![The doctor tells the patient about the mechanism of development of osteochondrosis of the thoracic spine.](/images/article/1831/The%20doctor%20tells%20the%20patient%20about%20the%20mechanism%20of%20development%20of%20osteochondrosis%20of%20the%20thoracic%20spine.%20.jpg)
Osteochondrosis is the aging process of the spine and surrounding tissues. Experts replace osteochondrosis with a more precise term: "degenerative-dystrophic changes. "With age, these changes occur in each person's spine to varying degrees.
At an early stage, osteochondrosis almost does not manifest itself at all. Back pain means that changes in the spine have already begun and are progressing. In the article we will talk about osteochondrosis of the thoracic spine, its symptoms and treatment.
Due to its stability, the thoracic region suffers less frequently than the cervical and lumbar regions. Women are more susceptible to thoracic osteochondrosis. Those at risk are those who spend a lot of time sitting. Degenerative-dystrophic changes in the spine occur in 30% of people after 35 years of age and in 50-90% of older people.
In order not to waste time and avoid the consequences of osteochondrosis, it is important to consult a competent doctor at the first symptoms.
How the spine ages: the mechanism of development of osteochondrosis
The vertebral bodies are separated from each other by intervertebral discs. The intervertebral disc consists of a nucleus located in the center and an annulus fibrosus on the periphery. As we age, the discs receive less oxygen and nutrients and the cartilage tissue gradually breaks down. The discs lose firmness and elasticity. This is how osteochondrosis begins, which progresses with an unhealthy and sedentary lifestyle and leads to complications. Cracks appear on the surface of the annulus fibrosus and the nucleus pulposus protrudes through them: bulges and hernias develop. The damage process involves the vertebrae, ligaments, intercostal nerves, muscles and fascia. There is pain in the back, crunches when moving the body, the intervertebral joints lose mobility.
Stages of spinal osteochondrosis and its complications.
- First stage
The intervertebral disc produces less collagen and decreases water concentration. It becomes flatter. Cracks begin to form on its surface. Discomfort and fatigue appear in the back. X-rays usually show no changes initially.
- Second stage
The surface of the disc cracks, the nucleus moves away from the center and the annulus fibrosus loses its elasticity. This causes a protrusion of the disc: it protrudes into the spinal canal in the shape of a cone and puts pressure on the paravertebral ligaments. Moderate pain occurs. The surrounding muscles are constantly tight and limit the range of motion in the thoracic region. On the x-ray you can see how the height of the intervertebral space has decreased.
- Third stage
Through the fissure of the annulus fibrosus, the nucleus or part of it emerges into the lumen of the spinal canal. The vertebrae move closer together and osteophytes (bony growths) appear on their bodies. Osteophytes limit mobility and increase the surface area of the vertebrae so that the load is distributed more evenly. The roots of the spine are affected, causing back pain to intensify and spread along the ribs. The x-ray shows osteophytes and a sharp decrease in the intervertebral space.
- Fourth stage
At this stage, the back hurts intensely and constantly. Posture changes and a person finds it difficult to perform normal actions. The psycho-emotional sphere suffers. The x-ray shows a deformed spine.
Causes of thoracic osteochondrosis.
The main cause of osteochondrosis is the degenerative-dystrophic changes that occur in the spine with age. There are many factors and diseases that influence the development of osteochondrosis:
- sedentary lifestyle
- over weight
- frequent hypothermia
- bad habits
- improper weight lifting
- uneven load on one shoulder when carrying heavy objects
- hereditary predisposition
- flatfoot
- the pregnancy
- breast-feeding
- spinal deformity, poor posture: scoliosis, kyphosis
- metabolic disorders in endocrine diseases: diabetes mellitus, gout, thyroid pathology
- Autoimmune diseases: systemic lupus erythematosus, rheumatoid arthritis.
- walking in high heels
- back injuries
Signs of osteochondrosis of the thoracic spine in women and men.
The clinical picture of osteochondrosis consists of the following syndromes: painful, muscle tonic, radicular and, sometimes, facet.
- pain syndrome
Protrusions, hernias and osteophytes put pressure on the paravertebral ligaments and pain occurs. In the initial stages of osteochondrosis, it appears only after heavy lifting or physical activity and disappears with rest. As the disease progresses, pain appears even without exercise.
- Muscle tonic syndrome
A persistent muscle spasm occurs in response to pain. Muscles often spasm throughout the spine, so pain occurs not only in the chest, but also in the neck and lower back.
- radicular syndrome
Lumps and hernias can compress the nerve root, causing pain and burning along the ribs. The pain usually appears at night and intensifies with exercise.
- facet syndrome
It develops with osteoarthritis of small joints between the vertebral arches. With this syndrome, the back hurts in the thoracic region. The pain can last for years and cause limited mobility.
A characteristic sign of thoracic osteochondrosis is pain between the shoulder blades. It intensifies when a person twists, bends, straightens or rounds their back. The pain can be acute or chronic:
- Acute pain occurs suddenly, after a sudden movement or turn. The attack is short-lived: it usually passes after changing the position of the body, but sometimes it lasts for several days.
- Chronic pain lasts 12 weeks. A person cannot stand for a long time, it hurts him to get up after sitting for a long time.
Other manifestations of osteochondrosis include:
- pain, burning, tight feeling in the chest
- pain behind the sternum, in the center of the chest, it can radiate to the collarbones, neck, ribs, arms, simulating cardiac pathology
- constant cracking in the back when moving
- difficulty breathing due to pain when inhaling and exhaling deeply
- difficulty moving the spine
- back muscle weakness
- depression, depression due to chronic pain
- feeling of a lump in the chest
Differential diagnosis is carried out with pathology of the lungs, cardiovascular system, mammary glands, exacerbation of diseases of the gastrointestinal tract.
Diagnosis of osteochondrosis of the thoracic spine.
At the first episodes of back pain, it is better to consult a neurologist. The doctor will establish the correct diagnosis, rule out similar diseases and find out why osteochondrosis develops.
At the initial appointment, the doctor takes a history: he asks the patient to talk about his ailments, the medications he takes, hereditary and chronic diseases, injuries, operations and working conditions. In women, the neurologist informs about the periods of pregnancy and lactation.
During the examination, the doctor pays attention to the patient's appearance: posture, weight-height ratio, body proportionality. He checks the neurological status: muscle strength, sensitivity in the extremities, tendon reflexes, range of motion in the spine. The doctor also evaluates pain using special scales.
Instrumental diagnostic methods help to establish a diagnosis:
- Bone scan. This is a simple study that reveals curvature of the spine, fractures and dislocations of the vertebrae, and narrowing of the intervertebral space.
- computed tomography. This is a more informative method, showing pathologies of the vertebrae and discs that are invisible on x-rays. It allows you to assess the degree of damage to the spine and monitor how treatment progresses.
- MRI image. Helps diagnose bulges, intervertebral disc herniations, and spinal nerve root pathology.
To exclude diseases of the heart and internal organs, the doctor may refer the patient for abdominal ultrasound, gastroscopy or ECG.
Treatment: what to do with osteochondrosis of the thoracic region.
You should not self-medicate, prescribe medications or procedures, as this can lead to dangerous side effects and complications. The doctor must treat the patient and monitor the dynamics of her condition.
The duration of therapy depends on the stage of the process and the main symptoms. For conservative treatment of osteochondrosis, doctors use the following methods:
drug therapy
Patients are prescribed the main groups of drugs:
- Non-steroidal anti-inflammatory drugs (NSAIDs) - relieve pain, relieve inflammation and swelling of tissues.
- Muscle relaxants: relax muscles and reduce pain.
- Glucocorticoids: slow down the destruction of intervertebral discs and reduce inflammation. They are prescribed when NSAIDs and muscle relaxants do not help.
Physical therapy
The instructor selects exercises to strengthen the muscles of the thoracic region, correct posture and improve spinal mobility.
Different typesphysiotherapy. Apply:
- Magnetic therapy: improves tissue metabolism, reduces pain and swelling.
- Laser therapy - promotes nutrition and tissue restoration, eliminates inflammation.
- Shock wave therapy: destroys deposits of calcium salts in the vertebrae and accelerates the regeneration of bone and cartilage tissue.
Acupuncture
It stimulates blood circulation in the tissues in the area of the affected vertebrae, relaxes the muscles, reduces pain and swelling.
Recording
Apply special adhesive tapes to the skin in the painful area of the back. The tapes regulate muscle tone and correctly distribute the load.
Massage, manual therapy.
As a complementary therapy to relax muscles and improve spinal mobility.
Doctors do everything possible to treat the patient conservatively. If available therapies do not help, the patient is referred for consultation with a neurosurgeon.
Complications: the dangers of thoracic osteochondrosis in men and women.
If you contact specialists in a timely manner and lead a healthy lifestyle, changes in the spine can be stopped. If a patient consults a doctor in the final stages, even adequate therapy does not always guarantee a good prognosis.
Osteochondrosis without treatment can lead to protrusion or herniation of the intervertebral disc, chronic pain in the back or other parts of the body, low mobility of the spine and its deformation.
Prevention of osteochondrosis
To prevent the development of osteochondrosis of the chest, neck and other parts, it is important to follow these rules:
- sleeping on an orthopedic mattress and pillow
- When lifting weights, do not bend over, but squat down so that the load falls on your hips.
- carry a bag or backpack alternately on the left and right shoulder, so as not to carry only one side
- avoid injuries
- quit smoking and excessive alcohol consumption
- drink enough water
- warm up while sitting for a long time, play sports, swim, walk
- control body weight
- timely treatment of infectious and chronic diseases.
- wear comfortable shoes
If you have back pain in the thoracic area or other parts of the spine, do not postpone the exam until later. Make an appointment with a neurologist. The doctor will make a complete diagnosis and develop a treatment plan. You will get rid of pain and maintain the health of your spine.