Thoracic osteochondrosis is a chronic pathology in which the bone vertebrae and the intervertebral discs located between them undergo degenerative changes. Destructive lesions in this area are quite rare due to low mobility and good protection by the rib cage. Osteochondrosis of the thoracic spine develops unnoticed, progresses slowly but persistently, and is also distinguished by a number of specific symptoms, disguised 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 prevent serious complications.
Causes and provoking factors
Degenerative-dystrophic processes in the thoracic segments of the spine occur against the background of endogenous disruptions and under negative external influences. Their development is most often provoked by the following factors:
- hereditary predisposition, the presence of a certain group of defective genes;
- excessive physical strain, especially lifting and holding various heavy objects;
- a sedentary lifestyle, causing overload in the area of vertebral bodies and intervertebral discs;
- congenital or acquired structural anomalies, for example, extra vertebrae, lordosis, kyphosis;
- back and/or chest injuries - fractures, prolonged compression;
- flat feet, club feet;
- impaired blood circulation in any area, not only in the thoracic spinal area;
- frequent hypothermia;
- overweight;
- endocrine pathology, 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 department. The disease can be a consequence of untreated, severe lumbar or cervical osteochondrosis.
Smoking, alcohol addiction and intoxication, including occupational hazards, predispose to the destruction of intervertebral joints with discs that are mainly composed 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 main symptom of the degenerative process is pain. Unlike cervical and lumbar osteochondrosis, it is extremely rare acute, burning, piercing. Patients usually describe the discomfort as dull, aching, or pressing. The pain syndrome can intensify when bending/turning the body, sudden unpleasant movements, during a coughing attack or during temperature changes. Its radiation is observed - spread beyond the affected area. Osteochondrosis of the thoracic spine is also manifested as follows:
- stiffness, feeling of limitation;
- specific clicks, squeaks when changing the position of the body;
- loss of sensitivity, paresis in the form of a sensation of "goosebumps", burning, numbness;
- muscle spasm, further limiting range of motion;
- adopting a forced position in which concern does not arise or is poorly expressed;
- pathological changes in posture, in later stages - walking;
- a slight decrease in growth as a result of 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 spasm, which is expressed by 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 a common innervation area with many internal organs. If a displaced disc has pinched a nerve root located near the spine, then pain can be felt in them, simulating common pathologies:
- severe cardiac pain resembling angina pectoris and even myocardial infarction;
- pain in the mammary glands becomes the reason for urgent differential diagnosis to exclude tumor processes;
- constant or periodic pains in the right hypochondrium, stomach or intestines, similar to those characteristic of gastritis, cholecystitis and ulcerative lesions.
When osteochondrosis worsens, the lower back or abdomen may hurt. Patients confuse discomfort with signs of renal pathology or gynecological disease. They refer to specialized specialists, who then refer patients to a neurologist or vertebrologist after examination.
Classification, main types
The usual classification of osteochondrosis of the thoracic spine is based on the nature of the pain syndrome. There are two types of it:
- dorsago - a sharp sharp pain in the sternum, which occurs mainly during a prolonged stay in one position of the body, often complicated by a feeling of lack of air during inhalation;
- dorsalgia in the form of light 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.
Step-by-step 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 more intense the pain, stiffness of movement and paresthesia. The stage of the disease determines the therapeutic tactics.
Phase I
There are still no changes in the X-ray. However, the intervertebral disc does not retain moisture better, without which its timely restoration is impossible. It begins to gradually thin, lose strength and elasticity. Only in some cases, slight discomfort appears in the chest 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.
Phase II
The structure of the annulus fibrosus becomes loose and fibrous. An enlargement of a disc herniation occurs with the extension of the nucleus pulposus in this direction. The distance between adjacent vertebrae decreases as the height of the disc decreases, which is clearly visualized on radiographic images. To compensate for the distribution of loads, muscle tissue is constantly tense. Stiffness increases, pain severity is still moderate.
Phase III
The annulus fibrosus is torn with the nucleus pulposus being squeezed beyond its borders. A herniated disc occurs, which causes severe symptoms and serious complications. Marked deformation of the vertebral bodies and the formation of single osteophytes (compensatory bone growth) are observed. The pain syndrome becomes constant, movements in the back are significantly limited.
Phase IV
At this stage, the diagnosis of thoracic osteochondrosis is not difficult. Connective tissue has grown and many osteophytes have formed. Adjacent vertebrae in the segment are blocked, completely or partially immobilized. Nerve roots are often compressed by inflammatory swelling, bony growths, and muscle spasms. This manifests itself as a burning pain, shooting. The patient copes poorly with homework and has difficulty moving.
Complications
The development of discogenic myelopathy, a dystrophic disease of the spinal cord resulting mainly from compression from a herniated disc, is dangerous. It is worth noting that with osteochondrosis of the thoracic spine, such a complication is rare. However, in clinical practice there have been cases of localization of discogenic myelopathy in one of the lower segments. Due to a gradually increasing neurological deficit, muscle strength decreases and tendon reflexes change. Ischemic areas form and nerve cells die (spinal cord infarction). This 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 level of sensitivity, checks tendon reflexes, studies the medical history and a history of spinal injuries. His diagnosis is confirmed by laboratory and instrumental studies:
- radiography in two projections, according to indications - a targeted image of a certain segment;
- magnetic resonance;
- evoked potentials;
- electroneurography;
- electromyography;
- general clinical blood and urine tests.
To find out the cause of specific symptoms and to exclude somatic diseases with similar clinical manifestations, electrocardiography, ultrasound scanning of heart structures and electroencephalography can be prescribed.
Methods of treatment of thoracic osteochondrosis
The therapy is comprehensive, aimed at eliminating symptoms and preventing the spread of the pathological process to other segments of the spine. In the acute phase, unbearable burning pain is eliminated by injecting medications, including directly into the affected area. The use of glucocorticosteroids in combination with anesthetics (drug blockade) is usually practiced. In other cases, drug therapy consists of taking tablets, capsules, rubbing with ointments and balms. The use of drugs from the following groups has been 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 a radicular syndrome has formed and other complications have appeared, then the person constantly lives in fear of experiencing excruciating pain again, and this can cause mental disorders. The prescription of sedatives and antidepressants can prevent such developments. In addition to medications, 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 current, UHF therapy, applications with ozokerite or paraffin, acupuncture, hirudotherapy;
- physical therapy and gymnastics;
- spinal traction.
In cases of significant damage to the vertebral discs and myelopathy, surgical treatment is always prescribed immediately. The hernial protrusion is removed, microdiscectomy is performed, puncture valorization or laser disc reconstruction is performed, an implant is placed, or the spinal segment is stabilized.
Prevention of thoracic osteochondrosis
The main goal of primary prevention of thoracic osteochondrosis is the elimination of factors that can cause thinning and cracking of the intervertebral disc. What doctors recommend:
- avoid excessive stress on the back;
- immediately treat all diseases - infectious, endocrine, inflammatory;
- seek medical help immediately for back injuries, even those that seem minor at first glance;
- give up alcohol and smoking or at least limit them;
- supplement 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 deterioration 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 and competent treatment.
Question answer
What is the difference between intercostal neuralgia and thoracic osteochondrosis?
In fact, intercostal neuralgia is a lesion of the intercostal nerves, which can complicate the course of osteochondrosis. There are two main differences between these pathological processes. Neuralgia is characterized by paroxysmal pain or burning, which is also intensified by inhalation. Thoracic osteochondrosis without damage to 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.