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 reinforced by a muscle corset. Less common are the complications - protrusion and herniation of the disc.
However, this disease has widespread symptoms that significantly reduce the quality of life and therefore requires treatment. The use of drugs only relieves symptoms and provides a temporary effect that does not affect the development of the disease.
To eliminate the symptoms reliably, you need to influence the cause of the development of the degenerative process in the disc. For this purpose, the clinic uses complex therapy, which gives positive results in more than 90% of cases. It includes oriental reflexology methods and physiotherapy - acupressure, acupuncture, moxotherapy and other therapeutic procedures.
Symptoms, signs
With osteochondrosis, flattening of the intervertebral disc occurs and the vertebrae converge, which leads to pinching of the spinal nerve roots. This causes pain between the shoulder blades (usually described as a sticking spike).
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 continuously, has an aching character and is called dorsalgia.
Irritation from the pinched root spreads along the nerve, radiates into the chest and is the cause of intercostal neuralgia - stabbing, cutting or burning pain in the chest, which increases with inhalation, movement, coughing, sneezing, laughing.
Another characteristic symptom of thoracic osteochondrosis is pain in the heart area, which is accompanied by signs of cardioneurosis - palpitations, palpitations, increased heart rate.
A pinched nerve root leads to sensory disturbances, numbness, hand weakness, coldness in the hands, cyanosis (blue discoloration) or skin whitening. These symptoms are usually unilateral.
Pain with osteochondrosis can also radiate to the shoulder, under the shoulder blade, and to the forearm.
Other symptoms of this disease are stiffness, tension in the back, numbness in the paravertebral area, shoulders, cervical collar area, difficulty breathing, feeling of a lump in the chest.
Nerves arising from the spinal cord in the thoracic region play an important role in the maintenance of the entire body. Therefore, symptoms of osteochondrosis may occur in seemingly unrelated areas of the spine. For this reason, it is called "chameleon disease. "
These symptoms include:
- heartburn, flatulence,
- loss of appetite, nausea,
- indigestion (dyspepsia),
- cough,
- cold feet,
- body numbness,
- pain in the right hypochondrium,
- stomach discomfort,
- sweating
In addition, thoracic osteochondrosis is indicated by impaired blood supply to the brain - headaches, stress instability, dizziness, gait instability, and loss of coordination.
Reasons for development, stage
The main role in the development of this disease is played by muscle spasms and tension (hypertonicity) of the back muscles. These spasms occur during a sedentary lifestyle, poor posture, or staying for a long time in a static and uncomfortable position (for example, at an office desk or while driving).
On the other hand, boring and hard physical work also provokes the occurrence of constant back muscle spasms (for example, working with lifting arms).
Muscle spasms block circulation and prevent blood flow to the spine. Because of this, nutrition of the intervertebral disc deteriorates.
An intervertebral disc is a shock-absorbing pad of connective tissue found between the vertebrae. In the center of each disc is a semi-liquid nucleus of pulp that contains a lot of moisture. Water provides resistance to load and resistance to compression.
Along the outer perimeter of each disc is reinforced with a rigid fibrous ring. The connective tissue of the disc is mainly composed of collagen - this substance is synthesized in the body and must be constantly supplied to the joints, intervertebral discs and other connective cartilage tissue for their continuous regeneration.
Muscle spasms disrupt blood flow, resulting in insufficient collagen reaching the disc for normal tissue repair. A lack of oxygen leads to a slowdown in metabolic processes.
As a result of metabolic disorders, intervertebral disc tissue renewal slows down, and its wear is accelerated. This leads to dystrophic and degenerative changes - the disc becomes dehydrated, cracked, dry, flat, and loses its shock-absorbing properties and elasticity.
Back muscle spasms are the main cause of excessive pressure on the spine in the thoracic region. If in the cervical region the intervertebral disc is pressed by the weight of the head, which increases with wrong posture, and the lumbar region is pressed by the weight of the body, which increases with excess body weight, then in the thoracic region muscle spasms play an extraordinary role. in the development of the disease. This spasm not only prevents blood flow, but also tightens the spine and compresses the intervertebral discs during the day and night. Intervertebral discs practically do not get a chance not only for cellular renewal, but also for easy rest and recovery. Therefore, the first thing a doctor should do when treating thoracic osteochondrosis is to relieve tense back muscles, eliminate muscle spasms, and hypertonicity. Without this, effective treatment of the disease is impossible.
Flattening of the intervertebral disc causes the gap between the vertebrae to become smaller, the vertebrae are closer together and pinch the nerve root. This causes pain, which causes reflex muscle spasms and further increases the pressure on the disc. Therefore, with the appearance of pain, the development of the disease, as a rule, accelerates.
These degenerative-dystrophic changes correspond to the first stage of osteochondrosis.
Important!
In old age, thoracic osteochondrosis usually develops against the background of general dehydration and metabolic disorders in the body. This is shown, in particular, by a decrease in height in older people, which occurs due to the thinning of the intervertebral discs.
In the second stage, the outer fibrous ring becomes non-fibrous. The tissue becomes loose, weak, and it cannot cope with maintaining the internal load. As a result, disc protrusion occurs (usually local) in the form of protrusions.
The protrusion directed towards the spinal cord is called dorsal. Protrusions directed to the side are called sides. The rarest case is a uniform protrusion of the disc along the entire perimeter.
The appearance of protrusions usually leads to increased pain. X-ray images clearly show a decrease in the height of the gap between the vertebrae, as well as the development of osteophytes - bone growth. They are formed along the edges of the vertebrae to balance the load on the spine as the intervertebral disc overcomes it less and less.
In the third stage of the disease, the fibrous ring of the disc cannot withstand the internal pressure and breaks. Through the resulting gap, part of the nucleus pulposus of the disc is squeezed out - an intervertebral hernia occurs.
In the fourth stage of the disease, the range of movements in the back decreases sharply, the pain syndrome becomes constant, and a broad picture of neurological disorders develops.
Diagnostics
At the initial appointment, the doctor asks the patient about the symptoms, the circumstances of their occurrence, reviews the medical history, conducts an external examination, pays attention to the posture, the presence or absence of spinal deformities (scoliosis, kyphosis).
The cause of pain syndrome (dorsago, dorsalgia) can be both osteochondrosis and vertebral displacement (spondylolisthesis), ankylosing spondyloarthrosis, ankylosing spondyloarthrosis.
Osteochondrosis of the thoracic region is usually accompanied by muscle tension in the back and hypertonicity of the spinal muscles. The doctor palpates and uses successive pressures to find the pain point (trigger) that corresponds to the center of the muscle spasm.
To get more detailed information, the doctor prescribes an x-ray or MRI.
X-ray for thoracic osteochondrosis provides the most general information - it helps to distinguish the disease from spondylolisthesis, to see osteophytes, and to narrow the gap between the vertebrae.
Magnetic resonance imaging better shows soft connective tissue. With its help, the doctor can examine in detail the structure of the intervertebral disc, see protrusions, hernias (size, location, shape), as well as the condition of ligaments, intervertebral joints, blood vessels, nerve roots, and see spinal cord stenosis (or its danger).
Based on the MRI data, the doctor makes a diagnosis and determines an individual treatment plan.
Treatment of osteochondrosis of the thoracic region
Drug treatment
To relieve pain in the back and intercostal neuralgia in thoracic osteochondrosis, non-steroidal anti-inflammatory drugs in the form of ointments, tablets or injections can be used. The main effect of these drugs is anti-inflammatory, so their use is justified in cases where pinched nerve roots are accompanied by inflammation, that is, with thoracic radiculitis. NSAIDs also reduce muscle tissue inflammation against the background of persistent spasms and hypertension.
In case of acute pain syndrome, paravertebral or epidural blockade can be used - analgesic injection. In the first case, the injection is made at the site where the nerve root is pinched, in the second case, in the area between the vertebral periosteum and the spinal cord membrane.
To relieve muscle tension and reduce pressure on nerve roots, blood vessels, and intervertebral discs, muscle relaxants and antispasmodics are used.
A vitamin complex is prescribed to nourish nerve tissue and prevent its atrophy.
To slow down the process of destruction of connective tissue, chondroprotectors can be prescribed.
These drugs have a symptomatic effect and can somewhat slow the progression of the disease, but in general they have almost no effect on the process of degenerative changes in the intervertebral disc.
Treatment is not medicine
Non-drug treatment of thoracic osteochondrosis includes methods of physiotherapy, reflexology, and physical therapy.
The main goal of treatment is to relieve the inflammatory process, improve blood circulation and restore metabolic processes in the spinal disc, stimulation of connective tissue cell renewal. The clinic uses complex therapy using oriental medicine methods for this purpose.
Important!
Physical therapy exercises help shape and strengthen the muscle corset, remove irrational load on the spine, and serve as a prevention of congestion and the formation of muscle spasms.
Surgery
For large hernias, especially dorsal ones, with the threat of spinal cord stenosis, and especially if they are present, surgical excision—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, operations on the thoracic region are performed very rarely.
Treatment at the clinic
Treatment of thoracic osteochondrosis in the clinic is carried out in complex sessions, which include several procedures - acupuncture, acupressure, moxotherapy, stone therapy, vacuum therapy, hirudotherapy for individual indications.
High efficiency is achieved due to the synergy of individual methods and the elimination of the cause of the disease.
- Acupressure. By pressing firmly on the back trigger point, the doctor removes muscle spasms, tension, congestion, improves blood circulation and restores unobstructed blood flow to the spine. Thanks to this, the load on the intervertebral disc is reduced, and the process of metabolism and tissue regeneration is accelerated as the influx of oxygen and collagen increases.
- Acupuncture. Inserting needles into the bioactive points of the back, legs, arms, head, chest eliminates symptoms associated with impaired conservation - numbness, weakness in the arms. With the help of this procedure, intercostal neuralgia and other vertebrogenic pains are reduced. In addition, acupuncture enhances the effect of acupressure and has anti-inflammatory and anti-edema effects.
- Moxibustion therapy. Heating the bioactive points in the spinal area is done with a burning wormwood cigar. This procedure activates metabolic processes, increases blood flow to the intervertebral discs, stimulates and accelerates their recovery.
- Vacuum therapy. Cupping and cupping massages create blood flow and help promote blood circulation.
- Manual therapy. Using gentle traction on the spine, the doctor unloads the intervertebral discs, increases the distance between the vertebrae, releases 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 carefully relax the back muscles, eliminate spasms and free the spine. To do this, the muscles are well warmed up and relaxed through massage. If this is not done, the use of physical effort can cause injuries - ruptures, sprains or fractures. The hardware method of spinal traction for osteochondrosis is ineffective and even dangerous, so it is not used in the clinic.
Hirudotherapy
Placement of medicinal leeches improves local blood circulation, blood supply to the intervertebral disc, and has an anti-inflammatory effect.
Stone therapy
Smooth stones heated to a certain temperature are placed along the spine to warm and relax the spinal muscles, improve blood circulation and stimulate blood flow.
The duration of the treatment session at the clinic is 1-1. 5 hours, depending on individual signs. A course of treatment usually includes 10-15 complex sessions. Once completed, a control MRI is performed to evaluate the treatment results achieved.
Complications
The main complication of thoracic osteochondrosis is spinal cord stenosis due to a herniated disc with the development of body paralysis.
Other complications that may be associated with body preservation disorders due to pinching the spinal nerve roots: the 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.
Important!
If a child or teenager suffers from scoliosis, it is advisable to cure the 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 are 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 full of complications from the respiratory, digestive and cardiovascular systems.