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. Even rarer are its complications - protrusion and disc herniation.
However, this disease manifests itself with extensive symptoms that significantly reduce the quality of life and therefore requires treatment. The use of drugs only silences the symptoms and provides a temporary effect that does not affect the development of the disease.
To reliably eliminate the symptoms, you need to affect the cause of the development of degenerative processes in the discs. For this purpose, complex therapy is applied in the clinic, which gives a positive result in more than 90% of cases. It includes methods of Eastern reflexology and physiotherapy - acupressure, acupuncture, moxa therapy and other therapeutic procedures.
Symptoms, signs
In osteochondrosis, there is a flattening of the intervertebral discs and the vertebrae converge, which leads to pinching of the roots of the spinal nerves. This causes pain between the shoulder blades (commonly described as a stuck peg).
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 pain character and is called dorsalgia.
The irritation from a pinched root spreads along the nerve, radiates into the chest and causes intercostal neuralgia - a piercing, cutting or burning pain in the chest that is aggravated by inhaling, moving, coughing, sneezing, laughing.
Another characteristic symptom of thoracic osteochondrosis is pain in the heart area, which is accompanied by signs of cardioneurosis - palpitations, palpitations, rapid pulse.
A pinched nerve root causes innervation disruption, numbness, arm weakness, coldness in the arm, cyanosis (blue discoloration) or white 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 area, shoulders, neck-collar area, difficulty breathing, feeling of a lump in the chest.
The nerves that exit the spinal cord in the thoracic region play an important role in the innervation of the entire body. Therefore, the symptoms of osteochondrosis can appear in areas that, at first glance, are not related 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
- body tingling
- pain in the right hypochondrium,
- abdominal discomfort
- sweating
In addition, thoracic osteochondrosis is manifested by impaired blood supply to the brain - headache, pressure instability, dizziness, unstable gait and loss of coordination.
Causes of development, stages
A major role in the development of the disease is played by muscle spasms and tension (hypertonus) 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, heavy physical work also provokes the appearance of constant muscle spasms in the back (for example, work with raised arms).
Muscle spasms impede circulation and prevent blood flow to the spine. Because of this, the nutrition of the intervertebral discs deteriorates.
Intervertebral discs are shock-absorbing cushions of connective tissue located between the vertebrae. In the center of each disc is a pulpy, semi-fluid core that contains a lot of moisture. Water provides load resistance and compression resistance.
Along the outer perimeter of each disc is reinforced with a tough fibrous ring. The connective tissue of the discs consists 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 insufficient collagen reaching the discs for normal tissue repair. Lack of oxygen slows down metabolic processes.
As a result of metabolic disorders, tissue renewal of the intervertebral discs is delayed and their wear is accelerated. This leads to dystrophy and degenerative changes - the discs are dehydrated, cracked, dry, flattened, lose their shock-absorbing 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 with incorrect posture, and the lumbar region is pressed by the body weight, which increases with excess weight, then in the thoracic region, muscle spasms play an exclusive 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 during the day and at night. Intervertebral discs are practically deprived of the opportunity not only for cellular renewal, but also for simple rest and recovery. Therefore, the first thing the doctor should do in the treatment of thoracic osteochondrosis is to relax the tense back muscles, eliminate muscle spasms and hypertonicity. Without this, effective treatment of the disease is impossible.
The flattening of the intervertebral discs leads to a reduction in the gaps between the vertebrae, bringing the vertebrae closer together and pinching the nerve roots. This causes pain that triggers a reflex muscle spasm and further increases the pressure on the discs. Therefore, with the onset of pain, the development of the disease, as a rule, accelerates.
These degenerative-dystrophic changes correspond to the first stage of osteochondrosis.
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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 the elderly, which is due to thinning of the intervertebral discs.
In the second stage, the outer fibrous ring becomes fiberless. Its tissue loosens, weakens and cannot cope with maintaining the internal load. As a result, a protrusion of the disc (usually local) occurs in the form of a bulge.
A protrusion directed towards the spinal cord is called dorsal. Protrusions directed to the side are called lateral. The rarest case is a uniform bulging of the disc around the entire perimeter.
The appearance of a protrusion usually leads to increased pain. An X-ray image clearly shows a decrease in the height of the gap between the vertebrae, as well as the development of osteophytes - bone growths. They are formed on the edges of the vertebrae to compensate for the load on the spine, as the intervertebral discs cope with them less and less.
In the third stage of the disease, the fibrous ring of the disc cannot withstand the internal pressure and ruptures. A part of the nucleus pulposus of the disc is squeezed through the resulting gap - an intervertebral hernia occurs.
At the fourth stage of the disease, the range of motion in the back sharply decreases, the pain syndrome becomes constant, and an extensive picture of neurological disorders develops.
Diagnosis
At the initial appointment, the doctor questions the patient about the symptoms, the circumstances of their occurrence, studies the medical history, conducts an external examination, paying attention to the posture, the presence or absence of spinal distortions (scoliosis, kyphosis).
The cause of the pain syndrome (dorsago, dorsalgia) can be both osteochondrosis and displacement of the vertebrae (spondylolisthesis), ankylosing spondylarthrosis, ankylosing spondyloarthrosis.
Osteochondrosis of the chest is usually accompanied by muscle tension in the back and hypertonus of the spinal muscles. The doctor performs palpation and uses successive pressures to find pain (trigger) points that correspond to the centers of muscle spasms.
To get more detailed information, the doctor prescribes an X-ray or MRI.
Radiography 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.
An MRI shows soft connective tissue better. With its help, the doctor can examine in detail the structure of the intervertebral discs, see the bulge, the hernia (its size, location, shape), as well as the condition of the ligaments, intervertebral joints, blood vessels, nerve roots, and see stenosis of the spinal cord (or itsdanger).
Based on the MRI data, the doctor makes a diagnosis and determines an individual treatment plan.
Treatment of osteochondrosis of the chest
Drug treatments
Non-steroidal 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 the pinched nerve root is accompanied by inflammation, i. e. with thoracic sciatica. NSAIDs also reduce the 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 - injection of an analgesic. 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.
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 process of destruction of connective tissue, chondroprotectors can be prescribed.
These drugs have a symptomatic effect and can to some extent slow down the development 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-drug treatment of thoracic osteochondrosis includes methods of physiotherapy, reflexology and physiotherapy.
The main goals of the treatment are to alleviate the inflammatory process, improve blood circulation and restore metabolic processes in the spinal discs, stimulate cell renewal of the connective tissue. For this purpose, complex therapy using Eastern medicine methods is applied in the clinic.
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Physiotherapy exercises help to form and strengthen the muscle corset, remove unreasonable loads on the spine and serve as prevention of congestion and the formation of muscle spasms.
surgery
In the case of large hernias, especially dorsal, with a 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, chest surgeries are performed extremely rarely.
Treatment in the clinic
The 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 according to individual indications.
The high efficiency is achieved thanks to the synergy of the individual methods and the elimination of the cause of the disease.
- Acupressure. By strongly pressing the trigger points on the back, the doctor removes muscle spasms, tension, congestion, improves blood circulation and restores the 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 flow of oxygen and collagen increases.
- Acupuncture. Placing needles in bioactive points on the back, legs, arms, head, chest removes the symptoms associated with impaired innervation - numbness, weakness in the arm. Intercostal neuralgia and other vertebral pains are relieved with the help of this procedure. In addition, acupuncture enhances the effect of acupressure and has an anti-inflammatory and anti-edematous effect.
- Moxibustion therapy. A smoldering wormwood cigar is used to heat bioactive points in the spine. 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 circulation.
- Manual therapy. Using a gentle pull on the spine, the doctor unloads 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 completely relax the muscles of the back, remove spasms and free the spine. To do this, the muscles are well warmed and relaxed by massage. If this is not done, the application of physical effort can lead to injury - a tear, sprain or fracture. Hardware methods of spinal traction in osteochondrosis are ineffective and even dangerous, so they are not used in the clinic.
Hirudotherapy
Applying medical leeches improves local blood circulation, blood supply to the intervertebral discs, 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 circulation and stimulate blood flow.
The duration of one treatment session in the clinic is 1-1. 5 hours depending on the individual indications. The course of treatment usually includes 10-15 complex sessions. After completion, a follow-up MRI is performed to evaluate the achieved results of the treatment.
Complications
The main complication of thoracic osteochondrosis is spinal cord stenosis due to disc herniation with the development of paralysis of the body.
Other possible complications are associated with disruption of the innervation of the body due to pinching of the spinal nerve roots: 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.
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If a child or teenager has scoliosis, it is advisable to treat this disease without hoping that it will disappear on its own. Lateral curvature of the spine occurs as a growing pain, but can last a lifetime.
In this case, constant 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 from the respiratory, digestive and cardiovascular systems.