Osteochondrosis affecting the thoracic spine is often disguised as a pathology of internal organs. It is manifested by pain in the heart, shortness of breath, a feeling of shortness of breath when inhaling and panic attacks. Therefore, the diagnosis of thoracic osteochondrosis is somewhat difficult. After its detection, conservative treatment is performed with medication, physical therapy, exercise therapy. And with severe damage to the thoracic discs and vertebrae, surgical intervention is necessary.
Brief description of the disease
Thoracic osteochondrosis is a degenerative dystrophic disease of the spine. In 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 acute growths - osteophytes. This becomes the reason for a strong restriction of mobility, compression of blood vessels and spinal roots.
Degrees of pathology
The degree of osteochondrosis is a set of symptoms characteristic of a given radiographic stage. The more deformed the discs and vertebrae, the more pronounced are the clinical manifestations. The severity of the pathology always determines the treatment tactics, it must be taken into account when choosing the drugs and methods of their use.
I grade
X-ray images generally do not show any changes. But the intervertebral disc has already started to collapse due to the inability to retain the moisture needed to restore its tissues. Sometimes, there is a slight discomfort in the back, which disappears quickly after a brief rest. Grade 1 osteochondrosis is usually discovered by chance during the diagnosis of other diseases.
grade II
The fibrous ring becomes loose, fibrous. One of the cracks in the surface of the disc increases, the pulposus nucleus extends there. On radiographs, a decrease in the distance between adjacent vertebral bodies is noticeable due to a decrease in the height of the disc. As a result of constant compensatory muscle tension, mobility of the thoracic region is limited and moderate painful sensations occur.
grade III
The integrity of the fibrous ring is violated, so the nucleus pulposus is squeezed out of it. A hernial protrusion is formed - the main cause of symptoms and serious complications of thoracic osteochondrosis. Vertebral bodies are deformed, unique osteophytes are formed. Pain in the thoracic region becomes constant, the range of motion of the spine is significantly reduced.
grade IV
X-ray images clearly show the growth of connective tissues, the formation of multiple osteophytes. The adjacent vertebral bodies are blocked, immobilized. Root syndrome develops, discogenic myelopathy often occurs - compression of the spinal cord, dangerous because of its irreversible consequences. The person hardly serves himself on a daily basis, loses the ability to exercise professional functions.
Causes of osteochondrosis of the thoracic spine
Thoracic osteochondrosis in people over 40-45 years old develops due to the natural aging of the body: slowing recovery reactions, decreased collagen production, which causes elasticity, strength of ligaments. At a younger age, it occurs as a result of increased stress on the spine or in the context of pathologies already present in the body:
- rheumatoid arthritis, systemic lupus erythematosus, scleroderma, ankylosing spondylitis;
- endocrine and metabolic diseases, for example, diabetes mellitus, gout, hypothyroidism, hyperthyroidism;
- congenital and acquired abnormalities, including kyphosis, scoliosis.
Previous spinal injuries, a sedentary lifestyle and a lack of vitamins and microelements in the body can cause premature disc destruction.
Signs and symptoms characteristic of the disease
Thoracic osteochondrosis develops gradually, at first without manifesting itself. It is in this course that the danger lies. A person feels mild back pain and discomfort due to banal muscle fatigue after a hard day of work, housework or gardening 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.
Right at the beginning
During the period of exacerbation, the pathology can manifest as pain between the shoulder blades, which occurs when bending, rotating the body. The range of motion is reduced and many specific signs of recurrence are present.
Chest pain
In osteochondrosis, chest pains appear first. They are not well located, they can be administered in the hands, in the collarbone, in the ribs. Heart pain is severe or moderate, resembles an attack of angina pectoris and is not eliminated by taking nitroglycerin. Sometimes they are similar to the sensations that occur during the exacerbation of cholecystitis, pancreatitis. But, unlike lesions of the pancreas or gallbladder, the pain is not accompanied by increased gas formation, heartburn and swelling.
Constriction in the chest
Pain between the shoulder blades is sometimes accompanied by a feeling of shortness of breath when inhaling. A person is frightened as expected, without understanding the reasons for this state. Doctors recommend not to panic, but to sit and measure your pulse. If the value obtained does not exceed 100 beats per minute, the probability of rupture of the lungs or heart is extremely low.
Other symptoms
Gradually, the symptoms of osteochondrosis are aggravated by the sensitivity disorder. There are sensations of numbness, tingling and crawling chills. From time to time, conditions that resemble panic attacks occur. They are characterized by fear, increased heart rate, excessive sweating and cold sweat. 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 they are irritated, depressed, the work of the gastrointestinal tract and the liver is impaired. Peristalsis is disturbed, epigastric pain, heartburn and belching occur.
Signs in the subacute stage
After an exacerbation, the subacute stage of the course of thoracic osteochondrosis begins. Pain and breathing problems persist, but they are much less severe. The person has not looked for a comfortable body position for a long time, in which he does not feel pain. The duration of the subacute phase is up to two weeks. If all medical recommendations are followed, remission occurs, which is characterized by the absence of pronounced symptoms. Violation of the regimen leads to a further exacerbation of osteochondrosis.
Remission
In the remission stage, mild discomfort can occur when the weather changes or hypothermia. Acute pain appears only with osteochondrosis of 2 to 4 degrees of severity due to the very sharp rotation or inclination of the body. Exacerbations of chronic pathologies, stress, increased physical activity and 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. During an external examination, he discovers spots in the chest area, with pressure on which pain occurs. The performance of functional tests allows to evaluate the safety of reflexes, to identify sensitivity disorders. Of the instrumental methods, radiography is the most informative. But for a detailed study of the spinal segment, computed tomography, magnetic resonance imaging can be performed. To exclude diseases of the cardiovascular system, patients receive an ECG.
First aid for exacerbation
The pain during the recurrence of thoracic osteochondrosis is acute, penetrating, so the person needs first aid. It should be calmed, placed 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 will need to call a doctor. Any non-steroidal anti-inflammatory medication can be taken to relieve pain between the shoulder blades.
How to treat thoracic osteochondrosis
Only an integrated approach to treatment will eliminate all symptoms of osteochondrosis, delay or completely stop its spread to healthy discs and vertebrae. With pathology of 1-2 degrees of severity, conservative methods of therapy are used. For osteochondrosis of 3-4 degrees, the formation of large hernias is characteristic. Surgical treatment may be necessary to relieve pressure on blood vessels and spinal roots.
Preparations
In the treatment of thoracic osteochondrosis, drugs from various clinical and pharmacological groups are used. In the initial stage, drugs are generally used for parenteral administration, which quickly have a therapeutic effect. A few days later, injectable solutions are replaced by safer tablets, ointments and plasters.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs have a pronounced analgesic, anti-inflammatory and anti-edema effect. Intramuscular administration of solutions allows to stop acute pain. To eliminate mild discomfort between the shoulder blades, local application agents are used. And with moderate pain, NSAIDs for oral administration work well.
Muscle relaxants
Muscle relaxants are used to relieve muscle spasms in response to severe pain. Most of the time, the treatment of thoracic osteochondrosis begins with the intramuscular administration of medications, which, in addition to the muscle relaxant tolperisone, include an anesthetic.
Chondroprotectors
In case of pathology of 1st degree of severity, the reception of the chondroprotective course helps in the restoration of damaged discs. In other cases, they are prescribed to improve the metabolism of the affected segment of the spine, to prevent disease progression.
Vitamin B preparations
Its use helps to increase blood flow, improve the functioning of the peripheral nervous system, restore trophism and innervation. The B vitamin complex has a beneficial effect on degenerative diseases of the nerves and the locomotor system.
Physiotherapy exercises
In the case of 1-degree thoracic osteochondrosis, therapy with daily exercises allows dispensing with the use of medications. 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 remission stage.
Standing position complex
In the standing position, the following therapeutic exercises are more therapeutically effective:
- place your palms on your shoulders, lean forward while lifting your legs bent, as if trying to reach the opposite knee with your elbow;
- raise your left hand and lean to the right. Perform the exercise in the opposite direction;
- Open your legs shoulder-width apart and raise your arms. Lean forward, touching the opposite foot with the palm.
The number of repetitions is 10-12 times in 2-3 sets.
From a prone position
For these exercises, you will need a gym mat or a thick double-fold blanket:
- lie on your stomach at the same time, raise your arms and legs;
- lying on your back, lift your upper body, stretch your palms up to 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 to 10 times.
Sitting
When performing such exercises, sudden and high amplitude movements, including twisting, should be avoided:
- sitting on the floor, stretch forward, trying to touch the opposite foot with the palm of your hand;
- sitting on a chair or stool, stretch your arms forward and slowly rotate from side to side;
- While sitting on the floor, wrap your arms around your knee and 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, paraffin and ozokerite applications are used in the treatment of thoracic osteochondrosis. In exacerbations, electrophoresis, ultraphonophoresis with glucocorticosteroids, anesthetics, B vitamins and chondroprotectors are performed.
Massage
A massage performed by a specialist helps to eliminate pain between the shoulder blades, to relax spasmodic skeletal muscles.
For osteochondrosis, all types of massage are therapeutically effective - classical, vacuum, acupuncture, connective tissue. At home, the self-massage is conveniently performed with a long-handled electric or wooden massager.
Acupuncture
Acupuncture is a method of treating pathologies by installing needles in bioactive points on the human body. They are thin, short, so when they pierce the skin, only slight discomfort occurs occasionally. But even this effect is sufficient for the production of substances in the body with analgesic and anti-inflammatory effects.
Nutrition
Nutritionists recommend that patients with thoracic osteochondrosis abandon fatty meats, rich soups, smoked meats, homemade and factory marinades. It is necessary to limit the amount of salt in the diet that causes the formation of edema. Every day you need to drink about 2. 5 liters of liquid - water, vegetable juices, red fruit juices, fruit jams.
Folk remedies
Decoctions and infusions of medicinal plants, ointments, alcohol and rubbing oil, compresses are allowed by neurologists to be used after the main therapy. Folk remedies are used to eliminate mild pain between the shoulder blades, sometimes arising after physical exertion.
Celery root
Peel the large celery root, finely chop and squeeze out the juice. Add 100 g of chopped fresh celery. Take 3 tablespoons up to 4 times a day with meals to clean the vertebral structures of harmful salt deposits.
Sunflower root
Pour a teaspoon of crushed dry sunflower roots with a glass of hot water. Bring to a boil, cook over low heat for 20 minutes, let cool under the lid and drain. Drink 3-4 times a day.
Ointment for home
In a pestle, grind a tablespoon of turpentine and thick honey, add 2 drops of each of the essential oils of juniper, rosemary and eucalyptus. Inject 100 g of medical petroleum jelly in small portions. Stir, transfer to a jar, store in the refrigerator, rub on the back for pain.
During pregnancy
Many systemic painkillers are contraindicated during pregnancy, so neurologists prefer medications for external use - ointments, gels, adhesives. If you can't do it without taking pills, then your dosages are reduced significantly. During pregnancy, the main therapy methods for thoracic 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, decreased sexual and reproductive function in women and men.
Prevention and prognosis
The prognosis is favorable with the timely detection of the disease, competent and comprehensive treatment. If complications of thoracic osteochondrosis develop, only compliance with all medical recommendations will achieve a stable remission.
As a prophylaxis of pathology, neurologists recommend excluding the factors that cause it from the normal way of life. These are overweight, low physical activity, deficiency of vitamins and minerals, excessive stress on the spine.