Thoracic osteochondrosis is a degenerative disease of the thoracic spinal column, in which literally “premature aging”, “wear and tear” of intervertebral discs, joints, and the vertebrae themselves occurs.The disease does not occur as often as cervical or lumbar osteochondrosis, due to the structural features of the thoracic spinal column:
- The thoracic vertebrae are firmly fixed, as they are connected to the ribs, and through them to the sternum, forming a single structure - the chest.This part of the spine has less mobility compared to the lumbar or cervical spine.
- In the thoracic region, the spine has a physiological bend - kyphosis.This is an arc whose apex faces backward.The spine is curved forward, so the highest mechanical loads occur on the anterior and lateral parts of the vertebrae; the degenerative process predominantly develops in the anterior part.
- Osteophytes - bone growths on the vertebral bodies - in thoracic osteochondrosis are mainly located in the anterior part, due to this the symptoms of the disease are weakly expressed and may be absent for a long time.
What happens in the vertebrae during osteochondrosis of the thoracic spine?
With osteochondrosis of this part of the spinal column, the degenerative process begins with the intervertebral disc.Changes occur in it at the biochemical level, due to this the disc swells for a while, then its height decreases.He ceases to cope with his function normally.
Then, tears and cracks appear in the peripheral part of the intervertebral disc - the fibrous ring.Это предрасполагает к последующему развитию межпозвонковой грыжи.
The degenerative process also develops in the intervertebral and spinal-costal joints (spondyloarthrosis).This leads to narrowing of the intervertebral foramina through which the spinal cord roots exit, pinching, irritation and dysfunction of the latter.
Due to dysfunction of the intervertebral discs, the load on the vertebrae increases.A compensatory mechanism is activated - bone growths - osteophytes - appear along the edges of the vertebral bodies.This condition is called spondylosis.
Treatment of osteochondrosis of the thoracic spine according to modern standards
The disease occurs in the form of alternating exacerbations, when all the symptoms clearly manifest themselves, and remissions - periods of improvement.
During exacerbation of osteochondrosis, spinal traction is used.The patient is placed on a bed with a raised head and secured with special rings by the armpits, so that traction occurs due to the weight of his own body.Underwater traction can also be used.The patient is in a vertical position in the pool, a special float is attached to his neck, and a load of a certain weight is suspended from his legs.
Pain syndrome due to thoracic osteochondrosis is combated with the help of painkillers and anti-inflammatory drugs.The doctor may use a paravertebral block, when an anesthetic solution is injected into the area of the affected nerve roots.According to indications, sedatives are prescribed to help relieve stress and nervous tension caused by the disease.
Physiotherapeutic procedures include ultrasound treatment, electrophoresis with novocaine, diadynamic currents, and UHF therapy.To unload the spine, a neurologist may prescribe wearing a corset.
During remission, treatment of thoracic osteochondrosis includes massage, physical therapy, physiotherapy, and sanatorium-resort treatment.
The need for surgical treatment for osteochondrosis of the thoracic region occurs very rarely.
Do not self-medicate - it may not only be useless, but also cause harm.In order to receive effective therapy for thoracic osteochondrosis, you need to undergo an examination, understand the causes of the problem, the pathological processes that occur in the body.
The main symptom of osteochondrosis of the thoracic spine is pain.It is characterized by some features:
- By nature, she is most often stupid.Burning, aching pain is less common.
- The pain intensifies during sudden movements, turns of the body, during a deep breath, after prolonged stress on the back, sleep (especially on an uncomfortable mattress or pillow).
- Most often, pain is localized between the shoulder blades, but can be of a girdling nature.
- At night, there may be sensations that many patients describe as: “as if the back was being squeezed by iron pincers.”
In addition to pain, thoracic osteochondrosis may cause other symptoms caused by compression of the nerve roots.
Other symptoms of thoracic osteochondrosis
Pain leads to spasm of blood vessels.This manifests itself in the form of chilliness in the legs, peeling of the skin, and increased brittleness of the nails.
Symptoms of the disease can mimic disorders of the internal organs.If the degenerative process affects the upper part of the thoracic spine, so-called pseudocardiac syndrome may occur.There is a sharp pain in the chest, sometimes it radiates under the shoulder blade, into the arm and jaw.The person gets scared, freezes, is afraid to move or take a deep breath, as this increases the pain.In such cases, it is necessary to carry out a differential diagnosis between osteochondrosis and angina pectoris.
Sometimes pain occurs in the pit of the stomach, under the right rib - in this case, the manifestations of the disease resemble pathologies of the stomach, liver, and gall bladder.
Sometimes there are disorders of the digestive organs, urination disorders, and in the genital area.
Understanding the symptoms of thoracic osteochondrosis is not always easy.Often, to make a correct diagnosis, the doctor has to prescribe an additional examination to rule out disorders of the cardiovascular system and digestive organs.
What causes the symptoms of osteochondrosis of the thoracic spine?
Manifestations of the disease are caused by a number of pathological processes occurring in the spinal column:
- Reduced height of the intervertebral disc: as a result, the diameter of the intervertebral foramen through which the nerve roots pass decreases.
- Compression of nerve roots by pathologically altered intervertebral joints.
- Compression of the roots by osteophytes - bony outgrowths on the vertebrae.
- The formation of intervertebral hernias - in the thoracic spine they are much less common than in the lumbar and cervical spine.
Effective treatment of symptoms of thoracic osteochondrosis
You can often cope with the symptoms of thoracic osteochondrosis at home.Many people “save” themselves, without doctors, with over-the-counter painkillers and painkillers, and by applying heat.
However, self-medication is only a temporary reduction in symptoms, and if done incorrectly, the problem can only worsen.During an exacerbation of osteochondrosis of the thoracic region, gymnastics and massage are contraindicated.On the contrary, at this time you should try to unload the spinal muscles as much as possible.
An experienced neurologist will correctly assess your condition and prescribe treatment that will help.The symptoms described in this article do not always indicate thoracic osteochondrosis; competent differential diagnosis is often necessary.
The causes of thoracic osteochondrosis are not fully understood, and in general, this disease raises a large number of questions for many doctors.Some even argue that such a disease does not actually exist, and its manifestations are usually caused by completely different pathologies.By the way, in English-speaking medicine this term refers to completely different diseases.
Possible causes of cervicothoracic osteochondrosis
It is currently believed that the disease can be caused by one of the following reasons, or a combination of them:
- Autoimmune disorders in the body.The immune system begins to work incorrectly and attack the body’s own connective tissue, ligaments, and cartilage.
- Injuries suffered.For example, a subluxation or compression fracture of a vertebra in the thoracic region increases the risk of osteochondrosis in the future.
- Age.Many people over 40 years old experience degenerative changes in their spines.But not everyone gets sick.
- Permanent spinal injury.Most often this occurs in people who constantly work sitting or standing in the same position and make the same type of movements.
- Congenital malformations of the vertebrae.Because of them, the functioning of the spinal column is disrupted, the load on the vertebrae and intervertebral discs is distributed incorrectly.This contributes to the development of the degenerative process.
What reasons can lead to exacerbation of osteochondrosis of the thoracic spine?
The disease proceeds in waves - an exacerbation occurs, the symptoms of osteochondrosis become pronounced, then they subside - remission occurs.Factors that can provoke another exacerbation:
- In more than half of the cases, this occurs after sudden movements, prolonged stay in a monotonous position (static loads on the spine), intense physical activity, or heavy lifting.
- Hypothermia - both general and directly in the thoracic spine.
- Nervous tension, stress.
- Spinal injuries - acute (bruise), chronic (with prolonged and intense loads on the spinal column).
- Various infections.
Sometimes (in 15-20% of cases) exacerbation of thoracic osteochondrosis occurs for no apparent reason.
What diseases can cause symptoms resembling thoracic osteochondrosis?
The diagnosis of “osteochondrosis” is not always made justifiably; even the doctor cannot always figure out what is happening to the patient.Back pain often occurs due to other diseases:
- Myofascial pain syndrome.A common condition in which pain occurs as a result of constant spasm of the back muscles.
- Herniated discs.They are rare in the thoracic region, but can also be the main cause of pain between the shoulder blades and neurological disorders.
- Injuries.If the injury was relatively mild - for example, a soft tissue bruise, a muscle strain - the symptoms of “osteochondrosis” bother you for some time and then go away on their own, even if no treatment has been carried out.Pain can also be caused by more serious injuries - for example, a compression fracture, vertebral subluxation.
In order to correctly understand the causes of back problems, the patient must be examined by an experienced doctor and a full examination must be carried out.
When the manifestations of “osteochondrosis” begin to bother you, you need to carry out a correct, comprehensive diagnosis and understand the true causes of the symptoms that have arisen.They are not always located in the spine itself.This helps to prescribe the appropriate treatment and deal with the problem as quickly and effectively as possible.
Diagnosis of thoracic osteochondrosis in the doctor’s office: what happens during a visit to a neurologist?
The initial appointment will begin with the doctor asking you some questions:
- What symptoms bother you?How long ago did they appear?How often do exacerbations occur?
- What is the nature of the pain?Does it radiate to the arm, neck, or under the shoulder blade?What does it feel like most?
- After what does the pain usually intensify?After what do you feel better?
- Have you had any injuries or other problems with your spine before?Have you already undergone treatment?Which?
- Do you have problems with the cardiovascular system, stomach, liver, gall bladder?
Next, a neurological examination will be performed.The doctor will press certain points on your back in the thoracic spine area to determine if the pain is occurring.You will then be sent for examination.
What diagnostic methods are used for osteochondrosis of the thoracic spine?
For thoracic osteochondrosis, the doctor prescribes an examination, which may include the following diagnostic methods:
- Radiography.Usually photographs are taken in two projections: full face and profile.Based on the images in the photographs, you can evaluate the condition of the bodies and arches, articulations of the vertebrae, the height of the intervertebral discs, and the width of the spinal canal.
- X-ray contrast studies.Discography(images after the injection of a contrast solution into the intervertebral disc) and myelography (injection of a contrast solution into the space surrounding the spinal cord) help to detect at what level the spinal cord and its roots are compressed by the deformed intervertebral disc.Recently, these studies are practically not used, as more accurate diagnostic methods have appeared - CT and MRI.
- Computed tomographyin case of thoracic osteochondrosis, it helps to detect the affected intervertebral disc, assess its size, the degree of “wear”, compression of the spinal cord and its roots.
- Magnetic resonance imagingallows you to examine the spinal cord and its roots, the degree of their damage, detect intervertebral hernia, narrowing of the lumen of the spinal canal.
The scope of the diagnosis is exactly such that the neurologist can obtain all the necessary information, establish the correct diagnosis and prescribe the optimal treatment.
How difficult is it to diagnose osteochondrosis in the thoracic spine?
The main manifestation of thoracic osteochondrosis is pain in the back and chest.This symptom can occur with a variety of different diseases.Moreover, they are not always associated with the spine.
For example, pain from myofascial pain syndrome is the result of chronic spasm of the back muscles.Often the disease must be differentiated from pathologies of the heart, stomach, liver, and other internal organs.
Diagnosis of osteochondrosis of the thoracic spine always requires a careful approach from the doctor; it is important not to miss other possible pathologies.