Thoracic osteochondrosis is a chronic disease of the spine in which degenerative-dystrophic changes occur in the intervertebral discs.
The thoracic spine is less affected by osteochondrosis compared to the cervical and lumbar spine. This is explained by the fact that it is relatively inactive, stable and well strengthened by a muscular corset. Even rarer are its complications: disc protrusion and herniation.
However, this disease presents with extensive symptoms that significantly reduce quality of life and therefore requires treatment. The use of medications only dulls the symptoms and provides a temporary effect that does not affect the development of the disease.
To reliably eliminate the symptoms, it is necessary to influence the cause of the development of degenerative processes in the discs. To do this, the clinic uses a complex therapy that gives positive results in more than 90% of cases. Includes methods of reflexology and oriental physiotherapy: acupressure, acupuncture, moxotherapy and other therapeutic procedures.
Symptoms, signs
With osteochondrosis, a flattening of the intervertebral discs occurs and the vertebrae come together, which causes pinching of the roots of the spinal nerves. This causes pain between the shoulder blades (usually described as a sticky spike).
Pain syndrome in thoracic osteochondrosis can be acute, intense or chronic, moderate.
In the first case, the acute pain appears suddenly and is called back pain. In the second case, the pain is felt constantly, has a painful character and is called backgia.
Irritation from a pinched root spreads along the nerve, radiating into the chest and becomes the cause of intercostal neuralgia - stabbing, cutting or burning pain in the chest, which intensifies with inhalation, movement, coughing, sneezing and laughing.
Another characteristic symptom of thoracic osteochondrosis is pain in the heart area, which is accompanied by signs of cardioneurosis: palpitations, heart palpitations and increased heart rate.
The pinched nerve root causes altered innervation, numbness, weakness of the hand, a feeling of cold in the hand, cyanosis (blue discoloration) or paleness of the skin. These symptoms are usually unilateral.
Pain with osteochondrosis can also radiate to the shoulder, under the shoulder blade and to the forearm.
Other symptoms of the disease are stiffness, tension in the back, numbness in the paravertebral region, shoulders, cervical neck area, difficulty breathing, feeling of a lump in the chest.
The nerves arising from the spinal cord in the thoracic region play an important role in the innervation of the entire body. Therefore, the symptoms of osteochondrosis can appear in areas seemingly unrelated to the spine. For this reason it is called "chameleon disease. "
These symptoms include:
- heartburn, bloating,
- loss of appetite, nausea,
- indigestion (dyspepsia),
- cough,
- cold feet,
- numbness of the body,
- pain in the right hypochondrium,
- discomfort in the abdomen,
- perspiration
In addition, thoracic osteochondrosis is manifested by a violation of the blood supply to the brain: headaches, pressure instability, dizziness, instability when walking and loss of coordination.
Reasons for development, stages.
The main role in the development of the disease is played by muscle spasms and tension (hypertonicity) of the back muscles. These spasms occur during a sedentary lifestyle, poor posture, or prolonged stay in a static, uncomfortable position (for example, at an office desk or while driving).
On the other hand, hard and monotonous physical work also causes persistent muscle spasms in the back (for example, working with raised arms).
Muscle spasms impede circulation and impede blood flow to the spine. Because of this, the nutrition of the intervertebral discs deteriorates.
Intervertebral discs are shock-absorbing pads of connective tissue located between the vertebrae. In the center of each disc is a semifluid, pulpy nucleus that contains a lot of moisture. Water provides resistance to loads and resistance to compression.
Along the outer perimeter of each disc it is reinforced with a rigid fibrous ring. The connective tissues of the discs are mainly composed of collagen; This substance is synthesized in the body and must be constantly supplied to the joints, intervertebral discs and other connective and cartilaginous tissues for their continuous regeneration.
Muscle spasms interfere with blood flow, causing not enough collagen to reach the discs for normal tissue repair. Lack of oxygen causes a slowdown in metabolic processes.
As a result of metabolic alterations, tissue renewal of the intervertebral discs slows down and their wear accelerates. This leads to dystrophy and degenerative changes: the discs become dehydrated, cracked, dry, flattened and lose their shock-absorbing properties and elasticity.
Back muscle spasms are the main cause of excess stress on the spine in the thoracic region. If in the cervical region the intervertebral discs are pressed by the weight of the head, which increases with incorrect posture, and in the lumbar region by the body weight, which increases with excess weight, then in the thoracic region muscle spasms They play an exceptional role. in the development of the disease. These spasms not only impede blood flow, but also strain the spine and compress the intervertebral discs both day and night. Intervertebral discs are practically deprived of the opportunity not only for cell renewal, but also for simple rest and recovery. Therefore, the first thing a doctor should do when treating thoracic osteochondrosis is to relax the tense muscles of the back, eliminate muscle spasms and hypertonicity. Without this, effective treatment of the disease is impossible.
The flattening of the intervertebral discs causes the spaces between the vertebrae to narrow, the vertebrae to move closer together and pinch the nerve roots. This causes pain, which causes a reflex muscle spasm and further increases the pressure on the discs. Therefore, with the appearance of pain, the development of the disease usually accelerates.
These degenerative-dystrophic changes correspond to the first stage of osteochondrosis.
Important!
In old age, thoracic osteochondrosis usually develops against the background of general dehydration and metabolic disorders in the body. This is manifested, in particular, by a decrease in height in older people, which occurs due to the thinning of the intervertebral discs.
In the second stage, the outer annulus fibrosus no longer has fibers. Its tissue becomes loose, weak and cannot withstand the internal load. As a result, a bulge-shaped (usually local) disc bulge occurs.
A protuberance directed toward the spinal cord is called a dorsal. The protuberances directed to one side are called lateral. The rarest case is uniform protrusion of the disc along the entire perimeter.
The appearance of a protrusion usually causes increased pain. An X-ray image clearly shows a decrease in the height of the space between the vertebrae, as well as the development of osteophytes - bone outgrowths. They form along the edges of the vertebrae to compensate for the loads on the spine, since the intervertebral discs support them less and less.
In the third stage of the disease, the annulus fibrosus of the disc cannot withstand the internal pressure and ruptures. Through the resulting cleft, part of the nucleus pulposus of the disc is expelled: an intervertebral hernia occurs.
In the fourth stage of the disease, the range of motion in the back decreases sharply, the pain syndrome becomes constant, and an extensive picture of neurological disorders develops.
Diagnosis
At the initial appointment, the doctor asks the patient about the symptoms, the circumstances of their occurrence, studies the medical history, conducts an external examination, paying attention to posture, the presence or absence of spinal deformities (scoliosis, kyphosis) .
The cause of pain syndrome (dorsago, dorsalgia) can be both osteochondrosis and vertebral displacement (spondylolisthesis), ankylosing spondyloarthrosis, ankylosing spondyloarthrosis.
Osteochondrosis of the thoracic region is usually accompanied by muscle tension in the back and hypertonicity of the spinal muscles. The doctor performs palpation and uses successive pressures to find pain points (triggers) that correspond to the centers of muscle spasms.
To obtain more detailed information, the doctor prescribes an X-ray or MRI.
X-rays for thoracic osteochondrosis provide the most general information: they help to differentiate the disease from spondylolisthesis, to see osteophytes and narrowing of the spaces between the vertebrae.
MRI shows soft connective tissue better. With their help, the doctor can examine in detail the structure of the intervertebral discs, see the protrusion, hernia (its size, location, shape), as well as the condition of the ligaments, intervertebral joints, blood vessels, roots nerves and see spinal cord stenosis (or its danger).
Based on the MRI data, the doctor makes a diagnosis and determines an individual treatment plan.
Treatment of osteochondrosis of the thoracic region.
Pharmacological treatments
To relieve back pain and intercostal neuralgia in thoracic osteochondrosis, non-steroidal anti-inflammatory drugs can be used in the form of ointments, tablets or injections. The main effect of these drugs is anti-inflammatory, so their use is justified in cases where a pinched nerve root is accompanied by inflammation, that is, with thoracic radiculitis. NSAIDs also reduce inflammation of muscle tissue against the background of spasms and persistent hypertension.
In case of acute pain syndrome, a paravertebral or epidural block can be used - an injection of an analgesic. In the first case, the injection is made in the place where the nerve root is pinched, in the second case - in the area between the periosteum of the vertebra and the membrane of the spinal cord.
To relieve muscle tension and reduce pressure on nerve roots, blood vessels and intervertebral discs, muscle relaxants and antispasmodics are used.
Vitamin complexes are prescribed to nourish nervous tissues and prevent their atrophy.
To slow down the process of destruction of connective tissue, chondroprotectors can be prescribed.
These drugs have a symptomatic effect and can somewhat slow down the development of the disease, but in general they have almost no effect on the process of degenerative changes in the intervertebral discs.
Non-pharmacological treatment
Non-drug treatment of thoracic osteochondrosis includes physiotherapy, reflexology and physiotherapy methods.
The main goals of treatment are the relief of the inflammatory process, the improvement of blood circulation and the restoration of metabolic processes in the intervertebral discs and the stimulation of cell renewal of the connective tissue. To do this, the clinic uses complex therapy that uses oriental medicine methods.
Important!
Physiotherapy exercises help to form and strengthen the muscle corset, eliminate unreasonable loads on the spine and serve to prevent congestion and the formation of muscle spasms.
Surgery
For large hernias, especially dorsal ones, with the threat of spinal cord stenosis, and especially if it is present, a surgical operation (discectomy) may be indicated.
Part of the disc is removed or the entire disc is removed and replaced with a prosthesis. Although discectomy is a common type of surgical intervention, operations in the thoracic region are performed very rarely.
Treatment in the clinic.
Treatment of thoracic osteochondrosis in the clinic is carried out in complex sessions, including various procedures: acupuncture, acupressure, moxotherapy, stone therapy, vacuum therapy, hirudotherapy for individual indications.
High efficiency is achieved due to the synergy of individual methods and the elimination of the cause of the disease.
- Acupressure. By strongly pressing the trigger points in the back, the doctor eliminates muscle spasms, tension and congestion, improves blood circulation and restores unhindered blood flow to the spine. Thanks to this, the load on the intervertebral discs is reduced and the processes of metabolism and tissue regeneration are accelerated as the influx of oxygen and collagen increases.
- Acupuncture. Insertion of needles into bioactive points on the back, legs, arms, head and chest eliminates the symptoms associated with disturbed innervation: numbness and weakness in the arm. With the help of this procedure, intercostal neuralgia and other vertebrogenic pain are relieved. In addition, acupuncture enhances the effect of acupressure and has an anti-inflammatory and anti-edematous effect.
- Moxibustion therapy. Heating the bioactive points in the spinal area is done with a smoking wormwood cigarette. This procedure activates metabolic processes, increases blood flow to the intervertebral discs, stimulates and accelerates their recovery.
- Vacuum therapy. Cupping massage and cupping create blood flow and help improve blood circulation.
- Manual therapy. Using gentle spinal traction, the doctor unloads the intervertebral discs, increases the distance between the vertebrae, releases compressed nerve roots, relieves pain and increases the range of motion in the back.
Gentle traction, or traction, is the only manual therapy technique indicated for thoracic osteochondrosis. Before starting, the doctor must completely relax the back muscles, eliminate spasms and free the spine. To do this, the muscles are well warmed and relaxed through massages. If this is not done, the application of physical effort can lead to injury: break, sprain or fracture. Hardware methods of spinal traction for osteochondrosis are ineffective and even dangerous, therefore they are not used in the clinic.
Hirudotherapy
Placing medicinal leeches improves local blood circulation, blood supply to the intervertebral discs and has an anti-inflammatory effect.
stone therapy
Smooth stones heated to a certain temperature are placed along the spine to deeply warm and relax the spinal muscles, improve blood circulation and stimulate blood flow.
The duration of a treatment session in the clinic is 1 to 1. 5 hours, depending on individual indications. The treatment course usually includes 10 to 15 complex sessions. At the end, a control MRI is performed to evaluate the results obtained from the treatment.
Complications
The main complication of thoracic osteochondrosis is spinal cord stenosis due to a herniated disc with the development of body paralysis.
Other possible complications are associated with disruption of the innervation of the body due to pinching of the roots of the spinal nerves: the development of diseases of the gastrointestinal tract, kidneys, heart and reproductive system.
Prevention
To prevent the development of thoracic osteochondrosis, you should avoid a sedentary lifestyle and monitor your posture.
Important!
If a child or adolescent has scoliosis, it is advisable to cure this disease without waiting for it to disappear on its own. Lateral curvature of the spine occurs as increasing pain, but can last a lifetime.
In this case, persistent muscle tension and spasms will be inevitable, which in turn will lead to the development of osteochondrosis and, possibly, its complications. And this is added to the fact that scoliosis itself is fraught with complications of the respiratory, digestive and cardiovascular systems.