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, as a consequence, this leads to an irreversible change in their structure, as well as in the shape of the discs themselves that make up the thoracic spine.
As a person ages, these changes in his spine develop more and more, and by the age of approximately 40-45 years, almost everyone suffers from spinal osteochondrosis.Osteochondrosis of the thoracic spine itself develops much less frequently than, for example, the lumbar or cervical spine, since the vertebrae in it are much less mobile than in other vertebral zones.In addition, the back area in the chest area has a more developed corset of muscles, which supports the spine in the thoracic region much better than in others.
What is this thoracic osteochondrosis?
Thoracic osteochondrosisdirectly represents a separation of the discs between the vertebrae with a simultaneous decrease in their thickness and, as a consequence, subsequent pinching of the nerve endings located in the intercostal zone of the human chest.
However, we note once again that due to the fact that the physiological fixation by the ribs in humans is quite rigid, the part of the spine in the chest area is the least susceptible to osteochondrosis.It is thoracic osteochondrosis that is a rare phenomenon relative to, for example, cervical or lumbar osteochondrosis.
Usually, with osteochondrosis of the thoracic spine, the discs between the vertebrae of the thoracic spine, which includes twelve thoracic vertebrae, are involved in the pathology process.But most often, with osteochondrosis of the thoracic region, pathological changes occur in the upper thoracic vertebrae.There are several degrees of damage to thoracic osteochondrosis, and below we will look at them in more detail.
Predisposing factors for the development of thoracic osteochondrosis
Modern science has not yet fully established the exact causes of thoracic osteochondrosis.At the moment, it is customary in medicine to identify 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 part 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;
- blood supply disturbances in the chest area.
Causes contributing to the disease of thoracic osteochondrosis
To a large extent, the development of the disease of osteochondrosis is generally promoted by physical inactivity, that is, a lack of muscle loads, leading to a weakening of the functions of the muscular corset and, as a consequence, to increased loads on the intervertebral discs and ligaments.
Additional reasons for the development of thoracic osteochondrosis are:
- hypothermia of the body;
- presence of chronic stressful situations;
- previous infections;
- difficult physical labor conditions;
- hormonal disorders that have arisen in the body;
- disruption of the metabolic process in the body;
- the presence of congenital defects of the spine, namely its thoracic region.
As a result of exposure to a combination of these factors, or sometimes even just one, dystrophic-degenerative irreversible processes develop in the discs between the vertebrae over time:
- the nucleus pulposus of the intervertebral disc gradually begins to lose the fluid that it secreted to provide a lubricating function, which ultimately significantly reduces the shock-absorbing function of this disc;
- Due to the increased load on it, the fibrous ring of the vertebrae itself becomes more vulnerable, which in turn leads to its gradual destruction.
Symptoms and signs of thoracic osteochondrosis of the spine
Clinical symptoms of thoracic osteochondrosis completely depend on the following factors:
- age of the patient;
- degree of damage by the disease;
- stages of osteochondrosis of the thoracic spine: remission or exacerbation.
The main signs of osteochondrosis of the thoracic region are:
- pain in the chest in the spine area, the so-called dorsago;
- painful damage to the nerve endings of the spinal cord - radiculopathy;
- abdominal syndrome;
- cardiac syndrome or changes in the heart muscle, with characteristic pain that persists even under the influence of trinitroglycerin;
- pulmonary syndrome, in the form of congestion in the lungs with signs of hypoxia, that is, suffocation.
An increase in body temperature in a patient with thoracic osteochondrosis is not observed, which is also a direct differential diagnostic sign.Dorsalgia 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 palpating, the pain in this area of the chest only intensifies and the symptoms increase.
In addition, characteristic symptoms of thoracic osteochondrosis with compression myelopathy, that is, deformation of nerve endings, are:
- sensation of “pins and needles” - paresthesia;
- pain along the compressed nerve is a common symptom;
- decreased sensitivity to temperature and touch;
- Impaired motor function of the spine is also one of the characteristic symptoms.
If you discover such symptoms, you need to consult a specialist.The appearance of symptoms in combination and their intensity are especially dangerous.At the same time, it is inappropriate to treat symptoms without eradicating the causes and factors of the disease.
Degree of 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 osteochondrosis of the thoracic region (similarly - lumbar and cervical osteochondrosis) and, accordingly, four periods of its development.Let's take a closer look at them.
First degreewhich is characterized by the fact that cracks appear inside the fibrous ring, into which the nucleus pulposus subsequently penetrates.This period of development of the disease thoracic osteochondrosis is characterized by the following signs:
- the appearance of pain in the spine that does not extend beyond the localization of the lesion;
- these pains can be either constant or expressed as lumbago;
- Convulsive contraction of muscles in the thoracic region may occur, accompanied by pain in the cardiac region.
Second degreeThe development of thoracic osteochondrosis is characterized by the pathological occurrence of increased intervertebral mobility with the following clinical manifestations:
- subluxations appear in the thoracic spine;
- pain intensifies during movement;
- discomfort appears when the position is maintained for a long time.
Third degreecharacterized by rupture of the fibrous ring and the exit of the nucleus pulposus beyond its limits.During 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, muscular-tonic and reflex-dystrophic.
In addition to the above, the third degree of osteochondrosis of the thoracic region is characterized by a change in the following conditions of the spine:
- weak fixation of the spine;
- limited mobility of the spinal region, manifested in the form of kyphosis or scoliosis.
Fourth degree– the dystrophic-degenerative process affects all structures surrounding the spine.The yellow, interspinous and other ligaments are involved in this pathological process, and fibrosis occurs in the structures surrounding the spinal column.During this period of the disease with thoracic osteochondrosis, a so-called state of remission is clinically observed.
Complications
With further progression of the disease with thoracic osteochondrosis, associated complications may develop:
- inflammation of the nerve endings of the spinal cord;
- the occurrence of intervertebral hernias;
- development of vegetative-vascular dystonia;
- development of Schmorl's hernia;
- disease with spondyloarthrosis;
- pathological growth of bone growths - osteophytes;
- significant reduction of the spinal canal.
It should be noted that the severity of complications arising from thoracic osteochondrosis completely depends on the rate of progress of the disease process and, of course, on the effectiveness of treatment methods for 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 x-ray examination, the results of which are quite informative.The signs of thoracic osteochondrosis identified in this study are the following:
- the contours of the discs between the vertebrae are disrupted;
- the edges of the cover plates have acquired a wavy character;
- intervertebral discs have changed their shape;
- osteophytes appeared - pathological bone growths in the spine;
- the uncinate processes of the vertebrae have 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 formed between the vertebrae.
In some cases, a method of diagnosing thoracic osteochondrosis of the spine is practiced through an X-ray contrast study, which determines the following signs of this disease:
- in case of advanced pathology, the contrast agent 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 in nature;
- When the intervertebral disc is destroyed, the contrast agent largely penetrates beyond its boundaries, up to penetration into the spinal canal.
Only correct diagnosis allows you to determine the correct treatment.
Treatment of osteochondrosis
Treatment of thoracic osteochondrosis is possible using one of the following methods, used taking into account the results of the diagnosis of thoracic osteochondrosis, namely:
- conservative-traditional treatment of the spine;
- treatment of thoracic osteochondrosis using traction;
- surgical intervention.
Treatment of thoracic osteochondrosis, called conservative, is complex for the treatment of any type of osteochondrosis: medications, physiotherapy, exercise therapy.Non-steroidal anti-inflammatory drugs are aimed at relieving pain in the spine, which is known for thoracic osteochondrosis.It should be noted that these medications very well eliminate inflammatory processes, as well as swelling that occurs, helping to reduce the process of compression of the nerve roots.In more complex cases of thoracic osteochondrosis, the attending physician may additionally prescribe a number of medications, for example, some strong painkillers and muscle relaxants that block the appearance of muscle spasms.
When the pain subsides or has been managed, that is, during remission, physiotherapy treatment is prescribed, as well as exercise therapy and massage.All these are important components of complex treatment.One of the main physiotherapeutic means of treating and preventing the disease is pulsed magnetic therapy through special therapeutic devices for clinical and home use.
Only magnetic therapy with special parameters is approved for use during exacerbations; there are therapeutic devices to combat both acute and chronic pain.This system is also suitable for treating the lumbosacral and cervical spine.
In addition to the above, traction treatment can also be successfully used to treat thoracic osteochondrosis, that is, treatment of thoracic osteochondrosis through special traction.With this method, the paravertebral muscles, tissues and ligaments are subjected to traction, which leads to an increase in the intervertebral distance.Even one and a half millimeters will be enough to reduce swelling, eliminate compression, and also relieve tension in the muscles adjacent to the spine.In any case, the main principle of conservative treatment is its complexity.Treatment will have to be carried out 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.