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 than the cervical and lumbar spine. This can be explained by the fact that it is relatively inactive, stable and well strengthened by the muscular ligament. Its complications are even rarer - protrusion and herniated disc.
However, this disease is associated with extensive symptoms that significantly reduce the quality of life, and therefore requires treatment. The use of drugs only dulls the symptoms and provides a temporary effect that does not affect the development of the disease.
In order to reliably eliminate the symptoms, it is necessary 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 oriental reflexology and physiotherapy - acupressure, acupuncture, moxa therapy and other therapeutic procedures.
Symptoms, signs
In osteochondrosis, the intervertebral discs are flattened and the vertebrae come together, which leads to pinching of the spinal nerve roots. This causes pain between the shoulder blades (commonly known as a sticking stake).
The 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 constantly felt, aching in nature, and is called dorsalgia.
The irritation of the pinched root spreads along the nerve, radiates into the chest and becomes the cause of intercostal neuralgia – stabbing, cutting or burning pain in the chest, which increases with inhalation, movement, coughing, sneezing and laughing.
Another characteristic symptom of thoracic osteochondrosis is pain in the area of the heart, accompanied by signs of cardioneurosis - palpitations, palpitations, increased heart rate.
Pinching of the nerve root leads to disruption of the innervation, numbness, weakness of the hand, coldness of the hand, cyanosis (blue discoloration) or blanching of the skin. These symptoms are usually unilateral.
Osteochondrosis pain 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, in the shoulders, in the neck-collar area, difficulty breathing, and a feeling of a lump in the chest.
In the thoracic region, the nerves originating from the spinal cord play an important role in the innervation of the entire body. Therefore, the symptoms of osteochondrosis can appear in areas that are apparently not connected to the spine. This is why it 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 abdomen,
- sweating
In addition, thoracic osteochondrosis manifests itself in the disturbance of blood supply to the brain - headaches, pressure instability, dizziness, unsteady gait and loss of coordination.
Causes and stages of development
The main role in the development of the disease is played by muscle spasms and tension (hypertonia) of the back muscles. These spasms occur during a sedentary lifestyle, poor posture, or prolonged, static, uncomfortable positions (such as at an office desk or while driving).
On the other hand, monotonous, difficult physical work also triggers the development of permanent muscle spasms in the back (for example, work with raised arms).
Muscle spasms impede circulation and blood flow to the spine. Because of this, the nutrition of the intervertebral discs deteriorates.
Intervertebral discs are cushions of shock-absorbing connective tissue found between the vertebrae. In the center of each disk is a pulpy, semi-liquid core that contains a lot of moisture. Water resists load and resists pressure.
Each disc is reinforced with a stiff fibrous ring around its outer circumference. The connective tissues of the intervertebral discs consist mainly of collagen - this substance is synthesized in the body and must constantly supply the joints, intervertebral discs and other connective, cartilaginous tissues for their continuous regeneration.
Muscle spasms disrupt blood flow, resulting in insufficient collagen reaching the discs to restore normal tissue. A 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 dry out, crack, dry out, flatten, lose their shock-absorbing properties and elasticity.
Back muscle spasms are the main cause of excessive strain on the spine in the thoracic region. If the intervertebral discs in the neck region are pressed by the weight of the head, which increases with incorrect posture, and the lumbar region by the body weight, which increases with excess weight, then muscle spasms play an exceptional role in the chest region. in the development of the disease. These spasms not only block blood flow, but also stretch the spine and compress the intervertebral discs both day and night. The intervertebral discs are practically deprived not only of cell renewal, but also of the possibility of simple rest and regeneration. Therefore, the first thing the doctor should do in the treatment of thoracic osteochondrosis is to relax the tense back muscles, eliminate muscle spasms and hypertonia. Without this, effective treatment of the disease is impossible.
The flattening of the intervertebral discs leads to the narrowing of the spaces between the vertebrae, the vertebrae moving closer to each other and the pinching of 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 of the body. This is especially evident in the decrease in height of older people, which occurs due to the thinning of the intervertebral discs.
In the second stage, the outer fibrous ring becomes non-fibrous. Its tissue loosens, weakens, and cannot cope with maintaining the internal load. As a result, a protrusion occurs on the plate (usually locally) in the form of a protrusion.
The projection towards the spinal cord is called dorsal. Protrusions directed to the side are called lateral. The rarest case is a uniform protrusion of the plate along the entire circumference.
The appearance of the protrusion usually leads to increased pain. The reduction in the height of the gap between the vertebrae and the formation of osteophytes - bone growths - are clearly visible on the X-ray. They form along the edges of the vertebrae to compensate for the load on the spine, as the intervertebral discs cope less and less with them.
In the third stage of the disease, the fibrous ring of the disc cannot withstand the internal pressure and ruptures. Through the resulting gap, a part of the nucleus pulposus of the disc is pushed out - an intervertebral hernia occurs.
In the fourth stage of the disease, the range of motion of the back is sharply reduced, the pain syndrome becomes constant, and an extensive picture of neurological disorders develops.
Diagnostics
At the first appointment, the doctor asks the patient about the symptoms and the circumstances of their occurrence, examines the medical history, performs an external examination, paying attention to the posture, the presence or absence of spinal deformities (scoliosis, kyphosis).
Pain syndrome (dorsago, dorsalgia) can be caused by osteochondrosis and displacement of the vertebra (spondylolisthesis), spondyloarthrosis ankylopoetica, spondyloarthrosis ankylopoetica.
Osteochondrosis of the thoracic region is usually accompanied by back muscle tension and hypertonia of the spinal muscles. The doctor palpates and applies successive pressures to find the pain (trigger) points corresponding to the center of the muscle spasms.
In order to obtain more detailed information, the doctor prescribes an X-ray or MRI.
X-rays on 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 the structure of the discs in detail, see the protrusion, the hernia (size, location, shape), as well as the condition of the ligaments, intervertebral joints, blood vessels, nerve roots, orsee spinal cord stenosis (or risk thereof).
Based on the MRI data, the doctor makes a diagnosis and determines an individual treatment plan.
Treatment of osteochondrosis of the thoracic region
Medicinal 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 it is accompanied by inflammation of the pinched nerve root, i. e. thoracic radiculitis. NSAIDs also reduce the inflammation of muscle tissue in the background of spasms and persistent high blood pressure.
In case of acute pain syndrome, paravertebral or epidural blockade can be used - pain-relieving injection. In the first case, the injection is given 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.
Muscle relaxants and antispasmodics are used to relieve muscle tension and reduce pressure on nerve roots, blood vessels, and intervertebral discs.
Vitamin complexes are prescribed to nourish nerve tissues and prevent their atrophy.
Chondroprotectors can be prescribed to slow down the destruction process of connective tissues.
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 of the discs.
It is not a drug treatment
Non-drug treatment of thoracic osteochondrosis includes methods of physiotherapy, reflexology and physical therapy.
The main goal of the treatment is to alleviate the inflammatory process, improve blood circulation and restore metabolic processes in the discs, and stimulate the cell renewal of connective tissues. For this purpose, the clinic uses complex therapy with the methods of Eastern medicine.
Important!
Physiotherapy exercises help build and strengthen the ligaments, eliminate irrational loads on the spine, and prevent congestion and muscle spasms.
Surgery
For large hernias with a risk of spinal cord stenosis, especially dorsal hernias, and especially if they exist, surgical operation - discectomy - can be justified.
A portion 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 thoracic region are performed extremely rarely.
Treatment at the clinic
The treatment of thoracic osteochondrosis is carried out in the clinic in complex sessions, which include a number of procedures - acupuncture, acupressure, moxa therapy, stone therapy, vacuum therapy, hirudotherapy for individual indications.
High efficiency can be achieved through the synergy of the individual methods and the elimination of the cause of the disease.
- Acupressure. By strongly pressing the trigger points on the back, the doctor eliminates muscle spasms, tension, congestion, improves blood circulation and restores unobstructed blood flow in the spine. Thanks to this, the load on the intervertebral discs is reduced, and with the increase in the flow of oxygen and collagen, the processes of metabolism and tissue regeneration are accelerated.
- Acupuncture. Inserting the needles into the bioactive points of the back, legs, arms, head, and chest eliminates the symptoms associated with damaged innervation - numbness, arm weakness. With the help of the procedure, intercostal neuralgia and other vertebrogenic pains can be alleviated. In addition, acupuncture enhances the effect of acupressure and has an anti-inflammatory and edema-reducing effect.
- Moxibustion therapy. The bioactive points in the area of the spine are heated with a smoldering wormwood cigar. This procedure activates metabolic processes, increases the blood flow of the intervertebral discs, stimulates and accelerates their recovery.
- Vacuum therapy. Cupping and cupping promote blood flow and improve circulation.
- Manual therapy. By gently pulling on the spine, the doctor relieves the intervertebral discs, increases the distance between the vertebrae, releases compressed nerve roots, relieves pain and increases the range of motion of the back.
Light traction or traction is the only manual therapy technique recommended for thoracic osteochondrosis. Before starting, the doctor must thoroughly relax the back muscles, eliminate spasms and free the spine. For this, the muscles must be well warmed up and relaxed with a massage. If this is not done, physical exertion can lead to injury - tears, sprains or fractures. Hardware methods of spinal traction in osteochondrosis are ineffective and even dangerous, so they are not used in the clinic.
Hirudotherapy
The placement of medicinal leeches improves local blood circulation, blood supply to the 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 at the clinic is 1-1. 5 hours, depending on the individual indication. The treatment process usually consists of 10-15 complex treatments. After completion, we perform a control MRI to evaluate the treatment results achieved.
Complications
The main complication of thoracic osteochondrosis is the narrowing of the spinal cord due to disc herniation with the development of body paralysis.
Other possible complications are associated with the disruption of the innervation of the body due to pinching of the spinal nerve roots: 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 teenager has scoliosis, it is advisable to treat this condition without hoping that it will go away on its own. Lateral curvature of the spine presents as growing pains, but can last a lifetime.
In this case, persistent muscle tension and spasms are inevitable, which in turn leads to the development of osteochondrosis and possible complications. And this is in addition to the fact that scoliosis itself is fraught with complications of the respiratory system, digestive system and cardiovascular system.