Thoracic osteochondrosis is a chronic pathology in which bone vertebrae and the intervertebral discs located between them undergo degenerative changes. Destructive lesions in this zone are extremely rare due to low mobility and good protection by the rib cage. Osteochondrosis of the thoracic spine develops imperceptibly, develops slowly but steadily, and is also characterized by a number of specific symptoms that are masked as diseases of internal organs. In this regard, it is very important to consult a doctor at the first, still mild signs of back problems. Timely treatment helps prevent serious complications.
Causes and precipitating factors
Degenerative-dystrophic processes in the thoracic segments of the spine occur against the background of endogenous disturbances and under negative external influences. Their development is mostly caused by the following factors:
- hereditary predisposition, the presence of a certain set of defective genes;
- excessive physical strength, especially lifting and carrying various heavy objects;
- a sedentary lifestyle that causes congestion in the area of vertebral bodies and intervertebral discs;
- congenital or acquired structural anomalies, for example, accessory vertebra, lordosis, kyphosis;
- back and / or chest injuries - fractures, long-term compression;
- straight legs, club feet;
- violation of blood circulation in any region, not only in the thoracic spine;
- frequent hypothermia;
- overweight;
- endocrine pathologies, metabolic disorders, for example, 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 department. The disease can be the result of untreated, severe lumbar or cervical osteochondrosis.
Smoking, alcohol addiction and intoxication, as well as occupational hazards, lead to the destruction of intervertebral joints with discs consisting mainly of cartilage. Thoracic osteochondrosis 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. In contrast to cervical and lumbar osteochondrosis, it is extremely rarely sharp, burning, piercing. Patients usually describe anxiety as dull, painful, or oppressive. The pain syndrome may intensify when bending / turning the body, awkward sudden movements, during a coughing attack or during temperature changes. Its radiation is noted - it spreads beyond the affected area. Osteochondrosis of the thoracic spine also manifests itself as follows:
- feeling of stiffness, limitation;
- special clicks, crisp when changing body position;
- loss of sensitivity, paresis in the form of a "creeping goosebumps" feeling, burning, numbness;
- muscle spasms further restrict range of motion;
- adopting a mandatory position in which anxiety does not arise or is poorly expressed;
- pathological changes in posture, in later stages - gait;
- a slight decrease in growth due to the destruction of the intervertebral joints and the convergence of the vertebral bodies.
Due to the constant tension of the back muscles, the muscles of the neck and lower back 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 has compressed the nerve root located near the spine, pain simulating common pathologies may be felt:
- severe heart pain similar to angina pectoris and even myocardial infarction;
- pain in the mammary glands is the reason for an urgent differential diagnosis to exclude tumor processes;
- constant or periodic pain in the right hypochondrium, stomach or intestines similar to those characteristic of gastritis, cholecystitis and ulcerative lesions.
When osteochondrosis worsens, lower back or abdominal pain may occur. Patients confuse anxiety with symptoms of kidney pathology or gynecological disease. They turn to specialized specialists, who after examination refer patients to a neurologist or vertebrologist.
Classification, main types
The general classification of thoracic spine osteochondrosis is based on the nature of the pain syndrome. It has two types:
- dorsago - a sharp sharp pain in the sternum, mainly occurs during a long stay in one position of the body, often aggravated by a feeling of lack of air when breathing;
- dorsalgia in the form of mild painful sensations in the back, which appear periodically and subside after rest.
This division of pathology into groups allows the doctor to quickly decide on the choice of analgesic.
Staged development of thoracic osteochondrosis
In its development, osteochondrosis of the thoracic spine passes 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 is no change in X-ray yet. However, the intervertebral disc no longer retains moisture well, without which it cannot be restored in time. It gradually begins to thin, lose its strength and elasticity. Only in some cases, mild discomfort occurs in the thoracic region. A person perceives it 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.
Stage II
The structure of the fibrous ring is loose and fibrous. With the protrusion of the pulposus nucleus in this direction, the expansion of a crack in the disc occurs. As the height of the disc, which is clearly visible on radiographic images, decreases, the distance between adjacent vertebrae decreases. To compensate for the distribution of loads, the muscle tissue is constantly tense. Stiffness increases, the intensity of pain is still moderate.
III stage
The fibrous ring breaks when the nucleus pulposus is pushed beyond its limits. A herniated disc occurs, causing severe symptoms and severe complications. There is a significant deformation of the vertebral bodies and the formation of single osteophytes (compensatory bone growth). The pain syndrome stabilizes, the movements of 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. In the segment, adjacent vertebrae are blocked, completely or partially immobilized. Nerve roots are often compressed by inflammatory swelling, bone growth and muscle spasm. It manifests itself as a burning, burning pain. The patient copes with housework poorly and has difficulty moving.
Complications
The development of discogenic myelopathy, a dystrophic disease of the spinal cord caused mainly by compression by a herniated disc, is dangerous. It should be noted that such a complication with osteochondrosis of the thoracic spine is rare. Nevertheless, in clinical practice, there have been cases of localization of discogenic myelopathy in one of the lower segments. Muscle strength decreases and tendon reflexes change due to gradually increasing neurological deficit. Ischemic areas are formed and nerve cells die (spinal cord infarction). It is characterized by movement disorders, sensory loss and trophic disorders.
Diagnostic measures
In the first consultation, the doctor listens to the patient's complaints, examines him, assesses the sensitivity level, checks the 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 indications - a targeted image of a certain segment;
- magnetic resonance imaging;
- evoked potentials;
- electroneurography;
- electromyography;
- general clinical blood and urine tests.
Electrocardiography, ultrasound examination of cardiac structures, and electroencephalography can be prescribed to find the cause of specific symptoms and exclude somatic diseases with similar clinical manifestations.
Methods of treatment of thoracic osteochondrosis
Therapy is comprehensive, aimed at eliminating symptoms and preventing the spread of the pathological process to other spinal segments. In the acute stage, unbearable burning pain is eliminated by injecting drugs, including directly into the affected area. The use of glucocorticosteroids together with anesthetics (drug blockades) is usually applied. In other cases, drug treatment 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 pronounced analgesic activity;
- antispasmodics for pinched nerves;
- means to improve blood circulation;
- preparations with vitamin B6, which improve the transmission of nerve impulses and activate regeneration.
If radicular syndrome has developed and other complications have arisen, then a person constantly lives with the fear of experiencing unbearable pain again, which can lead to mental disorders. The appointment of sedatives and antidepressants can prevent such development. In addition to drugs, the following methods are used in the treatment of osteochondrosis of the thoracic spine:
- therapeutic massage including vacuum and acupuncture;
- physiotherapeutic procedures - electrophoresis/ultraphonophoresis, magnetic therapy, pulsed currents, UHF therapy, applications with ozokerite or paraffin, acupuncture, hirudotherapy;
- physical therapy and gymnastics;
- stretching of the spine.
In cases of significant damage to the vertebral discs and myelopathy, surgical treatment is always prescribed immediately. A herniated disc is removed, 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 factors that can cause thinning and cracking of the intervertebral disc. What doctors recommend:
- avoid excessive stress on the back;
- treat all diseases in a timely manner - infectious, endocrine, inflammatory;
- seek immediate medical attention for back wounds, even those that seem minor at first glance;
- give up alcohol and smoking or at least limit them;
- fill your diet with fatty fish, fresh vegetables, fruits and dairy products;
- avoid hypothermia;
- Do physical therapy for at least 15 minutes every day.
Such preventive measures are effective for already diagnosed diseases of the thoracic, 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 symptoms of osteochondrosis of the thoracic spine and want to get rid of it, go to the clinic for full, competent treatment.
Question and 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 burning or burning pain, which is even aggravated by inhalation. Without disturbing the sensitive nerve endings, thoracic osteochondrosis manifests itself as a dull pain, as if from a distance.
The second difference is the forecast. After eliminating the cause of intercostal neuralgia, it disappears without a trace. Osteochondrosis responds well to treatment only in the initial stages of development.