Thoracic osteochondrosis is a chronic disease of the spine in which degenerative-dystrophic changes occur in the intervertebral discs.
The thoracic spine is less frequently affected by osteochondrosis than the cervical and lumbar spine. This is explained by the fact that its muscle corset is relatively inactive, stable and well strengthened. Even rarer are the complications - disc bulges and herniations.
However, this disease has widespread symptoms that significantly reduce the quality of life and requires treatment. The use of drugs only reduces symptoms and provides a temporary effect that does not affect the progression of the disease.
To reliably eliminate symptoms, you need to influence 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, moxitherapy and other therapeutic procedures.
Symptoms, signs
With osteochondrosis, the intervertebral discs become flattened and the vertebrae fuse together, which leads to entrapment of the spinal nerve roots. This causes pain between the shoulder blades (usually described as sticking studs).
Pain syndrome in thoracic osteochondrosis can be acute, intense or chronic, moderate.
In the first case, acute pain occurs suddenly and is called dorsago. In the second case, the pain is felt continuously, is achy and is called dorsalgia.
Irritation from a pinched root spreads along the nerve, radiates to the chest and becomes the cause of intercostal neuralgia - shooting, cutting or burning pain in the chest, which increases with inhalation, movement, 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.
Pinched nerve roots cause nervous disorders, numbness, hand weakness, cold feeling in the hands, cyanosis (blue discoloration) or paleness of the skin. These symptoms usually only occur on one side.
Pain in osteochondrosis can also radiate to the shoulders, under the shoulder blades, and into the forearms.
Other symptoms of the disease are stiffness, tension in the back, numbness in the paravertebral area, shoulders, cervical area, shortness of breath, feeling of a lump in the chest.
The nerves that emerge from the spinal cord in the thoracic region play an important role in the innervation of the entire body. Therefore, symptoms of osteochondrosis may occur in areas that seem unrelated to the spine. Therefore, this disease is called "chameleon disease".
These symptoms include:
- heartburn, bloating,
- loss of appetite, nausea,
- indigestion (dyspepsia),
- cough,
- cold feet,
- body numbness,
- pain in the right hypochondrium,
- discomfort in the stomach,
- sweating
In addition, thoracic osteochondrosis is manifested by impaired blood supply to the brain - headaches, pressure instability, dizziness, unstable gait and loss of coordination.
Reasons for development, stages
The main role in the development of this disease is played by muscle spasms and tension (hypertonicity) of the back muscles. These spasms occur during a sedentary lifestyle, poor posture, or being in a static, uncomfortable position for a long time (for example, at an office desk or while driving).
On the other hand, monotonous and heavy physical work also triggers persistent back muscle spasms (for example working with arms raised).
Muscle spasms impede circulation and inhibit blood flow to the spine. Because of this, the nutrition of the intervertebral discs deteriorates.
Intervertebral discs are shock-absorbing connective tissue pads found between the vertebrae. In the center of each disc is a semi-liquid, pulp-like core that contains a lot of water vapor. Water provides resistance to load and resistance to compression.
Along the outer perimeter of each disc is reinforced with a rigid fibrous ring. Disc connective tissue consists mainly of collagen - this substance is synthesized in the body and must be constantly supplied to joints, intervertebral discs and other cartilaginous connective tissues for continuous regeneration.
Muscle spasms disrupt blood flow, resulting in not enough collagen reaching the disc for normal tissue repair. Lack of oxygen causes a slowdown in metabolic processes.
As a result of metabolic disorders, the tissue renewal of intervertebral discs slows down, and their wear accelerates. This leads to dystrophy and degenerative changes - the discs become dehydrated, crack, dry out, flatten and lose their shock-absorbing properties and elasticity.
Back muscle spasms are the main cause of excessive stress on the spine in the chest area. 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 overweight, then in the thoracic region, muscle spasm plays an overwhelming role. in disease development. These spasms not only restrict blood flow, but also tighten the spine and compress the intervertebral discs both day and night. The 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 tense back muscles, eliminate muscle spasms and hypertonicity. Without this, effective treatment of the disease is impossible.
Flattening of the intervertebral discs causes the distance between the bones to become smaller, the vertebrae become closer together and the nerve roots are pinched. This causes pain, which causes reflex muscle spasm and further increases pressure on the disc. Therefore, when pain appears, the progression 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 the elderly, which occurs due to thinning of the intervertebral discs.
In the second stage, the outer fibrous ring becomes fibrous. The tissue becomes loose, weakened, and unable to withstand internal stress. As a result, there is a protrusion of the disc (usually local) in the form of a protrusion.
The protrusion leading to the spinal cord is called the dorsal. Protrusions directed to the sides are called lateral. The most rare case is a uniform protrusion of the disk throughout the entire perimeter.
The appearance of a bulge usually causes increased pain. X-ray images clearly show a decrease in the height of the gaps between the vertebrae, as well as the development of osteophytes - bone growths. They form along the edges of the spine to offset the load on the spine as the intervertebral discs cope less and less.
In the third stage of the disease, the fibrous ring 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 occurs.
In the fourth stage of the disease, the range of movements in the back decreases sharply, the pain syndrome becomes constant, and a broad picture of neurological disorders develops.
Diagnostic
At the initial meeting, the doctor asks the patient about the symptoms, the circumstances of their occurrence, studies the medical history, conducts an external examination, pays attention to body posture, the presence or absence of spinal abnormalities (scoliosis, kyphosis).
The causes of pain syndrome (dorsago, dorsalgia) can be osteochondrosis and displacement of the spine (spondylolisthesis), ankylosing spondyloarthrosis, ankylosing spondyloarthrosis.
Osteochondrosis of the thoracic region is usually accompanied by back muscle tension and spinal muscle hypertonicity. The doctor palpates and uses successive pressure to find the pain point (trigger) that corresponds to the center of the muscle spasm.
To obtain more detailed information, the doctor prescribes an X-ray or MRI examination.
X-ray for thoracic osteochondrosis provides the most general information - helps to differentiate the disease from spondylolisthesis, to see osteophytes, and to narrow the gaps between the vertebrae.
Magnetic resonance imaging shows soft and connective tissue better. With its help, the doctor can examine in detail the structure of the intervertebral discs, see protrusions, hernias (their size, location, shape), as well as the condition of the ligaments, intervertebral joints, blood vessels, nerve roots, and see spinal cord stenosis (or its danger).
Based on MRI data, the doctor makes a diagnosis and determines an individual treatment plan.
Treatment of osteochondrosis of the thoracic region
Drug treatment
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 this drug is anti-inflammatory, so its use is justified if a pinched nerve root is accompanied by inflammation, namely with thoracic radiculitis. NSAIDs also reduce muscle tissue inflammation that causes spasms and persistent hypertension.
In cases of acute pain syndrome, paravertebral or epidural blockade can be used - analgesic injections. In the first case, the injection is performed at the site of pinching of the nerve root, 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 provide nutrition to nervous tissue and prevent its atrophy.
To slow down the process of destruction of connective tissue, chondroprotectors may be prescribed.
These drugs have a symptomatic effect and somewhat slow down the progression 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 treatments for thoracic osteochondrosis include physiotherapy methods, reflexology and physical therapy.
The main goal of treatment is to eliminate the inflammatory process, improve blood circulation and restore metabolic processes in the spinal discs, stimulating the renewal of connective tissue cells. The clinic uses complex therapy using oriental medicine methods for this purpose.
Important!
Physiotherapy exercises help to shape and strengthen the muscle corset, eliminate irrational loads on the spine, and serve as prevention of congestion and the formation of muscle spasms.
Operation
For large hernias, especially dorsal hernias, with the threat of spinal cord stenosis, and especially when present, surgical operation—discectomy—may be indicated.
Part of the disc will be removed or the entire disc will be removed and replaced with a prosthesis. Despite the fact that discectomy is a common type of surgical intervention, operations on the thoracic region are performed very rarely.
Treatment in clinic
Treatment of thoracic osteochondrosis in the clinic is carried out in complex sessions, which include several procedures - acupuncture, acupressure, moxitherapy, stone therapy, vacuum therapy, hirudotherapy according to individual indications.
High efficiency is achieved through the synergy of individual methods and elimination of the causes of disease.
- acupressure. By pressing firmly on the trigger points on the back, the doctor eliminates muscle spasms, tension, congestion, improves blood circulation and restores unimpeded blood flow to the spine. Thanks to this, the load on the intervertebral discs is reduced, and metabolic processes and tissue regeneration are accelerated as the flow of oxygen and collagen increases.
- Acupuncture. Inserting needles into bioactive points on the back, legs, arms, head, chest eliminates symptoms associated with nervous disorders - numbness, weakness in the arms. With the help of this procedure, intercostal neuralgia and other vertebrogenic pain can be reduced. In addition, acupuncture enhances the effects of acupressure and has anti-inflammatory and anti-edema effects.
- Moxibustion therapy. Warming of bioactive points in the spine area is carried out with a smoldering 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 improve blood flow and help improve blood circulation.
- Manual therapy. By using gentle traction on the spine, the doctor unloads the intervertebral discs, increases the distance between the vertebrae, releases compressed nerve roots, reduces pain, and increases the range of motion of the back.
Gentle traction, or traction, is the only manual therapy technique indicated for thoracic osteochondrosis. Before starting, the doctor must thoroughly relax the back muscles, eliminate spasm 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 clinics.
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 warm and relax the spinal muscles, 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 treatment course usually includes 10-15 complex sessions. Upon completion, a control MRI is performed to evaluate the achieved treatment results.
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 disorders of the body's innervation due to pinched spinal nerve roots: the development of diseases of the digestive 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 teenager suffers from scoliosis, it is advisable to cure this disease without hoping that the disease will go away on its own. Lateral curvature of the spine occurs as increasing pain but can last a lifetime.
In this case, constant tension and muscle spasms are inevitable, which in turn will lead to the development of osteochondrosis and, possibly, its complications. And this is not counting the fact that scoliosis itself is fraught with complications for the respiratory, digestive and cardiovascular systems.