Thoracic osteochondrosis is a chronic pathology in which the bone vertebrae and the intervertebral discs between them undergo degenerative changes. Due to the low mobility and the good protection by the rib framework, destructive lesions in this zone are quite rare. Osteochondrosis of the thoracic spine develops unnoticed, progresses slowly but persistently and is also characterized by a number of specific symptoms that disguise themselves as diseases of the internal organs. In this context, it is very important to seek medical help at the first, slight signs of back problems. Timely treatment helps prevent serious complications.
Causes and provoking factors
Degenerative-dystrophic processes in the thoracic spinal segments occur against the background of endogenous disorders and under negative external influences. Their development is most often provoked by the following factors:
- hereditary predisposition, the presence of a certain set of defective genes;
- excessive physical exertion, especially lifting and carrying various heavy objects;
- a sedentary lifestyle that leads to congestion in the vertebral bodies and intervertebral discs;
- congenital or acquired structural anomalies, for example accessory vertebrae, lordosis, kyphosis;
- Back and/or chest injuries – fractures, sustained compression;
- flat feet, club feet;
- Circulatory disorders in all areas, not just in the thoracic spine;
- frequent hypothermia;
- obesity;
- 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 entire spine directly depends on the condition of its individual sections. The disease can be the result of untreated, severe lumbar or cervical osteochondrosis.
Smoking, alcohol addiction and poisoning, including occupational hazards, promote the destruction of intervertebral joints, the intervertebral discs of which are predominantly made of cartilage. Thoracic osteochondrosis is diagnosed more often 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 and stabbing. Patients usually describe the symptoms as dull, aching or oppressive. The pain syndrome can worsen when bending/turning the body, with unpleasant sudden movements, with a coughing fit or with temperature changes. The radiation is found to radiate beyond the affected area. Osteochondrosis of the thoracic spine is also manifested as follows:
- stiffness, feeling of tightness;
- specific clicks, crunches when changing body position;
- Loss of sensitivity, paresis in the form of a "crawling goosebumps feeling", burning, numbness;
- muscle cramps that further restrict freedom of movement;
- Adopting a forced position in which the discomfort does not occur or is only mild;
- pathological changes in posture, in later stages - gait;
- a slight decline in growth resulting from the destruction of the intervertebral joints and the convergence of the vertebral bodies.
Due to the constant tension of the back muscles, spasms of the neck and lower back muscles also occur, which is manifested by pain in these parts.
The clinical picture of thoracic osteochondrosis is a combination of pain syndromes. The fact is that the affected segments lie in a common innervation zone with many internal organs. If a displaced disc has pinched a nerve root near the spine, pain is felt in them, 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 pain in the right hypochondrium, stomach or intestines is similar to that characteristic of gastritis, cholecystitis and ulcerative lesions.
As osteochondrosis worsens, pain in the lower back or abdomen may occur. Patients confuse discomfort with signs of kidney disease or gynecological disease. They contact specialized specialists who, after the examination, refer the patient to a neurologist or vertebral doctor.
Classification, main types
The usual classification of osteochondrosis of the thoracic spine is based on the type of pain syndrome. There are two types of it:
- Dorsago – a sharp, acute pain in the sternum that occurs mainly when staying in one body position for a long time and is often complicated by a feeling of lack of air when inhaling;
- Dorsalgia in the form of mild painful sensations in the back that occur regularly and subside after rest.
This division of pathology into groups allows the doctor to quickly decide on the choice of analgesic.
Gradual development of thoracic osteochondrosis
In its development, osteochondrosis of the thoracic spine goes through four stages. Each has its own symptoms and radiological markers. The more pronounced the deformation of the intervertebral discs and vertebrae, the greater the pain, stiffness of movement and paresthesia. The stage of the disease determines the therapy tactics.
Stage I
No changes can be seen on the x-ray. However, the intervertebral disc no longer stores moisture well, without which timely recovery is not possible. It gradually begins to become thinner, loses strength and elasticity. Only in isolated cases can there be slight discomfort in the chest area. A person perceives it as muscle fatigue and does not consult a doctor. Therefore, the disease at this stage is usually an incidental finding during examination for another reason.
Stage II
The structure of the fibrous ring becomes loose and fibrous. When the nucleus pulposus protrudes in this direction, a tear in the intervertebral disc enlarges. The distance between adjacent vertebrae decreases as the height of the intervertebral disc decreases, which is clearly visible on x-ray images. In order to balance the load distribution, the muscle tissue is constantly tense. The stiffness increases, the pain intensity is still moderate.
Stage III
The fibrous ring tears, squeezing the nucleus pulposus beyond its limits. A herniated disc occurs, causing severe symptoms and serious complications. Significant deformation of the vertebral bodies and the formation of individual osteophytes (compensatory bone growths) occur. The pain syndrome becomes constant, movements in the back are significantly restricted.
IV stage
At this stage, the diagnosis of thoracic osteochondrosis is not difficult. Connective tissue has grown and several osteophytes have formed. Adjacent vertebrae in the segment are blocked, completely or partially immobilized. Nerve roots are often pinched due to inflammatory swelling, bone growth, and muscle spasms. This is manifested by a burning, stabbing pain. The patient copes poorly with household duties and has difficulty moving.
Complications
The development of discogenic myelopathy, a dystrophic disease of the spinal cord primarily due to compression from a herniated disc, is dangerous. It is worth noting that such a complication is rare in osteochondrosis of the thoracic spine. Nevertheless, 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, loss of sensitivity and trophic disorders.
Diagnostic measures
At the first consultation, the doctor listens to the patient's complaints, examines him, assesses the degree of his sensitivity, checks tendon reflexes, examines the medical history and history of spinal injuries. His diagnosis is confirmed by laboratory and instrumental studies:
- Radiography in two projections, depending on the indications - a targeted image of a specific segment;
- magnetic resonance imaging;
- evoked potentials;
- electroneurography;
- electromyography;
- general clinical blood and urine tests.
To find out the cause of certain symptoms and exclude somatic diseases with similar clinical manifestations, electrocardiography, ultrasound examination of cardiac structures and electroencephalography can be prescribed.
Treatment methods for thoracic osteochondrosis
Therapy is comprehensive and aimed at eliminating symptoms and preventing the spread of the pathological process to other spinal segments. In the acute stage, burning, unbearable pain is eliminated by injecting medication, including directly into the affected area. The use of glucocorticosteroids is usually practiced in combination with anesthetics (drug blockades). In other cases, drug therapy consists of taking tablets, capsules, rubbing ointments and balms. The use of medications from the following groups has proven successful:
- muscle relaxants to relieve muscle spasms;
- non-steroidal anti-inflammatory drugs with a pronounced analgesic effect;
- antispasmodics for pinched nerves;
- preparations for improving blood circulation;
- Preparations with 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 lead to psychological disorders. Prescribing sedatives and antidepressants can prevent such developments. In the treatment of osteochondrosis of the thoracic spine, in addition to medications, the following methods are used:
- therapeutic massage, including vacuum and acupuncture;
- physiotherapeutic procedures – electrophoresis/ultraphonophoresis, magnetic field therapy, pulsed currents, UHF therapy, applications with ozokerite or paraffin, acupuncture, hirudotherapy;
- physiotherapy and gymnastics;
- Spinal traction.
In cases of significant disc damage and myelopathy, surgical treatment is always prescribed immediately. The hernia protrusion is removed, a microdiscectomy, puncture valorization or laser reconstruction of the intervertebral disc is performed, an implant is inserted 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 strain on your back.
- promptly treat all diseases - infectious, endocrine, inflammatory;
- For back injuries, even if they seem minor at first glance, seek medical attention immediately;
- abstain from 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 diseases of the thoracic, cervical or lumbar spine that have already been diagnosed. With their help, exacerbations and the 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 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 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 stabbing or burning pain, which also increases when inhaling. Thoracic osteochondrosis without injury to sensitive nerve endings is manifested by dull, distant pain.
And 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.