Osteochondrosis affecting the thoracic spine is often masked as pathology of the internal organs. It manifests itself as pain in the heart, shortness of breath, a feeling of lack of air when inhaling and panic attacks. Therefore, the diagnosis of thoracic osteochondrosis is somewhat difficult. After its detection, conservative treatment is carried out using drugs, physiotherapy, physical therapy. And with severe damage to the thoracic discs and vertebrae, surgery is required.
Brief description of the disease
Thoracic osteochondrosis is a degenerative-dystrophic disease of the spine. In the initial stage of its development, the intervertebral discs are slowly destroyed. They become thin, brittle, and radial cracks appear on their surface. To stabilize the thoracic segment affected by osteochondrosis, the bone tissue of the vertebrae grows with the formation of acute growths - osteophytes. This becomes the reason for a strong limitation of mobility, compression of blood vessels and spinal roots.
Degrees of pathology
The degree of osteochondrosis is a set of symptoms characteristic of a given radiographic stage. The more deformed the discs and vertebrae, the more pronounced the clinical manifestations. The severity of the pathology always determines the tactics of treatment, it must be taken into account when choosing drugs and methods of use.
I degree
X-ray images usually show no change. But the intervertebral disc has already begun to collapse due to the inability to hold the moisture needed to restore its tissues. Sometimes there is a slight discomfort in the back, which quickly disappears after a short rest. Grade 1 osteochondrosis is usually discovered by chance when diagnosing other diseases.
II degree
The fibrous ring loosens, fibrous. One of the cracks on the surface of the disc increases and the nucleus pulposus extends there. On radiographs, a decrease in the distance between adjacent vertebral bodies is noted due to a decrease in disc height. As a result of constant compensatory muscle tension, the mobility of the thoracic region is limited and moderate painful sensations occur.
III degree
The integrity of the fibrous ring is violated, so the nucleus pulposus is expelled from it. A hernial protrusion forms, the main cause of severe symptoms and severe complications of thoracic osteochondrosis. The vertebral bodies are deformed, single osteophytes are formed. Pain in the thoracic region becomes constant, the range of motion in the spine is significantly reduced.
IV degree
X-ray images clearly show the growth of connective tissues, the formation of more osteophytes. The adjacent vertebral bodies are blocked, immobilized. Radicular syndrome develops, discogenic myelopathy often occurs: compression of the spinal cord, dangerous for its irreversible consequences. A person hardly serves himself in everyday life, loses the ability to perform professional tasks.
Causes of osteochondrosis of the thoracic spine
Thoracic osteochondrosis in people over 40-45 years of age develops due to the natural aging of the body: slowing of recovery reactions, decreased production of collagen, which causes elasticity, strength of the ligaments. At a young age, it manifests itself due to increased stress on the spine or against the background of pathologies already present in the body:
- rheumatoid arthritis, systemic lupus erythematosus, scleroderma, ankylosing spondylitis;
- endocrine and metabolic diseases, for example diabetes mellitus, gout, hypothyroidism, hyperthyroidism;
- congenital and acquired anomalies, including kyphosis, scoliosis.
Previous spinal injuries, a sedentary lifestyle and a lack of vitamins and microelements in the body can lead to premature disc destruction.
Signs and symptoms characteristic of the disease
Thoracic osteochondrosis develops gradually, initially without manifesting itself. It is in this course that its danger lies. A person experiences mild back pain and discomfort from trivial muscle strain after a hard day of work, housework, or gardening and does not seek medical help. Therefore, usually patients are diagnosed with a pathology of 2-3 degrees of severity, which is difficult to treat conservatively.
At the beginning
During the period of exacerbation, the pathology can manifest itself as pain between the shoulder blades, which occurs when bending, turning the body. The range of motion is reduced and there are many specific signs of relapse.
Chest pain
With osteochondrosis, chest pains appear first. They are not clearly localized, they can be given to the hands, collarbone, ribs. Pain in the heart is severe or moderate, resembles an attack of angina pectoris, is not eliminated by taking nitroglycerin. Sometimes they are similar to the sensations that occur during the exacerbation of cholecystitis, pancreatitis. But unlike injuries to the pancreas or gallbladder, the pain is not accompanied by increased gas production, heartburn and bloating.
Constriction in the chest
Pain between the shoulder blades is sometimes accompanied by a feeling of lack of air when inhaling. A person is predictably scared, not understanding the reasons for this state. Doctors recommend not to panic, but to sit down and measure your pulse. If the value obtained does not exceed 100 beats per minute, the probability of rupture of the lungs or heart is extremely low.
Other symptoms
Gradually, the symptoms of osteochondrosis are aggravated by the sensitivity disturbance. There are sensations of numbness, tingling, crawling chills. From time to time, conditions that resemble panic attacks occur. They are characterized by fear, increased heart rate, excessive sweating and cold sweats. If these symptoms are accompanied by chest pain, it is necessary to take nitroglycerin and call a doctor. A similar set of symptoms may indicate a myocardial infarction.
The spinal roots, located in the thoracic region, innervate the internal organs. When they are irritated, compressed, the work of the gastrointestinal tract and liver is upset. Peristalsis is disturbed, epigastric pain, heartburn, belching occur.
Signs in the subacute phase
After an exacerbation, the subacute phase of the course of thoracic osteochondrosis begins. Pain and breathing problems persist but are much less intense. A person is no longer looking for a comfortable position of the body for a long time, in which pain is not felt. The duration of the subacute phase is up to two weeks. If all medical recommendations are followed, remission occurs, which is characterized by the absence of pronounced symptoms. Violation of the regime leads to a new exacerbation of osteochondrosis.
Remission
In the phase of remission, mild discomfort may occur when the weather changes or hypothermia. Acute pain appears only with osteochondrosis of 2-4 degrees of severity due to too sharp rotation or tilt of the body. Exacerbations of chronic diseases, stress, increased physical activity and prolonged stay in one position of the body can provoke another relapse.
Principles of disease diagnostics
The neurologist makes a primary diagnosis based on the patient's complaints, on the data of the anamnesis. On external examination, he discovers points in the thoracic region, with pressure on which pain occurs. Performing functional tests allows you to assess the safety of reflexes, to identify sensitivity disorders. Among the instrumental methods, radiography is the most informative. But for a detailed study of the spinal segment, CT, MRI can be performed. To exclude diseases of the cardiovascular system, patients are assigned an ECG.
First aid in case of exacerbation
The pain during a relapse of thoracic osteochondrosis is sharp, piercing, so a person must receive first aid. It should be soothed, laid on a hard surface, covered with a warm blanket. If the relapse is accompanied by an increase in heart rate, shortness of breath, increased anxiety, it is necessary to call a doctor. Any non-steroidal anti-inflammatory drug can be taken to relieve pain between the shoulder blades.
How to treat thoracic osteochondrosis
Only a comprehensive approach to treatment will eliminate all symptoms of osteochondrosis, slow or completely stop its spread to healthy discs and vertebrae. With pathology of 1-2 degrees of severity, conservative methods of therapy are used. For osteochondrosis 3-4 degrees, the formation of large hernias is characteristic. Surgical treatment may be needed to relieve pressure on blood vessels and spinal roots.
Preparations
In the treatment of thoracic osteochondrosis, drugs of various clinical and pharmacological groups are used. At the initial stage, agents for parenteral administration are usually used, which quickly provide a therapeutic effect. A few days later, the injection solutions are replaced with safer tablets, ointments and patches.
Non-steroidal anti-inflammatory drugs (NSAIDs)
NSAIDs have a marked analgesic, anti-inflammatory and anti-edema effect. Intramuscular administration of solutions allows to stop acute pain. To eliminate a slight discomfort between the shoulder blades, agents of local application are used. And with moderate pain, oral NSAIDs are fine.
Muscle relaxants
Muscle relaxants are used to relieve muscle spasms in response to severe pain. Most often, the treatment of thoracic osteochondrosis begins with the intramuscular administration of drugs, which, in addition to the muscle relaxant tolperisone, include an anesthetic.
Chondroprotector
In case of pathology of the 1st degree of severity, the reception of the course of chondroprotectors helps to restore damaged discs. In other cases, they are prescribed to improve metabolism in the affected segment of the spine, to prevent the progression of the disease.
Preparations of vitamins of group B
Their use helps to increase blood flow, improve the functioning of the peripheral nervous system, restore trophism and innervation. The complex of vitamins of group B has a beneficial effect on degenerative diseases of the nerves and the musculoskeletal system.
Physiotherapy exercises
In case of 1 degree thoracic osteochondrosis, daily physical therapy allows you to do without the use of drugs. Recovery occurs by strengthening the muscles, improving the blood supply to the tissues with nutrients. In other cases, exercise and regular training help prevent healthy spinal segments from being involved in the destructive process and prolong the stage of remission.
Complex from a standing position
In a standing position, the following therapeutic exercises are the most effective from a therapeutic point of view:
- put your palms on your shoulders, bent forward, lifting your bent legs, as if trying to reach the opposite knee with your elbow;
- raise your left hand, lean to the right. Do the exercise in the opposite direction;
- Spread your legs shoulder-width apart, raise your arms. Lean forward, touching the opposite foot with the palm of your hand.
The number of repetitions is 10-12 times in 2-3 sets.
From a prone position
To complete these exercises you will need a gym mat or a thick double folded blanket:
- lie on your stomach, at the same time raise your arms and legs;
- lying on your back, raise your upper body, stretch your palms to your feet;
- lying on your back, bend one leg, wrap it behind the other, trying to touch the floor with your knee.
Each exercise should be done 7-10 times.
Sitting
When performing such exercises, it is necessary to avoid sudden and wide-ranging movements, including twisting:
- sitting on the floor, stretch forward, trying to touch the opposite foot with the palm of your hand;
- sitting on a chair or stool, stretch your arms forward and slowly turn from side to side;
- while sitting on the floor, wrap your arms around your knee, bring it as close to your chest as possible.
In the first lessons, the exercises should be repeated 5-7 times, after about a month - 15-20 times.
Physiotherapy
Magnetic therapy, laser therapy, UHF therapy, sine currents, shock wave therapy, paraffin and ozokerite applications are used in the treatment of thoracic osteochondrosis. In exacerbations, electrophoresis, ultraphonophoresis with glucocorticosteroids, anesthetics, vitamins of group B, chondroprotectors are performed.
Massage
A massage performed by a specialist helps to eliminate pain between the shoulder blades, to relax the spasmodic skeletal muscles.
In case of osteochondrosis, all types of massage are therapeutically effective: classical, vacuum, acupuncture, connective tissue. At home, self-massage is conveniently performed using a long-handled wooden or electric massager.
Acupuncture
Acupuncture is a method of treating pathology by installing needles in the bioactive points of the human body. They are thin, short, so when you puncture the skin, only mild discomfort occasionally occurs. But even this effect is sufficient for the body to produce substances with analgesic and anti-inflammatory effects.
Nutrition
Nutritionists recommend patients with thoracic osteochondrosis to give up fatty meats, rich soups, smoked meats, homemade and factory marinades. It is necessary to limit the amount of salt in the diet that causes edema to form. Every day you need to drink about 2, 5 liters of liquid: water, vegetable juices, berry drinks, fruit compotes.
Folk remedies
Decoctions and infusions of medicinal plants, ointments, rubbing alcohol and oil, compresses can be used by neurologists after the main therapy. Folk remedies are used to eliminate mild pain between the shoulder blades, sometimes arising after physical exertion.
Celery root
Peel the large celery root, chop finely, squeeze the juice. Add 100 g of chopped fresh celery. Take 3 tablespoons up to 4 times a day with meals to clean the vertebral structures from harmful salt deposits.
Sunflower root
Pour a teaspoon of dried and chopped sunflower roots with a glass of hot water. Bring to a boil, simmer for 20 minutes, cool under the lid, drain. Drink 3-4 times a day.
Household ointment
In a mortar, grind a tablespoon of gum turpentine and thick honey, add 2 drops each of essential oils of juniper, rosemary and eucalyptus. Inject 100 g of medical petroleum jelly in small portions. Mix, transfer to a jar, refrigerate, rub on the back for pain.
During pregnancy
Many systemic analgesics are contraindicated during pregnancy, so neurologists prefer drugs for external use: ointments, gels, patches. If you can't help but take the pills, their dosages are significantly reduced. During the period of pregnancy, the main methods of therapy for thoracic osteochondrosis are massage and physical therapy.
Possible consequences
In the absence of medical intervention, thoracic osteochondrosis can cause pneumosclerosis, arrhythmias, vegetative-vascular dystonia, deterioration of the gastrointestinal tract, impaired sexual and reproductive function in women and men.
Prevention and prognosis
The prognosis is favorable with the timely detection of the disease, competent and comprehensive treatment. If complications of thoracic osteochondrosis have developed, only compliance with all medical recommendations will allow to achieve a stable remission.
As a prophylaxis of the disease, neurologists recommend excluding the factors that cause it from the usual way of life. This is overweight, poor physical activity, vitamin and mineral deficiency, excessive stress on the spine.