![The doctor informs the patient about the mechanism of development of osteochondrosis of the thoracic spine](/images/article/1831/The%20doctor%20informs%20the%20patient%20about%20the%20mechanism%20of%20development%20of%20osteochondrosis%20of%20the%20thoracic%20spine.jpg)
Osteochondrosis is the process of aging of the spine and surrounding tissues. Experts replace osteochondrosis with a more precise term: "degenerative-dystrophic changes". With age, such changes occur in the spine of each person 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 started and are progressing. In the article we will talk about osteochondrosis of the thoracic spine, symptoms and treatment.
Due to its stability, the thoracic region suffers less often than the cervical and lumbar regions. Women are more susceptible to thoracic osteochondrosis. People 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 is made up of a nucleus located in the center and a fibrous ring at 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; with an unhealthy and sedentary lifestyle, it progresses and leads to complications. Cracks appear on the surface of the annulus fibrosus and the nucleus pulposus protrudes through them - a protrusion and hernia develop. The injury process involves the vertebrae, ligaments, intercostal nerves, muscles and fascia. There are pains 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 step
The surface of the disc cracks, the nucleus moves away from the center and the annulus fibrosus loses its elasticity. This leads to a disc protrusion: it protrudes into the spinal canal in the shape of a cone and puts pressure on the paravertebral ligaments. Moderate pain appears. The surrounding muscles are constantly tense and limit the range of movement in the thoracic region. On the x-ray you can see how the height of the intervertebral space has decreased.
- Third step
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 reduction in the intervertebral space.
- Step four
At this stage, the back hurts and constantly. The posture changes and it is difficult for a person 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 degenerative-dystrophic changes that occur in the spine with age. There are many factors and diseases that influence the development of osteochondrosis:
- sedentary lifestyle
- Overweight
- frequent hypothermia
- bad habits
- poor weight lifting
- uneven load on one shoulder when carrying heavy objects
- hereditary predisposition
- flat foot
- pregnancy
- breastfeeding
- spinal deformity, poor posture - scoliosis, kyphosis
- metabolic disorders in endocrine diseases - diabetes mellitus, gout, thyroid pathology
- autoimmune diseases - systemic lupus erythematosus, rheumatoid arthritis
- walk 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, musculo-tonic, radicular and sometimes facet.
- Pain syndrome
Protrusions, hernias and osteophytes put pressure on the paravertebral ligaments and pain occurs. In the early stages of osteochondrosis, it appears only after heavy lifting or physical activity and disappears with rest. As the disease progresses, pain occurs even without exercise.
- Musculotonic 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
Protrusions and herniations 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 with osteoarthritis 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 intensifies when a person turns, 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 disappears after a change in body position, but it sometimes lasts several days.
- Chronic pain lasts 12 weeks. A person cannot stand for a long time and 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, it can radiate towards the collarbones, neck, ribs, arms, simulating a cardiac pathology
- constant cracking in the back when moving
- shortness of breath due to pain during deep inhalation and exhalation
- 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 best to contact a neurologist. The doctor will make the correct diagnosis, rule out similar diseases and find out why osteochondrosis develops.
During the first appointment, the doctor collects the 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 inquires about the periods of pregnancy and breastfeeding.
During the examination, the doctor pays attention to the patient's appearance: posture, weight/height ratio, body proportionality. Checks neurological status: muscle strength, limb sensitivity, tendon reflexes, spinal range of motion. The doctor also assesses pain using special scales.
Instrumental diagnostic methods make it possible to establish a diagnosis:
- X-ray. This is a simple study that reveals 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 pathology of the vertebrae and discs invisible on x-rays. Allows you to assess the degree of damage to the spine and monitor the progress of treatment.
- Magnetic resonance imaging. It helps diagnose protrusions, herniated intervertebral discs and spinal nerve root pathology.
To exclude diseases of the heart and internal organs, the doctor may refer the patient to an abdominal ultrasound, gastroscopy or ECG.
Treatment: what to do in case of osteochondrosis of the thoracic region
You should not self-medicate, prescribe medications or procedures - this can lead to dangerous side effects and complications. The doctor must treat the patient and monitor the dynamics of his condition.
The duration of treatment 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:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) - relieve pain, relieve 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 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 restoration of tissues, eliminates inflammation.
- Shock wave therapy - destroys deposits of calcium salts on the vertebrae, accelerates the regeneration of bone and cartilage tissues.
Acupuncture
It stimulates blood circulation in the tissues of the affected vertebrae area, relaxes the muscles, reduces pain and swelling.
Registration
Application of special adhesive tapes to the skin in the painful area of the back. The bands regulate muscle tone and distribute the load correctly.
Massage, manual therapy
As a complementary therapy to relax muscles and improve mobility of the spine.
Doctors do everything possible to treat the patient conservatively. If the available therapies are not sufficient, the patient is referred for consultation to 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 stage, even adequate treatment 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 follow these rules:
- sleep on an orthopedic mattress and pillow
- When lifting weights, do not bend, but squat so that the load falls on the hips
- carry a bag or backpack alternately on the left and right shoulder, so as not to load only one side
- avoid injuries
- quit smoking and excessive alcohol consumption
- drink enough water
- do a warm-up by sitting for a long time, play sports, swim, walk
- monitor body weight
- rapid treatment of infectious and chronic diseases
- wear comfortable shoes
If you suffer from back pain in the chest or other parts of the spine, do not postpone the examination. Make an appointment with a neurologist. The doctor will carry out a complete diagnosis and establish a treatment plan. You will get rid of pain and maintain the health of your spine.