Thoracic osteochondrosis is a chronic disease of the spine in which degenerative-dystrophic changes occur on 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 reinforced by a muscular corset. Its complications - protrusion and disc herniation - are even rarer.
However, this disease manifests itself with extensive symptoms that significantly reduce the quality of life and therefore requires treatment. The use of drugs only suppresses the symptoms and gives a temporary effect that does not affect the development of the disease.
To reliably remove the symptoms, you need to affect the cause of the development of degenerative processes in the discs. For this purpose, the clinic uses complex therapy that gives positive results in more than 90% of cases. It includes methods of oriental reflexology and physiotherapy - acupressure, acupuncture, moxa therapy and other therapeutic procedures.
Symptoms, signs
In osteochondrosis, there is a flattening of the intervertebral discs and fusion of the vertebrae, which leads to pinching of the roots of the spinal nerves. This causes pain between the shoulder blades (commonly described as a stabbing pain).
Pain syndrome in thoracic osteochondrosis can be acute, intense 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 a painful character and is called dorsalgia.
Irritation from the 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 when inhaling, moving, coughing, sneezing, laughing.
Another characteristic symptom of thoracic osteochondrosis is pain in the region of the heart, which is accompanied by signs of cardioneurosis - palpitations, palpitations, rapid heartbeat.
A pinched nerve root causes innervation disturbances, numbness, hand weakness, coldness in the hand, cyanosis (blue color) or pale skin. These symptoms are usually unilateral.
Pain in osteochondrosis can also radiate to the shoulder, under the shoulder blade and to the forearm.
Other symptoms of the disease are stiffness, tension in the back, numbness in the paravertebral region, shoulders, neck area, difficulty breathing, feeling of a lump in the chest.
Nerves arising 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 that are apparently not connected to the spine. For this reason, it was called "chameleon disease".
These symptoms include:
- heartburn, bloating,
- loss of appetite, nausea,
- indigestion (dyspepsia),
- cough,
- cold feet,
- body numbness,
- pain in the right hypochondrium,
- stomach discomfort,
- sweating
In addition, thoracic osteochondrosis is manifested by impaired blood supply to the brain - headaches, pressure instability, dizziness, gait instability and loss of coordination.
Reasons for development, stages
Muscle spasms and tension (hypertonus) of the back muscles play a major role in the development of the disease. 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, heavy physical work also causes persistent back muscle spasms (for example, working with raised arms).
Muscle spasms disrupt circulation and impede blood flow to the spine. Because of this, the nutrition of the intervertebral discs deteriorates.
Intervertebral discs are cushions of shock-absorbing connective tissue located between the vertebrae. At the center of each disc is a pulpy, semi-fluid core that contains a lot of moisture. Water provides resistance to loads and resistance to compression.
Along the outer perimeter, each disc is reinforced with a stiff fibrous ring. The connective tissues of the discs consist mainly of collagen - this substance is synthesized in the body and must be constantly supplied to the joints, intervertebral discs and other connective, cartilaginous tissues for their continuous regeneration.
Muscle spasms interfere with blood flow, resulting in a lack of collagen reaching the discs for normal tissue repair. A lack of oxygen leads to a slowdown in metabolic processes.
As a result of metabolic disorders, tissue renewal of intervertebral discs slows down, and their wear accelerates. This leads to dystrophy and degenerative changes - the discs become dehydrated, crack, dry out, flatten and lose their cushioning properties and elasticity.
Back muscle spasms are the main cause of excessive strain 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 due to improper posture, and the lumbar part is pressed by the body weight, which increases with excess weight, then in the thoracic part muscle spasms play an exceptional role. in the development of the disease. These spasms not only impede blood flow, but also tighten the spine and compress the intervertebral discs both day and night. Intervertebral discs are practically deprived of the possibility not only of cell renewal, but also of simple rest and recovery. Therefore, the first thing a doctor should do when treating thoracic osteochondrosis is to relax tense back muscles, eliminate muscle spasms and hypertonus. Without it, effective treatment of the disease is impossible.
The flattening of the intervertebral discs causes the gaps between the vertebrae to become smaller, the vertebrae to move closer together and pinch the nerve roots. This causes pain, which causes a reflex muscle spasm and further increases the 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 is caused by the thinning of the intervertebral discs.
In the second stage, the outer fibrous ring becomes non-fibrous. Its tissue becomes loose, weakened and cannot cope with maintaining the internal load. As a result, the disc bulges (usually locally) in the form of a bulge.
The protrusion directed towards the spinal cord is called dorsal. Protrusions directed to the side are called lateral. The rarest case is a uniform protrusion of the disc along the entire perimeter.
The appearance of a protrusion usually leads to increased pain. The X-ray image clearly shows a reduction in the height of the gap between the vertebrae, as well as the development of osteophytes - bone growths. They form along the edges of the vertebrae to compensate for the load on the spine as the intervertebral discs cope less and less with them.
In the third stage of the disease, the fibrous ring of the disc cannot withstand the internal pressure and bursts. Through the resulting gap, part of the nucleus pulposus of the disc is pushed out - an intervertebral hernia occurs.
In the fourth stage of the disease, the range of motion in the back decreases sharply, the pain syndrome becomes constant, and an extensive picture of neurological disorders develops.
Diagnostics
At the initial examination, the doctor asks the patient about the symptoms, the circumstances of their occurrence, studies the anamnesis, performs an external examination, paying attention to the posture of the body, the presence or absence of spinal deformities (scoliosis, kyphosis).
The cause of pain syndrome (dorsago, dorsalgia) can be osteochondrosis and displacement of vertebrae (spondylolisthesis), ankylosing spondyloarthrosis, ankylosing spondyloarthrosis.
Osteochondrosis of the thoracic region is usually accompanied by muscle tension in the back and hypertonus of the spinal muscles. The doctor palpates and uses repeated pressure to find painful (trigger) points that correspond to the centers of muscle spasms.
To get more detailed information, the doctor prescribes an X-ray or magnetic resonance.
An X-ray for thoracic osteochondrosis gives the most general information - it helps to distinguish the disease from spondylolisthesis, to see osteophytes and narrowing of the gaps between the vertebrae.
Magnetic resonance imaging better shows soft, connective tissue. With its help, the doctor can examine in detail the structure of the intervertebral discs, see the protrusion, hernia (its 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 MR data, the doctor makes a diagnosis and determines an individual treatment plan.
Treatment of osteochondrosis of the thoracic region
Drug treatments
Nonsteroidal anti-inflammatory drugs in the form of ointments, tablets or injections can be used to relieve back pain and intercostal neuralgia in thoracic osteochondrosis. The main effect of these drugs is anti-inflammatory, so their use is justified in cases where a pinched nerve root is accompanied by its inflammation, i. e. with thoracic radiculitis. NSAIDs also reduce muscle tissue inflammation in the background of spasms and persistent hypertension.
In the case of an acute pain syndrome, paravertebral or epidural blockade - injection of analgesics - can be applied. In the first case, the injection is performed at the place of pinching of the nerve root, in the second case, in the area between the periosteum of the vertebra and the membrane of the spinal cord.
Muscle relaxants and antispasmodics are used to relieve muscle tension and reduce pressure on nerve roots, blood vessels and intervertebral discs.
Vitamin complexes are prescribed to nourish nerve tissue and prevent their atrophy.
To slow down the process of destruction of connective tissue, chondroprotectors can 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 changes on the intervertebral discs.
Treatment without drugs
Treatment of thoracic osteochondrosis without drugs includes methods of physiotherapy, reflexology and physical therapy.
The main goals of the treatment are to alleviate the inflammatory process, improve blood circulation and restore metabolic processes in the spinal discs, and stimulate cellular renewal of the connective tissue. For this purpose, the clinic uses complex therapy using oriental medicine methods.
Important!
Physical therapy exercises help to form and strengthen the muscle corset, remove irrational loads from the spine and serve as prevention of congestion and muscle spasms.
Operation
In the case of large hernias, especially dorsal ones, with the threat of spinal cord stenosis, and especially if it is present, a surgical 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 on the thoracic region are performed extremely rarely.
Treatment in the clinic
Treatment of thoracic osteochondrosis in the clinic is carried out in complex sessions, which include several procedures - acupuncture, acupressure, moxa therapy, stone therapy, vacuum therapy, hirudotherapy for individual indications.
High efficiency is achieved through synergy of individual methods and elimination of the cause of the disease.
- Acupressure. By strongly pressing the trigger points on the back, the doctor eliminates muscle spasms, tension, congestion, improves blood circulation and restores smooth 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 flow of oxygen and collagen increases.
- Acupuncture. Inserting needles into bioactive points on the back, legs, arms, head, chest eliminates symptoms associated with disturbed innervation - numbness, weakness in the hand. With the help of this procedure, intercostal neuralgia and other vertebrogenic pains are alleviated. In addition, acupuncture enhances the effect of acupressure and is anti-inflammatory and anti-edematous.
- Moxibustion therapy. Heating the bioactive points in the spine area is performed 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 massage and cupping create blood flow and help improve blood circulation.
- Manual therapy. By gently tractioning the spine, the doctor relieves the intervertebral discs, increases the distance between the vertebrae, releases the compressed nerve roots, relieves pain and increases the range of motion in the back.
Gentle traction, or traction, is the only manual therapy technique indicated for thoracic osteochondrosis. Before starting, the doctor must thoroughly relax the back muscles, remove 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 - rupture, sprain or fracture. Hardware methods of spinal traction for osteochondrosis are ineffective and even dangerous, so they are not used in the clinic.
Hirudotherapy
Placing 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 muscles of the spine, improve blood circulation and stimulate blood flow.
Duration of treatment in the clinic is 1-1. 5 hours, depending on individual indications. A course of treatment usually includes 10-15 complex sessions. Upon completion, a control magnetic resonance imaging is performed to assess the achieved treatment results.
Complications
The main complication of thoracic osteochondrosis is spinal cord stenosis due to disc herniation with the development of body paralysis.
Other possible complications are associated with the 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, 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 teenager has scoliosis, it is advisable to treat this disease without hoping that it will go away on its own. Lateral curvature of the spine occurs as a growing pain, but can last a lifetime.
In this case, permanent muscle tension and spasms will be inevitable, which in turn will lead to the development of osteochondrosis and, eventually, its complications. And that in addition to the fact that scoliosis itself is full of complications from the respiratory, digestive and cardiovascular systems.