Thoracic osteochondrosis is a chronic pathology in which the bone vertebrae and the intervertebral discs located between them undergo degenerative changes. Destructive injuries in this area are quite rare due to poor mobility and good protection by the rib structure. Osteochondrosis of the thoracic spine develops unnoticed, progresses slowly but persistently, and is also distinguished by a number of specific symptoms, masked as diseases of internal organs. In this regard, it is very important to contact your doctor at the first, still slight, signs of back problems. Timely treatment helps prevent serious complications.
Causes and provoking factors
Degenerative-dystrophic processes in the thoracic segments of the spine occur against the background of endogenous disruptions and under negative external influences. Their development is often caused by the following factors:
- hereditary predisposition, presence of a certain set of defective genes;
- excessive physical exertion, especially lifting and carrying various heavy objects;
- a sedentary lifestyle, which causes congestion in the area of the vertebral bodies and intervertebral discs;
- congenital or acquired structural anomalies, for example accessory vertebrae, lordosis, kyphosis;
- back and/or chest injuries - fractures, prolonged compression;
- flat feet, club feet;
- impaired blood circulation in any area of the thoracic spine, not only;
- frequent hypothermia;
- overweight;
- endocrine pathologies, metabolic disorders, such as diabetes, gout, hypothyroidism, hyperthyroidism;
- systemic diseases - rheumatoid arthritis, systemic lupus erythematosus, scleroderma;
- ankylosing spondylitis.
The strength and mobility of the spine as a whole directly depends on the condition of each department. The disease may be a consequence of severe untreated lumbar or cervical osteochondrosis.
Smoking, alcohol dependence and intoxication, including occupational hazards, predispose to the destruction of intervertebral joints with discs consisting mainly of cartilage. Thoracic osteochondrosis is diagnosed more often in older adults than in young and middle-aged people. This is due to the natural aging of the organism, a slowdown in recovery processes and the presence of one or more somatic pathologies.
Symptoms and signs of the disease
The main symptom of the degenerative process is pain. Unlike cervical and lumbar osteochondrosis, it is extremely rarely acute, burning, penetrating. Patients usually describe the discomfort as dull, aching, or pressing. The pain syndrome may intensify when bending/turning the body, with sudden and awkward movements, during a cough attack or during temperature changes. Its irradiation is noted, widespread beyond the affected area. Osteochondrosis of the thoracic spine also manifests itself as follows:
- stiffness, feeling of constriction;
- specific clicks, crunches when changing body position;
- loss of sensitivity, paresis in the form of a sensation of "creeping goosebumps", burning, numbness;
- muscle spasms, which further limit range of motion;
- adoption of a forced position in which the discomfort does not manifest itself or is expressed weakly;
- pathological changes in posture, in later stages - gait;
- a slight decrease in growth due to the destruction of the intervertebral joints and convergence of the vertebral bodies.
Due to the constant tension of the back muscles, the muscles of the neck and lower back also have spasms, which is expressed in pain in these parts.
The clinical picture of thoracic osteochondrosis is a combination of pain syndromes. The fact is that the affected segments are located in the zone of common innervation with many internal organs. If a displaced disc has pinched a nerve root located near the spine, pain may be felt, simulating common pathologies:
- severe heart pain resembles angina pectoris and even myocardial infarction;
- pain in the mammary glands becomes the reason for an urgent differential diagnosis to exclude tumor processes;
- constant or periodic pain in the right hypochondrium, stomach or intestines resembles those characteristic of gastritis, cholecystitis and ulcerative lesions.
When osteochondrosis worsens, the lower back or abdomen may hurt. Patients confuse discomfort with signs of renal pathology or gynecological disease. They turn to specialized specialists, who then refer patients to a neurologist or vertebrologist after the examination.
Classification, main typologies
The common classification of osteochondrosis of the thoracic spine is based on the nature of the pain syndrome. There are two types:
- dorsago - a sharp, sharp pain in the sternum, occurring mainly during prolonged stay in one body position, often complicated by a feeling of lack of air when inhaling;
- dorsalgia in the form of mild painful sensations in the back, which appear periodically and subside after rest.
This division of pathology into groups allows the doctor to quickly decide on the choice of analgesic.
Stage-by-stage development of thoracic osteochondrosis
In its development, osteochondrosis of the thoracic spine goes through four stages. Each has its own symptoms and radiographic markers. The more pronounced the deformation of the discs and vertebrae, the more intense the pain, stiffness of movements and paresthesia. The stage of the disease determines therapeutic tactics.
Phase I
There are no changes on the x-ray yet. However, the intervertebral disc no longer retains moisture well, without which its timely recovery is impossible. It gradually begins to thin, lose strength and elasticity. Only in some cases does mild discomfort appear in the thoracic region. A person perceives it as muscle fatigue and does not consult a doctor. Therefore, the disease at this stage is usually an accidental diagnostic finding during examination for another reason.
Phase II
The structure of the annulus fibrosus becomes loose and fibrous. There is a widening of a crack in the disc with the protrusion of the nucleus pulposus in this direction. The distance between adjacent vertebrae decreases as the height of the disc decreases, this is clearly visualized on x-ray images. To compensate for the distribution of loads, the muscle tissue is constantly tense. Stiffness increases, pain severity is still moderate.
Phase III
The fibrous ring breaks and the nucleus pulposus is crushed beyond its boundaries. A herniated disc occurs, causing severe symptoms and serious complications. Significant deformation of the vertebral bodies and the formation of individual osteophytes (compensatory bone growths) are observed. The pain syndrome becomes constant, back movements are significantly limited.
IV stage
At this stage, diagnosing thoracic osteochondrosis is not difficult. Connective tissues grew and more osteophytes formed. The adjacent vertebrae in the segment are blocked, completely or partially immobilized. Nerve roots are often pinched by inflammatory swelling, bony growths, and muscle spasms. This manifests as a burning, stabbing pain. The patient copes poorly with household chores and has difficulty moving around.
Complications
The development of discogenic myelopathy, a dystrophic disease of the spinal cord resulting mainly from compression by a herniated disc, is dangerous. It is worth noting that with osteochondrosis of the thoracic spine such a complication is rare. However, in clinical practice, cases of localization of discogenic myelopathy in one of the lower segments have occurred. Due to the progressive increase in neurological deficit, muscle strength decreases and tendon reflexes change. Ischemic areas form and nerve cells die (spinal cord infarction). This is characterized by movement disorders, loss of sensitivity and trophic disorders.
Diagnostic measures
At the first visit, the doctor listens to the patient's complaints, examines him, assesses the level of sensitivity, checks tendon reflexes, studies the medical history and history of spinal injuries. His diagnosis is confirmed by laboratory and instrumental studies:
- x-ray in two projections, according to indications: a targeted image of a certain segment;
- MRI;
- evoked potentials;
- electroneurography;
- electromyography;
- general clinical blood and urine tests.
To find out the cause of specific symptoms and exclude somatic diseases with similar clinical manifestations, electrocardiography, ultrasound scanning of cardiac structures and electroencephalography may be prescribed.
Methods of treatment for thoracic osteochondrosis
Therapy is comprehensive, aimed at eliminating symptoms and preventing the spread of the pathological process to other spinal segments. In the acute phase, burning and unbearable pain is eliminated by injecting drugs, even directly into the affected area. The use of glucocorticosteroids in combination with anesthetics (pharmacological blockade) is usually practiced. In other cases, drug therapy consists of taking tablets, capsules, rubbing ointments and balms. The use of drugs from the following groups has proven effective:
- muscle relaxants to relieve muscle spasms;
- non-steroidal anti-inflammatory drugs with pronounced analgesic activity;
- antispasmodics for pinched nerves;
- means to improve blood circulation;
- preparations with vitamin B6, which improve the transmission of nerve impulses and activate regeneration.
If a radicular syndrome has formed and other complications have arisen, the person constantly lives in fear of experiencing excruciating pain again, and this can cause mental disorders. Prescribing sedatives and antidepressants can prevent such developments. In addition to drugs, the following methods are used in the treatment of osteochondrosis of the thoracic spine:
- therapeutic massage, including vacuum and acupuncture;
- physiotherapeutic procedures - electrophoresis/ultraphonophoresis, magnetotherapy, pulsed currents, UHF therapy, applications with ozokerite or paraffin, acupuncture, hirudotherapy;
- physiotherapy and gymnastics;
- spinal traction.
In case of significant damage to the vertebral discs and myelopathy, surgical treatment is always prescribed immediately. The hernial protrusion is removed, microdiscectomy, puncture enhancement or laser disc reconstruction is performed, an implant is installed, or the spinal segment is stabilized.
Prevention of thoracic osteochondrosis
The main goal of primary prevention of thoracic osteochondrosis is to eliminate factors that can trigger thinning and rupture of the intervertebral disc. What doctors recommend:
- avoid excessive stress on the back;
- promptly treat all diseases: infectious, endocrine, inflammatory;
- seek medical attention immediately for back injuries, even those that at first appear minor;
- give up alcohol and smoking or at least limit them;
- replenish your diet with fatty fish, fresh vegetables, fruits and dairy products;
- avoid hypothermia;
- Do physical therapy for at least 15 minutes every day.
Such preventive measures are effective for already diagnosed diseases of the thoracic, cervical or lumbar spine. With their help it will be possible to prevent exacerbations and progression of the degenerative-dystrophic process.
If you have signs of osteochondrosis of the thoracic spine and want to get rid of it, contact the clinic for comprehensive and competent treatment.
Question Answer
What is the difference between intercostal neuralgia and thoracic osteochondrosis?
In fact, intercostal neuralgia is a lesion of the intercostal nerves, which can complicate the course of osteochondrosis. There are two main differences between these disease processes. Neuralgia is characterized by stabbing or burning paroxysmal pain, which also intensifies with inhalation. Thoracic osteochondrosis without violation of sensitive nerve endings is manifested by a dull pain, as if distant.
And the second difference is the forecast. After eliminating the cause of intercostal neuralgia, it disappears without a trace. Osteochondrosis responds well to treatment only in the initial stages of development.