Thoracic osteochondrosis is a chronic pathology in which the bone vertebrae and intervertebral discs located between them undergo degenerative changes. Destructive lesions in this area are quite rare due to the low mobility and good protection of the rib framework. Osteochondrosis of the thoracic spine develops unnoticed, progresses slowly but persistently, and is also distinguished by a number of specific symptoms, masquerading as diseases of internal organs. In this regard, it is very important to consult a doctor at the first, even slight, signs of back problems. Prompt 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 disturbances and under negative external influences. Their development is most often caused by the following factors:
- hereditary predisposition, the presence of a certain set of defective genes;
- excessive physical exertion, including lifting and carrying various heavy objects;
- a sedentary lifestyle, causing congestion in the vertebral bodies and intervertebral discs;
- congenital or acquired structural abnormalities, e. g. , accessory vertebrae, lordosis, kyphosis;
- back and/or chest injuries – fractures, prolonged compression;
- flat feet, club feet;
- impaired blood circulation in the thoracic region of the spine, and not only in it;
- frequent hypothermia;
- Overweight;
- endocrine pathologies, 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 state of each department. The disease can be the consequence of severe and untreated lumbar or cervical osteochondrosis.
Smoking, alcohol dependence and intoxication, including occupational risks, predispose to the destruction of intervertebral joints, the discs of which are mainly made up of cartilage. Thoracic osteochondrosis is more often diagnosed in older people than in young and middle-aged people. This is due to the natural aging of the body, a slowdown in 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 rarely acute, burning, piercing. Patients typically describe the discomfort as dull, aching, or pressing. The pain syndrome can intensify during bending or rotation of the body, sudden and awkward movements, during a coughing fit or during changes in temperature. Its irradiation is noted – extended beyond the affected area. Osteochondrosis of the thoracic spine also manifests itself as follows:
- stiffness, feeling of constraint;
- specific clicks, crunches when changing body position;
- loss of sensitivity, paresis in the form of a feeling of "creeping goosebumps", burning, numbness;
- muscle spasms, further limiting range of motion;
- adoption of a forced position in which discomfort does not arise or is weakly expressed;
- pathological changes in posture, in later stages - gait;
- a slight decrease in growth resulting from the destruction of the intervertebral joints and the convergence of the vertebral bodies.
Due to the constant tension in the back muscles, the neck and lower back muscles also experience spasms, which results in pain in these parts.
The clinical picture of thoracic osteochondrosis is a set of pain syndromes. The fact is that the affected segments are located in a common innervation zone with many internal organs. If a displaced disc has pinched a nerve root located near the spine, then pain may be felt there, simulating common pathologies:
- severe heart pain resembles angina 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, in the stomach or intestines, resemble those characteristic of gastritis, cholecystitis and ulcerative lesions.
When osteochondrosis worsens, the lower back or abdomen may be painful. Patients confuse discomfort with signs of kidney pathology or gynecological disease. They turn to specialized specialists, who then refer patients to a neurologist or vertebrologist after examination.
Classification, main types
The common classification of osteochondrosis of the thoracic spine is based on the nature of the pain syndrome. There are two types :
- dorsago - sharp, sharp pain in the sternum, which occurs mainly during prolonged stay in one body position, often complicated by a feeling of lack of air when inhaling;
- back pain in the form of mild painful sensations in the back, appearing periodically and fading after rest.
This division of pathology into groups allows the doctor to quickly decide on the choice of painkiller.
Step-by-step 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 movements and paresthesias. The stage of the disease determines the therapeutic tactics.
Stage I
There is no change yet on the x-ray. However, the intervertebral disc no longer retains moisture well, without which its rapid restoration is impossible. It gradually begins to thin, losing strength and elasticity. Only in some cases does slight discomfort appear in the chest area. A person perceives it as muscle fatigue and does not consult a doctor. Therefore, disease at this stage is usually an incidental diagnostic finding during an examination for another reason.
Stage II
The structure of the annulus fibrosus becomes loose and fibrous. Widening of a disc fissure occurs with protrusion of the nucleus pulposus in that direction. The distance between adjacent vertebrae decreases as the height of the disc decreases, which is clearly visible in x-ray images. To compensate for the distribution of loads, the muscle tissue is constantly tense. Stiffness increases, pain intensity is still moderate.
Stage III
The annulus fibrosus ruptures and the nucleus pulposus is compressed beyond its limits. A herniated disc occurs, leading to serious symptoms and serious complications. There is significant deformation of the vertebral bodies and the formation of unique osteophytes (compensatory bone growths). The pain syndrome becomes constant, back movements are significantly limited.
Stage IV
At this stage, the diagnosis of thoracic osteochondrosis is not difficult. Connective tissues developed and multiple osteophytes formed. The vertebrae adjacent to the segment are blocked, totally or partially immobilized. Nerve roots are often pinched by inflammatory swelling, bony growths and muscle spasms. This manifests itself as burning, stabbing pain. The patient performs household chores poorly and has difficulty moving.
Complications
The development of discogenic myelopathy, a dystrophic disease of the spinal cord resulting primarily from compression by a herniated disc, is dangerous. It should be noted that with osteochondrosis of the thoracic spine, such a complication is rare. Nevertheless, in clinical practice there have been cases of localization of discogenic myelopathy in one of the lower segments. Due to a progressively 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, loss of sensitivity and trophic disorders.
Diagnostic measures
During 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 history of spinal injuries. Its diagnosis is confirmed by laboratory and instrumental studies:
- x-ray in two projections, according to indications - a focused image of a certain segment;
- Magnetic resonance imaging;
- evoked potentials;
- electroneurography;
- electromyography;
- general clinical analyzes of blood and urine.
To find out the cause of specific symptoms and exclude somatic diseases with similar clinical manifestations, electrocardiography, ultrasound of cardiac structures and electroencephalography may be prescribed.
Methods for treating thoracic osteochondrosis
Therapy is comprehensive and aimed at eliminating symptoms and preventing the spread of the pathological process to other segments of the spine. In the acute stage, burning and unbearable pain is eliminated by injecting drugs, including directly into the affected area. The use of glucocorticosteroids in combination with anesthetics (drug blockades) is usually practiced. In other cases, drug treatment consists of taking tablets, capsules, applying 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 based on vitamin B6, which improve the transmission of nerve impulses and activate regeneration.
If radicular syndrome has formed and other complications have arisen, the person constantly lives in fear of experiencing excruciating pain again, which can cause mental disorders. Prescribing 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 currents, UHF therapy, applications with ozokerite or paraffin, acupuncture, hirudotherapy;
- physiotherapy and gymnastics;
- spinal traction.
In case of significant damage to the spinal discs and myelopathy, surgical treatment is always prescribed immediately. The hernial protrusion is removed, a microdiscectomy, puncture enhancement or laser reconstruction of the disc 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 to eliminate factors that can trigger thinning and cracking of the intervertebral disc. What doctors recommend:
- avoid excessive stress on the back;
- promptly treat all diseases - infectious, endocrine, inflammatory;
- seek immediate medical attention for back injuries, even those that seem minor at first glance;
- give up alcohol and tobacco or at least limit them;
- replenish 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 exacerbations and progression of the degenerative-dystrophic process.
If you have signs of osteochondrosis of the thoracic spine and want to get rid of them, contact the clinic for comprehensive and competent treatment.
Question Answer
What is the difference between intercostal neuralgia and thoracic osteochondrosis?
In fact, intercostal neuralgia is damage to the intercostal nerves, which can complicate the course of osteochondrosis. There are two main differences between these disease processes. Neuralgia is characterized by paroxysmal shooting or burning pain, which intensifies even when inhaling. Thoracic osteochondrosis without damage to sensitive nerve endings is manifested by dull, as if distant, pain.
And the second difference concerns the forecasts. After eliminating the cause of intercostal neuralgia, it disappears without a trace. Osteochondrosis responds well to treatment only in the early stages of development.