Osteochondrosis of the thoracic spine refers to a 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 45 years old. Timely diagnosis and initiation of treatment can slow the progression of the disease.
Development Mechanism
Degenerative-dystrophic pathology, which includes osteochondrosis, is characterized by the presence of several main links of the pathological process, including:
- Malnutrition (trophism) of cartilage tissue, which occurs against the background of excessive load 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.
- Violation of the functional state of the joint or the structure of the spine (intervertebral discs), which contains cartilage tissue.
Osteochondrosis involves the defeat of the intervertebral discs and joints of the ridge processes in various parts. The discs between the vertebrae are flattened, which causes compression of the motor and sensory nerve fibers of the spinal roots. The mechanism of development of the disease is always accompanied by the addition of neurological symptoms.
Causes of the disease
Osteochondrosis of the thoracic ridge is a polyetiologic 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 disturbances against the background of normal loads. In this case, osteochondrosis can develop in young people.
- Birth defects and abnormalities in the development of structures of the musculoskeletal system, leading to changes in blood flow in the tissues and deterioration of the nutrition of cartilage components.
- Postponed injuries of various parts of the ridge (fractures, bruises, dislocations and subluxations of the joints), which lead to a change in the ratio of various structures with the subsequent development of degenerative-dystrophic processes.
- Insufficient physical activity (sedentary lifestyle), leading to tissue congestion.
- Systematic increase in loads on the thoracic spine (arduous physical work, prolonged static loads).
- Disruption of the metabolism of mineral salts in the body, which causes a decrease in the resistance of bone processes, intervertebral discs and subsequent malnutrition of cartilage structures.
- Deterioration of the blood supply to the tissues of the spine, occurring against the background of compression of the main arteries or veins.
- Bad habits - nicotine and alcohol are vascular toxins that cause deterioration of blood flow in the tissues and a violation of their nutrition.
Finding out 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 for the prevention of redevelopment 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 in the chest area - at first the pain appears after exertion, 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 a dull, aching back pain between the shoulder blades.
- Unpleasant feeling of "squeezing" in the back, which does not allow you to breathe in completely.
- Violation of skin sensitivity in the form of numbness in various parts of the body (the changes cover the skin of the upper or lower extremities on one side of the body) due to compression of sensitive nerve fibers of the roots of the spinal cord.
- Muscle weakness in an arm or leg is usually on one side of the body.
- Violation of the functional state of the digestive system, which is accompanied by belching, heartburn, abdominal pain, gas (bloating), unstable stool.
- Changes in the back and arms, including dry skin, increased fragility of the nails (the result of a violation of the state of autonomic nerve fibers when the spinal root is compressed).
- Changes in the functional state of the pelvic organs, which are manifested by impaired urination, constipation, impotence in men, unstable menstrual cycle in women.
Manifestations appear gradually, a person cannot accurately indicate the moment of his development. For a long time, the intensity of 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 - pain manifests itself in the form of seizures that restrict back movement and interfere with full breathing.
- Back pain is a constant aching pain localized in the area of the vertebrae affected by the pathological process.
Osteochondrosis of the thoracic spine is the cause of constant discomfort and a decrease in the quality of human life. Depending on the degree of changes, 4 stages of the development of 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 slight pain, mainly after exertion.
- Stage 3 - the formation of a herniated disc, damage to the root of the spinal cord, constant aching pain appears, neurological symptoms develop.
- Stage 4 - pronounced changes resulting in severe and constant pain, numbness of the skin in various parts of the body, decrease in muscle strength, mainly in the upper extremities.
Determination of the stage of the course of the pathological process is carried out on the basis of the clinical manifestations of the disease. To clarify the nature and severity of the changes, additional objective diagnoses are prescribed using imaging techniques of the spine.
Diagnostic
Based on the clinical picture, the doctor draws a first conclusion. To determine the localization and nature of the change, as well as the stage of the pathological process, an additional examination is prescribed with visualization of the thoracic ridge:
- 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 a layer-by-layer tissue scanning x-ray technique that has a high separation capacity and can visualize minimal changes in the thoracic ridge.
- Magnetic Resonance Imaging - for visualization, the phenomenon of resonance of the nuclei of compounds that occurs in a magnetic field is used. The technique involves scanning the body, while the human body is not exposed to radiation.
To determine the functional state of various organs and systems, laboratory tests are prescribed (clinical, biochemical blood test, urine test). After the diagnosis, the doctor has the opportunity to choose the optimal treatment.
Treatment of osteochondrosis of the thoracic spine
The treatment of osteochondrosis of the thoracic spine is always complex. It is aimed at restoring the nutrition of cartilage components, normalizing their properties, as well as the functional state of the vertebrae and roots of the spinal cord. For this, 2 main areas of therapeutic measures are used:
- Conservative treatment.
- Invasive surgical intervention.
Often the two directions of therapeutic measures are combined.
Conservative treatment
The basis of conservative treatment is the use of drugs from several groups:
- Nonsteroidal anti-inflammatory drugs - reduce the severity of the inflammatory response and pain.
- Adrenal hormones - Reduces inflammation and neurological pain.
- Muscle relaxants - Drugs reduce the tone of striated muscles in the spine, thereby reducing compression of the roots of the spinal cord.
- Diuretics - means reducing tissue swelling and compression of the roots of the spinal cord due to increased urine excretion.
- 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 nervous tissue, contribute to the early restoration of the functional state of the roots of the spinal cord.
- 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), exercise therapy (physiotherapy exercises with special exercises), back massage, physiotherapy procedures (magnetotherapy, mud baths, electrophoresis) are prescribed. When implementing therapeutic measures, it is important to adhere to dietary recommendations (refusal of fatty fried foods, alcohol) and general (adequate sleep, rational work and rest). Conservative therapy allows to achieve a significant improvement in the condition.
Surgeries
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 herniated disc followed by plasty of the hernial orifice.
- Foraminectomy - removal of bone growths narrowing the canal in the area where the roots of the spinal cord exit.
- Laminectomy is a widening of the canal of the exit area of the vertebral roots.
In modern hospitals, surgery is performed using minimally invasive endoscopic techniques. For the plastic opening of the hernial orifice, special meshes are usually used of durable material that does not cause inflammatory reactions.
Prevention
To prevent the development of a pathological process, you need to follow several simple preventive recommendations, including:
- Eight hours of sufficient sleep.
- Limit the impact of stressors (chronic stress can provoke the development of pathological processes).
- Normalization of the regime of work and rest.
- Restriction of hard physical labor.
- Rejection of bad habits.
- Rational nutrition with a sufficient supply of vitamins and vegetable fibers.
- Sufficient engine speed with dynamic exercises (load), walking in the open air.
Osteochondrosis of the thoracic spine is characterized by a progressive chronic course. The disease requires long-term treatment, so it is easier and more accessible to prevent its development.