Osteochondrosis is the most common disease of all spinal diseases. Since osteochondrosis is directly a dystrophic-degenerative lesion of the discs located between the vertebrae, therefore, as a result, this leads to an irreversible change in their structure, as well as in the shape of the discs themselves, which make up the thoracic spine.
With an increase in a person's age, these changes in his spine develop more and more, and by the age of about 40-45 almost everyone suffers from osteochondrosis of the spine. By itself, osteochondrosis of the thoracic spine develops much less frequently than, for example, the lumbar or cervical spine, since the vertebrae contained in it are much less mobile than in other vertebral zones. In addition, the back area in the chest area has a more developed muscular corset, which supports the spine in the thoracic region much better than in others.
What is this thoracic osteochondrosis?
Thoracic osteochondrosisdirectly represents a stratification of discs between the vertebrae with a simultaneous decrease in their thickness and, consequently, the subsequent pinching of the nerve endings located in the intercostal area of the human thorax.
However, we note once again that due to the fact that the physiological fixation of the ribs in humans is quite rigid, the spine in the chest area is less susceptible to osteochondrosis. It is thoracic osteochondrosis which is a rare phenomenon, for example, cervical or lumbar osteochondrosis.
Usually, with osteochondrosis of the thoracic spine, the pathological process involves the discs between the vertebrae of the thoracic spine, which includes twelve thoracic vertebrae. But most often with osteochondrosis of the thoracic region, pathological changes occur with the upper thoracic vertebrae. There are different degrees of injury with thoracic osteochondrosis and further we will consider them in more detail.
Predisposing factors for the development of thoracic osteochondrosis
The exact causes of the onset of osteochondrosis of the thoracic region have not yet been fully established by modern science. At present, it is customary in medicine to distinguish the following predisposing factors, or so-called risk factors, due to which osteochondrosis of the thoracic region occurs in the spine:
- hereditary predisposition;
- excessive physical activity in this section of the spine;
- spinal injuries, such as falls or bruises in the thoracic region;
- changes that occur with age in the intervertebral discs and lead to a decrease in hydration in the tissues of the discs;
- violations of blood supply in the chest area.
Causes contributing to the disease of thoracic osteochondrosis
In general, the development of the disease with osteochondrosis is generally favored by hypodynamia, that is, the lack of muscle loads, which leads to a weakening of the functions of the muscular corset and, consequently, to an increase in the loads on the intervertebral discs and ligaments.
Additional reasons for the development of thoracic osteochondrosis are:
- hypothermia of the body;
- the presence of chronic stressful situations;
- transferred infections;
- difficult conditions of physical work;
- hormonal disorders that have arisen in the body;
- violation of the metabolic process in the body;
- the presence of congenital defects of the spine, namely its thoracic region.
In the course of exposure to a combination of these factors, or sometimes even one, irreversible dystrophic-degenerative processes develop in the discs between the vertebrae over time:
- the nucleus pulposus of the intervertebral disc gradually begins to lose fluid, which was secreted by them to provide a lubricating function, which ultimately significantly reduces the damping function of this disc;
- the fibrous ring of the vertebrae themselves, due to the increased load on it, becomes more vulnerable, which in turn leads to its gradual destruction.
Symptoms and signs of thoracic osteochondrosis of the spine
The clinical symptoms of thoracic osteochondrosis depend entirely on the following factors:
- the patient's age;
- the degree of affection of the disease;
- stages of osteochondrosis of the thoracic spine: remission or exacerbation.
The main signs of thoracic osteochondrosis are:
- chest pain in the spine, the so-called dorsago;
- painful damage to the nerve endings of the spinal cord - radiculopathy;
- abdominal syndrome;
- heart syndrome or changes in the heart muscle, with characteristic pains that persist even under the influence of glyceryl trinitrate;
- pulmonary syndrome, in the form of stagnation in the lungs with signs of hypoxia, that is, suffocation.
An increase in body temperature is not observed in a patient with thoracic osteochondrosis, which is also a direct differential diagnostic sign. The backbone in the chest area as one of the main symptoms of osteochondrosis indicates the occurrence of cracks in the fibrous ring and deformation of the nucleus pulposus. When palpated, the pain in this area of the chest intensifies, the symptoms increase.
In addition, the characteristic symptoms of thoracic osteochondrosis with compression myelopathy, that is, the deformation of the nerve endings, are:
- feeling of "goosebumps" - paresthesia;
- pain along the pinched nerve - these are common symptoms;
- decreased sensitivity to temperature and touch;
- disorders of the motor function of the spine are also one of the characteristic symptoms.
Having found such symptoms, it is necessary to consult a specialist. The appearance of symptoms as a whole and their intensity are particularly dangerous. At the same time, it is inappropriate to treat the symptoms without eliminating the causes and factors of the disease.
Degrees of the disease with thoracic osteochondrosis
Each degree of the disease with thoracic osteochondrosis is characterized by its own pathology, which has only its own clinical signs. Modern medicine distinguishes four degrees of degenerative disc disease of the thoracic region (similarly - lumbar and cervical degenerative disc disease) and, accordingly, four periods of its development. Let's consider them in more detail.
First degree,therefore it is characteristic that cracks appear inside the fibrous ring, into which the nucleus pulposus subsequently penetrates. This period of development of the disease with thoracic osteochondrosis is characterized by the following symptoms:
- the appearance of pain in the spine that does not go beyond the localization of the lesion;
- these pains can be permanent or be expressed by low back pain;
- there may be a convulsive contraction of the muscles in the thoracic region, accompanied by pain in the heart region.
Second degreethe development of thoracic osteochondrosis is characterized by the pathological onset of increased intervertebral mobility with the following clinical manifestations:
- subluxations appear in the thoracic spine;
- pain increases during movement;
- discomfort appears with prolonged posture.
Third gradecharacterized by the rupture of the fibrous ring and the exit of the nucleus pulposus beyond its limits. In this period of the disease with osteochondrosis of the thoracic spine, intervertebral hernias begin to appear, the clinical signs of which are quite severe. Namely - neurovascular, muscle-tonic and reflex-dystrophic.
In addition to the above, for the third degree of osteochondrosis of the thoracic region, a change in the following conditions of the spine is characteristic:
- weak fixation of the position of the spine;
- limitation of mobility of the spinal region, manifested in the form of kyphosis or scoliosis.
Fourth degree- the dystrophic-degenerative process already affects all the structures that are surrounded by the spinal column. This pathological process involves the yellow, interspinous and other ligaments, and fibrosis occurs in the structures surrounding the spine. In this period of the disease with thoracic osteochondrosis, the so-called state of remission is clinically observed.
complications
With further progression of the disease with thoracic osteochondrosis, the development of concomitant complications is possible:
- inflammation of the nerve endings of the spinal cord;
- the occurrence of intervertebral hernias;
- development of vascular dystonia;
- the development of Schmorl's hernia;
- spondyloarthrosis disease;
- pathological growth of bone growths - osteophytes;
- a significant decrease in the spinal canal.
It should be noted that the severity of complications occurring in thoracic osteochondrosis depends entirely on the rate of progress of the disease process that has arisen and, of course, on the effectiveness of methods for the treatment of osteochondrosis of the thoracic spine.
Diagnostics and its methods
In practice, several methods are used to diagnose thoracic osteochondrosis. Of these, the most common is the X-ray examination, the results of which are quite informative. The signs of thoracic osteochondrosis found in this study are as follows:
- the contours of the discs between the vertebrae are broken;
- the edges of the integumentary plates acquired a wavy character;
- the intervertebral discs have changed shape;
- osteophytes appeared - pathological bone growths in the spine;
- the hooked processes of the vertebrae are increased and sharpened;
- the bodies of the thoracic vertebrae have changed their normal shape;
- the height of the discs between the vertebrae has significantly decreased;
- herniated discs between the vertebrae formed.
In some cases, a method is practiced for diagnosing thoracic osteochondrosis of the spine by means of an X-ray contrast study, which determines the following signs of this ailment:
- in case of advanced pathology, the contrast medium completely fills the disc between the vertebrae;
- with the help of a contrast agent, the contours of the nucleus pulposus are visible, which are uneven;
- when the intervertebral disc is destroyed, the contrast medium penetrates far beyond its limits, until it penetrates the spinal canal.
Only the correct diagnosis can determine the correct treatment.
Treatment of osteochondrosis
Treatment of thoracic osteochondrosis is possible in one of the following ways, used taking into account the results of diagnostics of thoracic osteochondrosis, namely:
- conservative-traditional treatment of the spine;
- treatment of thoracic osteochondrosis with traction;
- surgical intervention.
Treatment of thoracic osteochondrosis, called conservative, is complex for the treatment of any type of osteochondrosis: drugs, physiotherapy, physiotherapy exercises. Non-steroidal anti-inflammatory drugs are intended to relieve pain in the spine, known for thoracic osteochondrosis. It should be noted that these drugs very well eliminate inflammatory processes and the resulting swelling, helping to reduce the compression of the nerve roots. In more complex cases of breast osteochondrosis, the attending physician may prescribe a number of additional medications, for example, some powerful pain relievers and muscle relaxants that block the appearance of muscle spasms.
When the pain subsides or has managed to stop, that is, during remission, physiotherapy treatment is prescribed, as well as, in addition, physical therapy and massage. These are all important components of a complete treatment. One of the main physiotherapeutic tools for the treatment and prevention of the disease is pulsed magnetotherapy which uses special medical devices for clinical and home use.
Only magnetotherapy of special parameters is allowed for use during exacerbations; there are medical devices to deal with both acute and chronic pain. This system is also suitable for the treatment of the lumbosacral and cervical spine.
In addition to the above, traction treatment, that is, the treatment of thoracic osteochondrosis by special traction, can be successfully used to treat thoracic osteochondrosis. With this method, the muscles, tissues and paravertebral ligaments are stretched, which leads to an increase in the intervertebral distance. Even one and a half millimeters will already be enough to reduce swelling, eliminate compression and relieve tension in the muscles adjacent to the spine. In any case, the fundamental principle of conservative treatment is its complexity. The treatment will have to be done for a long time and regularly, this is the only way to hope for results.
But surgical intervention as a type of treatment for osteochondrosis is advisable only when the above methods of treating thoracic osteochondrosis do not give the desired result.