Thoracic osteochondrosis is a chronic disease of the spine in which degenerative-dystrophic changes occur in the intervertebral discs.
The thoracic spine is less often 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 hernia.
However, this disease presents with extensive symptoms that significantly reduce the quality of life and therefore requires treatment. The use of medications only suppresses the symptoms and provides a temporary effect that does not affect the development of the disease.
To reliably eliminate the symptoms, you need to affect the cause of the development of degenerative processes in the discs. For this purpose, the clinic uses complex therapy, which gives positive results in more than 90% of cases. It includes methods of reflexology and oriental physiotherapy - acupressure, acupuncture, moxa therapy and other therapeutic procedures.
Symptoms, signs
With osteochondrosis, flattening of the intervertebral discs occurs and the vertebrae fuse, which leads to compression of the spinal nerve roots. This causes pain between the shoulder blades (usually described as a sticking pole).
Pain syndrome in thoracic osteochondrosis can be acute, intense or chronic, moderate.
In the first case, acute pain appears suddenly and is called dorsago. In the second case, the pain is constantly felt, has an aching character and is called dorsalgia.
Irritation from a crushed root spreads along the nerve, radiates to the chest and becomes the cause of intercostal neuralgia - stabbing, cutting or burning pain in the chest, which is intensified by inhaling, moving, coughing, sneezing, laughing.
Another characteristic symptom of thoracic osteochondrosis is pain in the heart area, which is accompanied by signs of cardioneurosis - palpitations, palpitations, increased heart rate.
A compressed nerve root leads to disruption of innervation, numbness, weakness of the hand, feeling of coldness in the hand, cyanosis (blue spot) or blanching 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 area, difficulty breathing, feeling of a lump in the chest.
Nerves emerging 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 that are apparently unrelated to the spine. For this reason, it is called "chameleon disease".
These symptoms include:
- heartburn, bloating,
- loss of appetite, nausea,
- indigestion (indigestion),
- cough,
- cold feet,
- body numbness,
- pain in the right hypochondrium,
- stomach discomfort,
- sweating
In addition, thoracic osteochondrosis is manifested by impaired blood supply to the brain - headaches, pressure instability, dizziness, instability in walking and loss of coordination.
Development reasons, 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 standing in a static and uncomfortable position (for example, at an office desk or while driving).
On the other hand, monotonous, difficult physical work also provokes the appearance of constant back muscle spasms (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 cushions of connective tissue found between the vertebrae. At the center of each disc is a pulpy, semi-liquid core that contains a lot of moisture. Water provides resistance to loads and resistance to compression.
Along the outer circumference of each disc 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 tissues, cartilage for their continuous regeneration.
Muscle spasms interfere with blood flow, resulting in a lack of collagen in the discs for normal tissue repair. The lack of oxygen leads to a slowdown in metabolic processes.
As a result of metabolic disorders, tissue renewal of the intervertebral discs slows down and their wear accelerates. This leads to dystrophy and degenerative changes - the discs are dehydrated, cracked, dry, flattened and lose their shock-absorbing properties and elasticity.
Back muscle spasms are the main cause of excessive 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 the lumbar region is pressed by the weight of the body, which increases with excess weight, then in the chest region muscle spasms playan extraordinary role. in the development of the disease. These spasms not only impede blood flow, but also tighten the spine and compress the intervertebral discs both during the day and at night. Intervertebral discs are practically deprived of the opportunity not only for cellular renewal, but also for simple rest and recovery. Therefore, the first thing a doctor should do when treating thoracic osteochondrosis is to relax tense back muscles, eliminate muscle spasms and hypertonicity. Without this, effective treatment of the disease is impossible.
The flattening of the intervertebral discs leads to the reduction of the gaps between the vertebrae, bringing them closer together and tightening 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, as a rule, 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 the elderly, which occurs due to the thinning of the intervertebral discs.
In the second stage, the outer fibrous ring becomes fiberless. Its tissue loosens, weakens and cannot cope with carrying the internal load. As a result, a disc protrusion occurs (usually local) in the form of a protrusion.
An extension directed towards the spinal cord is called dorsal. Extensions directed to the side are called lateral. The rarest case is the uniform elongation of the disc along the entire circumference.
The appearance of elongation usually leads to increased pain. An X-ray image clearly shows a decrease in the height of the gap between the vertebrae, as well as the development of osteophytes - bone growth. They form along the edges of the vertebrae to compensate for the loads on the spine as the intervertebral discs bear less and less of them.
In the third stage of the disease, the fibrous annulus of the disc cannot withstand the internal pressure and ruptures. Through the resulting gap, part of the nucleus pulposus of the disc is squeezed - an intervertebral hernia appears.
In the fourth stage of the disease, the range of motion in the back is significantly reduced, the pain syndrome becomes constant and a wide picture of neurological disorders develops.
Diagnosing
At the initial meeting, the doctor asks the patient about the symptoms, the circumstances of their occurrence, studies the medical history, performs an external examination, paying attention to the posture, the presence or absence of spinal deformities (scoliosis, kyphosis).
The cause of the 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 get more detailed information, the doctor prescribes an X-ray or MRI.
X-rays for thoracic osteochondrosis provide the most general information - it helps to distinguish the disease from spondylolisthesis, to see osteophytes and narrowing of the gaps between the vertebrae.
Magnetic resonance imaging shows the soft connective tissue better. With its 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, nerve roots and see the stenosis ofspinal cord (or its risk).
Based on the MRI data, the doctor makes a diagnosis and determines an individual treatment plan.
Treatment of osteochondrosis of the thoracic region
Drug treatments
To relieve back pain and intercostal neuralgia in thoracic osteochondrosis, non-steroidal anti-inflammatory drugs in the form of ointments, tablets or injections can be used. The main effect of these drugs is anti-inflammatory, so their use is justified in cases where a pressed nerve root is associated with its 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, paravertebral or epidural blockade can be used - an injection of an analgesic. In the first case, the injection is made in the place where the nerve root is pressed, 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 nerve tissues and prevent their atrophy.
To slow down the process of destruction of connective tissue, chondroprotectors can be prescribed.
These medications 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-drug treatment
Non-drug treatment of thoracic osteochondrosis includes methods of physiotherapy, reflexology and physical therapy.
The main goals of treatment are to relieve the inflammatory process, improve blood circulation and restore metabolic processes in the spinal discs, stimulate cellular renewal of connective tissues. The clinic uses complex therapy using oriental medicine methods for this purpose.
Important!
Physical therapy exercises help to form and strengthen the muscle corset, eliminate irrational loads on the spine and serve as prevention of overload 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. Despite the fact that discectomy is a common type of surgical intervention, operations in the chest region are performed extremely rarely.
Treatment in the clinic
Treatment of thoracic osteochondrosis in the clinic is carried out in complex sessions, which include several procedures - acupuncture, acupressure, moxa therapy, 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 forcefully pressing the trigger points of the back, the doctor eliminates muscle spasms, tension, congestion, improves blood circulation and restores unobstructed blood flow to the spine. Thanks to this, the load on the intervertebral discs is reduced, and the processes of tissue metabolism and regeneration are accelerated with increased oxygen and collagen flow.
- Acupuncture. Inserting needles into the bioactive points of the back, legs, arms, head, chest eliminates the symptoms associated with damaged innervation - numbness, weakness in the arm. With the help of this procedure, intercostal neuralgia and other vertebrogenic pains are relieved. In addition, acupuncture increases the effect of acupressure and has an anti-inflammatory and anti-edematous effect.
- Moxibustion therapy. Heating the bioactive points in the spine area is performed with a burning wormwood cigar. This procedure activates metabolic processes, increases blood flow to the intervertebral discs, stimulates and accelerates their recovery.
- Vacuum therapy. Cupping and cupping massage create blood flow and help improve blood circulation.
- Manual therapy. Using gentle traction on the spine, 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 up and relaxed through massage. If this is not done, the application of physical effort can lead to injury - rupture, sprain or fracture. Hardware methods of spinal traction for osteochondrosis are ineffective and even dangerous, so 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 muscles of the spine, improve blood circulation and stimulate blood flow.
The duration of a treatment session in the clinic is 1-1. 5 hours, depending on individual indications. The course of treatment usually includes 10-15 complex sessions. After completion, a control MRI is performed to evaluate the achieved results of the treatment.
Complications
The main complication of thoracic osteochondrosis is spinal cord stenosis due to disc herniation with the development of body paralysis.
Other possible complications are associated with disruption of the innervation of the body due to compression of the nerve roots of the spine: the development of diseases of the gastrointestinal tract, kidneys, heart and reproductive system.
Preventing
To prevent the development of thoracic osteochondrosis, you should avoid a sedentary lifestyle and monitor your posture.
Important!
If a child or teenager has scoliosis, it is advisable to treat this disease without hoping that it will go away on its own. Lateral curvature of the spine appears as a growing pain, but can last a lifetime.
In this case, constant muscle tension and spasms will be inevitable, which in turn will lead to the development of osteochondrosis and, possibly, to its complications. And this is in addition to the fact that scoliosis itself is fraught with complications from the respiratory, digestive and cardiovascular systems.