![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.jpg)
Osteochondrosis is the aging process of the spine and surrounding tissues. Experts replace osteochondrosis with a more precise term - "degenerative-dystrophic changes". Over the years, such changes appear on the spine of each person to a different degree.
In the early stage, osteochondrosis is almost not manifested at all. Back pain means that changes in the spine have already started 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 who spend a lot of time sitting are at risk. 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 osteochondrosis development
Vertebral bodies are separated from each other by intervertebral discs. The intervertebral disc consists of a core, 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 strength and elasticity. This is how osteochondrosis begins, which, along with an unhealthy and sedentary lifestyle, progresses and leads to complications. Cracks appear on the surface of the fibrous ring, and the nucleus pulposus penetrates through them - a protrusion and hernia develop. The damage process involves vertebrae, ligaments, intercostal nerves, muscles and fascia. There is pain in the back, creaking when moving the body, intervertebral joints lose mobility.
Stages of osteochondrosis of the spine and its complications
- The first stage
The intervertebral disc produces less collagen and reduces water concentration. It becomes flatter. Cracks are beginning to form on its surface. Discomfort and fatigue appear in the back. X-rays usually show no changes at first.
- The second stage
The surface of the disc cracks, the nucleus moves away from the center, and the annulus fibrosus loses its elasticity. This leads to disc protrusion: it protrudes into the spinal canal in the form of a cone and puts pressure on the paravertebral ligaments. Moderate pain occurs. The surrounding muscles are constantly tense and limit the range of motion in the thoracic region. On the x-ray, you can see how the height of the intervertebral space is reduced.
- The third phase
Through the fissure of the annulus fibrosus, the nucleus or part of it exits into the lumen of the spinal canal. The vertebrae come closer to each other, and osteophytes appear on their bodies - bony growths. Osteophytes limit mobility and increase the surface area of the vertebrae so that the load is distributed more evenly. The spinal roots are affected, due to which the pain in the back intensifies and spreads along the ribs. X-ray shows osteophytes and sharp reduction of the intervertebral space.
- The fourth stage
At this stage, the back hurts a lot and constantly. The posture changes and it is difficult for the person to perform normal activities. The psycho-emotional sphere suffers. X-ray shows a deformed spine.
Causes of thoracic osteochondrosis
The main cause of osteochondrosis is 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
- pregnancy
- breastfeeding
- spinal deformity, 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 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 lifting a heavy load or physical activity and goes away with rest. As the disease progresses, pain occurs even without exercise.
- Muscle-tonic syndrome
A persistent muscle spasm occurs in response to pain. Muscles often spasm all over the spine, so pain occurs not only in the chest, but also in the neck and lower back.
- Radicular syndrome
Protrusions and hernias can compress the nerve root, causing pain and burning along the ribs. The pain often occurs at night and worsens with exercise.
- Facet syndrome
It develops in arthrosis of the 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 is amplified when the person turns, bends, straightens or rounds the back. Pain can be acute or chronic:
- Acute pain occurs suddenly, after a sudden movement or turning. The attack is short-lived: it usually disappears after changing the position of the body, but sometimes it lasts for several days.
- Chronic pain lasts for 12 weeks. The person cannot stand 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 collarbones, neck, ribs, arms, simulating cardiac pathology
- constant creaking in the back when moving
- difficulty breathing 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 gastrointestinal tract diseases.
Diagnosis of osteochondrosis of the thoracic spine
For 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.
During the first examination, 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. For women, the neurologist learns about pregnancy and breastfeeding periods.
During the examination, the doctor pays attention to the patient's appearance: posture, weight-to-height ratio, body proportions. Checks neurological status: muscle strength, limb sensitivity, tendon reflexes, range of motion in the spine. The doctor also evaluates the pain using special scales.
Instrumental diagnostic methods help to diagnose:
- Radiography. This is a simple study that reveals curvature of the spine, fractures and dislocations of the vertebrae, and narrowing of the intervertebral space.
- CT scanner. This is a more informative method that shows the pathology of the vertebrae and discs that is invisible on X-rays. It allows you to assess the extent of spinal damage and monitor how treatment is progressing.
- M. R. I. It helps to diagnose protrusions, herniated intervertebral discs and spinal nerve root pathology.
In order to rule out diseases of the heart and internal organs, the doctor may refer the patient to an abdominal ultrasound, gastroscopy or EKG.
Treatment: what to do for osteochondrosis of the thoracic region
You should not self-medicate, self-prescribe drugs or procedures - 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. Doctors use the following methods for conservative treatment of osteochondrosis:
Drug therapy
Patients are prescribed the main groups of drugs:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) - relieve pain, reduce inflammation and tissue swelling.
- 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 chest muscles, correct posture and improve spine mobility.
Different typesphysiotherapy. Apply:
- Magnetic therapy - improves tissue metabolism, reduces pain and swelling.
- Laser therapy - promotes nutrition and tissue renewal, eliminates inflammation.
- Shock wave therapy - destroys deposits of calcium salts on 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.
Taping
Applying special adhesive tapes to the skin in the painful area of the back. The bands regulate muscle tone and properly distribute the load.
Massage, manual therapy
As a complementary therapy for muscle relaxation and improving spinal mobility.
Doctors do everything possible to treat the patient conservatively. If available therapies do not help, the patient is referred to a neurosurgeon for consultation.
Complications: dangers of thoracic osteochondrosis in men and women
If you turn to specialists in time and lead a healthy lifestyle, changes in the spine can be stopped. If the patient consults a doctor in the final stage, 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, poor 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 adhere to the following rules:
- sleep on an orthopedic mattress and pillow
- When lifting weights, do not bend over, but squat so that the load falls on the hips
- carry the bag or backpack alternately on the left and right shoulder, so as not to burden only one side
- avoid injury
- stop smoking and excessive alcohol consumption
- drink enough water
- Warm up while sitting for a long time, do sports, swim, walk
- monitor body weight
- timely treatment of infectious and chronic diseases
- wear comfortable shoes
If you have back pain in the thoracic or other parts of the spine, do not postpone the examination until later. Make an appointment with a neurologist. The doctor will carry out a complete diagnosis and create a treatment plan. You will get rid of pain and maintain the health of your spine.