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 osteoarthritis than 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 more rare are its complications - disc protrusion and herniation.
However, the disease has many symptoms that significantly reduce quality of life and therefore requires treatment. Using medication only reduces symptoms and brings temporary effects, without affecting the development of the disease.
To reliably eliminate symptoms, you need to influence the cause of the development of degenerative processes in the intervertebral disc. For this purpose, the clinic uses complex therapy, which gives positive results in more than 90% of cases. It includes Oriental acupressure and physiotherapy methods - acupressure, acupuncture, massage therapy and other therapeutic procedures.
Symptoms, signs
When there is osteoarthritis, the discs will flatten and the vertebrae will stick together, leading to compression of the spinal nerve roots. This causes pain between the shoulder blades (often described as a sticky pile).
Pain syndrome in thoracic osteoarthritis can be acute, severe or chronic, moderate.
In the first case, acute pain occurs suddenly and is called dorsago. In the second case, the pain is felt constantly, has an aching nature and is called back pain.
Irritation from the compressed root spreads along the nerve, radiates into the chest and becomes the cause of intercostal neuralgia - stabbing pain, cuts or burning in the chest, pain that increases when inhalingenter, move, cough, sneeze, laugh.
Another characteristic symptom of thoracic osteoarthritis is pain in the heart area, accompanied by signs of cardiac neuropathy - palpitations, tachycardia, increased heart rate.
Compressed nerve roots lead to nerve distribution disorders, numbness, weakness in the hands, cold feeling in the hands, cyanosis (blue discoloration) or pale skin. These symptoms are often one-sided.
Pain from osteoarthritis can also spread to the shoulder, under the shoulder blade and to the forearm.
Other symptoms of the disease are joint stiffness, back tension, numbness in the paraspinal area, shoulders, neck area, difficulty breathing, and feeling like there is a lump in the chest.
Nerves arising from the spinal cord in the thoracic region play an important role in the nerve distribution of the entire body. As a result, osteoarthritis symptoms can occur in areas seemingly unrelated to the spine. For this reason, it is called "chameleon disease".
These symptoms include:
- heartburn, bloating,
- loss of appetite, nausea,
- indigestion (dyspepsia),
- cough,
- cold feet,
- whole body numbness,
- pain in the right lower quadrant,
- abdominal discomfort,
- sweat
In addition, thoracic osteoarthritis is manifested by impaired blood supply to the brain - headaches, unstable pressure, dizziness, unsteady gait and loss of coordination.
Causes of development, stages
The main role in the development of the disease is played by muscle spasms and tension (hypertonia) of the back muscles. These spasms occur with a sedentary lifestyle, poor posture, or prolonged stay in a static, uncomfortable position (for example, at a desk or while driving).
On the other hand, heavy, monotonous work also causes persistent back muscle spasms (for example, when working with raised arms).
Muscle spasms impede circulation and impede blood flow to the spine. Because of this, the nutrition of the intervertebral disc is impaired.
Intervertebral discs are shock-absorbing pads of connective tissue found between vertebrae. In the center of each disc is a semi-liquid, powdery filling that contains a lot of moisture. Water provides load-bearing and compression resistance.
Along the outer circumference of each disc is reinforced with a ring of stiff fibers. The connective tissue of the intervertebral disc consists mainly of collagen - this substance is synthesized in the body and must be continuously supplied to the joints, disc and other cartilage and connective tissues for their continuous regeneration. .
Muscle spasms impede blood flow, resulting in not enough collagen reaching the disc for normal tissue repair. Lack of oxygen leads to a slowdown in metabolism.
Due to metabolic disorders, tissue regeneration of intervertebral discs slows down and their wear rate increases. This leads to dystrophy and degeneration - the intervertebral discs become dehydrated, crack, dry out, collapse and lose their shock-absorbing properties and elasticity.
Back muscle spasms are the main cause of excessive stress on the spine in the thoracic region. If in the cervical region the intervertebral discs are compressed by the weight of the head, increasing with incorrect posture, and the lumbar region is compressed by body weight, increasing with excess weight, then in the thoracic region, muscle spasms closea special role. in the development of the disease. These spasms not only restrict blood flow but also strain the spine and compress the discs both day and night. The intervertebral disc has practically no opportunity not only for cell renewal, but also for simple rest and recovery. Therefore, the first thing the doctor should do when treating thoracic osteoarthritis is to relax tense back muscles, eliminate muscle spasms and increased tone. Without this, effective treatment of the disease is impossible.
The flattening of the intervertebral discs leads to the space between the vertebrae becoming smaller and smaller, the vertebrae coming closer together and compressing the nerve roots. This causes pain, causes reflex muscle spasms, and adds pressure to the disc. Therefore, with the appearance of pain, the development of the disease often accelerates.
These degenerative-dystrophic changes correspond to the first stages of osteoarthritis.
Important!
In old age, osteochondrosis of the chest often develops based on general dehydration and metabolic disorders in the body. This is especially manifested by a decrease in height in older people, which occurs due to thinning of the intervertebral disc.
In the second stage, the outer annulus becomes fiberless. Its tissue becomes loose, weak and cannot cope with maintaining internal loads. As a result, the disc protrudes (usually locally) in a protruding form.
The part that protrudes toward the spinal cord is called the dorsum. The protruding parts that point to one side are called lateral. The rarest case is that the disc protrudes uniformly along the entire circumference.
The appearance of the protrusion often leads to increased pain. X-ray images clearly show a decrease in the height of the distance between the vertebrae, as well as the development of bone spurs - bone growth. They form along the edges of the vertebrae to compensate for the load on the spine as the discs have less and less to deal with.
In the third stage of the disease, the annulus fibrosus of the intervertebral disc cannot withstand internal pressure and ruptures. Through the space created, part of the nucleus pulposus of the intervertebral disc is forced out - a herniation between the vertebrae occurs.
In the fourth stage of the disease, the range of motion in the back decreases sharply, the pain syndrome becomes constant, and a broader picture of neurological disorders develops.
Diagnose
At the first appointment, the doctor asks the patient about the symptoms, the circumstances of their occurrence, studies the medical history, performs an external examination, pays attention to posture, the presence or absence of spinal deformities (scoliosis, kyphosis).
The cause of pain syndrome (dorsago, dorsalgia) can be cartilage degeneration and vertebral misalignment (vertebral dislocation), ankylosing spondylitis, ankylosing spondylitis.
Thoracic osteonecrosis is often accompanied by back muscle tension and increased spinal muscle tone. The doctor performs palpation and uses sequential pressure to find tender (trigger) points that correspond to muscle spasm centers.
To get more detailed information, the doctor prescribes an X-ray or MRI.
X-ray for thoracic osteochondrosis provides the most general information - it helps distinguish the disease from spondylolisthesis, see bone spurs and narrow the space between vertebrae.
Magnetic resonance imaging shows soft tissue, better alignment. With its help, the doctor can examine in detail the structure of the intervertebral discs, see the protrusion, herniation (its size, location, shape), as well as the condition of the ligaments, joints between vertebrae, blood vessels, nerve roots and see spinal stenosis (or its dangers).
Based on MRI data, the doctor makes a diagnosis and determines an individual treatment plan.
Treatment of osteoarthritis in the thoracic region
Drug treatment
To relieve back pain and intercostal neuralgia in thoracic osteoarthritis, nonsteroidal anti-inflammatory drugs in the form of ointments, tablets or injections can be used. The main effect of these drugs is anti-inflammatory, so their use is reasonable in cases where nerve roots are compressed with inflammation, that is, radiculitis of the chest area. NSAIDs also reduce muscle tissue inflammation caused by spasms and persistent hypertension.
In case of acute pain syndrome, paravertebral or epidural blockade - injection of analgesics can be used. In the first case, the injection is made at the site of compression of the nerve root, in the second case, in the area between the periosteum of the vertebra and the membrane of the spinal cord.
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 destruction of connective tissue, chondroprotective drugs may be prescribed.
These drugs treat symptoms and can somewhat slow down the progression 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-pharmacological treatment for thoracic osteoarthritis includes physical therapy, acupressure, and physiotherapy.
The main goal of treatment is to reduce the inflammatory process, improve blood circulation and restore metabolic processes in the spinal discs, stimulating cell regeneration of connective tissues. The clinic uses complex therapy using oriental medicine methods for this purpose.
Important!
Physiotherapeutic exercises help form and strengthen the muscle corset, remove unreasonable loads on the spine, and also work to prevent blockages and the formation of muscle spasms.
Surgery
For large hernias, especially lumbar hernias, there is a risk of spinal stenosis, and especially if present, an 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 at the clinic
Treatment of osteochondrosis of the chest area in the clinic is carried out in complex courses, including several procedures - acupuncture, acupressure, chiropractic therapystone therapy, stone therapy, vacuum therapy, hirud therapy for individual indications.
High efficiency is achieved thanks to the combination of individual methods and the elimination of the cause of the disease.
- Acupressure. By pressing firmly on trigger points in the back, the doctor will eliminate muscle spasms, tension, congestion, improve blood circulation and restore unimpeded blood flow to the spine. Thanks to this, the load on the intervertebral discs is reduced, metabolism and tissue regeneration are accelerated as the amount of oxygen and collagen increases.
- Acupuncture. Inserting needles into biologically active points in the back, legs, arms, head, chest helps eliminate symptoms associated with neurological impairment - numbness, weakness in the arms. With the help of this procedure, intercostal neuralgia and other vertebrae pain will be reduced. In addition, acupuncture also enhances the effect of acupressure and has anti-inflammatory and anti-edema effects.
- Moxibustion therapy. Warming of biologically active points in the spinal area is carried out with a smoldering wormwood cigar. This procedure activates metabolic processes, increases blood flow to the intervertebral discs, stimulates and accelerates their recovery.
- Vacuum therapy. Cupping and cupping massage induces blood circulation and helps improve blood circulation.
- Manual therapy. Using gentle traction of the spine, the doctor will unload the discs, increase the space between the vertebrae, release compressed nerve roots, reduce pain and increase range of motion in the back.
Light traction or traction is the only manual therapy technique indicated for thoracic osteoarthritis. Before starting, the doctor must thoroughly relax the back muscles, eliminate spasms and release the spine. To do this, the muscles are well warmed up and relaxed through massage. If this is not done, the use of physical exertion can lead to injury - cuts, sprains or fractures. Spinal traction hardware methods to treat osteoarthritis are ineffective and even dangerous, so they are not used in the clinic.
Hirudo therapy
Placing medicinal leeches helps improve local blood circulation, blood supply to the intervertebral discs and has an anti-inflammatory effect.
Stone therapy
Fine 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 course of treatment in the clinic is 1–1. 5 hours, depending on individual indications. The treatment course usually includes 10-15 complex sessions. After completion, a control MRI scan was performed to evaluate the achieved treatment results.
symptoms
The main complication of thoracic spondylosis is spinal cord stenosis due to disc herniation accompanied by total body paralysis.
Other possible complications are associated with disruption of the body's nervous system due to compression of spinal nerve roots: the development of diseases of the gastrointestinal tract, kidneys, heart and reproductive system.
Prevent
To prevent the development of thoracic osteoarthritis, you should avoid a sedentary lifestyle and monitor your posture.
Important!
If a child or teenager has scoliosis, the disease should be treated without hoping that it will go away on its own. Unilateral curvature of the spine occurs as growing pain but can last a lifetime.
In this case, persistent muscle tension and spasms are inevitable, which in turn will lead to the development of osteonecrosis and possibly its complications. And this is combined with the fact that scoliosis itself causes many complications from the respiratory, digestive and cardiovascular systems.