Osteochondrosis is the aging process of the spine and surrounding tissues. Experts replace osteochondrosis with a more accurate term - "degenerative-dystrophic changes. "With age, these changes occur in each person's spine to varying degrees.
At an early stage, osteochondrosis hardly manifests itself. 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 than the cervical and lumbar regions. Women are more susceptible to thoracic osteochondrosis. Those at risk are those who spend a lot of time sitting. Degenerative dystrophic changes in the spine occur in 30% of people after the age of 35 and in 50–90% of the elderly.
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 consists of a nucleus located in the center and a fibrous ring on the periphery. As we age, the discs receive less oxygen and nutrients, and the cartilaginous 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 fibrous ring and the nucleus pulposus protrudes through them - protrusions and hernias develop. The damage process involves vertebrae, ligaments, intercostal nerves, muscles and fascia. There is back pain, clicking noises when moving the body, intervertebral joints lose mobility.
Stages of spinal osteochondrosis and its complications
- First step
The intervertebral disc produces less collagen and reduces 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 stage
The surface of the disc cracks, the nucleus moves away from the center, and the fibrous ring loses its elasticity. This leads to protrusion of the disc: 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 has decreased.
- Third stage
Through the fissure of the fibrous ring, 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 spinal roots are affected, causing the back pain to intensify and spread along the ribs. The x-ray shows osteophytes and a marked decrease in the intervertebral space.
- Fourth stage
At this stage, the back hurts strongly 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
- inappropriate lifting of weights
- uneven load on one shoulder when carrying heavy objects
- hereditary predisposition
- flat foot
- pregnancy
- breast-feeding
- spinal deformity, poor 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: painful, muscle-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 lifting weights or physical activity and disappears with rest. As the disease progresses, pain occurs even without exercise.
- Muscular-tonic 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 hernias can compress the nerve root, causing pain and burning in the ribs. The pain usually occurs at night and intensifies with exercise.
- Facet syndrome
It develops with osteoarthritis of 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 curves their back. Pain can be acute or chronic:
- The sharp pain occurs suddenly, after a sudden movement or turning. The attack is short-lived: it usually disappears after a change in body position, but sometimes it lasts for several days.
- Chronic pain lasts 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, feeling of constriction 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 crunching in the back when moving
- shortness of breath due to pain when inhaling and exhaling deeply
- 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 pathologies of the lungs, cardiovascular system, mammary glands, exacerbations of diseases of the gastrointestinal tract.
Diagnosis of osteochondrosis of the thoracic spine
In the first episodes of back pain, it is best to consult a neurologist. The doctor will establish the correct diagnosis, rule out similar diseases and find out why osteochondrosis develops.
At the initial consultation, the doctor takes an anamnesis: he asks the patient to talk about complaints, medications he is taking, hereditary and chronic diseases, injuries, operations and working conditions. In women, the neurologist learns 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 the neurological status: muscle strength, sensitivity in the limbs, tendon reflexes, range of motion of the spine. The doctor also assesses pain using special scales.
Instrumental diagnostic methods help to establish a diagnosis:
- Radiography. This is a simple study that reveals curvature of the spine, fractures and dislocations of the vertebrae and narrowing of the intervertebral space.
- Computed tomography. This is a more informative method, showing pathology of the vertebrae and discs that is invisible on x-rays. It allows you to assess the degree of damage to the spine and monitor the progress of treatment.
- Magnetic resonance imaging. Helps diagnose protrusions, intervertebral disc herniation and spinal nerve root pathology.
To exclude diseases of the heart and internal organs, the doctor may refer the patient for an abdominal ultrasound, gastroscopy or ECG.
Treatment: what to do with 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 therapy depends on the stage of the process and the main symptoms. For conservative treatment of osteochondrosis, doctors use the following methods:
Drug therapy
Patients receive the main groups of medicines:
- 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.
Physiotherapy
The instructor selects exercises to strengthen the muscles of the thoracic region, correct posture and improve spinal mobility.
Different kindsphysiotherapy. To apply:
- Magnetic therapy - improves tissue metabolism, reduces pain and swelling.
- Laser therapy - promotes nutrition and tissue restoration, eliminates inflammation.
- Shock wave therapy - destroys deposits of calcium salts in the vertebrae, accelerates the regeneration of bone and cartilage tissue.
Acupuncture
Stimulates blood circulation in the tissues in the region of the affected vertebrae, relaxes the muscles, reduces pain and swelling.
Recording
Applying special adhesive tapes to the skin in the painful area of the back. The tapes regulate muscle tone and correctly distribute the load.
Massage, manual therapy
As a complementary therapy to relax muscles and improve spinal mobility.
Doctors do everything possible to treat the patient conservatively. If available therapies do not help, the patient is referred for consultation with 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 stages, even adequate therapy does not always guarantee a good prognosis.
Untreated osteochondrosis can cause protrusion or hernia of the intervertebral disc, chronic pain in the back or other parts of the body, low 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 over, but squat so that the load falls on your hips
- carry a bag or backpack alternately on the left and right shoulder, so as not to carry only one side
- Avoid injuries
- stop smoking and excessive alcohol consumption
- drink a lot of water
- warm up by sitting for a long time, play sports, swim, walk
- monitor body weight
- timely treatment of infectious and chronic diseases
- wear comfortable shoes
If you have pain in your back, thoracic region, or other parts of your spine, do not postpone the exam until later. Make an appointment with a neurologist. The doctor will make a complete diagnosis and draw up a treatment plan. You will get rid of pain and maintain the health of your spine.