Osteochondrosis affecting the thoracic spine is often disguised as pathologies of internal organs.It manifests itself as heartache, 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 diagnosis, conservative treatment is carried out with medication, physiotherapy and exercise therapy.In case of severe damage to the thoracic discs and vertebrae, surgical intervention is required.
Brief description of the disease
Thoracic osteochondrosis is a degenerative-dystrophic disease of the spine.In the initial stages of its development, the intervertebral discs slowly die.They become thin, brittle, and radial cracks appear on their surface.In order to stabilize the thoracic segment affected by osteochondrosis, the bone tissue of the vertebrae grows with the formation of sharp growths - osteophytes.This causes a sharp limitation of mobility, compression of blood vessels and spinal roots.
Degrees of pathology
The degree of osteochondrosis is a set of symptoms characteristic of a certain radiographic section.The more deformed the discs and vertebrae, the more pronounced the clinical manifestations.The severity of the pathology always determines the treatment tactics and must be taken into account when choosing drugs and methods of application.
I degree
X-rays usually show no changes.However, the intervertebral disc has already begun to deteriorate, as it is unable to retain the moisture needed to repair its tissues.Sometimes there is a slight discomfort in the back, which quickly disappears after a short rest.Osteochondrosis of the 1st degree is usually discovered accidentally during the diagnosis of other diseases.
Grade II
The fibrous ring loosens and becomes fibrous.One of the fissures on the surface of the disc enlarges and the nucleus pulposus moves there.A decrease in the distance between adjacent vertebral bodies can be seen on X-rays due to a decrease in the height of the disc.As a result of the constant compensatory muscle tension, the mobility of the chest region is limited and moderate pain occurs.
Grade III
The integrity of the fibrous ring breaks down, so the nucleus pulposus is squeezed out of it.A hernial protrusion is formed - the main cause of severe symptoms and serious complications of thoracic osteochondrosis.The vertebral bodies are deformed, single osteophytes are formed.The pain in the chest region becomes constant and the range of motion of the spine is significantly reduced.
Grade IV
The proliferation of connective tissue and the formation of multiple osteophytes are clearly visible on the X-rays.Adjacent vertebral bodies are blocked and immobilized.Radicular syndrome develops, and often discogenic myelopathy - compression of the spinal cord, which is dangerous due to its irreversible consequences.The person has difficulties in everyday life and loses the ability to perform professional tasks.
Causes of osteochondrosis of the thoracic spine
In people over 40-45 years of age, thoracic osteochondrosis develops due to the natural aging of the body: slowing down of recovery reactions, decrease in collagen production, which determines the flexibility and strength of the ligaments.At a younger age, it occurs against the background of increased load on the spine or pathologies already present in the body:
- rheumatoid arthritis, systemic lupus erythematosus, scleroderma, ankylosing spondylitis;
- endocrine and metabolic diseases, such as diabetes, gout, hypothyroidism, hyperthyroidism;
- congenital and acquired disorders, including kyphosis, scoliosis.
Premature destruction of the discs can be caused by previous spinal injuries, a sedentary lifestyle, vitamin and micronutrient deficiency in the body.
Typical signs and symptoms of the disease
Thoracic osteochondrosis develops gradually, without showing itself for the first time.The danger lies precisely in this process.You consider mild back pain and discomfort as banal muscle fatigue after a hard job, housework or gardening, and do not seek medical help.Therefore, patients are usually diagnosed with 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 manifest itself as pain between the shoulder blades, which occurs when bending or turning the body.Range of motion is reduced and many specific signs of relapse are present.
Chest pain
In the case of osteochondrosis, chest pain first appears.They are not clearly localized and may radiate to the arms, clavicle or ribs.The heart pain is severe or moderate, reminiscent of an angina attack, and does not go away with nitroglycerin.Sometimes they are similar to the sensations that occur during an exacerbation of cholecystitis or pancreatitis.But unlike changes in the pancreas or gallbladder, the pain is not accompanied by increased gas formation, heartburn or bloating.
Tightness in the chest
The pain between the shoulder blades is sometimes accompanied by a feeling of lack of air when inhaling.As expected, the person is frightened, he does not understand the reasons for this condition.Doctors recommend not to panic, but to sit down and take your pulse.If the value obtained does not exceed 100 beats per minute, then the probability of lung or heart failure is extremely low.
Other symptoms
Gradually, the symptoms of osteochondrosis are aggravated by sensitivity disorders.Numbness, tingling and crawling sensations appear.From time to time, conditions similar to panic attacks occur.They are characterized by fear, increased heartbeat, excessive sweating and cold sweats.If these symptoms are accompanied by chest pain, you should take nitroglycerin and call a doctor.A similar set of symptoms may indicate a heart attack.
The spinal roots located in the chest region innervate the internal organs.If they are irritated or compressed, the functioning of the gastrointestinal tract and liver will be disturbed.Peristalsis stops, epigastric pain, heartburn and belching occur.
Signs in the subacute phase
After the exacerbation, the subacute stage of thoracic osteochondrosis occurs.The pain and breathing problems are still there, but much less intense.People no longer look for a comfortable position for a long time in which they do not feel pain.The duration of the subacute stage is no more than two weeks.If all medical recommendations are followed, remission occurs, characterized by the absence of pronounced symptoms.Violation of the system leads to a new exacerbation of osteochondrosis.
Remission
During the remission phase, slight discomfort may occur if the weather changes or hypothermia occurs.Acute pain occurs only in cases of 2-4 degrees of osteochondrosis due to too sharp turning or tilting of the body.Aggravation of chronic pathologies, stress, increased physical activity and prolonged stay in one position can cause another relapse.
Principles of disease diagnosis
The neurologist makes a primary diagnosis based on the patient's complaints and medical history.During an external examination, he discovers points in the chest region that cause pain when pressed.Performing functional tests allows the integrity of reflexes to be assessed and sensory abnormalities to be identified.Among the instrumental methods, radiography is the most informative.But for a detailed examination of the spinal segment, CT and MRI can be performed.In order to rule out cardiovascular diseases, patients are prescribed an EKG.
First aid in case of aggravation
The pain that occurs during a relapse of thoracic osteochondrosis can be acute and stabbing, so the person should be given first aid.He should be calmed down, placed on a hard surface and covered with a warm blanket.If the relapse is accompanied by an increased heart rate, shortness of breath, or increased anxiety, you should call a doctor.You can take any non-steroidal anti-inflammatory drug to relieve the pain between the shoulder blades.
How to treat thoracic osteochondrosis
Only an integrated approach to treatment allows you to get rid of all the symptoms of osteochondrosis, slow down or completely stop its spread to healthy discs and vertebrae.For pathology of 1-2 severity, conservative therapeutic methods are used.The development of large hernias is characteristic of 3-4 degree osteochondrosis.In order to eliminate the compression of blood vessels and spinal roots, surgical treatment may be necessary.
Drug
Medicines from various clinical and pharmacological groups are used in the treatment of thoracic osteochondrosis.At the initial stage, drugs for parenteral administration are usually used, which quickly produce a therapeutic effect.After a few days, the injection solutions are replaced by safer tablets, ointments and patches.
Non-steroidal anti-inflammatory drugs (NSAIDs)
NSAIDs have a pronounced analgesic, anti-inflammatory and anti-edema effect.Intramuscular administration of solutions allows to relieve acute pain.Local preparations are used to eliminate mild discomfort between the shoulder blades.Moderate pain can be well treated with oral NSAIDs.
Muscle relaxants
Muscle relaxants are used to relieve muscle spasms caused by severe pain.Most often, the treatment of thoracic osteochondrosis begins with the intramuscular administration of drugs that, in addition to the muscle relaxant tolperisone, also contain an anesthetic.
Chondroprotectors
In the case of pathology of 1st severity, taking the discs helps to restore the damaged discs.In other cases, it is prescribed to improve the metabolism in the affected segment of the spine and prevent the progression of the disease.
Vitamin B preparations
Their use helps to increase blood flow, improve the functioning of the peripheral nervous system, and restore trophism and innervation.B complex vitamins have a beneficial effect on degenerative diseases of the nervous system and musculoskeletal system.
Therapeutic practice
In the case of thoracic osteochondrosis of the 1st degree, daily exercise therapy allows you not to use drugs.Recovery is done by strengthening the muscles and improving the blood supply to the 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 phase.
From a complex standing position
In a standing position, the following therapeutic exercises are the most effective:
- put your palms on your shoulders, lean forward, while simultaneously raising your bent legs, as if trying to reach the opposite knee with your elbow;
- Raise your left hand and bend to the right.Do the exercise in the opposite direction;
- Place your feet shoulder-width apart and raise your arms.Lean forward and touch your opposite leg with your palm.
The number of repetitions is 10-12 times in 2-3 approaches.
From a supine position
To perform the exercises, you will need a gymnastic mat or a thick blanket folded in half:
- lie on your stomach, raise your arms and legs at the same time;
- lying on your back, raise your upper body, stretch your palms towards your feet;
- lying on your back, bend one leg, bring it behind the other and try to touch the surface of the floor with your knee.
Each exercise should be performed 7-10 times.
From a sitting position
When performing such exercises, sudden, high-amplitude movements, including twisting, should be avoided:
- sitting on the floor, stretch forward and try to touch the opposite leg with your palm;
- while sitting on a chair or stool, stretch your arms forward and slowly turn them from side to side;
- sitting on the floor, squeeze your knees together with your hands and pull them as close to your chest as possible.
During the first hours, the exercises should be repeated 5-7 times, after about a month - 15-20 times.
Physiotherapy treatment
Magnetic therapy, laser therapy, UHF therapy, sine currents, shock wave therapy, paraffin and ozokerite applications are used in the treatment of thoracic osteochondrosis.During exacerbations, electrophoresis and ultraphonophoresis are performed with glucocorticosteroids, anesthetics, B vitamins and chondroprotectors.
Massage
A massage performed by a specialist helps to eliminate the pain between the shoulder blades and relax the spasmodic skeletal muscles.
In osteochondrosis, all types of massage are therapeutically effective - classic, vacuum, acupuncture, connective tissue.At home, self-massage can be done comfortably using a long-handled wooden or electric massager.
Acupuncture
Acupuncture is a method of treating pathology by placing needles on bioactive points of the human body.They are thin and short, so there is only occasional mild discomfort when piercing the skin.But even such an effect is enough for the body to produce pain-relieving and anti-inflammatory substances.
Food
Nutritionists recommend that patients with thoracic osteochondrosis avoid fatty meats, rich soups, smoked meats, and homemade and factory marinades.You need to limit the amount of salt in your diet, which causes edema.You should drink about 2.5 liters of liquid every day - water, vegetable juices, berry fruit drinks, fruit compotes.
Folk remedies
After the main therapy, neurologists allow the use of herbal decoctions and infusions, ointments, alcohol and oil rubs, and poultices.Folk remedies are used to eliminate mild pain between the shoulder blades, sometimes after physical activity.
Celery root
Peel the large celery root, chop it on a fine grater, squeeze out the juice.Add 100 g of chopped fresh celery.3 tablespoons up to 4 times a day during meals to clean the vertebral structures from harmful salt deposits.
sunflower root
Pour a teaspoon of dry crushed sunflower root into a glass of hot water.Bring to a boil, simmer for 20 minutes over low heat, cool under a lid, and filter.Drink in 3-4 portions during the day.
Homemade ointment
Grind a tablespoon of rubber turpentine and thick honey in a mortar, add 2 drops of juniper, rosemary and eucalyptus essential oils.Add 100 g of medical petroleum jelly in small portions.Mix it, put it in a bottle, store it in the refrigerator, rub it into the back against pain.
During pregnancy
Many systemic painkillers are contraindicated during pregnancy, so neurologists prefer products for external use - ointments, gels and patches.If you cannot do without taking the tablets, then their dose is significantly reduced.During pregnancy, the main methods of treating thoracic osteochondrosis are massage and exercise therapy.
Possible consequences
In the absence of medical intervention, thoracic osteochondrosis can cause pneumosclerosis, cardiac arrhythmia, vegetative-vascular dystonia, deterioration of the gastrointestinal tract, and impairment of sexual and reproductive function in women and men.
Prevention and prognosis
The prognosis is favorable if the disease is detected in time and competent, comprehensive treatment is carried out.If complications of thoracic osteochondrosis have developed, then only compliance with all medical recommendations will make it possible to achieve stable remission.
In order to prevent pathology, neurologists recommend excluding the factors that provoke it from the usual lifestyle.These are overweight, low physical activity, lack of vitamins and microelements, and excessive strain on the spine.