Osteochondrosis is the aging process of the spine and surrounding tissues. Experts replace osteochondrosis with a more accurate term - "degenerative-dystrophic changes". With age, such changes occur in the spine of each person to varying degrees.
At an early stage, osteochondrosis is almost not manifested 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, symptoms and treatment.
Because of its stability, the thoracic region suffers less often 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 the age of 35 and in 50-90% of elderly 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 osteochondrosis development
The vertebral bodies are separated from each other by intervertebral discs. The intervertebral disc consists of a nucleus, which is located in the center, and a fibrous ring on the periphery. As we age, the discs receive less oxygen and nutrients and the cartilage tissue gradually breaks down. Discs lose firmness and elasticity. This is how osteochondrosis begins; with an unhealthy and sedentary lifestyle, it progresses and leads to complications. Cracks appear on the surface of the fibrous ring, and the nucleus pulposus protrudes through them - protrusion and hernia develop. The injury process involves vertebrae, ligaments, intercostal nerves, muscles and fascia. There is pain in the back, creaking when moving the body, the intervertebral joints lose mobility.
Stages of spinal osteochondrosis and its complications
- The first phase
The intervertebral disc produces less collagen and lowers water concentration. It becomes flatter. Cracks begin to appear on its surface. Discomfort and fatigue appear in the back. X-rays usually show no changes at first.
- Second phase
The surface of the disc cracks, the nucleus moves away from the center and the annulus fibrosus loses its elasticity. This leads to the elongation of the disc: it protrudes into the spinal canal in the form of a cone and exerts pressure on the paravertebral ligaments. Moderate pain appears. The surrounding muscles are constantly tense and limit the range of motion in the chest region. In the x-ray you can see how the height of the intervertebral space has decreased.
- The third stage
Through the fissure of the fibrous ring, the nucleus or a part of it comes out into the lumen of the spinal canal. Vertebrae get closer to each other and osteophytes - bone protrusions - appear in their bodies. Osteophytes limit mobility and increase the surface area of the vertebrae so that the load is distributed more evenly. The spinal roots are affected, causing the back pain to intensify and spread along the ribs. X-ray shows osteophytes and a sharp decrease in the intervertebral space.
- The fourth stage
At this stage, the back hurts hard and constantly. Posture changes and it is difficult for a person to perform normal actions. The psycho-emotional sphere suffers. 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 affect the development of osteochondrosis:
- sedentary lifestyle
- overweight
- frequent hypothermia
- bad habits
- improper weight lifting
- uneven load on one shoulder when carrying heavy objects
- hereditary predisposition
- flat feet
- pregnant
- breastfeeding
- deformation of the spine, bad 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: pain, muscle-tonic, radicular and sometimes aspect.
- Pain syndrome
Sprains, hernias, and osteophytes put pressure on the paravertebral ligaments and cause pain. In the initial stages of osteochondrosis, it appears only after heavy lifting or physical activity and goes away with rest. As the disease progresses, pain occurs even without exercise.
- Muscular-tonic syndrome
A continuous muscle spasm occurs in response to pain. Muscles often burst throughout the spine, so pain appears 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 often occurs at night and intensifies with exercise.
- Facet syndrome
It develops with arthrosis of the small joints between the vertebral arches. With this syndrome, the back hurts in the chest 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 turns, bends, straightens or rounds the back. Pain can be acute or chronic:
- Acute pain occurs suddenly, after a sudden movement or turn. The attack is short-lived: it usually goes away after changing the position of the body, but sometimes it drags on for several days.
- Chronic pain lasts 12 weeks. A person cannot stay for a long time; it hurts to get up after sitting for a long time.
Other manifestations of osteochondrosis include:
- pain, burning, tightness in the chest
- pain behind the sternum, in the center of the chest, can radiate to the collar, neck, ribs, arms, simulating heart pathology
- constant creaking in the back when moving
- shortness of breath due to pain during deep inhalation and exhalation
- difficulty in 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
In the first episodes of back pain, it is better to consult a neurologist. The doctor will make the correct diagnosis, rule out similar diseases and find out why osteochondrosis develops.
At the initial appointment, the doctor collects an anamnesis: he asks the patient to talk about complaints, medications he takes, hereditary and chronic diseases, injuries, operations and working conditions. In women, the neurologist learns about periods of pregnancy and breastfeeding.
During the examination, the doctor pays attention to the patient's appearance: posture, weight-height ratio, body proportionality. Controls the neurological condition: muscle strength, sensation in the limbs, tendon reflexes, range of motion in the spine. The doctor also assesses the pain using special scales.
Instrumental diagnostic methods help to make a diagnosis:
- X-rays. This is a simple study that reveals the curvature of the spine, fractures and dislocations of the vertebrae and narrowing of the intervertebral space.
- CT scan. This is a more informative method, showing the pathology of the vertebrae and discs that is invisible on X-rays. It allows you to assess the degree of damage to the spine and monitor how the treatment is progressing.
- Magnetic resonance imaging. It helps in the diagnosis of protrusions, herniations of intervertebral discs and pathology of the nerve roots of the spine.
To exclude diseases of the heart and internal organs, the doctor may direct the patient to an abdominal ultrasound, gastroscopy or ECG.
Treatment: what to do for osteochondrosis of the thoracic region
You should not self-medicate, prescribe medications or procedures for yourself - this can lead to side effects and dangerous complications. The doctor must treat the patient and monitor the dynamics of his condition.
How long the therapy will last depends on the stage of the process and the main symptoms. For the 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 tissue swelling.
- Muscle relaxants - relax muscles and reduce pain.
- Glucocorticoids - slow 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 chest region, correct the posture and improve the mobility of the spine.
Different typesphysiotherapy. Apply:
- Magnetic therapy - improves tissue metabolism, reduces pain and swelling.
- Laser therapy - promotes tissue nutrition and restoration, eliminates inflammation.
- Shock wave therapy - destroys deposits of calcium salts in the vertebrae, 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.
WIRETAPPING
Applying special adhesive tapes to the skin in the area of back pain. The bands regulate muscle tone and correctly distribute the load.
Massage, manual therapy
As a complementary therapy to relax the muscles and improve the mobility of the spine.
Doctors do everything possible to treat the patient conservatively. If available therapies do not help, the patient is referred for consultation to a neurosurgeon.
Complications: risks of thoracic osteochondrosis in men and women
If you contact specialists at the right time and lead a healthy lifestyle, changes in the spine can be stopped. If a patient consults a doctor in the final stages, then even adequate therapy does not always guarantee a good prognosis.
Untreated osteochondrosis 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:
- sleep on an orthopedic mattress and pillow
- When lifting weights, do not bend over, but sit down so that the load falls on the hips
- carry a bag or backpack alternately on the left and right shoulder, so that you do not burden only one side
- avoid injury
- quit smoking and excessive alcohol consumption
- drink enough water
- warm up by sitting for a long time, play sports, swim, walk
- monitor body weight
- timely treatment of infectious and chronic diseases
- wear comfortable shoes
If you have back pain in the chest or other parts of the spine, do not postpone the examination for later. Make an appointment with a neurologist. The doctor will make a complete diagnosis and draw up a treatment plan. You will get rid of pain and maintain the health of the spine.