The human spine in the literal sense of the word support. It is designed in such a way that it can withstand heavy loads. In the case when another type of negative effect is exerted on the body, osteonecrosis of the chest develops.
Osteochondrosis is a disease in which the discs lose their elasticity, elasticity and strength, or in other words, their degenerative and dystrophic changes occur. The basis is a violation of metabolic processes in the tissues of the disc. In addition, there is a change in the structure of the vertebrae themselves.
The eligibility of using the term "vertebral osteolysis" is currently disputed, as is the removal of all back pain for this matter.
In the 10th Amendment International Classification of Diseases, the nosological unit is the absence of "osteochondrosis", but the term persists among physicians.
Degenerative-dystrophic changes in the thoracic spine do not develop frequently, they can mimic the symptoms of somatic disease.
If pain is present on the left side of the chest, even increasing on inspiration, in conjunction with exercise, then ECG recording is mandatory to rule out acute coronary syndrome.
What is that disease?
Thoracic osteonecrosis is the rarest form of unnatural changes in the spine. The fact is, in contrast to the lumbar and cervical regions, the thoracic region of the spine is supported and strengthened by the ribs.
Osteomas of the thoracic spine are less common than other forms of this condition, because the thoracic spine is reinforced with ribs.
Symptoms are often similar to those of heart disease, as well as diseases of the pleura.
Diagnosis is made on the basis of X-ray, CT, MRI. Treatment is selected to relieve symptoms and prevent further deterioration of spinal cartilage.
Even significant loads cause minimal damage to the vertebrae in this area. However, the main danger to the vertebrae in this area is prolonged inactivity.
Such bone resorption causes changes both in the vertebrae themselves and in neighboring organs. The onset of the disease is generally mild, without severe pain. At the same time, the identification of osteosarcoma in the thoracic region is extremely difficult because of its peculiarity in impersonating other diseases.
Often, this pathology can be confused with:
- angina pectoris;
- diseasesGastrointestinal(gastritis, ulcer, colitis);
- diseaseshearts;
- inflammationappendix;
- kidneystomachache.
With a thorough examination, it soon turned out that the symptoms of other diseases were not confirmed, while there were obvious signs of one degree of osteonecrosis.
The prevalence of disease
The risk group includes workers of any type of activity. Usually, thoracic osteonecrosis (GO) occurs in people over the age of 55, but in younger people, you may also see the first signs of the disease's development. In the survey sample of doctors, 38% were male and 62% were female.
The first stage of HO occurred in 71% of people surveyed. Bone tumors are the most common cause of disability among working people. There are between 33 and 165 cases per 100 workers per year. The other things. many cases within a year a person has many relapses, each time having to take sick leave.
Degree
The development of thoracic osteonecrosis goes through several stages:
- Dehydration of tissuesplate,for what they lose flexibility and elasticity. At this stage, the discs are gradually flattened and transformed, they can still withstand the load, but the person already feels uncomfortable.
- Dehydration Jailbreakfibrousdisc ring. When the position of the body changes, pain is pronounced.
- DistanceThe outer sheath of the disc, the nucleus pulposus comes out, forming a herniated mass, touching the nerve roots extending from the spine, in such a situation, a sharp pain occurs.
- Convergenceadjacent vertebrae, their displacement, flattening and growth.
Osteochondrosis is divided into several degrees:
- Sick1 degreewas diagnosed with a ruptured disc, when there was a sharp pain in the sternum, like an electric shock, and the muscles were extremely tense.
- Degree 2It is characterized by the appearance of a disc bulge, when part of it begins to press on the nerve root, but the nucleus pulposus remains intact and does not prolapse. This degree of osteonecrosis occurs intermittently between exacerbations and remission.
- In3 degreesthe pain is permanent, because the nerve endings are stimulated constantly. At this stage, there are signs of numbness in the limbs, heaviness in the head, heart rhythm disturbances, insomnia, increased nerves due to poor general health.
- In4 degreesIrreversible transformations are observed in the vertebrae, after their convergence and transformation, the spine loses mobility at this place.
Depending on the severity and stage of the disease, symptoms and other factors, the appropriate treatment method is selected.
Reason
Bone tumors occur for a number of reasons, but the most common are:
- Excessiveweighthuman body. The spine cannot continuously bear too much weight.
- Mistakenutrition.Due to low consumption of foods containing calcium and simultaneous consumption of foods that cause this substance to be washed out of the body, bone tissue is destroyed. The vertebrae wear down gradually. In addition, if the diet lacks enough saturated and unsaturated fatty acids, the discs are affected, lacking these important micronutrients.
- Smoke.The use of tobacco disrupts the metabolism in the body and this significantly affects the condition of the discs.
- Violationposture.Systemic violation of the normal position of the spine leads to scoliosis, which, in turn, causes osteonecrosis.
- sedentaryLifestyle. Sedentary work and lack of any physical activity results in the muscles of the body to lose tone. They relax and are unable to fully support the spine, causing the spine to curve.
- Increase physicalpayload.Most often they happen to professional athletes, however, in everyday conditions there are still such situations. If the impact is strong on the spine, it can change the position of the vertebrae, forming protrusions, hernias.
- Genetictrend. Quite often, similar pathological disorders of the vertebrae and discs are found in close relatives.
- The agechanges. Over the years, the body stops synthesizing glycosaminoglycans and other important compounds that give the discs elasticity. The bone tissue becomes porous and fragile, which means that the vertebrae are easily deformed.
- hurtbackside. Even a minor injury to the spine does not go away without leaving a mark and giving rise to changes in the vertebrae.
In addition, hormonal disorders in the body, hypothermia and infectious diseases can become the driving force for the development of osteonecrosis.
Symptom
Because thoracic osteonecrosis has similar symptoms to many other diseases, it can be difficult to distinguish its signs. However, doctors agree that obvious symptoms of osteonecrosis can be considered:
- middle painribs;
- pain abovethe four limbs,accompanied by tingling and numbness;
- deep painbreath;
- pain when tryingAdvancedhand;
- inability to commit by the body's organsleanin one direction or another;
- convulsionin muscles;
- Haggardskin due to improper functioning of nerve endings;
- feelinglow back painbehind.
The pain increases at night, the body temperature decreases, when turning.
Because the pain can radiate anteriorly above the sternum, it is often confused with heart pain.
| Vertebral no. | What parts of the body are associated with | What is the cause? |
|---|---|---|
| D1 | Trachea, esophagus | Cough, asthma, arrhythmia |
| D2 | Palm, wrist, hand | Pain in the chest, palms and arms |
| D3 | Chest, pleura, lungs, bronchi | Pneumonia, pleurisy, asthma, bronchitis |
| D4 | Bile duct and bladder | Jaundice, gallstones |
| D5 | Solar plexus | Jaundice, poor blood clotting |
| D6 | Liver | Ulcers, gastritis, digestive problems, liver dysfunction |
| D7 | 12 duodenum, pancreas | Feces, digestive disorders, ulcers and diabetes |
| D8 | Diaphragm, spleen | Weakened immune system, allergies |
| D9 | Adrenals | Weakness, fatigue, kidney problems |
| D10 | Kidney | Infertility, digestive problems, female genital diseases |
| D11 | Ureters | Kidney disease, urinary problems |
| D12 | Fallopian tubes, inguinal ring, colon and small intestine | Infertility, genital diseases, fecal and digestive problems |
With osteonecrosis of the thoracic spine, 2 common syndromes can be observed - lumbago and backache.
Dorsago is a syndrome that is accompanied by sharp, sharp, and sudden pain in the sternum. The usual inhalation and exhalation and the attempt to rotate the body in one direction or another are accompanied by painful sensations. This syndrome often occurs in people who have to sit for a long time in one position, leaning forward.
Back pain - unlike back, it develops imperceptibly, in about a month. It is characterized by sharp pain and discomfort in the chest. The pain increases in the dark, when taking a deep breath, and in an uncomfortable body position.
| Where does it hurt? | How does it manifest? |
|---|---|
| Breast | A feeling of constriction in the back and chest, shortness of breath, pain when breathing and bending over, sometimes felt in the heart and left breastbone area. |
| Neck | Numbness in hands, hoarse voice, difficulty breathing, headache, dizziness, impaired vision and hearing |
| Small in the back | Cold feet syndrome, spasms of the lower extremities, increased sweating, abnormalities in the genitourinary system, lower back pain - dull or acute |
Specific and rare symptoms of osteonecrosis of the breast:
- feelinghumpin the throat, pain in the larynx and esophagus, which occurs if the disease affects the upper chest;
- symptompancreatitis,cholecystitis occurs when the mid-chest area is affected;
- pathologicalintestinecapable of simulating the defeat of the subthoracic region;
- intercostalNerve pain,arising from root invasion of the intercostal nerve, the pain in this case is shingles in nature. It is easy to confuse sciatica with many diseases of the internal organs;
- lungsyndrome - manifested by symptoms of hypoxia and congestion in the lungs.
During the course of the disease, some and almost all symptoms can be observed simultaneously, and they vary depending on the stage of thoracic osteonecrosis.
| Coefficient | Bone tumor | Heart attack | Angina pain |
|---|---|---|---|
| Intensity | Less often strong, usually milder pain | So strong I can't stand it | Weak |
| Period | Long: one day or more | A few hours or a few days | 1 to 15 minutes |
| Location | Left sternum, back, area between shoulder blades | Neck, behind sternum | Neck, behind sternum |
Diagnose
The main methods for the diagnosis of thoracic osteonecrosis are:
- X ray.In the images obtained with its help, the following signs are often present: a changed shape of the vertebral body; the presence of bone growth; reduce the height of the intervertebral disc; uneven contour of the plates; thinning of the spinal canal; degenerative processes in the structure of the spine.
- ComputerCT scan. In difficult cases, it is necessary to obtain an accurate 3D model of the spine.
- Neurophysiologycheck. Tendon reflexes are evaluated, as is neuromuscular (electromyography) conduction.
- Researchbloodto determine the level of calcium in it.
Because thoracic osteonecrosis can be difficult to diagnose, it's important to know its main symptoms so you can see your doctor promptly.
Acute first aid
If it is necessary to eliminate the attack in the short term, experts recommend adhering to a number of recommendations.
First of all, the area where the pain syndrome is present needs to be warmed up. For this, it is better to use special ointments. Doctors strongly advise against using herbal decoction, because of the possibility of serious burns. Wool scarves or scarves work best for warm compresses.
Next, you need to keep a body position that does not cause the manifestation of unpleasant sensations. Lie on a hard surface like the floor.
At the time of an exacerbation, a tight bandage should be applied to the chest.
Taking pain relievers will help stop or reduce the severity of the attack.
If after 60 minutes your condition does not improve, you need to call an ambulance. When the doctor arrives, he needs to be told about the use of painkillers.
Treatment
Treatment of thoracic osteonecrosis includes a series of the following procedures:
- Anti-inflammatorynon-steroidal drugs - help reduce inflammation and relieve pain. Hormonal preparations are added if necessary.
- Muscle relaxants- relax tense muscles.
- Sedativemedication - to relieve anxiety and discomfort caused by constant pain.
- Diureticmedicine to reduce swelling.
- Drugsto stimulate blood circulation.
- Chondroprotectors.The drug is prescribed to accelerate the regeneration of cartilage tissue - there is not enough evidence base, the effect is individual.
- Acupuncture.Acupuncturists can relieve pain in osteonecrosis by targeting specific areas of the body.
- Physical therapy.
- Handmadetherapy. An experienced chiropractor can improve blood circulation, relieve muscle spasms, and prevent the development of osteonecrosis.
- Massage.It is permissible to use this method of treatment in the absence of disc herniation.
- Supersonictherapy.
- Electromagnetictherapy.
- Mud therapy.
- Lengthen.Thanks to this method, the muscles and spine are stretched up to 1. 5 mm. This leads to the decompression of nerve endings, while the inflammatory process is eliminated, pain disappears and local blood circulation increases.
If standard treatment is unsuccessful or a disc has formed, surgery is rarely required.
The diet should include dishes that are natural chondroprotectors - jelly meat, jellies, puddings, rich broths cooked from lamb and beef.
All doctors say that swimming is essential for maintaining spine health. This type of activity allows you to evenly distribute the load throughout the body, helps to correct the spine, strengthens the back muscles, and generally improves the health of the body. However, it should be remembered that in the case of a hernia, such a method of rehabilitation is excluded while the exacerbation is ongoing.
Physical therapy
If you are diagnosed with grade 1 thoracic osteonecrosis, regular exercise will allow you to deal with the problem without resorting to medication. In addition, to achieve positive results, it is recommended to exercise at the gym for at least 4 months.
To treat the disease, daily should perform the following exercises:
- lean forward, while alternately flexing the lower limbs;
- perform side bends by alternately raising your arms;
- simultaneously raise the upper and lower limbs in the prone position;
- Lean forward, reaching out with your arms and feet on the opposite side.
Each exercise is repeated 10 times. It is allowed to take 3 approaches.
Experts offer a different set of exercises:
- Maintain a standing position. Raise your arms as you inhale and lower as you exhale.
- Sit on a backrest chair. Inhale and pull your shoulders back so that the shoulder blades are as close together as possible. Bend the lower back slightly.
- Walk on four legs. Lift right leg and left arm off the floor, straighten and extend away. In this position, you need to linger for 15 seconds. Then, return to the starting position and do the same with the opposite limbs.
- Do the "cat" exercise. To do this move, you also need to take a stance, stand on all fours, bend your lower back, and bend your body upwards.
You have to do it 15-20 times each time. If during any exercise painful sensations appear, it is better not to do it.
After the muscle corset becomes stronger, the specialist will advise you to move on to more complex exercises.
It must be remembered that in the period of exacerbation of the disease, the load should be minimal, but you should not completely abandon classes.
Consequences and complications
Complications with the appearance of thoracic osteonecrosis are not uncommon, since the disease is latent and asymptomatic at first, recognizable when the disease is advanced. The following complications are distinguished:
- tighteningspinal canal;
- overgrownbone tissue of the vertebrae;
- degenerative spondylolisthesis(cervical spondylosis, back sclerosis);
- inflammationnerve roots of the spine;
- vegetative-vasculardystonia.
The nature and severity of complications depend on prompt and proper treatment. At the same time, at a younger age, the consequences are often more difficult to avoid.
Methods of prevention
Therefore, there is no separate prevention for osteonecrosis; It is generally necessary to take care of the spine to prevent any changes in it. Therefore, you should adhere to the following rules:
- Do not allowinjurybackbone. Athletes need to carefully balance the load and use sports belts and belts to support the spine. People with physically active jobs need to strengthen their back muscles to support the spine.
- Make a special complexexerciseexercise. It is necessary to normalize blood circulation in the spine so that the discs do not lack the necessary trace elements. When working sedentary, you need to get up at least once an hour and warm up a bit.
- When there are the smallest typical signs of spinal diseases (tingling, numbness, low back pain), you need to applyConsultationfor a neuroscientist.
It is necessary to take care of the health of the spine, adhere to moderate physical activities, avoid bad habits, eat in moderation and drink more water. All of this will help prevent changes in the vertebrae and the discs between them and keep the spine functioning in the long run.
Answers to common questions
Which doctor is treating?
At the first symptoms of the manifestation of the pathology, you need to contact a chiropractor or neurologist. In order to prescribe a complex treatment, you will also need to consult with a traumatologist (if the cause of the disease is a bruise, trauma, fracture), an osteopathic physician (identify the area of the lesion). spine), rheumatologist (inflammation in the connective tissue).
How long does the exacerbation last?
The duration of the acute phase can range from 3 to 14 days. In the absence of treatment, relapses can be repeated over and over, causing gradual damage to new areas.
What position do you sleep in?
Experts recommend doing a side pose relative to the embryonic position. Sleeping on your back is also allowed but in this case the internal organs can put pressure on the ribcage area. Sleeping on your stomach can cause pain in your neck.