Thoracic osteochondrosis is a chronic disease of the spine in which degenerative-dystrophic changes occur in the intervertebral discs.
The thoracic spine is less frequently affected by osteochondrosis compared to the cervical and lumbar spine. This is explained by the fact that it is relatively inactive, stable and well reinforced by a muscular corset. Even more rare are its complications - protrusion and herniated disc.
However, this disease presents with extensive symptoms that significantly reduce the quality of life and therefore requires treatment. The use of drugs only suppresses the symptoms and provides a temporary effect that does not affect the development of the disease.
To reliably eliminate the symptoms, you need to affect the cause of the development of degenerative processes in the discs. For this purpose, the clinic uses complex treatment, which gives positive results in more than 90% of cases. It includes methods of oriental reflexology and physiotherapy - acupuncture, acupuncture, moxibustion and other therapeutic procedures.
Symptoms, signs
With osteochondrosis, flattening of the intervertebral discs occurs and the vertebrae fuse together, which leads to pinching of the spinal nerve roots. This causes pain between the shoulder blades (commonly described as a sticking peg).
The pain syndrome in thoracic osteochondrosis can be acute, severe or chronic, moderate.
In the first case, the sharp pain appears suddenly and is called dorsago. In the second case the pain is constantly felt, has a painful character and is called dorsal.
Irritation from a pinched root spreads along the nerve, radiates to the chest and becomes the cause of intercostal neuralgia - a stabbing, cutting or burning pain in the chest, which intensifies with inhalation, movement, coughing, sneezing, laughing.
Another characteristic symptom of thoracic osteochondrosis is pain in the heart area, which is accompanied by signs of cardioneurosis - palpitations, palpitations, increased heart rate.
A pinched nerve root results in nerve damage, numbness, arm weakness, coldness in the hand, cyanosis (blue discoloration) or skin whitening. These symptoms are usually unilateral.
Pain with osteochondrosis may also radiate to the shoulder, below the shoulder blade, and to the forearm.
Other symptoms of the disease are stiffness, tension in the back, numbness in the paraspinal area, in the shoulders, in the cervical-collar area, difficulty breathing, feeling of a lump in the chest.
Nerves originating from the spinal cord in the thoracic region play an important role in the innervation of the entire body. Therefore, symptoms of osteochondrosis may appear in areas seemingly unrelated to the spine. For this reason, it is called "chameleon disease".
These symptoms include:
- heartburn, bloating,
- loss of appetite, nausea,
- dyspepsia (dyspepsia),
- cough,
- frozen feet,
- body numbness,
- right hypochondrium pain,
- abdominal discomfort,
- sweating
In addition, thoracic osteochondrosis is manifested by impaired blood supply to the brain - headaches, pressure instability, dizziness, gait instability and loss of coordination.
Reasons for development, stages
The main role in the development of the disease is played by muscle spasms and tension (hypertonicity) of the back muscles. These spasms occur during a sedentary lifestyle, poor posture or prolonged stay in a static, uncomfortable position (for example, at an office or while driving).
On the other hand, monotonous, hard physical work also causes the appearance of persistent muscle spasms of the back (for example, work with raised arms).
Muscle spasms block circulation and block blood flow to the spine. Because of this, the nutrition of the intervertebral discs deteriorates.
Intervertebral discs are shock-absorbing cushions of connective tissue located between the vertebrae. In the center of each disc is a pulpy, semi-fluid core that contains a lot of moisture. Water provides resistance to loads and resistance to compression.
Along the outer perimeter each disc is reinforced with a rigid fibrous ring. The connective tissues of the discs are mainly composed of collagen - this substance is synthesized in the body and must be constantly supplied to the joints, intervertebral discs and other connective, cartilaginous tissues for their continuous regeneration.
Muscle spasms interfere with blood flow, resulting in not enough collagen reaching the discs for normal tissue repair. The lack of oxygen leads to a slowdown in metabolic processes.
As a result of metabolic disorders, tissue renewal of the intervertebral discs slows down and their deterioration accelerates. This leads to dystrophy and degenerative changes - the discs become dehydrated, cracked, dry, flattened and lose their shock-absorbing properties and elasticity.
Back muscle spasms are the main cause of excessive pressure on the spine in the thoracic region. If in the cervical region the intervertebral discs are pressed by the weight of the head, which increases with incorrect posture, and the lumbar region is pressed by the body weight, which increases with excess weight, then in the thoracic region muscle spasms play an excellent role in the developmentdisease. These spasms not only impede blood flow, but also tighten the spine and compress the intervertebral discs both day and night. Intervertebral discs are practically deprived of the opportunity not only for cellular renewal, but also for simple rest and recovery. Therefore, the first thing a doctor should do when treating thoracic osteochondrosis is to relax the strained back muscles, eliminate muscle spasms and hypertonia. Without it, effective treatment of the disease is impossible.
The flattening of the intervertebral discs causes the spaces between the vertebrae to become smaller, the vertebrae to come closer together and pinch the nerve roots. This causes pain, which causes reflex muscle spasm and further increases the pressure on the discs. Therefore, with the appearance of pain, the development of the disease, as a rule, accelerates.
These degenerative-dystrophic changes correspond to the first stage of osteochondrosis.
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In old age, thoracic osteochondrosis usually develops against the background of general dehydration and metabolic disorders in the body. This is manifested, in particular, by a decrease in height in older people, which occurs due to thinning of the intervertebral discs.
In the second stage, the outer annulus fibrosus becomes fiberless. Its tissue relaxes, weakens and cannot cope with maintaining the internal load. As a result, a protrusion of the disc (usually local) appears in the form of a protrusion.
A projection that goes towards the spinal cord is called dorsal. Projections directed to the side are called laterals. The rarest case is the uniform protrusion of the disc around the entire perimeter.
The appearance of a protrusion usually leads to increased pain. An X-ray image clearly shows a decrease in the height of the space between the vertebrae, as well as the development of osteophytes - bone waste. They form along the ends of the vertebrae to offset the loads on the spine as the intervertebral discs deal with them less and less.
In the third stage of the disease, the annulus fibrosus of the disc cannot withstand the internal pressure and ruptures. Through the resulting gap, part of the pulpy core of the disc is squeezed out - an intervertebral hernia appears.
In the fourth stage of the disease, the range of motion in the back decreases sharply, the pain syndrome becomes stable, and an extensive picture of neurological disorders develops.
Diagnostics
At the initial appointment, the doctor asks the patient about the symptoms, the circumstances of their occurrence, studies the medical history, conducts an external examination, paying attention to the body posture, the presence or absence of spinal deformities (scoliosis, kyphosis).
The cause of the pain syndrome (back, back) can be both osteochondrosis and vertebral displacement (spondylolisthesis), ankylosing spondylarthropathy, ankylosing spondyloarthropathy.
Osteochondrosis of the thoracic region is usually accompanied by muscle tension in the back and hypertonicity of the spinal muscles. The doctor palpates and uses successive pressures to find pain (trigger) points that correspond to muscle spasm centers.
To get more detailed information, the doctor prescribes an X-ray or MRI.
X-rays for thoracic osteochondrosis provide the most general information - it helps to differentiate the disease from spondylolisthesis, the appearance of osteophytes and narrowing of the spaces between the vertebrae.
MRI shows soft, connective tissue better. With its help, the doctor can examine in detail the structure of the intervertebral discs, see the protrusion, herniation (size, location, shape), as well as the condition of the ligaments, intervertebral joints, blood vessels, nerve rootsand see spinal cord stenosis (or the risk of it).
Based on the MRI data, the doctor makes a diagnosis and determines an individual treatment plan.
Treatment of osteochondrosis of the thoracic region
Pharmaceutical treatments
To relieve back pain and intercostal neuralgia in thoracic osteochondrosis, non-steroidal anti-inflammatory drugs in the form of ointments, tablets or injections can be used. The main effect of these drugs is anti-inflammatory, so their use is justified in cases where a pinched nerve root is accompanied by its inflammation, that is, with thoracic radiculitis. NSAIDs also reduce muscle tissue inflammation in the context of spasms and persistent hypertension.
In case of acute pain syndrome, a paraspinal or epidural block can be used - an injection of an analgesic. In the first case, the injection is made at the point where the nerve root is pressed, in the second case, in the area between the periosteum of the vertebra and the membrane of the spinal cord.
To relieve muscle tension and reduce pressure on nerve roots, blood vessels and intervertebral discs, muscle relaxants and antispasmodics are used.
Vitamin complexes are prescribed to nourish nerve tissues and prevent their atrophy.
To slow down the process of destruction of connective tissues, chondroprotectors can be prescribed.
These drugs have a symptomatic effect and can somewhat slow down the development of the disease, but in general they have almost no effect on the process of degenerative changes in the intervertebral discs.
Non-pharmacological treatment
The non-pharmacological treatment of thoracic osteochondrosis includes methods of physiotherapy, reflexology and physical therapy.
The main goals of treatment are to relieve the inflammatory process, improve blood circulation and restore metabolic processes in the spinal discs, stimulate cell renewal of connective tissues. The clinic uses complex treatment with oriental medicine methods for this purpose.
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Physiotherapy exercises help shape and strengthen the muscle corset, eliminate unreasonable loads on the spine and serve as a prevention of congestion and the formation of muscle spasms.
Surgery
For large hernias, especially dorsal, with a risk of spinal cord stenosis, and especially if present, surgery may be indicated - discectomy.
A part of the disc is removed or the entire disc is removed and replaced with a prosthesis. Although discectomy is a common type of surgery, operations on the thoracic region are extremely rare.
Treatment at the clinic
Treatment of thoracic osteochondrosis in the clinic is carried out in complex sessions, which include various procedures - acupuncture, acupuncture, moxibustion, stone therapy, vacuum therapy, irudotherapy for individual indications.
High performance is achieved due to the synergy of individual methods and the elimination of the cause of the disease.
- Acupuncture. By pressing strongly on the trigger points of the back, the doctor eliminates muscle spasms, tension, congestion, improves blood circulation and restores unobstructed blood flow to the spine. Thanks to this, the load on the intervertebral discs is reduced and the processes of tissue metabolism and regeneration are accelerated as the inflow of oxygen and collagen increases.
- Acupuncture. The introduction of needles into bioactive points of the back, legs, arms, head, chest eliminates the symptoms associated with a disorder of innervation - numbness, weakness in the hand. With the help of this procedure, intercostal neuralgia and other spinal pains are relieved. In addition, acupuncture enhances the effect of acupuncture and has anti-inflammatory and anti-edematous effects.
- Moxibustion treatment. Heating the bioactive points in the spine area is done with a smoldering wormwood cigar. This process activates metabolic processes, increases blood flow to the intervertebral discs, stimulates and accelerates their recovery.
- Vacuum therapy. Cupping massage and cupping create blood flow and help improve blood circulation.
- Manual therapy. Using gentle traction on the spine, the doctor unloads the intervertebral discs, increases the distance between the vertebrae, releases compressed nerve roots, relieves pain and increases the range of motion in the back.
Gentle traction, or traction, is the only manual therapy technique indicated for thoracic osteochondrosis. Before starting, the doctor must thoroughly relax the back muscles, eliminate spasms and release the spine. To do this, the muscles are well warmed up and relaxed through massage. If this is not done, the application of physical effort can lead to injury - tear, sprain or fracture. Material methods of traction of the spine for osteochondrosis are ineffective and even dangerous, so they are not used in the clinic.
Hirudotherapy
Applying medicinal leeches improves local blood circulation, blood supply to the intervertebral discs and has an anti-inflammatory effect.
Stone therapy
Smooth stones heated to a certain temperature are placed along the spine to deeply warm and relax the spinal muscles, improve blood circulation and stimulate blood flow.
The duration of a treatment session in the clinic is 1–1. 5 hours, depending on the individual indications. The course of treatment usually includes 10-15 complex sessions. After completion, a control MRI is performed to evaluate the achieved treatment results.
Complications
The main complication of thoracic osteochondrosis is spinal cord stenosis due to disc herniation with development of physical paralysis.
Other possible complications are related to disruption of the innervation of the body due to pinching of the spinal nerve roots: the development of diseases of the gastrointestinal tract, kidneys, heart and reproductive system.
Prevention
To prevent the development of thoracic osteochondrosis, you should avoid a sedentary lifestyle and monitor your posture.
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If a child or teenager has scoliosis, it is best to treat this condition without hoping that it will go away on its own. Lateral curvature of the spine occurs as growing pains, but can last a lifetime.
In this case, persistent muscle tension and spasms will be inevitable, which in turn will lead to the development of osteochondrosis and, possibly, its complications. And this is in addition to the fact that scoliosis itself is fraught with complications from the respiratory, digestive and cardiovascular systems.