Thoracic osteochondrosis is rare in clinical practice. It was previously diagnosed mainly in the elderly, but is now commonly found in patients under the age of 35. The pathology develops more often in women than in men. This degenerative-dystrophic disease is difficult to diagnose, as severe symptoms appear only at later stages.
In addition, the symptoms of this disorder can easily be confused with signs of impaired lung and heart function. This disease cannot go untreated, as it can cause curvature of the spine, the development of persistent pain syndrome and other complications that can adversely affect the quality of human life.What is thoracic osteochondrosis?
In the international classification of diseases this pathological condition has code ICD-10 - M42. Thoracic osteochondrosis is much less common than cervical or sacral. This is not accidental. Due to the presence of a hard chest in this part of the body, this part of the spine is physiologically less mobile.
The thoracic region contains more vertebrae than the cervical and lumbar ones, but in this part of the spine the discs are thinner. These anatomical features help to reduce the mobility of this part of the spine so that it is less susceptible to injury.
However, when exposed to a number of adverse factors, osteochondrosis can develop. Initially, there are signs of damage to one disc, but in the future other elements may be involved in the pathological process. As the disease progresses, the bone elements are damaged, as well as the ligaments and muscles that support the spine.
Degenerative-dystrophic processes in the thoracic region increase more slowly. It often takes years before the fibrous rings on damaged discs are destroyed so much that protrusions and hernias appear.
Severe clinical manifestations occur after a critical reduction in disc height and root entrapment. This can lead not only to dorsago, ie short-term attacks of chest pain, but also to disruption of the innervation of internal organs. It is much more difficult to treat compressed nerve roots extending into this area.
Reasons for development
In most cases, spinal problems do not appear suddenly. A disease such as osteochondrosis is no exception. This pathology, affecting the intervertebral discs, is the result of prolonged degenerative-dystrophic processes. In most cases, it is impossible to determine exactly what triggered the development of the disorder. Factors that can provoke the appearance of osteochondrosis of the chest include:
- congenital or acquired deformities of the spine;
- overweight;
- congestion of the spine during pregnancy;
- infectious diseases;
- hypothermia;
- metabolic disorders;
- hormonal disorders;
- chronic stress;
- bad habits;
- connective tissue diseases;
- dysplastic changes;
- posture disorders;
- unhealthy diet;
- injuries.
Detraining has a negative effect on the condition of the spine. People who lead a sedentary lifestyle are more likely to suffer from thoracic osteochondrosis. In addition, age-related changes and metabolic delays observed in patients over 55 years of age contribute to these disorders.
Genetic predisposition can be a factor that can provoke the development of pathology. The genes that create the conditions for the appearance of osteochondrosis of the breast have not yet been identified, but in people with a family history of cases of this disease, it is diagnosed more often.
Symptoms and signs
The clinic of this pathological condition depends on the stage of neglect of the process, the level at which the lesion of the intervertebral disc has occurred, and the age of the patient. In the early stages of development there are no specific signs, but general symptoms may appear periodically. Often in the initial stages of development the disease manifests itself only with the onset of cold weather or after physical exertion. The initial manifestations of the development of osteochondrosis of the chest include:
- rapid fatigue;
- back pain and pressure;
- muscle spasms;
- cold limbs.
As the disease progresses, the patient's condition worsens. Chest pain occurs. They especially often appear against the background of prolonged stay in one position or during sudden movements. In addition, when lifting weights, severe pain syndrome can occur. Turning the torso can cause increased pain. The presence of osteochondrosis is also indicated by the appearance of dull pain in the shoulder blades.
Often osteochondrosis of the thoracic region is accompanied by the appearance of an unusual bend. In severe cases, the patient may develop a hump. In addition, this disease can provoke pain during deep inhalation and exhalation.
When the nerve roots are compressed, there is often a feeling of stiffness in the upper limbs and skin of the upper body. Due to the violation of the innervation and blood circulation of the skin, a feeling of tingling appears. Legs and hands are always cold. There may be sensory damage to the limbs. In advanced cases, this disease can lead to symptoms of damage to other organs as a result of a violation of their innervation. The following may appear in the later stages of the process:
- intercostal neuralgia;
- stool disorders;
- bloating;
- heartburn and nausea;
- itching and burning in the legs;
- disorders of the reproductive system;
- asthma attacks.
As the pathology progresses, a person's ability to work decreases. Physical activity is minimized. In the future, this disorder may create the preconditions for the development of severe complications. The risk of pathological fractures increases. The curvature of the spine leads to compression of the organs located in the chest.
In an unfavorable course, the disease progresses with a violation of the heart muscle and a decrease in lung volume. Most often, such severe complications are accompanied by widespread osteochondrosis, in which several intervertebral discs are affected at once.
Degrees of thoracic osteochondrosis
The existing classification subdivides the process of development of this pathological condition into 4 stages. Each of them is characterized by the presence of a number of changes in the structure of the intervertebral discs, vertebrae and other elements that form this part of the spine.
First degree
In the first degree of pathology there are no pronounced clinical manifestations, but specific changes in the structure of the intervertebral discs can now be detected with a comprehensive diagnosis. The fibrous ring, which lacks moisture and nutrients, gradually loses its elasticity. Microcracks often form on the tissues, in which the pulpal nucleus is squeezed. Disc displacement in the spinal canal is possible. Protrusions form. There are no signs of rupture of annular fibrosis.
Second degree
With the transition of the disease to the second degree, the first clinical manifestations are observed. Patients sometimes experience pain and other neurological signs. When making a specific diagnosis, signs of a decrease in the elasticity of the tissues forming ring-shaped fibrosis can be found. The cartilage becomes very thin, which leads to an increased risk of hernia. There is a reduction in the height of the intervertebral discs, due to which the structures of the spine acquire unusual mobility.
Third degree
In the third stage, the changes in the structure of the discs become so pronounced that the first signs of the development of kyphosis or scoliosis appear. Often at this stage of the process, the damaged annular fibrosis ruptures. This phenomenon is accompanied by the release of the nucleus pulposus beyond the disc. The hernia, depending on the direction of the bulge, can compress the nerve roots or the spinal cord. Severe pain and neurological disorders occur. Increases the mobility of the spine, which creates conditions for injuries and fractures.
Fourth degree
With the transition of the pathology to the fourth stage of development, the structure of the intervertebral discs is disrupted so much that they cease to perform a cushioning function. Annular fibrosis and nuclear pulposis lose elasticity. These elements begin to ossify. Due to the violation of the cushioning function of the discs, the vertebrae suffer, which carry too much load.
At the ends of the vertebrae adjacent to the damaged disc, osteophytes, ie bone growths, begin to grow rapidly. The surrounding connections are involved in the pathological process. They lose elasticity and stop supporting the spine properly. In addition, at this stage of the development of the pathological process, the work of the muscular apparatus is disturbed.
Diagnosis
When signs of developing this disorder appear, the patient needs to consult a neurologist and orthopedic surgeon. First, the doctor conducts an external examination and collects a medical history. Laboratory tests often prescribed to diagnose this disease include blood and urine tests. X-rays are taken to obtain information about the presence of defects in the structure of the spine. This study reveals:
- reduce the height of the disk;
- serrated edges of elements;
- hernia;
- replacement of vertebral bodies;
- formation of osteophytes and so on.
A discography is assigned to clarify the defects in the structure of the disc. This study allows you to identify the uneven contours of the pulse nucleus, to assess the degree of destruction of the disc and the reduction of tissue density. CT and MRI are often done for better imaging. Because the clinical manifestations of thoracic osteochondrosis are similar to the symptoms of ischemic heart disease, electrocardiography is often prescribed to differentiate these conditions.
Treatment Options
This pathological condition requires complex treatment. First of all, patients are selected drugs that help eliminate the symptomatic manifestations and improve the nutrition of the intervertebral discs. Drug treatment should be supplemented with physiotherapy and exercise. As a supplement you can use some folk remedies. It is also recommended that you follow a specific diet.
Medicines
In case of severe pain syndrome, the patient is advised to adhere to bed rest. This will reduce the intensity of the pain. Analgesics and NSAIDs are often prescribed to relieve the discomfort. If the pain syndrome is too intense, blockage may be needed. Glucocorticosteroids are often prescribed to relieve pain in this disease.
Chondroprotectors are prescribed to improve the saturation of nutrients and water on the intervertebral discs. In some cases, antispasmodics and muscle relaxants are prescribed in short courses. These drugs help relieve muscle spasm. If necessary, diuretics are prescribed to eliminate soft tissue swelling. To improve the condition of the nerve endings subjected to compression, the patient needs B vitamins.
Physiotherapy and massage
Physical therapy and massage are the most important components of osteochondrosis treatment, but they can only be used after drug suppression of symptoms. Properly selected exercises help to improve lung ventilation and strengthen the muscular corset that supports the spine.
First, all the necessary exercises must be learned under the supervision of an exercise instructor. In the future, the patient can do exercises at home. People with this condition may be advised to take lessons in the pool.
Massage helps to eliminate muscle hypertension and improve soft tissue nutrition. In order not to cause harm, the procedures must be performed by a specialist. In most cases, a classic massage is performed, which includes sequential rubbing, smoothing and pinching of the problem area. Acupressure and segmental massage can be very helpful. These techniques involve affecting the pain points. They help to improve blood circulation and lymphatic drainage. In most cases, it is enough for patients to perform procedures 2-3 times a week.
Acupuncture
This method involves placing needles on areas of the patient's body. This method allows you to quickly eliminate muscle spasms and pain. Acupuncture procedures should be performed by a professional on the subject. If a specialist does this, the procedure will be almost painless. Acupuncture is contraindicated for people suffering from cancer, mental disorders. The use of this method for the treatment of osteochondrosis in the presence of severe inflammatory processes is not recommended.
Manual therapy
Manual therapy helps to restore the correct anatomical position of the vertebrae. In addition, this method helps to reduce the intensity of pain and muscle spasms. This effect helps to restore the ligament apparatus. Such procedures can slow the development of this pathological condition. The duration of the course of manual therapy is chosen individually for the patient.
Post-isometric relaxation technique
Postisometric relaxation procedures are a special technique that involves stretching all the muscles surrounding the spine and then relaxing them.
Such exercises should be performed under the supervision of a specialist who can assess the correctness of the movement and the severity of muscle tension. This method allows you to quickly eliminate pain and restore normal function of muscles and ligaments.
Folk remedies
It is impossible to treat osteochondrosis only with folk remedies, as this approach can lead to worsening of the disease. It is best to use various forms based on herbs and other natural ingredients in addition to traditional therapies. You should get a doctor's recommendation about the appropriateness of using this or that folk remedy before you start using it.
Celery root
Properly prepared celery root is believed to help saturate cartilage with nutrients and water. To prepare this product, 1 root must be chopped thoroughly and pour 1 liter of boiling water. You must insist on the composition for at least 8 hours. After this time you should strain the product and take 1 teaspoon 3 times daily before meals.
Sunflower root
A decoction of sunflower root is often used to treat osteochondrosis of the cervical spine. To prepare this product, you will need about 1 cup of chopped plant component, pour 3 liters of water. The mixture should be boiled for 3-5 minutes. The agent should then be cooled and taken in the form of tea for several days. To improve the taste of the drink, you can add honey to it. It is better to store the rest of the medicine in a thermos.
Homemade ointment
Ordinary home ointment can be used for rubbing with osteochondrosis. To prepare this product, you need to melt about 150 g of lard in a water bath. Then 2 tablespoons should be introduced into it. l. natural wax.
The composition should be boiled for at least 20 minutes. Then 1 tablespoon should be added to the heated mixture. l. fir oil. The product should be boiled for another 20 minutes. Finally, 2-3 minutes before removing the pan from the heat, add 1 tbsp. l. ammonia. The finished composition should be distributed in jars. Store homemade ointment in the refrigerator.
Nutrition in osteochondrosis of the chest
Patients with osteochondrosis of the chest need a balanced diet. Sufficient protein-rich foods should be included in the diet. It is recommended to regularly consume meals containing large amounts of chondroitin, including fish aspic, jelly meat, etc. It is imperative to include fermented dairy products, vegetables and fruits in the diet. Dishes should be steamed or baked. Fatty and fried foods should be avoided. It is recommended to take food in small portions, but often. This will avoid overeating.
Deterioration: what to do?
In the acute period of the disease it is desirable to reduce activity to a minimum. If possible, you should avoid postures in which the pain syndrome increases. First aid for exacerbation of osteochondrosis involves the use of drugs that reduce the severity of swelling, inflammation and pain. The patient is advised to rest in bed. It is advisable to stick to a sparing diet during this period. Only after eliminating the symptoms can you start exercise therapy and physiotherapy.
Forecast
Now this disease can be cured only in the early stages of development. In late diagnosis, therapy is aimed at eliminating symptoms and improving spinal motility. In some cases, surgical treatment is required. With an integrated approach to therapy, a person suffering from this pathology can lead a full life without experiencing pain and other neurological disorders.
Prevention
To prevent the development of this pathological condition, it is recommended to avoid sudden heavy lifting. You should always dress according to the weather, avoiding hypothermia. In addition, to prevent osteochondrosis, one must fight hypodynamics and monitor posture. As part of the prevention of this pathology, it is recommended to eat properly and carefully monitor your weight.