Thoracic osteochondrosis is a chronic pathology in which the bone vertebrae and the intervertebral discs between them undergo degenerative changes. Destructive lesions in this zone are quite rare due to low mobility and good protection of the rib cage. Osteochondrosis of the thoracic spine develops imperceptibly, progresses slowly but steadily, and is distinguished by a number of specific symptoms, which are disguised as diseases of the internal organs. In this regard, it is very important to consult a doctor at the first, even mild, signs of back problems. Timely treatment helps to avoid serious complications.
Causes and provoking factors
Degenerative-dystrophic processes in the thoracic segments of the spine occur against the background of endogenous disorders and as a result of negative external influences. Their development is most often provoked by the following factors:
- hereditary predisposition, the presence of certain defective genes;
- excessive physical exertion, especially lifting and carrying various heavy objects;
- a sedentary lifestyle that causes congestion in the area of the vertebral bodies and intervertebral discs;
- congenital or acquired structural abnormalities, such as accessory vertebrae, lordosis, kyphosis;
- back and/or chest injuries - fractures, prolonged compression;
- flat foot, stick sole;
- impaired blood circulation in any area, not only the thoracic spine;
- frequent hypothermia;
- overweight;
- endocrine diseases, 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 the result of untreated, severe lumbar or cervical osteochondrosis.
Smoking, alcohol addiction, and poisoning, including occupational hazards, predispose to the destruction of the intervertebral joints, where the discs are composed mostly of cartilage. Thoracic osteochondrosis is diagnosed more often in the elderly than in the young and middle-aged. This is due to the natural aging of the body, the slowing down of healing 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 oppressive. The pain syndrome may intensify during bending/turning of the body, awkward sudden movements, coughing fits or temperature changes. Irradiation can be observed - it spreads beyond the affected area. Osteochondrosis of the thoracic spine is manifested as follows:
- feeling of stiffness, constraint;
- specific clicks, crunches when changing body position;
- loss of sensitivity, paresis in the form of "creeping goosebumps", burning, numbness;
- muscle spasms, further limiting range of motion;
- adopting a forced situation in which discomfort does not occur or is weakly expressed;
- pathological changes in posture, in later stages - walking;
- 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 also spasm, which manifests itself in pain in these parts.
The clinical picture of thoracic osteochondrosis is a combination of pain syndromes. The fact that the affected segments are located in a common innervation zone with many internal organs. If a displaced disc has pinched the nerve root near the spine, pain can be felt in them, simulating common pathologies:
- severe heart pain resembles angina pectoris and even heart attack;
- pain in the mammary glands is a reason for urgent differential diagnosis in order to exclude neoplastic processes;
- constant or intermittent pain in the right hypochondrium, stomach or intestines, similar to pain characteristic of gastritis, cholecystitis and ulcerative lesions.
When osteochondrosis worsens, the lower back or abdomen may ache. Patients mistake the discomfort for signs of kidney pathology or gynecological disease. They turn to specialists who, after an examination, refer the 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 this:
- dorsago - sharp acute pain in the sternum, which occurs 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, appearing periodically and decreasing after rest.
Dividing the pathology into such groups allows the doctor to quickly decide on the choice of pain reliever.
Staged 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 more intense the pain, stiffness of movement and paresthesia. The therapeutic tactics are determined by the stage of the disease.
Section I
There is no change in the x-ray yet. However, the intervertebral disc no longer holds moisture well, without which timely recovery is impossible. It gradually thins, loses its strength and elasticity. Mild discomfort in the chest region occurs only in some cases. 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.
section II
The structure of the fibrous ring loosens and becomes fibrous. An enlargement of a fissure in the disc occurs when the nucleus pulposus protrudes in this direction. The distance between adjacent vertebrae decreases as the height of the disc decreases, which is clearly visible on X-rays. To compensate for the distribution of loads, the muscle tissue is constantly stretched. Stiffness increases, pain severity remains moderate.
section III
The annulus fibrosus ruptures while the nucleus pulposus is pushed beyond its borders. A herniated disc occurs, causing severe symptoms and serious complications. The deformation of the vertebral bodies and the formation of single osteophytes (compensatory bone growths) are significant. The pain syndrome becomes constant, and back movements are significantly limited.
Section IV
At this stage, diagnosing thoracic osteochondrosis is not difficult. The connective tissues grew and more osteophytes formed. Adjacent vertebrae of the segment are blocked, completely or partially immobilized. Nerve roots are often pinched by inflammatory swelling, bony growths, and muscle spasms. This manifests as a burning, shooting pain. The patient copes poorly with household tasks and has difficulty moving.
Complications
Discogenic myelopathy, a dystrophic disease of the spinal cord, which primarily results from compression by a herniated disc, is dangerous. It is worth noting that such a complication is rare with osteochondrosis of the thoracic spine. However, in clinical practice there have been cases when discogenic myelopathy is localized in one of the lower segments. Due to the gradually increasing neurological deficit, muscle strength decreases and tendon reflexes change. Ischemic areas develop and nerve cells die (spinal cord infarction). This 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, assesses the level of sensitivity, checks the tendon reflexes, examines the medical history and the history of spinal injuries. Its diagnosis is confirmed by laboratory and instrumental tests:
- radiography in two projections, as indicated - a targeted image of a certain segment;
- magnetic resonance imaging;
- evoked potentials;
- electroneurography;
- electromyography;
- general clinical blood and urine test.
Electrocardiography, ultrasound examination of cardiac structures, and electroencephalography can be prescribed to detect the cause of specific symptoms and to rule out somatic diseases with similar clinical manifestations.
Methods of treatment of thoracic osteochondrosis
The therapy is comprehensive and aims to eliminate the symptoms and prevent the pathological process from spreading to other spinal segments. In the acute stage, the burning unbearable pain is eliminated by injecting drugs, including directly into the affected area. Generally, glucocorticosteroids are used in combination with anesthetics (drug blockade). In other cases, drug therapy consists of rubbing tablets, capsules, ointments and balms. The use of drugs belonging to the following groups has proven to be effective:
- muscle relaxants to relieve muscle spasms;
- non-steroidal anti-inflammatory drugs with a pronounced analgesic effect;
- anticonvulsants for pinched nerves;
- means to improve blood circulation;
- Preparations containing vitamin B6, which improve the transmission of nerve impulses and activate regeneration.
If radicular syndrome has developed and other complications have occurred, then a person is constantly afraid of experiencing unbearable pain again, and this can cause mental disorders. Prescribing sedatives and antidepressants can prevent such developments. In addition to drugs, the following methods are used to treat osteochondrosis of the thoracic spine:
- therapeutic massage, including vacuum and acupuncture;
- physiotherapy procedures - electrophoresis/ultraphonophoresis, magnetic therapy, pulse currents, UHF therapy, use of ozokerite or paraffin, acupuncture, hirudotherapy;
- physical therapy and gymnastics;
- spine traction.
In case of significant damage to the discs and myelopathy, immediate surgical treatment is always prescribed. The protrusion of the hernia is removed, microdiscectomy, puncture valorization or laser reconstruction of the disc is performed, an implant is inserted, or the spine is stabilized.
Prevention of thoracic osteochondrosis
The main goal of the primary prevention of thoracic osteochondrosis is to eliminate factors that can cause thinning and cracks of the intervertebral disc. What doctors recommend:
- avoid excessive load on the back;
- immediately treat all diseases - infectious, endocrine, inflammatory;
- seek medical help immediately for back injuries, even those that at first glance seem minor;
- stop drinking 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 in cases of already diagnosed diseases of the thoracic, cervical or lumbar spine. With their help, the aggravation and progression of the degenerative-dystrophic process can be prevented.
If you have signs of osteochondrosis of the thoracic spine and want to get rid of it, contact the clinic for full, 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 that 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 when inhaling. Thoracic osteochondrosis without violation of sensitive nerve endings is dull, as if it manifests itself in distant pain.
The second difference is forecasting. After eliminating the cause of intercostal neuralgia, it disappears without a trace. Osteochondrosis responds well to treatment only in the initial stages of development.