Osteochondrosis of the chest is a chronic pathology in which the bony vertebrae and intervertebral discs located between them undergo degenerative changes. Destructive lesions in this zone are quite rare due to low mobility and good protection by the rib cage. Osteochondrosis of the thoracic spine develops imperceptibly, progresses slowly but persistently, and is characterized by a series of specific symptoms that are masked as diseases of internal organs. In this regard, it is very important to seek medical help at the first, still mild, signs of back problems. Timely treatment helps prevent severe complications.
Causes and provoking factors
Degenerative-dystrophic processes in the thoracic segments of the spine occur against the background of endogenous disorders and under negative external influences. Their development is most often caused by the following factors:
- hereditary predisposition, the 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 body of the vertebrae 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;
- impaired blood circulation in any, and not only in the thoracic region of the spine;
- 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 can be a consequence of untreated, severe lumbar or cervical osteochondrosis.
Smoking, alcohol addiction and intoxication, including occupational hazards, predispose to the destruction of intervertebral joints with discs consisting mainly of cartilage. Osteochondrosis of the chest is more often diagnosed in the elderly than in young and middle-aged people. This is due to the natural aging of the body, the slowing down of the recovery process and the presence of one or more somatic pathologies.
Symptoms and signs of the disease
The leading symptom of the degenerative process is pain. Unlike cervical and lumbar osteochondrosis, acute, burning, piercing is extremely rare. Patients usually describe the discomfort as dull, aching or pressing. The pain syndrome can intensify when bending/turning the body, unpleasant sudden movements, during coughing attacks or during temperature changes. Its radiation is observed - spreading beyond the affected area. Osteochondrosis of the thoracic spine is also manifested in the following way:
- stiffness, feeling of tightness;
- specific clicks, creaking when changing body position;
- loss of sensitivity, paresis in the form of "creeping goosebumps", tingling, numbness;
- muscle spasms, additional limitation of range of motion;
- adoption of a forced position in which discomfort does not occur or is weak;
- pathological changes in posture, in later stages - gait;
- a slight decrease in growth as a result of the destruction of the intervertebral joints and the convergence of the vertebral bodies.
Due to the constant tension of the back muscles, the muscles of the neck and lower back also spasm, 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 common zone of innervation with many internal organs. If the displaced disc has pinched the nerve root located near the spine, then pain can be felt in them, simulating common pathologies:
- severe pain in the heart resembles angina pectoris and even myocardial infarction;
- pain in the mammary glands becomes a reason for urgent differential diagnosis to exclude tumor processes;
- constant or periodic pains in the right hypochondrium, in the stomach or intestines, resembling those characteristic of gastritis, cholecystitis and ulcerative lesions.
When osteochondrosis worsens, the lower back or abdomen may hurt. Patients mistakenly believe that it is a sign of kidney pathology or gynecological disease. They turn to specialized specialists, who then refer patients to a neurologist or vertebrologist after an examination.
Classification, main types
The usual classification of osteochondrosis of the thoracic spine is based on the nature of the pain syndrome. There are two types of it:
- dorsago - sharp acute pain in the sternum, which occurs mainly during a long stay in one position of the body, often complicated by a feeling of lack of air when inhaling;
- dorsalgia in the form of mild painful sensations in the back, which occasionally appear and subside after rest.
This division of pathology into groups allows the doctor to quickly decide on the choice of analgesics.
Gradual development of thoracic osteochondrosis
In its development, osteochondrosis of the thoracic spine goes through four stages. Each of them has its own symptoms and radiographic markers. The more pronounced the deformation of the discs and vertebrae, the more intense the pain, stiffness of movement and paresthesia. The stage of the disease determines the 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 restoration is impossible. It begins to gradually thin, lose strength and elasticity. Only in some cases there is a slight discomfort in the thoracic region. The person perceives it as muscle fatigue and does not consult a doctor. Therefore, the disease at this stage is most often an accidental diagnostic finding during an examination for another reason.
Phase II
The structure of the fibrous ring becomes loose and fibrous. There is an enlargement of one fissure on the disc with the protrusion of the nucleus pulposus in this direction. The distance between adjacent vertebrae decreases as the disc height decreases, which is clearly seen on radiographs. In order to compensate for the distribution of the load, the muscle tissue is constantly under tension. Stiffness increases, pain intensity is still moderate.
Phase III
The annulus fibrosus ruptures, and the nucleus pulposus is pushed beyond its borders. A herniated disc appears, causing severe symptoms and severe complications. There is significant deformation of the vertebral bodies and the formation of individual osteophytes (compensatory bone growths). The pain syndrome becomes constant, movements in the back are significantly limited.
IV stage
At this stage, diagnosing thoracic osteochondrosis is not difficult. Connective tissues grew and more osteophytes formed. Adjacent vertebrae in the segment are blocked, completely or partially immobilized. Nerve roots are often compressed by inflammatory swelling, bony growths and muscle spasms. This manifests as a burning, shooting pain. The patient copes poorly with household duties and has difficulty moving.
Complications
The development of discogenic myelopathy, a dystrophic disease of the spinal cord that is primarily the result of compression of 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 been recorded. Due to the gradual increase in the neurological deficit, there is a decrease in muscle strength and a change in tendon reflexes. Ischemic areas are formed and nerve cells die (spinal cord infarction). It is characterized by movement disorders, loss of sensitivity and trophic disorders.
Diagnostic measures
At the first consultation, the doctor listens to the patient's complaints, examines him, assesses the level of sensitivity, checks tendon reflexes, studies the anamnesis and history of spinal injuries. His diagnosis was confirmed by laboratory and instrumental studies:
- radiography in two projections, according to indications - targeted image of a certain segment;
- M. R. I;
- evoked potentials;
- electroneurography;
- electromyography;
- general clinical blood and urine tests.
In order to reveal the cause of specific symptoms and exclude somatic diseases with similar clinical manifestations, electrocardiography, ultrasound scanning of cardiac structures and electroencephalography can be prescribed.
Methods of treatment of thoracic osteochondrosis
The therapy is comprehensive, aimed at eliminating symptoms and preventing the spread of the pathological process to other segments of the spine. In the acute stage, burning unbearable pain is eliminated by injecting drugs, including directly into the affected area. Glucocorticosteroids are usually used in combination with anesthetics (blockade drugs). In other cases, drug therapy consists of taking tablets, capsules, rubbing ointments and balms. The use of drugs from the following groups has proven to be effective:
- muscle relaxants to relieve muscle spasms;
- non-steroidal anti-inflammatory drugs with pronounced analgesic effect;
- antispasmodics for pinched nerves;
- means for improving blood circulation;
- preparations with vitamin B6 that improve the transmission of nerve impulses and activate regeneration.
If radicular syndrome has developed and other complications have arisen, then the person constantly lives in fear of excruciating pain again, and this can cause psychological 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, magnetic therapy, pulse currents, UHF therapy, ozokerite or paraffin applications, acupuncture, hirudotherapy;
- physical therapy and gymnastics;
- spinal traction.
In cases of significant damage to the vertebral discs and myelopathy, surgical treatment is always prescribed immediately. The hernial protrusion is removed, a microdiscectomy is performed, puncture valorization or laser disc reconstruction is performed, an implant is installed or a spinal segment is stabilized.
Prevention of thoracic osteochondrosis
The main goal of primary prevention of thoracic osteochondrosis is the removal of factors that can cause thinning and rupture of the intervertebral disc. What doctors recommend:
- avoid excessive back strain;
- timely treat all diseases - infectious, endocrine, inflammatory;
- seek immediate medical attention for back injuries, even those that seem minor at first glance;
- give up alcohol and smoking or at least limit them;
- fill 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 you want to get rid of it, contact the clinic for complete, competent treatment.
The answer to the question
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 pathological processes. Neuralgia is characterized by paroxysmal shooting or burning pain, which intensifies even when breathing. Osteochondrosis of the chest without injury to sensitive nerve endings manifests itself as a dull, distant pain.
And the other 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.