Diagnosis and treatment of osteochondrosis of the thoracic spine


Thoracic osteochondrosis is a common degenerative disease. There are specific symptoms of thoracic osteochondrosis, indicating the beginning of the pathology. In the early stages, the discomfort does not bother the patient much, so he is in no hurry to seek help from a specialist. Over time, the symptoms intensify, which forces the patient to go to the doctor, where a neglected pathology is found. You should find out what the early signs of osteochondrosis are and what treatment methods are most effective.

What is thoracic osteochondrosis and how it arises

Osteochondrosis of the thoracic region is characterized by the occurrence of destructive-dystrophic processes in the mid-section of the crest. The destruction is located between the 8th and 19th vertebrae. To find out which vertebrae is affected, it is necessary to carry out accurate diagnostic studies. Osteochondrosis of the thoracic region is often accompanied by formidable complications, including prolapse or hernia. Without complications, the disease is rare, as the destruction of cartilage tissue inevitably leads to the destruction of the entire vertebral structure.

When a patient develops an age-related circulatory disorder or age-related joint wear, the fibrous ring located in the intervertebral disc cavity begins to collapse, losing its normal structure. As the destruction is slow, in the initial stages microfissures appear, through which the nucleus pulposus passes.

As the inner component leaks, the fibrous ring begins to weaken, which leads to gradual elongation and rupture. When the nucleus pulposus protrudes, an intervertebral hernia occurs, which is the most common complication of osteochondrosis. The pathology involves damage to cartilage tissue, which causes significant discomfort. Severe back pain is also associated with neurological syndromes that develop from pinching or irritation of the nerve roots.

Symptoms of breast osteochondrosis

In the initial phase, the patient does not feel discomfort, therefore, in this phase, the disease can only be detected by chance. The disease has many symptoms that can be disguised as other pathologies.

The symptoms of thoracic osteochondrosis can be felt by the following manifestations:

  • Breathing is difficult. Problems arise, manifested by shortness of breath and a feeling of shortness of breath. This indicates damage to the thoracic vertebrae and spinal cord.
  • The main symptom is pain in the chest region. There is also a feeling of pressure in the heart, reminiscent of an ischemic attack.
  • Discomfort occurs when the back bends. As the disease progresses, the pain in this position increases.
  • In the context of deteriorating blood circulation, there is a feeling of coldness in the lower or upper extremities.
  • Chest pain in the context of emerging intervertebral hernias. Discomfort is usually felt most strongly on the left or right side of the affected area.
  • Discomfort in the throat and difficulty in swallowing. If there is irritation of the nerve endings in the upper part of the chest region, a cough appears.
  • Women may experience chest pain that is unrelated to cyclical changes or hormonal imbalances.
  • Tingling or burning sensation appears in the area of the legs and feet.
  • Hair and nails become brittle, opaque.
  • Herpes zoster occurs less frequently.
  • Back and chest pain occur at the same time.
  • Less commonly, there is discomfort in the stomach, liver, or pancreas.
  • The onset of severe pain in the ribs, which indicates intercostal neuralgia.
  • There are signs of thoracic chondrosis and compression - a similar condition.
  • There are problems with the functioning of the gastrointestinal tract. Feels nauseous, feeling heavy in the stomach.
  • In men, some libido may drop. Problems arise in the genitourinary sphere.
  • When standing or sitting for a long time, great discomfort occurs.
  • There is a severe headache accompanied by dizziness. Migraines with aura may appear.
  • The patient often develops intercostal neuralgia.
  • Pain may radiate to the neck or lower back.
  • If you find in the thoracic osteochondrosis aggregate and its signs or some of them, it is necessary to urgently consult a therapist, neurologist, orthopedist. Furthermore, such symptoms should be alerted in the absence of problems with the gastrointestinal tract, cardiovascular system and lungs.

    There are also acute and subacute symptoms. If, with an exacerbation of osteochondrosis of the thoracic region, the patient experiences severe pain that deprives him of the ability to work and he can only observe bed rest, then the subacute course is slow and does not significantly limit the patient's motor activity.

    A clear sign of slow injury - no sharp pain. Symptoms in the subacute stage are cleared. No discomfort with basic body movements including inhaling, sneezing or turning. A person does not suffer from pain in a dream, so the process of falling asleep is made easier.

    So that the subacute course of the disease does not worsen and go into remission, important rules must be observed:

  • It is forbidden to lift weights.
  • You cannot bend over sharply.
  • It is forbidden to sit or stand for a long time. A person often unconsciously in this state assumes a posture that is harmful to the spine so that there is an excessive load on the crest, which leads to another exacerbation.
  • Avoid hypothermia. It has been proven that the non-compliance with a comfortable temperature regime for the body becomes an exacerbation of the inflammatory process. Moisture is also harmful to joints.
  • The duration of the sub-acute course is individual. If you follow the doctor's recommendations, the patient will be completely free of discomfort in 2-3 weeks. If conservative treatment and rest do not help, and the patient begins to feel nausea, dizziness, and weakness, an urgent specialist should be consulted. These symptoms indicate a flare-up.

    Degrees of development of osteochondrosis of the thoracic region

    There are 4 clinical stages of the disease, during which the patient develops signs of pathology:

  • In the initial stage, there are no clinical symptoms. The first stage occurs in the context of the appearance of destructive processes in cartilage and bone tissue. In the first stage, there is also no rupture or elongation of the fibrous ring, therefore, there are also no hernias. They can detect early protrusion and signs of cartilage degeneration.
  • The second stage presents with mild pain or discomfort. The attentive patient goes to the doctor, therefore, osteochondrosis of the thoracic region is readily detected. People who do not wish to see the specialist can still support the second stage, using the available remedies, but self-medication will not be enough for a long time. At this stage, the most common neurological symptoms may appear, including headache, burning in the interscapular area, neck pain, and increased blood pressure. Also at this stage, there is an increase in degenerative destruction in the spine: the fibrous ring protrudes, which leads to the appearance of an intervertebral hernia in the thoracic region.
  • The third step is already difficult for the patient. Persistent neurological syndromes develop, including constant, radiating pain in the shoulder blades, arms, collarbone, and lower back. The patient may have somatic and autonomic disturbances, indicating a disturbance in the functioning of the nervous system. The patient is often plagued by nausea, incessant headaches, dizziness, back pain. Disguised cardiac, gastroenterological, or pulmonary signs of the disease may also appear. At this stage, there is an active demineralization of the bone and cartilage tissue. There is a tendency for injuries.
  • The last step is the fourth. In the context of osteochondrosis and hernia, irreversible consequences arise - the mobility of the intervertebral discs is completely lost and the cartilaginous tissue at the site of a long course of inflammation is replaced by osteophytes. To remove them, an operation is required.
  • In order not to bring the body into a state similar to stage 3 or 4, it is best to see a doctor at the slightest sign. The sooner the disease is detected and therapy started, the faster the patient will return to normal and learn to live with osteochondrosis. The pathological destructive process cannot be completely stopped, but it can be slowed down by living a healthy lifestyle, using medications, and exercising daily. The later the patient sees the doctor, the more difficult it is to stop the severe pain syndrome associated with cartilage tissue degeneration.

    Risk factors and causes of disease

    There is no exact reason to cause destructive changes in the spine. An important role in the onset of the pathology is attributed to a hereditary factor. It has been proven that individuals who suffer from physical inactivity are more likely to have crest problems than those who exercise regularly. In addition, excessive physical activity can lead to cartilage destruction at an early age.

    The thinning and destruction of the intervertebral discs are closely related to spinal overload. If the muscles are not strong enough and the back is subjected to regular overload, cartilage tissue destruction occurs.

    What are the reasons that can cause osteochondrosis:

  • Obesity. When you are overweight, there is strong weight pressure on your spine. As a result, premature destruction of bone tissue occurs.
  • The presence of an abnormality in the structure of bones and cartilage. These problems are posed even during the period of intrauterine development.
  • Congenital asymmetry of intra-articular gaps in intervertebral joints of the tropism anomaly type, contributing to the occurrence of a degenerative-dystrophic process in the spine.
  • Presence of muscle spasm, spondylosis, chronically persistent trigger points and vascular disorders in the thoracic region. These pathologies also contribute to the appearance of osteochondrosis in the thoracic region.
  • Prolonged exposure to vibration in the spine in a sitting position. An example of a job is a minibus or bus driver.
  • Frequent physical exertion associated with weight lifting. Examples are work as a porter or professional sports activities.
  • Smoking and alcohol abuse. People with unhealthy lifestyles are more prone to lack of minerals in their bodies and poor circulation, causing back problems.
  • Sedentary lifestyle. With insufficient physical activity, accelerated calcium leaching occurs, which is associated with impaired metabolic processes. As a result, bones become brittle. In addition, muscle tissue atrophies, as a result of which the load on the spine is greatly increased. The result is pain, frequent discomfort with minimal physical effort.
  • Due to the intervertebral discs, sufficient mobility of the crest is provided. Intervertebral discs play a shock-absorbing role. With the development of osteochondrosis, an accelerated process of demineralization occurs, losing vital moisture from the joints. This leads to discomfort, decreased mobility in the spine.

    Risk factors for breast osteochondrosis include:

  • Advanced age. In the elderly, natural degeneration occurs, therefore, from the age of 40 onwards, the disease is detected more frequently.
  • Female. In girls, there are periods that contribute to the active release of calcium from the bones - pregnancy and menopause. Without adequate pharmacological support, spinal diseases can occur.
  • The presence of hormonal disorders, endocrine disorders. If the patient has diabetes mellitus or decompensated hypothyroidism, intervertebral disc degeneration may occur at an early age.
  • Prolonged immobilization. If the patient is sick and has to lie down for a long time, atrophic processes occur in the muscles, which causes back pain.
  • Anterior back injuries. When ligaments and tendons are stretched, the risk of osteochondrosis in the thoracic region increases.
  • The presence of scoliosis. Poor posture in the future causes serious back problems, including osteochondrosis and hernia.
  • Diagnosis of thoracic osteochondrosis

    If the patient suspects back problems, it is necessary to consult a therapist. The doctor does a general examination of the patient, asks about complaints, measures the pressure. If a neurological problem is suspected, the patient is referred to a restricted specialist - a traumatologist, neurologist or orthopedist.

    In consultation with the specialized specialist, they also ask about complaints, make an initial diagnosis of the patient. Based on a visual examination, a set of diagnostic measures is prescribed, including:

  • Radiography. With the help of an X-ray, you can assess the condition of the skeletal system in general terms. If the patient has a hernia or osteochondrosis, signs of pathology may be noticed - the distance between the intervertebral discs will be reduced and sometimes darkening is noticed at the site of the supposed hernia. If the result of the image does not please the specialist, you should continue looking for the cause of the pain and discomfort.
  • CT or MRI. The most accurate diagnostic methods that allow you to accurately examine the state of the focus of inflammation on the image. A more detailed image can be seen on MRI, but if there are contraindications (pacemaker or joint prostheses are present), CT scan is prescribed. CT is an enhanced radiograph that allows you to see the bone, tendon and ligament in detail. The image presents the image in the form of a three-dimensional image so that the details of the damage are clearly visible.
  • Biochemical and general blood test. These analyzes are necessary to assess the patient's health. If an increase in white blood cells, ESR is found, this indicates an active inflammatory process in the body. With the active destruction of bone tissue, reduced levels of calcium and a deficiency of cholecalciferol (vitamin D3) are found in the blood.
  • Scintigraphy of the spine. The research method reveals active destruction of bone tissue. Weak bone tissue is highly susceptible to fragility. The method will reveal the trend and signs of degeneration.
  • To diagnose the condition, you need to consult an experienced specialist. For the final diagnosis, a complete clinical picture is necessary, taking into account several methods of laboratory research.

    Thoracic osteochondrosis of the spine requires differentiation along with the following pathologies:

  • Dishormonal spondylopathy.
  • Pathologies of the urinary system, including urolithiasis, cystitis or pyelonephritis.
  • Diseases of the cardiovascular system, excluding sinus arrhythmia, tachycardia and angina pectoris.
  • Gastrointestinal tract diseases including chronic pancreatitis, stomach and duodenal ulcers, irritable bowel syndrome.
  • Previous injuries, fractures.
  • Chest tumors, including a malignant course.
  • Rheumatoid arthritis (determined by a blood test for C-reactive protein, rheumatic test, and ESR).
  • Osteomyelitis of the spine.
  • Acute inflammatory process.
  • Ankylosing spondylitis.
  • Spondylolisthesis.
  • Treatment of osteochondrosis of the thoracic spine

    To slow the progression of the disease, an integrated approach to therapy is needed. In the initial stages, only conservative therapy is shown, which consists of the use of medications and physical therapy treatment methods. In advanced cases, when the patient has large hernias and a pronounced degree of bone degeneration, an operation is prescribed. Do not self-medicate at home. Folk remedies do not eliminate osteochondrosis from the thoracic spine.

    In which cases is surgery performed?

    Osteochondrosis released from the thoracic region negatively affects the patient's quality of life. If the patient has constant discomfort that interferes with their normal life, taking into account the lack of effect of the drug treatment, then a surgical solution for the problem can be offered.

    Absolute indications for surgery include:

  • Lack of sensitivity in the bladder and intestines.
  • If the sensation in the legs disappears and the patient loses the ability to move independently.
  • Paralysis due to strong hernia overgrowth.
  • In other cases, the patient makes the decision to remove the hernia formation independently. If the disease really brings a lot of anguish and the patient's condition does not improve in the context of conservative treatment, doctors recommend surgery.

    Drug treatment for osteochondrosis of the thoracic spine

    During the period of exacerbation, the attending physician prescribes various medications necessary for use in order to alleviate the inflammatory process. The acute period is characterized by intense pain that can only be relieved with medication. If enough medication is taken, the patient improves. Only an experienced specialist can prescribe medication; self-medication is unacceptable.

    Osteochondrosis of the thoracic spine is treated with the following medications:

  • Non-steroidal anti-inflammatory drugs, analgesics or analgesics. These medications are designed to quickly relieve back pain associated with an active inflammatory process. The effect of taking pills or injections is felt the next day. Intake of any medication from the NSAID group is accompanied by side effects with prolonged use, therefore experts recommend limiting the use of medications to a minimum period, no longer than 1-2 weeks. Analgesics are more harmful to the gastric mucosa, causing gastropathy and inflammation. Patients at risk receive certain medications designed to protect the gastrointestinal mucosa. Examples are proton pump inhibitors, histamine H2 receptor blockers, antacids. People with ulcers and gastritis should avoid the use of NSAIDs or take modern analogues with selective effect.
  • Muscle relaxants. These medications are very effective in treating muscle spasticity. Relieves pain associated with muscle tension. They act on trigger points located in compressed muscle tissue. The more a person tries, the greater their number. Muscle relaxants remove tension in the muscles well and therefore exhibit an analgesic effect. You need to take medications on a course, the average duration of therapy is at least 2 to 4 weeks.
  • B group vitamins. Assign B1, B6, B12 in the form of injections with a combined composition. In large doses, these substances have an analgesic effect and a positive effect on the nervous system. Neurotrophic drugs are effective in treating pain associated with pinched nerve roots. With the help of nutrition, it is impossible to restore the standard of these substances necessary to obtain a therapeutic effect, as they are prescribed in the form of medication. The average duration of an injection course is 2-3 weeks. Then, if necessary, they switch to tablets.
  • Anti-inflammatory ointments, gels. If the pain is tolerable and systemic forms of NSAIDs are contraindicated, external medications will be prescribed. The advantage of external medicines is that they don't cause side effects. In rare cases, skin allergies can occur, but the ointment does not cause gastrointestinal or blood deterioration in the laboratory. Another advantage of outdoor products is the possibility of long-term use. You can rub the gels for up to 4 weeks, after which they take a break. The schedule and duration of therapy are determined by the treating physician.
  • Honorable protectors. These are complex substances used to nourish the cartilage tissue in the joints. The use of medications is required for a long course, at least six months, after which they take a break of 2-3 months and the course of therapy is repeated. Within 2-3 months, injectable delivery forms are used as they are better absorbed. Then they switch to supportive care, including the use of pills. It is important to understand that medication does not prevent cartilage tissue from being destroyed. They just create additional nutrition, which slows down the degenerative processes that take place in bones and joints.
  • Complex preparations of calcium and vitamin D3. It has been proven that residents of northern latitudes do not receive enough vitamin D3 because solar activity is low year-round in this region. To get rid of hypovitaminosis, it is necessary to take cholecalciferol supplements in winter and fall courses while solar activity is minimal. Without this vitamin, assimilation of calcium and other minerals is impossible. Due to a long-term calcium deficiency, the thinning of the bone tissue occurs over time, so that the person suffers from osteochondrosis and other complications. Calcium and D3 are better absorbed in combination, so complex preparations are prescribed. The dose and method of administration must be prescribed by the treating physician.
  • As an adjunct to treatment, homeopathy, antispasmodics and complex multivitamins may be prescribed.

    Conservative therapy for breast osteochondrosis

    During the recovery period, the patient must pay sufficient attention to rehabilitation. The more careful the patient maintains health, the less frequent attacks of illness will occur.

    The most effective conservative treatments include:

  • Exercise therapy. With the help of exercises, the patient learns to keep his back straight, strengthens the muscular corset. Physical therapy can be done at any age, several times a week. The complex is selected individually, taking into account the anatomical characteristics of the patient. Start running gradually, initially spending no more than 5 minutes a day. As the physical qualities improve, the patient learns to do more difficult exercises for a longer period of time.
  • Support corset. Anatomical devices serve to support weakened muscles, if there are contraindications to their strengthening. The patient chooses the dressing depending on the height and type of consultation. The attending physician must select the appropriate model. Duration and usage pattern are individually assigned. You cannot wear a corset all the time, otherwise your back muscles will be even weaker.
  • Massage. In medical practice, massage is one of the most popular and at the same time effective methods of conservative treatment in the presence of osteochondrosis of the thoracic region in a patient. During the recovery period, muscles need additional support. It is helpful when blood flow temporarily improves and overstretched muscles are released using correct technique. You need to attend specialized sessions several times a year on courses.
  • Physiotherapy. Physiotherapy procedures are very widespread in trauma, orthopedic and neurological practice. With the help of procedures, local blood flow is improved, systemic drugs are used externally, and the device acts on damaged tissues. As a result, the muscles are warmed up and the chronic inflammatory process is eliminated in the affected area. Examples of medical procedures - magnetotherapy, shock wave therapy, electrophoresis.
  • Less commonly, manual therapy and acupuncture are prescribed.

    Osteochondrosis of the thoracic region is a serious disease if started. To prevent the disease from progressing acutely, it is necessary to treat the condition comprehensively.