Thoracic osteochondrosis is a chronic disease of the spine in which degenerative-dystrophic changes occur in the intervertebral discs.
The thoracic spine is less 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 - protrusion and herniated disc.
However, this disease has 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 symptoms, it is necessary to influence the cause of the development of degenerative processes in the discs. To this end, 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, moxotherapy and other therapeutic procedures.
Symptoms, signs
In osteochondrosis, the intervertebral discs flatten and the vertebrae come together, which leads to compression of the spinal nerve roots. This causes pain between the shoulder blades (often described as pincushion).
Pain syndrome in thoracic osteochondrosis can be acute, intense or chronic, moderate.
In the first case, the sharp pain occurs suddenly and is called back pain. In the second case, the pain is felt constantly, has a painful character and is called back pain.
Irritation from a pinched root spreads along the nerve, radiates to the chest and becomes the cause of intercostal neuralgia - sharp, cutting or burning pain in the chest, which intensifies with inhalation, movement, coughing, sneezing, laughter.
Another characteristic symptom of thoracic osteochondrosis is pain in the region of the heart, which is accompanied by signs of cardioneurosis - palpitations, heart palpitations, increased heart rate.
Pinched nerve root leads to interruption of innervation, numbness, weakness of the hand, feeling of cold in the hand, cyanosis (bluish discoloration) or blanching of the skin. These symptoms are usually unilateral.
Pain in osteochondrosis can also radiate to the shoulder, under the shoulder blade and into the forearm.
Other symptoms of the disease are stiffness, tension in the back, numbness in the paravertebral region, shoulders, cervical collar region, difficulty breathing, sensation of a lump in the chest.
The nerves arising from the spinal cord in the thoracic region play an important role in innervating the entire body. Therefore, osteochondrosis symptoms can occur in areas seemingly unrelated to the spine. For this reason, it is called a "chameleon disease".
These symptoms include:
- heartburn, bloating,
- loss of appetite, nausea,
- indigestion (dyspepsia),
- cough,
- apprehensive,
- body numbness,
- pain in the right hypochondrium,
- discomfort in the abdomen,
- sweating
In addition, thoracic osteochondrosis is manifested by impaired blood supply to the brain - headaches, pressure instability, dizziness, unsteady gait and loss of coordination.
Reasons for development, 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 stay in a static, uncomfortable position (for example, at an office desk or while driving).
On the other hand, monotonous and hard physical work also provokes the occurrence of persistent muscle spasms in the back (for example, working with arms raised).
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. In the center of each disc there is a pulpy, semi-fluid nucleus that contains a lot of moisture. Water provides load resistance and compressive strength.
Along the outer perimeter of each disc it is reinforced with a rigid fibrous ring. The connective tissues of the discs consist mainly of collagen - this substance is synthesized in the body and must be constantly supplied to the joints, intervertebral discs and other cartilaginous connective tissues for their continuous regeneration.
Muscle spasms interfere with blood flow, meaning that not enough collagen reaches the discs for normal tissue repair. Lack of oxygen leads to a slowdown in metabolic processes.
As a result of metabolic disorders, 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 and elastic properties.
Back muscle spasms are the main cause of excess 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 body weight, which increases with excess weight, then in the thoracic region muscle spasms play an exceptional role . in the development of the disease. These spasms not only impede blood flow, but also tense the spine and compress the intervertebral discs during the day and night. 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.
The flattening of the intervertebral discs causes the spaces between the vertebrae to become smaller, the vertebrae to move closer together and compress 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 often develops against a 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 loses its fiber. Its tissue becomes loose, weakened and cannot withstand the maintenance of the internal load. As a result, a protrusion of the disc (usually local) occurs in the form of a protrusion.
A protrusion directed towards the spinal cord is called dorsal. Protrusions directed to the side are called lateral. The rarest case is uniform protrusion of the disc along the entire perimeter.
The appearance of protrusion often leads to increased pain. An X-ray image clearly shows a decrease in the height of the space between the vertebrae, as well as the development of osteophytes - bony outgrowths. They form along the edges of the vertebrae to compensate for the loads on the spine as the intervertebral discs deal with them less and less.
In the third stage of the disease, the fibrous ring of the disc cannot resist internal pressure and ruptures. Through the resulting gap, part of the nucleus pulposus of the disc is squeezed out – an intervertebral hernia occurs.
In the fourth stage of the disease, the range of motion in the back decreases sharply, the pain syndrome becomes constant and an extensive picture of neurological disorders develops.
Diagnosis
At the initial consultation, the doctor asks the patient about the symptoms, the circumstances of their occurrence, studies the medical history, carries out an external examination, paying attention to posture, the presence or absence of spinal deformities (scoliosis, kyphosis).
The cause of pain syndrome (dorsago, dorsalgia) can be 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 pressure to find pain points (triggers) that correspond to the centers of muscle spasms.
To obtain more detailed information, the doctor prescribes an x-ray or MRI.
X-rays for thoracic osteochondrosis provide the most general information - they help to differentiate the disease from spondylolisthesis, to see osteophytes and narrowing of the spaces between the vertebrae.
MRI shows soft connective tissue better. With its help, the doctor can examine in detail the structure of intervertebral discs, see protrusion, hernia (their size, location, shape), as well as the condition of ligaments, intervertebral joints, blood vessels, nerve roots and see spinal stenosis spinal cord (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 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, therefore their use is justified in cases where the pinched nerve root is accompanied by 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 - analgesic injection can be used. In the first case, the injection is made in the place where the nerve root is pinched, in the second case, in the region between the periosteum of the vertebra and the spinal cord membrane.
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 tissues, chondroprotectors can be prescribed.
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 in the intervertebral discs.
Non-drug treatment
Non-drug treatment of thoracic osteochondrosis includes physiotherapy, reflexology and physiotherapy methods.
The main goals of treatment are the relief of the inflammatory process, the improvement of blood circulation and the restoration of metabolic processes in the spinal discs, the stimulation of cell renewal of connective tissues. The clinic uses complex therapy using methods of oriental medicine for this purpose.
Important!
Physiotherapy exercises help to form and strengthen the muscular corset, eliminate unreasonable loads on the spine and serve as a prevention of congestion and the formation of muscle spasms.
Surgery
For large hernias, especially dorsal ones, with the threat of spinal 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 thoracic region are performed extremely rarely.
Treatment in the clinic
Treatment of thoracic osteochondrosis in the clinic is carried out in complex sessions, which include various procedures - acupuncture, acupressure, moxotherapy, 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 pressing hard on the trigger points of 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 the processes of metabolism and tissue regeneration are accelerated as the influx of oxygen and collagen increases.
- Acupuncture. Inserting needles into bioactive points on the back, legs, arms, head and chest eliminates symptoms associated with impaired innervation - numbness, weakness in the arm. With the help of this procedure, intercostal neuralgia and other vertebrogenic pains are relieved. Furthermore, acupuncture enhances the effect of acupressure and has an anti-inflammatory and anti-edematous effect.
- Moxibustion therapy. The bioactive points in the spine region are heated with a smoking absinthe cigar. This procedure activates metabolic processes, increases blood flow to the intervertebral discs, stimulates and accelerates their recovery.
- Vacuum therapy. Cupping massage and cupping create blood flow and help improve blood circulation.
- Manual therapy. Using gentle spinal traction, the doctor unloads the intervertebral discs, increases the distance between the vertebrae, releases compressed nerve roots, relieves pain, and increases 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 and relaxed through massage. If this is not done, the application of physical effort can cause injuries – rupture, sprain or fracture. Hardware methods of spinal traction for osteochondrosis are ineffective and even dangerous, therefore they are not used in the clinic.
Hirudotherapy
Placing medicinal leeches improves local blood circulation, blood supply to 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 spinal muscles, improve blood circulation and stimulate blood flow.
The duration of a treatment session at the clinic is 1–1. 5 hours, depending on individual indications. The course of treatment usually includes 10-15 complex sessions. Upon completion, a control MRI is performed to assess the achieved treatment results.
Complications
The main complication of thoracic osteochondrosis is spinal stenosis due to a herniated disc with the development of body paralysis.
Other possible complications are associated with disruption of the body's innervation due to compression 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 cure the disease without waiting for it to go away on its own. Lateral curvature of the spine occurs as a growing pain but can last a lifetime.
In this case, persistent muscle tension and spasms will be inevitable, which in turn will lead to the development of osteochondrosis and, possibly, its complications. And this is added to the fact that scoliosis itself is fraught with complications from the respiratory, digestive and cardiovascular systems.