Diagnosis and treatment of thoracic spine osteochondrosis

Osteochondrosis of the chest is a common degenerative disease. There are specific symptoms of thoracic osteochondrosis, which indicates the beginning of pathology. In the initial stages, the patient's discomfort does not bother him much, so he is in no hurry to seek help from a specialist. Over time, the symptoms intensify, forcing the patient to go to the doctor, where a neglected pathology is found. You should find out which early signs determine osteochondrosis and which treatment methods are most effective.

What is thoracic osteochondrosis and how does it occur?

Osteochondrosis of the thoracic region is characterized by the appearance of destructive-dystrophic processes in the middle part of the ridge. The destruction is located between the 8th and 19th vertebrae. To find out which spine is affected, accurate diagnostic studies are needed. Osteochondrosis of the thoracic region is often accompanied by terrible complications, including prolapse or hernia. Without complications, the disease is rare, because the destruction of cartilage tissue inevitably leads to the destruction of the entire spinal frame.

When a patient develops a circulatory disorder or age-related joint wear, the fibrous ring located in the cavity of the intervertebral disc begins to collapse, losing its normal structure. Since the destruction is slow, then in the initial stages microcracks appear through which the nucleus pulposus penetrates.

As the internal component leaks, the annular fibrosus begins to weaken, leading to gradual stretching and cracking. When the nucleus pulposus protrudes, an intervertebral hernia occurs, which is the most common complication of osteochondrosis. The pathology includes damage to the cartilage tissue, which causes significant discomfort. Severe back pain is also associated with neurological syndromes that develop by pinching or irritating nerve roots.

Symptoms of osteochondrosis of the breast

In the initial phase, the patient does not feel discomfort, so in this phase the disease can be detected only by chance. The disease has many symptoms that can be masked in other pathologies.

Symptoms of osteochondrosis in the chest can be felt by the following manifestations:

1. Breathing is difficult. Problems occur that manifest as shortness of breath and a feeling of shortness of breath. This indicates damage to the thoracic vertebrae and spinal cord.
2. The main symptom is pain in the chest area. There is also a feeling of pressure in the heart, reminiscent of an ischemic attack.
3. Discomfort occurs when the back is bent. As the disease progresses, the pain in this position increases.
4. Against the background of worsening blood circulation, coldness is felt in the lower or upper extremities.
5. Chest pain on the background of new intervertebral hernias. The discomfort is often felt more strongly on the left or right side of the affected area.
6. Discomfort in the throat and difficulty swallowing. If there is irritation of the nerve endings in the upper part of the thoracic region, a cough appears.
7. Women may experience chest pain that is not related to cyclical changes or hormonal imbalance.
8. Tingling or tingling occurs in the area of the legs and feet.
9. Hair and nails become brittle, without shine.
10. Herpes zoster occurs less frequently.
11. Back and chest pains occur at the same time.
12. Discomfort in the stomach, liver or pancreas is less common.
13. The onset of stiff ribs, indicating intercostal neuralgia.
14. There are signs of chondrosis and compression in the chest - a similar pathology.
15. There are problems with the gastrointestinal tract. He feels nauseous, heaviness in his stomach.
16. In men, several libido may fall. Problems occur in the genitourinary sphere.
17. When you stand or sit for a long time, serious discomfort occurs.
18. There is a severe headache accompanied by dizziness. Migraines with an aura can occur.
19. The patient often develops intercostal neuralgia.
20. The pain may radiate to the neck or lower back.

If you find in aggregate thoracic osteochondrosis and its signs or any of them, it is necessary to urgently consult a therapist, neurologist or orthopedist. Also, such symptoms should be warned in the absence of problems with the gastrointestinal tract, cardiovascular system and lungs.

There are both acute and subacute symptoms. If, with exacerbation of osteochondrosis of the thoracic region, the patient experiences severe pain that deprives him of working ability, and can only observe bed rest, then the subacute course is sluggish and does not significantly limit the patient's motor activity.

A clear sign of a sluggish lesion - no acute pain. Symptoms in the subacute phase are erased. There is no discomfort with basic body movements, including inhaling, sneezing, or turning. The person does not suffer from pain in sleep, so the process of falling asleep is facilitated.

Important rules must be followed so that the subacute course of the disease does not worsen and go into remission:

1. It is forbidden to lift weights.
2. You can't bend abruptly.
3. It is forbidden to be in a sitting or standing position for a long time. A person often unconsciously in this condition takes a position that is harmful to the spine, so there is an excessive load on the ridge, which leads to another deterioration.
4. Avoid hypothermia. It has been proven that non-adherence to a comfortable temperature regime for the body turns into a worsening of the inflammatory process. Humidity is also harmful to the joints.

The duration of the subacute course is individual. If you follow the medical recommendations, the patient will completely get rid of the discomfort within 2-3 weeks. If conservative treatment and rest do not help, and the patient begins to suffer from nausea, dizziness and weakness, a specialist should be consulted immediately. Such symptoms indicate re-exacerbation.

Degrees of development of thoracic osteochondrosis

There are 4 clinical stages of the disease, during which the patient develops signs of pathology:

1. There are no clinical symptoms in the initial phase. The first phase occurs against the background of the appearance of destructive processes in cartilage and bone tissue. In the first stage, there is also no cracking or stretching of the fibrous ring, so there is no hernia either. They can detect the initial bulge and signs of cartilage degeneration.
2. The second phase occurs with less pain or discomfort. A careful patient seeks medical attention, so osteochondrosis of the thoracic region is immediately detected. People who do not want to visit a specialist can still endure the second phase, using the available medications, but self-medication will not be long enough. The most common neurological symptoms may occur at this stage, including headache, tingling in the interscapular area, neck pain, and blood pressure spikes. Also at this stage there is an increase in degenerative destruction of the spine: the fibrous ring protrudes, leading to the appearance of an intervertebral hernia of the thoracic region.
3. The third phase is already difficult for the patient. Persistent neurological syndromes develop, including constant radiating pain in the shoulder blades, arms, collarbone, and lower back. The patient may show somatic and autonomic disorders, which indicates a disorder in the work of the nervous system. The patient is often tormented by nausea, constant headaches, dizziness, back pain. Concealed cardiac, gastroenterological or pulmonary signs of the disease may also occur. In this phase, there is an active demineralization of bone and cartilage tissue. There is a tendency to injure.
4. The last phase is the fourth. On the background of osteochondrosis and hernia, irreversible consequences occur - the mobility of the intervertebral discs is completely lost, and the cartilaginous tissue at the site of the long course of inflammation is replaced by osteophytes. Surgery is needed to remove them.

In order not to bring the body to a condition similar to stage 3 or 4, it is better to visit a doctor at the slightest sign. The sooner the disease is detected and therapy is started, the sooner the patient will return to normal and learn to live with osteochondrosis. The pathologically destructive process cannot be completely stopped, but it can be slowed down by leading a healthy lifestyle, using medications and daily gymnastics. The later the patient sees a doctor, the harder it is to stop the severe pain syndrome associated with cartilage tissue degeneration.

Risk factors and causes of disease

There is no exact reason that causes destructive changes in the spine. An important role in the occurrence of pathology is attributed to a hereditary factor. It has been proven that people who suffer from physical inactivity are more likely to have ridge problems than those who exercise regularly. Also, excessive physical activity can cause destruction of cartilage at an early age.

Thinning and destruction of intervertebral discs is closely related to spinal overload. If the muscles are not strong enough, and the back is subjected to regular overload, the cartilage tissue is destroyed.

What are the causes of osteochondrosis:

1. Obesity. When you are overweight, you put a lot of pressure on your spine. As a result, premature destruction of bone tissue occurs.
2. The presence of an anomaly in the structure of bones and cartilage. Such problems arise even during the period of intrauterine development.
3. Congenital asymmetry of intra-articular cavities in intervertebral joints of the tropism anomaly type, contributing to the occurrence of a degenerative-dystrophic process in the spine.
4. Presence of muscle spasm, spondylosis, chronically persistent trigger points and vascular disorders in the thoracic region. These pathologies also contribute to the occurrence of osteochondrosis of the thoracic region.
5. Prolonged exposure to vibrations on the spine in a sitting position. An example of a job is a minibus or bus driver.
6. Frequent physical activity associated with heavy lifting. Examples are loader work or professional sports activities.
7. Smoking and alcohol abuse. People with an unhealthy lifestyle are more likely to have a lack of minerals in the body and poor circulation, leading to back problems.
8. Sedentary lifestyle. With insufficient physical activity, there is an accelerated leaching of calcium, which is associated with poor metabolic processes. As a result, the bones become brittle. Also, the muscle tissue atrophies, due to which the load on the spine increases greatly. The result is pain, frequent discomfort with minimal physical exertion.

Due to the intervertebral discs, sufficient mobility of the ridge is ensured. Intervertebral discs play the role of a shock absorber. With the development of osteochondrosis, there is an accelerated process of demineralization, vital moisture from the joints is lost. This leads to discomfort, reduced mobility of the spine.

Risk factors for breast osteochondrosis include:

1. Advanced age. Natural degeneration occurs in older people, so after 40 years, the disease is more often detected.
2. Woman. In girls, there are periods that contribute to the active leaching of calcium from the bones - pregnancy and menopause. Without proper pharmacological support, spinal diseases are prone to occur.
3. The presence of hormonal disorders, endocrine diseases. If the patient has diabetes mellitus or uncompensated hypothyroidism, degeneration of the intervertebral disc may occur at an early age.
4. Prolonged immobilization. If the patient is ill and has to lie down for a long time, atrophic processes occur in the muscles, which causes back pain.
5. Previous back injuries. When ligaments and tendons are stretched, the risk of osteochondrosis in the thoracic region increases.
6. The presence of scoliosis. Poor posture in the future causes serious problems with the spine, including osteochondrosis and hernia.

Diagnosis of thoracic osteochondrosis

If the patient suspects back problems, it is necessary to consult a therapist. The doctor conducts a general examination of the patient, asks for complaints, measures blood pressure. If there is a suspicion of a neurological problem, the patient is referred to a specialist - traumatologist, neurologist or orthopedist.

At a meeting with a specialist they also ask for complaints, conduct an initial diagnosis of the patient. Based on the visual examination, a number of diagnostic measures are prescribed, including:

1. Radiography. With the help of an X-ray, you can generally assess the condition of the skeletal system. If the patient has a hernia or osteochondrosis, hints of pathology can be noticed - the distance between the intervertebral discs will be reduced, and at the site of the alleged hernia, darkening is sometimes noticed. If the image results do not match the specialist, continue to look for the cause of the pain and discomfort.
2. CT or MRI. The most accurate diagnostic methods that allow you to accurately examine the state of the focus of inflammation in the image. A more detailed picture can be seen on MRI, but if there are contraindications (presence of a pacemaker or prosthesis in the joints), computed tomography is prescribed. CT is an improved X-ray that allows you to see the bone, tendon and ligament in detail. The image shows the image in the form of a three-dimensional image, so that the details of the damage are clearly visible.
3. Biochemical and general blood test. These analyzes are necessary to assess the patient's health. If an increase in leukocytes, ESR, is detected, it indicates an active inflammatory process in the body. In addition to the active destruction of bone tissue, reduced levels of calcium and a lack of cholecalciferol (vitamin D3) are found in the blood.
4. Scintigraphy of the spine. The research method reveals active destruction of bone tissue. Weak bone tissue is very sensitive to fragility. The method will detect the tendency and signs of degeneration.

To diagnose the disease, you must consult an experienced specialist. A complete clinical picture is required for a final diagnosis, taking into account several laboratory research methods.

Thoracic osteochondrosis of the spine requires differentiation together with the following pathologies:

1. Dyshormonal spondylopathy.
2. Urinary tract pathologies, including urolithiasis, cystitis, or pyelonephritis.
3. Diseases of the cardiovascular system, excluding sinus arrhythmia, tachycardia and angina pectoris.
4. Gastrointestinal tract diseases, including chronic pancreatitis, gastric and duodenal ulcers, irritable bowel syndrome.
5. Previous injuries, fractures.
6. Tumors in the breast, including malignant flow.
7. Rheumatoid arthritis (determined by blood test for C-reactive protein, rheumatic test and ESR).
8. Osteomyelitis of the spine.
9. Acute inflammatory process.
10. Ankylosing spondylitis.
11. Spondylolisthesis.

Treatment of osteochondrosis of the thoracic spine

An integrated approach to therapy is needed to slow the progression of the disease. In the initial stages, only conservative therapy is shown, which consists of the use of drugs and physiotherapeutic methods of treatment. In advanced cases, when the patient has large hernias and a pronounced degree of bone degeneration, surgery is prescribed. Don’t self-medicate at home. Folk remedies do not remove osteochondrosis of the thoracic spine.

In which cases is the operation performed?

Initiated osteochondrosis of the thoracic region negatively affects the quality of life of the patient. If the patient has a constant discomfort that interferes with normal life, taking into account the lack of effect of drug treatment, then a surgical solution to the problem may be offered.

Absolute indications for surgery include:

1. Lack of sensitivity in the bladder and intestines.
2. If the sensitivity in the legs disappears and the patient loses the ability to move independently.
3. Paralysis due to strong overgrowth of hernia.

In other cases, the patient makes the decision to remove the hernial formation on his own. If the disease really brings severe pain, and the patient's condition does not improve in the background of conservative treatment, doctors recommend surgery.

Medical treatment of osteochondrosis of the thoracic spine

During the period of worsening, the doctor prescribes various medications necessary to alleviate the inflammatory process. The acute period is characterized by severe pain that can be relieved only by medication. If enough medication is taken, the patient gets better. Only an experienced specialist can prescribe medication; self-medication is unacceptable.

Osteochondrosis of the thoracic spine is treated with the following drugs:

1. Nonsteroidal anti-inflammatory drugs, painkillers or analgesics. These drugs are designed to quickly relieve back pain associated with an active inflammatory process. The effect of taking tablets or injections is felt the next day. Taking any drugs from the NSAID group is accompanied by side effects with long-term use, so experts recommend limiting the use of drugs to a minimum, no more than 1-2 weeks. Pain medications do the most damage to the gastric mucosa, causing gastropathy and inflammation. Patients at risk are given certain medications designed to protect the gastrointestinal mucosa. Examples are proton pump inhibitors, H2 histamine receptor blockers, antacids. People with ulcers and gastritis are better off avoiding the use of NSAIDs or taking modern analogues with a selective effect.
2. Muscle relaxants. These drugs are very effective in treating muscle spasticity. Relieve the pain associated with muscle tension. They act on trigger points located in the compressed muscle tissue. The more a person strains, the higher their number. Muscle relaxants remove muscle tension well and therefore show an analgesic effect. You need to take medication in the course, the average duration of therapy is at least 2-4 weeks.
3. B vitamins. Assign B1, B6, B12 in the form of injections of combined composition. In large doses, these substances have an analgesic effect and have a positive effect on the nervous system. Neurotrophic drugs are effective in treating pain associated with pinched nerve roots. With the help of diet it is impossible to compensate for the norm of these substances necessary to achieve a therapeutic effect, so they are prescribed in the form of drugs. The average length of one course of injections is 2-3 weeks. Then, if necessary, they switch to tablets.
4. Anti-inflammatory ointments, gels. If the pain is tolerable and systemic forms of NSAIDs are contraindicated, external medications are prescribed. The advantage of external drugs is that they do not cause side effects. In rare cases, skin allergies can occur, but the fat will not cause the digestive tract or laboratory blood to deteriorate. Another advantage of outdoor products is the possibility of long-term use. You can rub the gels for up to 4 weeks, after which they take a break. The scheme and duration of therapy is determined by the attending physician.
5. Honroprotectors. These are complex substances used to nourish the cartilaginous tissue of the joints. It is necessary to use the medication for a longer course, at least six months, after which there is a break of 2-3 months and the course of therapy is repeated. Within 2-3 months, injectable forms of release are used that are better absorbed. They then switch to supportive care, including the use of tablets. It is important to understand that medications do not stop the destruction of cartilage tissue. They only create additional nutrition, which slows down the degenerative processes that occur in the bones and joints.
6. Complex preparations of calcium and vitamin D3. It has been proven that the inhabitants of the northern latitudes do not have enough vitamin D3, because the solar activity in this region is low throughout the year. To get rid of hypovitaminosis, it is necessary to take cholecalciferol supplements in winter and autumn for courses while sun activity is minimal. Without this vitamin, the assimilation of calcium and other minerals is impossible. Due to the long lack of calcium, the bone tissue thins over time, so the person suffers from osteochondrosis and other complications. Calcium and D3 are better absorbed in combination, so complex preparations are prescribed. The dose and method of administration should be prescribed by the attending physician.

Homeopathy, antispasmodics and complex multivitamins may be prescribed in addition to treatment.

Conservative therapy for breast osteochondrosis

During the recovery period, the patient should pay sufficient attention to rehabilitation. The more carefully the patient maintains health, the less frequent attacks of the disease will occur.

The most effective conservative treatments include:

1. Exercise therapy. With the help of exercises, the patient learns to keep his back straight, strengthens the muscular corset. Physiotherapy can be done at any age, several times a week. The complex is selected individually, taking into account the anatomical features of the patient. Start executing gradually, initially spending no more than 5 minutes a day. As physical characteristics improve, the patient learns to do heavier exercises over a longer period of time.
2. Tightening corset. Anatomical devices serve as support for weakened muscles if there are contraindications for their strengthening. The patient chooses a bandage depending on the height and type of appointment. The attending physician must select the appropriate model. The duration and pattern of wearing are assigned individually. You cannot wear a corset day and night, otherwise your back muscles will become even weaker.
3. Massage. In medical practice, massages are one of the most popular and at the same time effective methods of conservative treatment, in the presence of osteochondrosis of the thoracic region in the patient. During the recovery period, the muscles need extra support. It is helpful when blood flow is temporarily improved and if overstretched muscles are unlocked with proper technique. You must attend specialist sessions several times a year for courses.
4. Physiotherapy. Physiotherapy procedures are widespread in trauma, orthopedic and neurological practice. With the help of procedures, local blood flow is improved, drugs are used systemically from the outside and the device acts on damaged tissues. As a result, the muscles heat up and the chronic inflammatory process is removed in the affected area. Examples of medical procedures - magnetotherapy, shock wave therapy, electrophoresis.

Manual therapy and acupuncture are prescribed less frequently.

Chest osteochondrosis is a serious disease if started. In order for the disease not to develop acutely, it is necessary to comprehensively treat the pathology.