Osteochondrosis of the thoracic spine refers to degenerative-dystrophic pathology. Ridge problems occupy the 5th place in the structure of all diseases of the musculoskeletal system. They are more common in people over the age of 45. Timely diagnosis and initiation of treatment make it possible to slow the progression of the disease.
Development mechanism
Degenerative-dystrophic pathology, which includes osteochondrosis, is characterized by the presence of several main links in the pathological process, they include:
- Malnutrition (trophism) of cartilage tissue, which occurs against the background of excessive stress or exposure to other provoking factors, is called dystrophy.
- The gradual destruction of cells and intercellular substance of cartilage tissue, which occurs as a result of malnutrition.
- The development of an inflammatory reaction, the severity of which depends on the degree of damage to the structures of cartilage tissue.
- Disorder of the functional state of the joint or the structure of the spine (intervertebral discs), which contains cartilage tissue.
Osteochondrosis involves damage to the intervertebral discs and ridge joints in various parts. The discs between the vertebrae are flattened, which leads to compression of the motor and sensory nerve fibers of the spinal roots. The mechanism of disease development is always accompanied by the addition of neurological symptoms.
Causes of the disease
Osteochondrosis of the thoracic spine is a polyetiological disease. This means that the process of dystrophy and degeneration of cartilage tissue is triggered due to the influence of a large number of provoking factors:
- Hereditary predisposition, which determines the nutritional characteristics of cartilage tissue with subsequent disorders against the background of normal loads. In this case, osteochondrosis can develop in young people.
- Congenital malformations and abnormalities in the development of the structures of the musculoskeletal system, leading to changes in blood flow to tissues and deterioration of the nutrition of cartilage components.
- Delayed injuries of different parts of the ridge (fractures, bruises, dislocations and subluxations of the joints), which lead to a change in the ratio of different structures with subsequent development of degenerative-dystrophic processes in them.
- Insufficient physical activity (sedentary lifestyle), which leads to congestion in the tissues.
- Systematically increased chest load (heavy physical work, prolonged static loads).
- Disruption of the metabolism of mineral salts in the body, which provokes a decrease in the strength of bone processes, intervertebral discs and subsequent malnutrition of cartilage structures.
- Deterioration of the blood supply to the spine, occurring against the background of compression of the main arteries or veins.
- Bad habits - nicotine and alcohol are vascular toxins that cause impaired blood flow to tissues and disruption of their nutrition.
Discovering the reasons for the development of the pathological process is an essential component of the diagnostic process. This is necessary for the subsequent appointment of effective treatment, as well as to prevent the recurrence of osteochondrosis.
Symptoms of osteochondrosis of the thoracic spine
The development of the degenerative-dystrophic process is accompanied by the appearance and subsequent increase in the intensity of the following symptoms of osteochondrosis:
- Pain in the spine at the level of the chest - at first the pain appears after exercise, a long stay of the human body in one position. Then the feelings of discomfort intensify and become permanent. Often the pathological process is accompanied by dull pain in the back between the shoulder blades.
- Unpleasant feeling of "squeezing" in the back, which does not allow you to inhale completely.
- Impaired skin sensitivity in the form of tingling in various parts of the body (changes cover the skin of the upper or lower limbs on one side of the body) due to compression of the sensitive nerve fibers of the spinal cord roots.
- Muscle weakness in the arm or leg is usually on one side of the body.
- Disorder of the functional state of the digestive system, which is accompanied by belching, heartburn, abdominal pain, flatulence (bloating), unstable stools.
- Changes in the back and hands, which include dry skin, increased fragility of the nails (the result of a violation of the condition of the autonomic nerve fibers when squeezing the spinal root).
- Changes in the functional state of the pelvic organs, which is manifested by impaired urination, constipation, impotence in men, unstable menstrual cycle in women.
Manifestations appear gradually, one cannot pinpoint the time of one's development. For a long time the intensity of the symptoms increases, new signs of the pathological process are added. By the nature and duration of the sensations of discomfort in the back, there are 2 types of pain in osteochondrosis of the thoracic spine:
- Dorsago - the pain manifests itself in the form of seizures, which restrict movement in the back and prevent full breathing.
- Dorsalgia is a constant painful pain localized in the area of the vertebrae, affected by the pathological process.
Chest osteochondrosis is a cause of constant discomfort and reduced quality of life. Depending on the degree of changes, 4 stages of the development of the pathology are distinguished:
- Stage 1 - minimal changes, increased mobility of the joints between the vertebrae, no symptoms.
- Stage 2 - protrusion (flattening) of the intervertebral disc, the appearance of mild pain, mainly after exercise.
- Stage 3 - the formation of a disc herniation, violation of the root of the spinal cord, there are pains in constant pain, neurological symptoms develop.
- Stage 4 - pronounced changes leading to severe constant pain, tingling of the skin in various parts of the body, decreased muscle strength, mainly in the upper extremities.
The determination of the stage of the pathological process is made on the basis of the clinical manifestations of the disease. To clarify the nature and severity of the changes, additional objective diagnostics are prescribed using imaging techniques of the spine.
Diagnosis
Based on the clinical picture, the doctor makes an initial conclusion. To determine the location and nature of the change, as well as the stage of the pathological process, an additional examination with visualization of the thoracic spine is prescribed:
- X-ray of the spine is the most common method of instrumental diagnosis, which allows you to identify gross changes in the structures of the spine.
- Computed tomography is an X-ray technique of layered tissue scanning, which has a high separation capacity and allows the visualization of minimal changes in the thoracic spine.
- Nuclear magnetic resonance - the phenomenon of resonance of the nuclei of compounds, which occurs in a magnetic field, is used for visualization. The technique involves scanning the body until the human body is exposed to radiation.
To determine the functional status of various organs and systems, laboratory tests (clinical, biochemical blood tests, urine) are prescribed. After diagnosis, the doctor has the opportunity to choose the optimal treatment.
Treatment of osteochondrosis of the thoracic spine
The treatment of osteochondrosis of the chest is always complicated. It is aimed at restoring the nutrition of cartilage components, normalizing their properties, as well as the functional state of the vertebrae and spinal cord roots. For this, 2 main areas of therapeutic measures are used:
- Conservative treatment.
- Invasive surgical intervention.
Often both directions of therapeutic measures are combined.
Conservative treatment
The basis of conservative treatment is the use of drugs from several groups:
- Non-steroidal anti-inflammatory drugs - reduce the severity of the inflammatory response and pain.
- Adrenal hormones - Reduce inflammation and neurological pain.
- Muscle relaxants - drugs reduce the tone of the striated muscles in the spine, thus reducing the compression of the roots of the spinal cord.
- Diuretics - means reducing tissue swelling and compression of the spinal cord roots due to increased urine output.
- Chondroprotectors - reduce the severity of degenerative processes, the destruction of cartilage tissue, contribute to its partial recovery.
- B vitamins - improve the course of metabolic processes in the nervous tissue, contribute to the early recovery of the functional state of the spinal cord roots.
- Vitamin C (ascorbic acid) - strengthens blood vessels, has an antioxidant effect (binds and inactivates free radicals, which are "fragments" of organic molecules with an unpaired electron and damage the membrane structures of cells).
During the period of remission (improvement of the condition and reduction of acute inflammatory phenomena) exercises are prescribed (physiotherapeutic exercises with special exercises), back massage, physiotherapeutic procedures (magnetotherapy, mud baths, electrophoresis). During the application of therapeutic measures it is important to follow the dietary (refusal of fatty fried foods, alcohol) and general (sufficient sleep, rational work and rest) recommendations. Conservative therapy makes it possible to achieve a significant improvement in the condition.
Surgical interventions
In the absence of the necessary therapeutic result against the background of the use of drugs, in case of progression of the pathological process in order to radically eliminate the problems, invasive surgical intervention is prescribed. It includes several techniques:
- Microdiscectomy - removal of a disc herniation with subsequent plastic surgery of the hernial opening.
- Foraminectomy - removal of bone growths narrowing the canal in the area of the exit of the spinal cord roots.
- Laminectomy is an enlargement of the canal at the base of the spinal roots.
In modern hospitals, surgery is performed using minimally invasive endoscopic techniques. Special nets made of durable material that does not cause inflammatory reactions are usually used for the plastic opening of the hernial opening.
Prevention
To prevent the development of a pathological process, you should follow a few simple preventive recommendations, which include:
- Adequate eight hours of sleep.
- Limiting the impact of stress factors (chronic stress can provoke the development of pathological processes).
- Normalization of the regime of work and rest.
- Limitation of hard physical work.
- Rejection of bad habits.
- Rational nutrition with sufficient intake of vitamins and plant fibers.
- Sufficient motor mode with dynamic exercises (charging), walking in the fresh air.
Osteochondrosis of the thoracic spine is characterized by a chronic progressive course. The disease requires long-term therapy, which makes it easier and more affordable to prevent its development.