Thoracic osteochondrosis is a chronic disease of the spine in which degenerative-dystrophic changes occur in the intervertebral discs.
The thoracic spine is less often affected by osteochondrosis 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. Its complications are even rarer: protrusion and herniated disc.
However, this disease has extensive symptoms that significantly reduce the quality of life and therefore requires treatment. The use of drugs only attenuates the symptoms and provides a temporary effect that does not affect the development of the disease.
To reliably eliminate symptoms, it is necessary to influence the cause of the development of degenerative processes in the discs. For this purpose, the clinic uses complex therapy, which gives positive results in more than 90% of cases. It includes methods of oriental reflexology and physiotherapy: acupressure, acupuncture, moxotherapy and other therapeutic procedures.
Symptoms, signs
With osteochondrosis, flattening of the intervertebral discs occurs and the vertebrae come together, which leads to pinching of the roots of the spinal nerves. This causes pain between the shoulder blades (usually described as a stick being stuck).
Pain syndrome in thoracic osteochondrosis can be acute, intense or chronic, moderate.
In the first case, the acute pain occurs suddenly and is called dorsago. In the second case the pain is felt constantly, has an aching nature and is called dorsalgia.
Irritation from a pinched root spreads along the nerve, radiates into the chest and becomes the cause of intercostal neuralgia: stabbing, cutting or burning pain in the chest, which intensifies with inhalation, movement, coughing, sneezing , laughter.
Another characteristic symptom of thoracic osteochondrosis is pain in the heart area, which is accompanied by signs of cardioneurosis: palpitations, heart palpitations, increased heart rate.
Crushing of the nerve root leads to interruption of innervation, numbness, weakness of the hand, cold sensation in the hand, cyanosis (blue discoloration) or whitening of the skin. These symptoms are usually unilateral.
Pain with osteochondrosis can also radiate to the shoulder, under the shoulder blade and forearm.
Other symptoms of the disease are stiffness, tension in the back, numbness in the paravertebral region, shoulders, neck-cervical area, difficulty breathing, sensation of a knot in the chest.
The nerves that arise from the spinal cord in the thoracic region play an important role in the innervation of the entire body. Therefore, symptoms of osteochondrosis can appear 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,
- numbness of the body,
- pain in the right hypochondrium,
- abdominal discomfort,
- sweating
In addition, thoracic osteochondrosis is manifested by reduced blood supply to the brain: headache, blood pressure instability, dizziness, unstable gait and loss of coordination.
Reasons for development, stages
The main role in the development of the disease is played by muscle spasms and tension (hypertonicity) of the back muscles. These spasms occur during a sedentary lifestyle, poor posture, or prolonged stay in a static, uncomfortable position (for example, at an office desk or while driving).
On the other hand, monotonous and hard physical work also causes the appearance of persistent muscle spasms of the back (for example, working with raised arms).
Muscle spasms impede circulation and impede blood flow to the spine. Because of this, the nutrition of the intervertebral discs deteriorates.
Intervertebral discs are shock-absorbing connective tissue pads located between the vertebrae. At the center of each disc is a pulpy, semi-fluid nucleus, which contains a lot of moisture. Water provides load resistance and compressive strength.
Along the external perimeter each disc is reinforced with a rigid fibrous ring. The connective tissues of the discs are mainly made up of collagen: this substance is synthesized in the body and must be constantly supplied to the joints, intervertebral discs and other cartilaginous connective tissues for their continuous regeneration.
Muscle spasms interfere with blood flow, resulting in not enough collagen reaching the discs for normal tissue repair. Lack of oxygen leads to a slowdown in metabolic processes.
Due to metabolic disorders, the renewal of intervertebral disc tissues slows down and their wear accelerates. This leads to dystrophy and degenerative changes: the discs become dehydrated, cracked, dried out, flattened 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 pressed by the weight of the head, which increases with incorrect posture, and the lumbar region is pressed by body weight, which increases with excess weight, then in the thoracic region muscle spasms play a role exceptional in the development of the disease. These spasms not only impede blood flow, but also tighten the spine and compress the intervertebral discs both during the day and at night. Intervertebral discs are practically deprived of the opportunity not only for cell renewal, but also for simple rest and recovery. Therefore, the first thing a doctor should do in the treatment of thoracic osteochondrosis is to relax tense back muscles, eliminate muscle spasms and hypertonicity. Without this, effective treatment of the disease is impossible.
The flattening of the intervertebral discs causes the spaces between the vertebrae to narrow, the vertebrae to move closer together and pinch the nerve roots. This causes pain, which causes a reflex muscle spasm and further increases pressure on the discs. Therefore, with the appearance of pain, the development of the disease, as a rule, accelerates.
These degenerative-dystrophic changes correspond to the first stage of osteochondrosis.
Important!
In old age, thoracic osteochondrosis usually develops against the background of general dehydration and metabolic disorders in the body. This is manifested, in particular, by a decrease in height in older people, which occurs due to thinning of the intervertebral discs.
In the second stage, the external fibrous ring becomes fiberless. Its tissue becomes loose, weakened and cannot cope with maintaining the internal load. As a result, disc protrusion (usually local) in the form of a protrusion occurs.
A protrusion directed towards the spinal cord is called dorsal. Protrusions directed laterally are called laterals. The rarest case is the uniform protrusion of the disk along the entire perimeter.
The appearance of protrusion usually leads to increased pain. An X-ray image clearly shows a decrease in the height of the space between the vertebrae, as well as the development of osteophytes - bone growths. They form along the edges of the vertebrae to compensate for the loads on the spine as the intervertebral discs can bear them less and less.
In the third stage of the disease, the fibrous ring of the disc cannot withstand the internal pressure and breaks. Through the resulting interstitium, part of the nucleus pulposus of the disc is crushed: an intervertebral hernia is formed.
In the fourth stage of the disease, the range of motion of the back decreases sharply, the pain syndrome becomes constant, and a broad picture of neurological disorders develops.
Diagnostics
At the first visit, the doctor asks the patient about the symptoms, the circumstances under which they occurred, studies the medical history, carries out an external examination, paying attention to the posture, the presence or absence of spinal deformities (scoliosis, kyphosis ).
The cause of pain syndrome (dorsago, dorsalgia) can be both osteochondrosis and vertebral displacement (spondylolisthesis), ankylosing spondyloarthrosis, ankylosing spondyloarthrosis.
Osteochondrosis of the thoracic region is usually accompanied by muscle tension in the back and hypertonicity of the spinal muscles. The doctor palpates and uses successive pressures to find painful (trigger) points that correspond to the centers of muscle spasms.
To obtain more detailed information, the doctor prescribes an x-ray or MRI.
X-rays for thoracic osteochondrosis provide the most general information: they help differentiate the disease from spondylolisthesis, see osteophytes and narrowing of the spaces between the vertebrae.
MRI shows soft connective tissue better. With its help, the doctor can examine in detail the structure of the intervertebral discs, see the protrusion, hernia (size, location, shape), as well as the condition of the ligaments, intervertebral joints, blood vessels, nerve roots and see spinal cord stenosis (or its danger).
Based on the MRI data, the doctor formulates a diagnosis and determines an individual treatment plan.
Treatment of osteochondrosis of the thoracic region
Pharmacological treatments
To relieve back pain and intercostal neuralgia in thoracic osteochondrosis, 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 justified in cases where a crushed nerve root is accompanied by its inflammation, that is, in thoracic radiculitis. NSAIDs also reduce inflammation of muscle tissue against the background of spasms and persistent hypertension.
In case of acute pain syndrome, paravertebral or epidural blockade can be used: an injection of analgesic. In the first case the injection is carried out in the place where the nerve root is pinched, 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 the nerve roots, blood vessels and intervertebral discs, muscle relaxants and antispasmodics are used.
Vitamin complexes are prescribed to nourish nervous tissues and prevent their atrophy.
To slow down the process of destruction of connective tissues, chondroprotectors may be prescribed.
These drugs have a symptomatic effect and can somewhat slow down the development of the disease, but in general they have almost no effect on the process of degenerative change of the intervertebral discs.
Non-pharmacological treatment
Non-drug treatment of thoracic osteochondrosis includes methods of physiotherapy, reflexology and exercise therapy.
The main goals of treatment are relief of the inflammatory process, improvement of blood circulation and restoration of metabolic processes in the spinal discs, stimulation of cell renewal of connective tissues. For this purpose the clinic uses complex therapy using methods of oriental medicine.
Important!
Physiotherapy exercises help to form and strengthen the muscle corset, eliminate irrational loads on the spine and serve to prevent congestion and the formation of muscle spasms.
Surgery
For large hernias, especially dorsal, with risk of spinal cord stenosis, and especially if present, surgery – 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 surgery, operations on the thoracic region are performed extremely rarely.
Treatment in clinic
Treatment of thoracic osteochondrosis in the clinic is carried out in complex sessions, which include several procedures: acupuncture, acupressure, moxotherapy, stone therapy, vacuum therapy, hirudotherapy for individual indications.
High efficiency is achieved through the synergy of individual methods and the elimination of the cause of the disease.
- Acupressure. By pressing forcefully on the trigger points of the back, the doctor eliminates muscle spasms, tension, congestion, improves blood circulation and restores unhindered blood flow to the spine. Thanks to this, the load on the intervertebral discs is reduced, and the processes of metabolism and tissue regeneration are accelerated as the influx of oxygen and collagen increases.
- Acupuncture. Insertion of needles into the bioactive points of the back, legs, arms, head, chest eliminates symptoms associated with impaired innervation: numbness, weakness of the arm. With the help of this procedure, intercostal neuralgia and other vertebrogenic pain are relieved. In addition, acupuncture enhances the effect of acupressure and has an anti-inflammatory and anti-edematous effect.
- Moxibustion therapy. Heating the bioactive points in the spine area is performed with a smoking absinthe cigar. This procedure activates metabolic processes, increases blood flow to the intervertebral discs, stimulates and accelerates their recovery.
- Vacuum therapy. Cupping massage and cupping create blood flow and help improve blood circulation.
- Manual therapy. Using gentle traction of the spine, the doctor unloads the intervertebral discs, increases the distance between the vertebrae, releases compressed nerve roots, relieves pain and increases the range of motion of the back.
Gentle traction, or traction, is the only manual therapy technique indicated for thoracic osteochondrosis. Before starting, the doctor must completely relax the back muscles, eliminate spasms and free the spine. To do this, the muscles are well warmed up and relaxed through massage. If this is not done, the application of physical effort can lead to injury: breakage, sprain or fracture. Hardware methods of spinal traction for osteochondrosis are ineffective and even dangerous, therefore they are not used in the clinic.
Hirudotherapy
The placement of medicinal leeches improves local blood circulation, blood supply to the intervertebral discs and has an anti-inflammatory effect.
Stone therapy
Smooth 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 treatment session in the clinic is 1–1. 5 hours, depending on individual indications. The course of treatment usually includes 10-15 complex sessions. At the end, a control MRI is performed to evaluate the treatment results obtained.
Complications
The main complication of thoracic osteochondrosis is spinal cord stenosis due to herniated disc with the development of bodily paralysis.
Other possible complications are associated with disruption of the innervation of the body due to pinching of the spinal nerve roots: the development of diseases of the gastrointestinal tract, kidneys, heart and reproductive system.
Prevention
To prevent the development of thoracic osteochondrosis, you should avoid a sedentary lifestyle and monitor your posture.
Important!
If a child or adolescent has scoliosis, it is advisable to treat this disease without hoping that it will disappear on its own. Lateral curvature of the spine presents as increasing pain but can last a lifetime.
In this case, persistent muscle tension and spasms will be inevitable, which in turn will lead to the development of osteochondrosis and, possibly, its complications. And this is in addition to the fact that scoliosis itself is fraught with complications affecting the respiratory, digestive and cardiovascular systems.