Diagnosis and treatment of osteochondrosis of the thoracic spine.

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

What is thoracic osteochondrosis and how does it arise?

Osteochondrosis of the thoracic region is characterized by the appearance of destructive dystrophic processes in the mid-section of the ridge. The destruction is located between the eighth and nineteenth vertebrae. To know which vertebra is affected, it is necessary to carry out precise diagnostic studies. Osteochondrosis of the thoracic region is often accompanied by formidable complications, such as prolapse or hernia. Without complications, the disease is rare, since the destruction of cartilage tissue inevitably leads to the destruction of the entire vertebral framework.

When a patient develops an age-related circulatory disorder or joint wear and tear, the annulus fibrosus located in the cavity of the intervertebral disc begins to collapse, losing its normal structure. Since the destruction is slow, microcracks appear in the initial stages, through which the nucleus pulposus is filtered.

As the internal component leaks out, the annulus fibrosus begins to weaken, leading to gradual stretching and rupture. When the nucleus pulposus protrudes, an intervertebral hernia occurs, which is the most common complication of osteochondrosis. The pathology involves damage to the cartilage tissue, causing 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 stage, the patient does not feel discomfort, therefore, at this stage, the disease can only be detected by chance. The disease has many symptoms that can be disguised as other pathologies.

Symptoms of thoracic osteochondrosis can be felt by the following manifestations:

1. 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.
2. The main symptom is pain in the chest area. There is also a feeling of pressure in the heart, quite reminiscent of an ischemic attack.
3. Discomfort occurs when the back bends. As the disease progresses, pain increases in this position.
4. Against the background of impaired blood circulation, there is a feeling of coldness in the lower or upper extremities.
5. Chest pain in the context of emerging intervertebral hernias. The discomfort is often felt most strongly on the left or right side of the affected area.
6. Throat discomfort and difficulty swallowing. If there is irritation of the nerve endings in the upper part of the thoracic region, a cough appears.
7. Women may experience chest pains that are not related to cyclical changes or hormonal imbalances.
8. A tingling or burning sensation appears in the area of the legs and feet.
9. Hair and nails become brittle and dull.
10. Shingles occurs less often.
11. Pain in the back and chest occurs at the same time.
12. Less often, there is discomfort in the stomach, liver, or pancreas.
13. The appearance of stiff pain in the ribs, indicating intercostal neuralgia.
14. There are signs of chondrosis and compression of the chest, a similar pathology.
15. There are problems in the work of the gastrointestinal tract. You feel nauseous, heaviness in your stomach.
16. In men, it can lower libido a bit. Problems arise in the genitourinary sphere.
17. When standing or sitting for a long time, great discomfort occurs.
18. There is a severe headache accompanied by dizziness. Migraines with aura may appear.
19. The patient often develops intercostal neuralgia.
20. The pain can radiate to the neck or lower back.

If you find in the aggregate thoracic osteochondrosis and its signs or some of them, it is necessary to urgently consult a therapist, neurologist, orthopedist. Also, these symptoms should be alerted in the absence of problems with the gastrointestinal tract, the cardiovascular system, and the 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 the patient of the ability to work and can only observe bed rest, then the subacute course is slow and does not significantly limit motor activity of the patient.

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

In order for the subacute course of the disease not to worsen and go into remission, important rules must be observed:

1. Lifting weights is prohibited.
2. You cannot lean sharply.
3. It is forbidden to sit or stand for a long time. A person often unconsciously in this state assumes a posture that is detrimental to the spine, so there is an excessive load on the ridge, leading to another exacerbation.
4. Avoid hypothermia. It has been shown that non-compliance with a comfortable temperature regime for the body turns into an exacerbation of the inflammatory process. Moisture is also bad for the joints.

The duration of the subacute course is individual. If you follow the medical recommendations, the patient will be completely free of the discomfort in 2-3 weeks. If conservative treatment and rest do not help, and the patient begins to suffer from nausea, dizziness and weakness, it is urgent to consult a specialist. Such symptoms indicate an exacerbation.

Degrees of development of osteochondrosis of the thoracic region.

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

1. In the initial stage, there are no clinical symptoms. The first stage occurs against the background of the appearance of destructive processes in cartilage and bone tissue. In the first stage, there is also no rupture or stretching of the fibrous ring, so there are no hernias either. They can detect early bumps and signs of cartilage degeneration.
2. The second stage presents with mild pain or discomfort. An attentive patient looks for a doctor, therefore, osteochondrosis of the thoracic region is quickly detected. People who do not want to visit a specialist can still endure the second stage, using 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 sudden increases in 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 of the thoracic region.
3. The third stage is already difficult for the patient. Persistent neurological syndromes develop, including constant radiating pain in the shoulder blades, arms, clavicle, and lower back. The patient may present somatic and autonomic disorders, indicating an alteration in the functioning of the nervous system. The patient is often tormented by nausea, incessant headaches, dizziness, backaches. Cardiac, gastroenterological, or pulmonary signs may also appear disguised as the disease. At this stage, there is an active demineralization of bone and cartilage tissue. There is a tendency to injure oneself.
4. The last stage is the fourth. Against the background of osteochondrosis and hernia, irreversible consequences arise: the mobility of the intervertebral discs is completely lost, and cartilage tissue instead of a prolonged course of inflammation is replaced by osteophytes. To remove them, an operation is required.

In order not to bring the body to a state similar to stage 3 or 4, it is better to visit a doctor at the slightest sign. The earlier the disease is detected and therapy is started, the faster the patient will return to normal and learn to live with osteochondrosis. The destructive pathological process cannot be completely stopped, but it can be slowed down by leading a healthy lifestyle, using medication and performing daily gymnastics. The later the patient goes to the doctor, the more difficult it is to stop the severe pain syndrome associated with the degeneration of cartilage tissue.

Risk factors and causes of the disease.

There is no exact reason that causes destructive changes in the spine. An important role in the appearance of pathology is attributed to a hereditary factor. It has been proven that people who suffer from physical inactivity are more likely to have problems with the ridge than those who exercise regularly. Also, excessive physical activity can lead to cartilage destruction at a young 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, the destruction of cartilage tissue occurs.

What reasons can cause osteochondrosis:

1. Obesity. When you are overweight, there is a strong pressure of weight on the spine. As a result, premature destruction of bone tissue occurs.
2. The presence of an abnormality in the structure of bones and cartilage. Such problems arise even during the period of intrauterine development.
3. Congenital asymmetry of the intra-articular spaces in the intervertebral joints of the type of tropism anomaly, which contributes to the appearance of a degenerative-dystrophic process in the spine.
4. The 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 of the thoracic region.
5. Prolonged exposure to vibrations in the spine in a sitting position. An example of work is a minibus or bus driver.
6. Frequent physical exertion associated with lifting heavy objects. Some examples are work as a loader or professional sports activities.
7. Smoking and alcohol abuse. People with unhealthy lifestyles are more likely to have a lack of minerals in their bodies and poor circulation, leading to back problems.
8. Sedentary lifestyle. With insufficient physical activity, accelerated calcium leaching occurs, which is associated with poor metabolic processes. As a result, the bones become brittle. In addition, the muscle tissue atrophies, which is why the load on the spine increases considerably. The result is pain, frequent discomfort with minimal physical exertion.

Due to the intervertebral discs, sufficient ridge mobility is provided. The intervertebral discs play a cushioning role. With the development of osteochondrosis, an accelerated process of demineralization occurs, vital moisture from the joints is lost. This leads to discomfort, decreased mobility in the spine.

Risk factors for breast osteochondrosis include:

1. Advanced age. In older people, a natural degeneration occurs, therefore, after the age of 40, the disease is detected more often.
2. Woman. In girls, there are periods that contribute to the active leaching of calcium from the bones: pregnancy and menopause. Without adequate pharmacological support, diseases of the spine are likely to occur.
3. The presence of hormonal disorders, endocrinological diseases. If the patient has diabetes mellitus or uncompensated hypothyroidism, degeneration of the intervertebral disc can occur at a young age.
4. 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.
5. Previous back injuries. When ligaments and tendons are stretched, the risk of osteochondrosis in the thoracic region increases.
6. The presence of scoliosis. Poor posture in the future will lead to serious spinal problems, such as osteochondrosis and hernia.

Diagnosis of thoracic osteochondrosis

If the patient suspects back problems, it is necessary to consult a therapist. The doctor conducts a general examination of the patient, asks about complaints, measures blood pressure. If there is a suspicion of a neurological problem, the patient is referred to a limited specialist: a traumatologist, neurologist or orthopedist.

At the appointment with a specialized specialist, they also ask about complaints, make an initial diagnosis of the patient. On the basis of a visual examination, a set of diagnostic measures is prescribed, including:

1. Bone scan. With the help of an X-ray, you can assess the state of the skeletal system in general terms. If the patient has a hernia or osteochondrosis, signs of pathology can be noted: the distance between the intervertebral discs will be reduced, and sometimes a darkening is noted at the site of the suspected hernia. If the results of the image do not suit the specialist, keep looking for the cause of pain and discomfort.
2. CT scan 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 (the presence of a pacemaker or prosthesis in the joints), a CT scan is prescribed. CT is an enhanced X-ray that allows you to see the bone, tendon, and ligament in detail. The image displays the image in the form of a three-dimensional image, so the details of the damage are clearly visible.
3. Biochemical and general blood test. These tests are necessary to assess the health of the patient. If an increase in leukocytes, 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.
4. Spine scan. The research method reveals the active destruction of bone tissue. Weak bone tissue is very susceptible to brittleness. The method will reveal the trend and signs of degeneration.

To diagnose the disease, you need to go to an experienced specialist. For the final diagnosis, a complete clinical picture is needed, taking into account various laboratory research methods.

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

1. Dyshormonal spondylopathy.
2. Pathologies of the urinary system, including urolithiasis, cystitis or pyelonephritis.
3. Diseases of the cardiovascular system, except sinus arrhythmia, tachycardia and angina pectoris.
4. Diseases of the gastrointestinal tract, including chronic pancreatitis, stomach and duodenal ulcers, irritable bowel syndrome.
5. Previous injuries, fractures.
6. Tumors in the chest, even of a malignant course.
7. Rheumatoid arthritis (determined by a C-reactive protein blood test, rheumatic test, and ESR).
8. Osteomyelitis of the spine.
9. Acute inflammatory process.
10. Ankylosing spondyloarthritis.
11. 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 drugs and physiotherapy treatment methods. In advanced cases, when the patient has large hernias and a pronounced degree of bone degeneration, an operation is prescribed. Don't self-medicate at home. Folk remedies do not eliminate osteochondrosis of the thoracic spine.

In which cases is surgery performed?

The initiated osteochondrosis of the thoracic region adversely affects the quality of life of the patient. If the patient has constant discomfort that interferes with normal life, taking into account the lack of effect of drug treatment, a surgical solution to the problem can be offered.

The absolute indications for surgery include:

1. Lack of sensation in the bladder and intestines.
2. If the sensitivity in the legs disappears and the patient loses the ability to move independently.
3. Paralysis due to strong overgrowth of the hernia.

In other cases, the patient makes the decision to independently eliminate the formation of hernias. If the disease really brings severe distress and the patient's condition does not improve against the background of conservative treatment, doctors recommend surgery.

Pharmacological treatment of osteochondrosis of the thoracic spine.

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

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

1. Non-steroidal anti-inflammatory drugs, pain relievers, or pain relievers. 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. Taking any drug from the group of NSAIDs is accompanied by side effects with prolonged use, therefore, experts recommend limiting the use of drugs to the minimum period, no more than 1-2 weeks. Pain relievers are more damaging to the gastric mucosa, causing gastropathy and inflammation. Patients at risk receive certain medications designed to protect the gastrointestinal mucosa. Some examples are proton pump inhibitors, histamine H2 receptor blockers, antacids. People with ulcers and gastritis are better off avoiding the use of NSAIDs or taking modern analogues with a selective effect.
2. Muscle relaxants. These drugs are very effective in treating muscle spasticity. Relieve pain associated with muscle tension. They act on the trigger points located in the pinched muscle tissue. The more a person overexerts himself, the greater their number. Muscle relaxants remove tension in muscles well and therefore exhibit an analgesic effect. You need to take drugs in a course, the average duration of therapy is at least 2-4 weeks.
3. Vitamins of group B. Assign B1, B6, B12 in the form of injections with a combined composition. In large doses, these substances have an analgesic effect and have 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 replenish the norm of these substances necessary to achieve a therapeutic effect, therefore, they are prescribed in the form of drugs. The average duration of a cycle of injections is 2-3 weeks. Then, if necessary, they switch to tablets.
4. Anti-inflammatory ointments, gels. If the pain is tolerable and systemic forms of NSAIDs are contraindicated, external drugs are prescribed. The advantage of external remedies is that they do not cause side effects. In rare cases, skin allergies may appear, but the ointment will not cause gastrointestinal or laboratory blood deterioration. 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 scheme and duration of therapy are determined by the attending physician.
5. Honor protectors. These are complex substances that are used to nourish the cartilage tissue of the joints. It is necessary to use drugs for a long course - at least six months, after which a 2-3 month break is taken and the course of therapy is repeated. Within 2-3 months, injectable release forms are used, as they are better absorbed. They then switch to supportive treatment, including the use of tablets. It is important to understand that medication does not stop the destruction of cartilage tissue. They only create additional nutrition, which slows down the degenerative processes that occur in the bones and joints.
6. Complex preparations of calcium and vitamin D3. It has been found that the inhabitants of the northern latitudes do not get enough vitamin D3, because the solar activity is low throughout the year in this region. To get rid of hypovitaminosis, it is necessary to take cholecalciferol supplements in winter and autumn in courses while solar activity is minimal. Without this vitamin, the assimilation of calcium and other minerals is impossible. Due to prolonged calcium deficiency, bone tissue thinning occurs over time, causing a person to suffer from osteochondrosis and other complications. Calcium and D3 are better absorbed in combination, so complex preparations are prescribed. The dose and the course of administration should be prescribed by the attending physician.

As an adjunct to treatment, homeopathy, antispasmodics, and complex multivitamins can be prescribed.

Conservative therapy for breast osteochondrosis.

During the recovery period, the patient should pay sufficient attention to rehabilitation. The more carefully the patient maintains health, the less frequent the attacks of the disease will be.

The most effective conservative treatments include:

1. Exercise therapy. With the help of exercises, the patient learns to keep the 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 features of the patient. Begin the performance gradually, at first spending no more than 5 minutes a day. As physical qualities improve, the patient learns to do more difficult exercises for a longer period of time.
2. Supportive corset. Anatomical devices serve to support weakened muscles, if there are contraindications to their strengthening. The patient chooses a bandage based on the height and type of appointment. The treating physician must select the appropriate model. The duration and pattern of use are assigned individually. You cannot wear a corset 24 hours a day, otherwise your back muscles will weaken even more.
3. 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, the muscles need additional support. It is useful when blood flow is temporarily improved and overstretched muscles are loosened using the correct technique. You must attend specialist sessions several times a year in the courses.
4. Physiotherapy. Physiotherapy procedures are widespread in trauma, orthopedic and neurological practice. With the help of procedures, local blood flow is improved, systemic drugs are used externally, and the apparatus acts on damaged tissues. As a result, the muscles heat up and the chronic inflammatory process is eliminated in the affected area. Examples of medical procedures: magnet therapy, shock wave therapy, electrophoresis.

Less often, manual therapy and acupuncture are prescribed.

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