heavy physical work also leads to the formation of persistent muscle spasms of the back (for example, working with raised arms).
Muscle spasms block blood circulation and block blood flow to the spine. For this reason, nutrition of intervertebral discs deteriorates.
Intervertebral discs are shock-absorbing cushions of connective tissue located between the vertebrae. At the center of each disc is a pulpy, semi-fluid core that contains a lot of moisture. Water provides load resistance and compression resistance.
Each disc is reinforced with a tough fibrous ring along the outer perimeter. 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 spasms impede blood flow, resulting in insufficient collagen reaching the discs for normal tissue repair. Oxygen deficiency slows down 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 become dehydrated, cracked, dry, flattened, lose shock absorption properties and elasticity.
Back muscle spasms are the main cause of excessive stress on the spine in the thoracic region. If the intervertebral discs in the neck are compressed by the weight of the head, which is increased by improper posture, and the lumbar region is compressed by the body weight, increased by excess weight, muscle spasms in the chest play an exceptional role. in the development of the disease. These spasms not only impede blood flow, but also compress the spine and compress the intervertebral discs both day and night. Intervertebral discs are practically devoid of opportunities not only for cell renewal, but also for simple rest and recovery. Therefore, the first thing a doctor should do during 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 causes narrowing of the spaces between the vertebrae, bringing the vertebrae closer together and compressing 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.
It is important!
Thoracic osteochondrosis in old age usually develops against the background of general dehydration and metabolic disorders in the body. This is especially evident in elderly people with a decrease in the neck due to the thinning of the intervertebral discs.
In the second stage, the outer fibrous ring becomes fiberless. Its tissue is loosened, weakened and unable to cope with the internal load. As a result, the protrusion of the disc occurs in the form of a (usually local) protrusion.
The protrusion directed towards the spinal cord is called dorsal. Protrusions directed to the side are called lateral. The rarest case is a uniform protrusion along the entire perimeter of the disc.
The appearance of the protrusion usually causes an increase in pain. The X-ray image clearly shows a decrease in the height of the space between the vertebrae, as well as the development of osteophytes - bone protrusions. Intervertebral discs form along the edges of the vertebrae to compensate for the loads on the spine as they are less and less able to handle them.
In the third stage of the disease, the fibrous ring of the disc cannot withstand the internal pressure and ruptures. A part of the nucleus pulposus of the disc is compressed through the resulting cavity - an intervertebral hernia occurs.
In the fourth stage of the disease, the range of motion in the back is sharply reduced, the pain syndrome stabilizes, and a wide picture of neurological disorders develops.
Diagnostics
At the initial appointment, the doctor asks the patient about the symptoms, the circumstances of their occurrence, studies the medical history, and conducts an external examination, paying attention to the posture, the presence of spinal deformities (scoliosis, kyphosis).
The cause of pain syndrome (dorsago, dorsalgia) can be both osteochondrosis and displacement of the spine (spondylolisthesis), ankylosing spondyloarthrosis, ankylosing spondyloarthrosis.
Osteochondrosis of the breast is usually accompanied by tension of the back muscles and hypertonicity of the spinal muscles. The doctor palpates and uses successive pressures to find pain (trigger) points that correspond to the centers of muscle spasms.
To get more detailed information, the doctor prescribes X-ray or MRI.
X-ray for thoracic osteochondrosis gives the most general information - it helps to distinguish the disease from spondylolisthesis, to see osteophytes and narrowing of the spaces between the vertebrae.
Magnetic resonance imaging shows soft, connective tissue better. With its help, the doctor examines the structure of the intervertebral discs in detail, looks for protrusions, tears (size, location, shape), as well as the condition of ligaments, intervertebral joints, blood vessels, nerve roots, and spinal cord stenosis (or its danger).
Based on the MRI data, the doctor diagnoses and prescribes an individual treatment plan.
Treatment of osteochondrosis of the thoracic region
Drug treatment
Non-steroidal anti-inflammatory drugs in the form of ointments, tablets or injections can be used to relieve pain in back and intercostal neuralgia in thoracic osteochondrosis. The main effect of these drugs is anti-inflammatory, so their use is justified in cases where inflammation of a compressed nerve root is accompanied by thoracic radiculitis. NSAIDs also reduce inflammation of muscle tissue against the background of spasms and persistent hypertension.
In case of acute pain syndrome, paravertebral or epidural block can be used - analgesic injection. In the first case, the injection is performed in the place where the nerve root is compressed, in the second case, in the area between the vertebral periosteum and the spinal cord membrane.
Muscle relaxants 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.
Chondroprotectors can be prescribed to slow down the process of destruction of connective tissues.
These drugs have a symptomatic effect and can somewhat slow down the progression of the disease, but in general, they have almost no effect on the process of degenerative changes in the intervertebral discs.
Non-drug treatment
Non-drug treatment of thoracic osteochondrosis includes physiotherapy, reflexology and physical therapy methods.
The main goals of the treatment are elimination of the inflammatory process, improvement of blood circulation and restoration of metabolic processes in the spinal discs, stimulation of cell renewal of connective tissues. In the clinic, complex therapy using oriental medicine methods is applied for this purpose.
It is important!
Physical therapy exercises help to shape and strengthen the muscle corset, remove irrational loads on the spine, prevent congestion and muscle spasms.
Surgery
For large hernias at risk of spinal cord stenosis, especially dorsal ones, and especially if present, surgery - discectomy - may be indicated.
A part of the disc is removed or the entire disc is removed and replaced with a prosthesis. Although discectomy is a common type of surgical intervention, operations in the thoracic region are performed quite rarely.
Treatment at the clinic
Treatment of thoracic osteochondrosis in the clinic is carried out in complex sessions that include several procedures - acupuncture, acupressure, moxa therapy, stone therapy, vacuum therapy, hirudotherapy for individual indications.
Due to the synergy of individual methods and elimination of the cause of the disease, high efficiency is achieved.
- Acupressure. By pressing forcefully on the trigger points of the back, the doctor relieves muscle spasms, tension, congestion, improves blood circulation and restores unobstructed blood flow to the spine. Thanks to this, the load on the intervertebral discs is reduced, the metabolism and tissue regeneration processes are accelerated as the flow of oxygen and collagen increases.
- Acupuncture. Insertion of needles into the bioactive points of the back, legs, arms, head, chest eliminates the symptoms related to innervation disorders - numbness, weakness in the arm. With the help of this procedure, intercostal neuralgia and other vertebrogenic pains are alleviated. In addition, acupuncture enhances the effect of acupressure and has anti-inflammatory and anti-edema effects.
- Moxibustion therapy. Warming of bioactive points in the spinal area is carried out with a smoked wormwood cigarette. This procedure activates metabolic processes, increases blood flow to the intervertebral discs, stimulates and accelerates their recovery.
- Vacuum therapy. Cupping massage and cupping create blood flow and help improve blood circulation.
- Manual therapy. Using gentle stretching of the spine, the doctor loosens the intervertebral discs, increases the distance between the vertebrae, releases compressed nerve roots, relieves pain and increases the range of motion in the back.
Gentle traction or traction is the only method of manual therapy indicated for thoracic osteochondrosis. Before starting, the doctor should thoroughly relax the back muscles, remove spasms and free the spine. For this, the muscles are well warmed up and relaxed through massage. If this is not done, the application of physical efforts can lead to injury - fracture, sprain or fracture. Hardware methods of stretching the spine for osteochondrosis are ineffective and even dangerous, so they are not used in the clinic.
Hirudotherapy
Placement of medicinal leeches improves local blood circulation, blood supply to intervertebral discs, has an anti-inflammatory effect.
Stone therapy
Smooth stones heated to a certain temperature are placed along the spine to deeply heat and relax the muscles of the spine, improve blood circulation and stimulate blood flow.
The duration of the treatment session in the clinic is 1-1. 5 hours, depending on individual indicators. The treatment course usually consists of 10-15 complex sessions. After completion, a follow-up MRI is performed to evaluate the treatment results.
Complications
The main complication of thoracic osteochondrosis is spinal cord stenosis due to disc herniation with the development of body paralysis.
Other possible complications are associated with the disruption of innervation of the body due to compression of the 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 monitor your posture.
It is important!
If a child or teenager has scoliosis, it is advisable to treat the disease without hoping that it will go away on its own. Lateral curvature of the spine occurs as increasing pain, but can last a lifetime.
In this case, continuous muscle tension and spasms 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 from the respiratory, digestive and cardiovascular systems.