Osteochondrosis is the most common disease of all diseases of the spine. Osteochondrosis being directly a dystrophic-degenerative lesion of the discs located between the vertebrae, this consequently leads to an irreversible modification of their structure, as well as of the shape of the discs themselves, which constitute the thoracic spine. .
With increasing age of a person, these changes in their spine develop more and more, and around the age of around 40-45 years, almost everyone suffers from osteochondrosis of the spine. vertebral. By itself, osteochondrosis of the thoracic spine develops much less frequently than, for example, the lumbar or cervical spine, since the vertebrae are much less mobile there than in other vertebral areas. In addition, the back area in the chest area has a more developed muscle corset, which supports the spine in the thoracic area much better than in the others.
What is this thoracic osteochondrosis?
Thoracic osteochondrosisdirectly represents a stratification of the discs between the vertebrae with a simultaneous decrease in their thickness and, as a result, the subsequent pinching of the nerve endings located in the intercostal zone of the human thorax.
However, we note once again that due to the fact that the physiological fixation by the ribs in humans is rather rigid, the spine in the chest area is less susceptible to osteochondrosis. It is thoracic osteochondrosis which is a rare phenomenon, for example osteochondrosis of the cervical or lumbar spine.
Usually, with osteochondrosis of the thoracic spine, the pathological process involves the discs between the vertebrae of the thoracic spine, which includes twelve thoracic vertebrae. But most often with osteochondrosis of the thoracic region, pathological changes occur with the upper thoracic vertebrae. There are several degrees of injury with thoracic osteochondrosis, and later we will consider them in more detail.
Factors predisposing to the development of thoracic osteochondrosis
The exact causes of the appearance of osteochondrosis of the thoracic region have not yet been fully established by modern science. At present, it is customary in medicine to distinguish the following predisposing factors, or risk factors, due to which osteochondrosis of the thoracic region occurs in the spine:
- hereditary predisposition;
- excessive physical activity in this section of the spine;
- injuries to the spine, such as falls or bruising in the chest area;
- changes that occur with age in the intervertebral discs and lead to a decrease in the hydration of the disc tissues;
- violations of the blood supply in the chest area.
Causes contributing to the disease of thoracic osteochondrosis
Overall, the development of the disease with osteochondrosis is usually promoted by hypodynamia, that is, a lack of muscle loads, leading to weakening of the functions of the muscle corset and, as a result, increased loads onthe intervertebral discs and ligaments.
Additional reasons for the development of thoracic osteochondrosis are:
- hypothermia of the body;
- the presence of chronic stressful situations;
- transferred infections;
- difficult conditions of physical work;
- hormonal disorders that have arisen in the body;
- violation of the metabolic process in the body;
- the presence of congenital malformations of the spine, namely its thoracic region.
During exposure to a combination of these factors, or even just one, irreversible dystrophic-degenerative processes develop over time in the intervertebral discs:
- the nucleus pulposus of the intervertebral disc gradually begins to lose fluid, which was secreted by them to provide a lubricating function, which ultimately significantly reduces the damping function of this disc;
- the fibrous ring of the vertebrae themselves, due to the increased load on it, becomes more vulnerable, which in turn leads to its gradual destruction.
Symptoms and signs of thoracic osteochondrosis of the spine
The clinical symptoms of thoracic osteochondrosis depend entirely on the following factors:
- the age of the patient;
- the degree of affection of the disease;
- stages of osteochondrosis of the thoracic spine: remission or exacerbation.
The main signs of thoracic osteochondrosis are:
- pain in the chest in the spine, the so-called dorsago;
- painful damage to the nerve endings of the spinal cord - radiculopathy;
- abdominal syndrome;
- cardiac syndrome or changes in the heart muscle, with characteristic pains that persist even under the influence of trinitroglycerin;
- pulmonary syndrome, in the form of stagnation in the lungs with signs of hypoxia, that is, choking.
An increase in body temperature in a patient with thoracic osteochondrosis is not observed, which is also a sign of direct differential diagnosis. Back pain in the thoracic region, one of the main symptoms of osteochondrosis, indicates the appearance of cracks in the fibrous ring and deformation of the nucleus pulposus. When palpating, the pain in this area of the chest only intensifies, the symptoms increase.
In addition, the characteristic symptoms of thoracic osteochondrosis with compression myelopathy, that is, the deformation of nerve endings, are:
- sensation of "goosebumps" - paresthesia;
- pain along the compressed nerve - are common symptoms;
- decreased sensitivity to temperature and touch;
- motor function disorders of the spine are also one of the characteristic symptoms.
Having found such symptoms, you need to consult a specialist. Especially dangerous is the appearance of symptoms in the complex and their intensity. At the same time, it is inappropriate to treat the symptoms without eradicating the causes and factors of the disease.
Degrees of disease with thoracic osteochondrosis
Each degree of the disease with thoracic osteochondrosis is characterized by its own pathology, which has only its own clinical signs. Modern medicine distinguishes four degrees of degenerative disc disease of the thoracic region (likewise - degenerative lumbar and cervical disc disease) and, therefore, four periods of its development. Let's consider them in more detail.
First degree,for which it is characteristic that cracks appear inside the fibrous ring, into which then penetrates the nucleus pulposus. This period of development of the disease with thoracic osteochondrosis is characterized by the following symptoms:
- the appearance of pain in the spine that does not go beyond the localization of the lesion;
- these pains can be either permanent or expressed by lumbago;
- there may be a convulsive contraction of the muscles in the chest region, accompanied by pain in the heart region.
Second degreethe development of thoracic osteochondrosis is characterized by the pathological appearance of increased intervertebral mobility with the following clinical manifestations:
- subluxations appear in the thoracic spine;
- pain increases during movement;
- discomfort appears with prolonged posture.
Third degreecharacterized by the rupture of the fibrous ring and the exit of the nucleus pulposus beyond its limits. In this period of the disease with osteochondrosis of the thoracic spine, intervertebral hernias begin to appear, the clinical signs of which are rather severe. Namely - neurovascular, muscle tonic and reflex dystrophic.
In addition to the above, for the third degree of osteochondrosis of the thoracic region, a change in the following conditions of the spine is characteristic:
- weak fixation of the position of the spine;
- limitation of mobility of the vertebral region, manifested in the form of kyphosis or scoliosis.
Fourth degree- the dystrophic-degenerative process already affects all the structures that are surrounded by the spine. This pathological process involves the yellow, interspinous and other ligaments, and fibrosis occurs in the structures surrounding the spine. In this period of the disease with thoracic osteochondrosis, the so-called remission state is clinically observed.
With the further progression of the disease with thoracic osteochondrosis, the development of concomitant complications is possible:
- inflammation of the nerve endings of the spinal cord;
- the appearance of intervertebral hernias;
- development of vascular dystonia;
- the development of Schmorl's hernia;
- spondylarthrosis disease;
- pathological growth of bone growths - osteophytes;
- a significant decrease in the spinal canal.
It should be noted that the severity of complications occurring in thoracic osteochondrosis depends entirely on the speed of progression of the process of the disease that has arisen and, of course, the effectiveness of the methods of treatment of osteochondrosis of the thoracic spine.
Diagnosis and its methods
In practice, several methods are used to diagnose thoracic osteochondrosis. Of these, the most common is the x-ray examination, the results of which are quite informative. The signs of thoracic osteochondrosis detected in this study are as follows:
- the contours of the discs between the vertebrae are broken;
- the edges of the integumentary plates have acquired a wavy character;
- the intervertebral discs have changed shape;
- osteophytes appeared - pathological bony growths in the spine;
- the hook-shaped processes of the vertebrae grew and sharpened;
- the bodies of the thoracic vertebrae have changed to normal shape;
- the height of the discs between the vertebrae has significantly decreased;
- herniated discs between the vertebrae have formed.
In some cases, a method of diagnosing thoracic osteochondrosis of the spine is carried out by means of an X-ray contrast study, which determines the following signs of this disease:
- in advanced pathology, the contrast agent completely fills the disc between the vertebrae;
- with the help of a contrast medium, the outlines of the nucleus pulposus are visible, which are uneven;
- when the intervertebral disc is destroyed, the contrast product penetrates far beyond its limits, until it enters the spinal canal.
Only the right diagnosis can determine the right treatment.
Treatment of osteochondrosis
Treatment of thoracic osteochondrosis is possible in one of the following ways, which are used taking into account the results of the diagnosis of thoracic osteochondrosis, namely:
- traditional conservative treatment of the spine;
- treatment of thoracic osteochondrosis with traction;
- operative surgery.
The treatment of thoracic osteochondrosis, said conservative, is complex for the treatment of any type of osteochondrosis: drugs, physiotherapy, physiotherapy exercises. Nonsteroidal anti-inflammatory drugs are aimed at relieving pain in the spine, known for chest osteochondrosis. It should be noted that these drugs very well eliminate inflammatory processes, as well as the resulting swelling, helping to reduce the compression of the nerve roots. In more complex cases of breast osteochondrosis, the attending physician may prescribe a number of additional drugs, for example, strong pain relievers and muscle relaxers that block the onset of muscle spasms.
When the pain subsides or has managed to stop, that is, during remission, physiotherapy treatment is prescribed, as well as exercise therapy and massage. These are all important parts of a comprehensive treatment. One of the main physiotherapeutic tools for the treatment and prevention of disease is pulsed magnetotherapy using special medical devices for clinical and home use.
Only magnetotherapy of special parameters is allowed for use in exacerbations; there are medical devices to treat both acute pain and chronic pain. This system is also suitable for the treatment of the lumbosacral and cervical spine.
In addition to the above, traction therapy, that is, treating chest osteochondrosis with special traction, can be used successfully to treat chest osteochondrosis. With this method, the muscles, tissues and paravertebral ligaments are stretched, which leads to an increase in the intervertebral distance. Even a millimeter and a half will already be enough to reduce swelling, eliminate compression and relieve tension in the muscles adjacent to the spine. In any case, the main principle of conservative treatment is its complexity. The treatment will have to be done for a long time and regularly, this is the only way to hope for results.
But surgical intervention as a type of osteochondrosis treatment is recommended only when the above methods of treatment of thoracic osteochondrosis do not give the desired result.