Thoracic osteochondrosis is a chronic pathology in which the bony vertebrae and the intervertebral discs located between them undergo degenerative changes. Destructive lesions in this area are quite rare due to low mobility and good protection by the rib cage. Osteochondrosis of the chest develops unnoticed, progresses slowly but persistently and is distinguished by a number of specific symptoms, disguised as diseases of internal organs. In this regard, it is very important to seek medical help at the first, still slight signs of back problems. Timely treatment helps to avoid serious complications.
Causes and provoking factors
Degenerative-dystrophic processes in the thoracic segments of the spine occur against the background of endogenous disturbances and negative external influences. Their development is most often provoked 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, causing congestion in the area of the vertebral bodies and intervertebral discs;
- congenital or acquired structural abnormalities, for example, extra vertebrae, lordosis, kyphosis;
- back and/or chest injuries - fractures, prolonged compression;
- flat feet, feet;
- impaired blood circulation in any, not only the thoracic part 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. Thoracic osteochondrosis is diagnosed more often in the elderly than in young and middle-aged people. This is due to the natural aging of the body, the delay in recovery processes 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, it is extremely rarely acute, burning, piercing. Patients typically describe the discomfort as dull, painful, or pressing. The pain syndrome may intensify when bending / turning the body, uncomfortable sudden movements, during a coughing fit or during temperature changes. Its radiation - spreading beyond the affected area is noted. Osteochondrosis of the chest is also manifested as follows:
- stiffness, feeling of limitation;
- specific clicks, crunch when changing body position;
- loss of sensitivity, paresis in the form of a "creeping goosebumps" sensation, burning, tingling;
- muscle spasms further limiting range of motion;
- acceptance of a forced position in which discomfort does not arise or is weakly expressed;
- pathological changes in the posture, in the 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 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 a common zone of innervation with many internal organs. If a displaced disc has pressed a nerve root located near the spine, then pain simulating common pathologies can be felt in them:
- severe heart pain resembles angina pectoris and even myocardial infarction;
- pain in the mammary glands becomes a reason for an urgent differential diagnosis to exclude tumor processes;
- constant or intermittent pain 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 mistake the discomfort for signs of kidney pathology or gynecological disease. They turn to specialized specialists who, after an examination, refer patients to a neurologist or vertebrologist.
Classification, main types
The general classification of osteochondrosis of the chest is based on the nature of the pain syndrome. There are two types of it:
- dorsago - sharp sharp pain in the sternum, which occurs mainly when staying in one body position for a long time, often complicated by a feeling of lack of air when inhaling;
- dorsalgia in the form of mild painful sensations in the back, periodically appearing and disappearing after rest.
This division of the pathology into groups allows the doctor to quickly make a decision on the choice of analgesic.
Staged development of thoracic osteochondrosis
In its development, osteochondrosis of the chest 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 the therapeutic tactics.
Stage I
There are still no changes on the x-ray. However, the intervertebral disc no longer retains moisture well, without which its timely recovery is impossible. It begins to gradually thin, lose strength and elasticity. Only in some cases does a slight discomfort appear in the chest area. One perceives it as muscle fatigue and does not consult a doctor. Therefore, the disease at this stage is usually an incidental diagnostic finding during examination for another reason.
Stage II
The structure of the annulus fibrosus becomes loose and fibrous. Widening of a fissure in the disc occurs with protrusion of the nucleus pulposus in that direction. The distance between adjacent vertebrae decreases as the height of the disc decreases, which is clearly visualized on radiographic images. To compensate for the distribution of the load, the muscle tissue is constantly under tension. Stiffness increases, pain severity is still moderate.
Stage III
The annulus fibrosus is torn, compressing the nucleus pulposus beyond its borders. A herniated disc results, causing severe symptoms and severe complications. There is significant deformation of the vertebral bodies and formation of single osteophytes (compensatory bone growths). The pain syndrome becomes constant, movements in the back are significantly limited.
IV stage
At this stage, the diagnosis of thoracic osteochondrosis is not difficult. Connective tissue has grown and numerous osteophytes have formed. Adjacent vertebrae in the segment are blocked, completely or partially immobilized. Nerve roots are often compressed by inflammatory swelling, bone spurs, and muscle spasms. This manifests as a burning, shooting pain. The patient copes poorly with household chores and moves with difficulty.
Complications
The development of discogenic myelopathy, a dystrophic disease of the spinal cord, which is mainly due to compression from a herniated disc, is dangerous. It is worth noting that with osteochondrosis of the chest, such a complication is rare. However, in clinical practice there are cases of localization of discogenic myelopathy in one of the lower segments. Due to a gradually increasing neurological deficit, muscle strength decreases and tendon reflexes change. Ischemic zones 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 the tendon reflexes, studies the medical history and the history of spinal injuries. The diagnosis is confirmed by laboratory and instrumental tests:
- radiography in two projections, according to the indications - directed image of a certain segment;
- magnetic resonance;
- evoked potentials;
- electroneurography;
- electromyography;
- general clinical blood and urine tests.
In order to establish 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 the symptoms and preventing the spread of the pathological process in other spinal segments. In the acute stage, burning unbearable pain is eliminated by injecting drugs, including directly into the affected area. The use of glucocorticosteroids in combination with anesthetics (drug blockades) 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 to be 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 radicular syndrome has formed and other complications have occurred, then the person constantly lives in fear of experiencing excruciating pain again, and this can cause mental disorders. Prescribing sedatives and antidepressants can prevent such a development. In addition to drugs, the following methods are used in the treatment of osteochondrosis of the chest:
- therapeutic massage, including vacuum and acupuncture;
- physiotherapy procedures - electrophoresis/ultraphonophoresis, magnetic therapy, pulsed currents, UHF therapy, applications with ozokerite or paraffin, acupuncture, hirudotherapy;
- PE and gymnastics;
- spinal thrust.
With significant damage to the spinal discs and myelopathy, immediate surgical treatment is always prescribed. The hernial protrusion is removed, a microdiscectomy, puncture valorization or laser disc reconstruction is performed, an implant is placed, or the spinal segment is stabilized.
Prevention of thoracic osteochondrosis
The main goal of the primary prevention of thoracic osteochondrosis is to eliminate the factors that can cause thinning and cracking of the intervertebral disc. What doctors recommend:
- avoid excessive load on the back;
- timely treatment of all diseases - infectious, endocrine, inflammatory;
- seek medical attention immediately for back injuries, even those that at first glance seem minor;
- 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 chest and want to get rid of it, contact the clinic for complete, 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 that 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 increases even with inhalation. Thoracic osteochondrosis without a violation of sensitive nerve endings is manifested by a dull, as if distant pain.
And the second difference is the forecast. After removing the cause of intercostal neuralgia, it disappears without a trace. Osteochondrosis responds well to treatment only in the initial stages of development.