Osteochondrosis affecting the thoracic spine is often disguised as pathology of internal organs. It is manifested by heart pain, shortness of breath, a feeling of lack of air when inhaling and panic attacks. Therefore, the diagnosis of thoracic osteochondrosis is somewhat difficult. After its detection, conservative treatment is carried out with the help of drugs, physiotherapy, exercise therapy. And with severe damage to the thoracic discs and vertebrae, surgery is required.
Brief description of the disease
Thoracic osteochondrosis is a degenerative-dystrophic disease of the spine. At the initial stage of its development, the intervertebral discs are slowly destroyed. They become thin, brittle, and radial cracks appear on their surface. To stabilize the thoracic segment affected by osteochondrosis, the bone tissue of the vertebrae grows with the formation of sharp growths - osteophytes. This becomes the reason for a strong restriction of mobility, compression of blood vessels and spinal roots.
Pathology diplomas
The degree of osteochondrosis is a set of symptoms characteristic of a certain radiographic stage. The more deformed the discs and vertebrae, the more pronounced the clinical manifestations. The severity of the pathology always determines the tactics of treatment, it should be taken into account when choosing drugs and methods of use.
degree I
X-ray images generally show no change. But the intervertebral disc has already begun to collapse due to the inability to retain moisture, which is necessary for the restoration of its tissues. Sometimes there is a slight discomfort in the back, which quickly disappears after a short rest. Osteochondrosis of grade 1 is usually discovered by chance when diagnosing other diseases.
degree II
The fibrous ring becomes loose, fibrous. One of the cracks on the surface of the disc increases, the nucleus pulposus extends into it. On x-rays, a decrease in the distance between adjacent vertebral bodies is noticeable due to a decrease in the height of the disc. Due to constant compensatory muscle tension, mobility of the thoracic region is limited and moderate pain sensations occur.
III degree
The integrity of the fibrous ring is violated, so that the nucleus pulposus is expelled from it. A hernial protrusion is formed - the main cause of severe symptoms and complications of thoracic osteochondrosis. Vertebral bodies are deformed, unique osteophytes are formed. Pain in the chest region becomes constant, the range of motion of the spine is significantly reduced.
degree IV
X-ray images clearly show the growth of connective tissues, the formation of several osteophytes. The adjacent vertebral bodies are blocked, immobilized. Radicular syndrome develops, discogenic myelopathy often occurs - compression of the spinal cord, dangerous for its irreversible consequences. A person hardly uses himself in everyday life, loses the ability to perform professional tasks.
Causes of osteochondrosis of the thoracic spine
Thoracic osteochondrosis in people over 40-45 years of age develops due to the natural aging of the body: slowing of recovery reactions, decreased production of collagen, which causes elasticity, resistance ofligaments. At a younger age, it occurs as a result of increased stress on the spine or against the background of pathologies already present in the body:
- rheumatoid arthritis, systemic lupus erythematosus, scleroderma, ankylosing spondylitis;
- endocrine and metabolic diseases, eg diabetes mellitus, gout, hypothyroidism, hyperthyroidism;
- congenital and acquired anomalies including kyphosis, scoliosis.
Previous spinal damage, a sedentary lifestyle and a lack of vitamins and microelements in the body can cause premature destruction of the disc.
Characteristic signs and symptoms of the disease
Thoracic osteochondrosis develops gradually, at first without showing up. It is in this course that its danger lies. A person experiences slight pain and discomfort in the back for banal muscle fatigue after a hard day of work, housework or in the garden and does not seek medical help. Therefore, patients are usually diagnosed with a pathology of 2-3 degrees of severity, which is difficult to treat conservatively.
At the very beginning
During the period of exacerbation, the pathology can be manifested by pain between the shoulder blades, which occurs when bending, rotating the body. The range of motion is reduced and many specific signs of relapse are present.
Chest pain
In osteochondrosis, chest pain appears first. They are not clearly located, they can be given to the hands, collarbone, ribs. The pain in the heart is severe or moderate, resembles an attack of angina pectoris, is not eliminated by taking nitroglycerin. Sometimes they are similar to the sensations that occur during exacerbation of cholecystitis, pancreatitis. But unlike damage to the pancreas or gallbladder, the pain is not accompanied by increased gas production, heartburn and bloating.
Constriction in the chest
Pain between the shoulder blades is sometimes accompanied by a feeling of lack of air when inhaling. A person is expected to be afraid, not understanding the reasons for this condition. Doctors recommend not to panic, but to sit down and measure the pulse. If the obtained value does not exceed 100 beats per minute, the probability of disruption of the lungs or heart is extremely low.
Other symptoms
Gradually, the symptoms of osteochondrosis are worsened by a sensitivity disorder. There are sensations of numbness, tingling, crawling. Occasionally, conditions that resemble panic attacks occur. They are characterized by fear, increased heart rate, excessive sweating, and cold sweating. If these symptoms are accompanied by chest pain, it is necessary to take nitroglycerin and call a doctor. A similar set of symptoms can indicate a myocardial infarction.
The spinal roots, located in the thoracic region, innervate the internal organs. When irritated, tablets, the work of the gastrointestinal tract and liver is disturbed. Peristalsis is disturbed, epigastric pain, heartburn, belching occurs.
Signs in subacute stage
After an exacerbation, the subacute stage of the course of thoracic osteochondrosis begins. The pain and breathing problems persist, but they are much less severe. A person has not been looking for a comfortable position of the body for a long time, in which pain is not felt. The duration of the subacute phase can be up to two weeks. Subject to all medical recommendations, remission occurs, characterized by the absence of pronounced symptoms. Violation of the diet leads to a further exacerbation of osteochondrosis.
Remission
In the remission stage, slight discomfort may occur when the weather changes or with hypothermia. Acute pain appears only with osteochondrosis of 2 to 4 degrees of severity due to too sharp rotation or tilting of the body. Exacerbation of chronic pathologies, stress, increased physical activity, prolonged stay in one position of the body can cause another relapse.
Principles of disease diagnosis
The neurologist makes a primary diagnosis based on the patient's complaints, anamnesis data. On an external examination, he discovers points in the thoracic region where pain occurs. The realization of functional tests makes it possible to evaluate the safety of the reflexes, to identify the disorders of sensitivity. Among the instrumental methods, radiography is the most informative. But for a detailed study of the spinal segment, computed tomography, MRI can be performed. To exclude diseases of the cardiovascular system, patients are given an ECG.
First aid for exacerbation
The pain during a relapse of thoracic osteochondrosis is sharp, penetrating, so a person should receive first aid. It should be soothed, put on a hard surface, covered with a warm blanket. If the relapse is accompanied by an increase in heart rate, shortness of breath, increased anxiety, you should call a doctor. Any nonsteroidal anti-inflammatory drug can be taken to relieve pain between the shoulder blades.
How to treat thoracic osteochondrosis
Only a comprehensive approach to treatment will eliminate all symptoms of osteochondrosis, slow or completely stop its spread to healthy discs and vertebrae. With a pathology of 1-2 degrees of severity, conservative methods of treatment are used. For osteochondrosis 3-4 degrees, the formation of large hernias is characteristic. Surgical treatment may be needed to relieve pressure on the blood vessels and spinal roots.
Preparations
In the treatment of thoracic osteochondrosis, drugs belonging to various clinical and pharmacological groups are used. At the initial stage, agents for parenteral administration are usually used, which quickly provide a therapeutic effect. A few days later, the injectable solutions are replaced with safer tablets, ointments and patches.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs have a pronounced analgesic, anti-inflammatory and anti-edema effect. The intramuscular administration of solutions allows the acute pain to be stopped. To eliminate slight discomfort between the shoulder blades, local application agents are used. And with moderate pain, oral NSAIDs work well.
Muscle relaxants
Muscle relaxants are used to relieve muscle spasms in response to severe pain. Most often, the treatment of thoracic osteochondrosis begins with the intramuscular administration of drugs which, in addition to the muscle relaxant tolperisone, include an anesthetic.
Chondroprotectors
In the event of a pathology of the 1st degree of severity, the reception of course of the chondroprotectors makes it possible to restore the damaged discs. In other cases, they are prescribed to improve metabolism in the affected segment of the spine, to prevent disease progression.
B vitamin preparations
Their use allows to increase blood flow, improve the functioning of the peripheral nervous system, restore trophism and innervation. The vitamin B complex has a beneficial effect on degenerative diseases of the nerves and the locomotor system.
Physiotherapy exercises
In case of thoracic osteochondrosis of 1 degree, daily physical therapy makes it possible to dispense with the use of drugs. Recovery occurs by strengthening muscles, improving blood supply to tissues with nutrients. In other cases, exercise and regular training help prevent the involvement of healthy spinal segments in the destructive process and prolong the stage of remission.
Complex from a standing position
While standing, the following therapeutic exercises are the most therapeutically effective:
- put your palms on your shoulders, lean forward, while lifting your bent legs, as if trying to reach the opposite knee with your elbow;
- raise your left hand, lean to the right. Perform the exercise in the opposite direction;
- Spread your legs shoulder width apart, raise your arms. Lean forward, touching the opposite foot with your palm.
The number of repetitions is 10 to 12 times in 2-3 sets.
From a lying position
To perform these exercises you will need a gym mat or a thick blanket folded twice:
- lie on your stomach, at the same time raise your arms and legs;
- lying on your back, lift your upper body, stretch your palms towards your feet;
- lying on your back, bend one leg, wrap it behind the other, trying to touch the floor with your knee.
Each exercise should be done 7-10 times.
Sitting
When performing such exercises, avoid sudden and large movements, including twisting:
- sitting on the floor, stretch forward, trying to touch the opposite foot with your palm;
- sitting on a chair or stool, stretch your arms forward and slowly turn side to side;
- Sitting on the floor, wrap your arms around your knee, pull it as close to your chest as possible.
In the first lessons, the exercises should be repeated 5-7 times, after about a month - 15-20 times.
Physiotherapy
Magnetic therapy, laser therapy, UHF therapy, sinusoidal currents, shock wave therapy, applications with paraffin and ozokerite are used in the treatment of thoracic osteochondrosis. In case of exacerbations, electrophoresis, ultraphonophoresis with glucocorticosteroids, anesthetics, B vitamins, chondroprotectors are carried out.
Massage
A massage performed by a specialist eliminates pain between the shoulder blades, relaxes spasmodic skeletal muscles.
In case of osteochondrosis, all types of massage are therapeutically effective - classic, vacuum, acupuncture, connective tissue. At home, self-massage is conveniently carried out using a long-handled wooden or electric massager.
Acupuncture
Acupuncture is a method of treating pathology by placing needles in bioactive points in the human body. They are thin, short, so when piercing the skin, only slight discomfort occasionally occurs. But even such an effect is sufficient for the production of substances in the body with anesthetic and anti-inflammatory effects.
Nutrition
Nutritionists recommend that patients with thoracic osteochondrosis should abandon fatty meats, rich soups, smoked meats, homemade and factory marinades. It is necessary to limit the amount of salt in the diet, which provokes the formation of edema. Every day you need to drink about 2. 5 liters of liquid - water, vegetable juice, red fruit drinks, fruit compotes.
Folk remedies
Decoctions and infusions of medicinal plants, ointments, alcohol and rubbing oil, compresses are allowed by neurologists to be used after the main treatment. Folk remedies are used to eliminate a slight pain between the shoulder blades, which sometimes occurs after physical exertion.
Celery root
Peel the large celeriac, finely chop it and squeeze out the juice. Add 100 g of chopped fresh celery. Take 3 tablespoons up to 4 times a day with meals to cleanse the spinal structures of harmful salt deposits.
Sunflower root
Pour a teaspoon of crushed dried sunflower roots with a glass of hot water. Bring to a boil, simmer over low heat for 20 minutes, cool under the lid, drain. Drink 3-4 times a day.
Homemade ointment
In a mortar, grind a tablespoon of turpentine gum and thick honey, add 2 drops of essential oils of juniper, rosemary, eucalyptus. Inject 100 g of medical vaseline in small portions. Stir, transfer to a jar, store in refrigerator, rub back for pain.
During pregnancy
Many systemic pain relievers are contraindicated during pregnancy, therefore neurologists prefer drugs for external use - ointments, gels, patches. If you can not do without pills, their dosage is significantly reduced. During the childbearing period, the main methods of treating chest osteochondrosis are massage and exercise therapy.
Possible consequences
In the absence of medical intervention, thoracic osteochondrosis can cause pneumosclerosis, arrhythmias, vegetative-vascular dystonia, deterioration of the gastrointestinal tract, impaired sexual and reproductive function in women andmen.
Prevention and prognosis
The prognosis is favorable with timely detection of the disease, competent and comprehensive treatment. If complications of thoracic osteochondrosis have developed, only compliance with all medical recommendations will allow you to achieve stable remission.
As a prophylaxis of pathology, neurologists recommend excluding the factors that provoke it from the usual way of life. This is overweight, low physical activity, vitamin and mineral deficiency, excessive stress on the spine.