Thoracic osteochondrosis

Thoracic osteochondrosis is a chronic pathology in which degenerative changes occur in the bony vertebrae and the intervertebral discs located between them. Destructive lesions in this area are very rare due to low mobility and good protection of the rib cage. Thoracic osteochondrosis develops unnoticed, progresses slowly but continuously, and also has many specific symptoms masquerading as visceral organ disease. In this regard, it is important to seek medical help immediately at the slightest sign of back problems. Prompt treatment can help prevent serious complications.

Causes and Predisposing Factors

The degenerative dystrophic process of the thoracic spine occurs against the background of endogenous destruction and negative external influences. Their development is usually caused by the following factors:

• Genetic predisposition, the presence of a specific set of defective genes;
• Excessive physical exertion, especially lifting and carrying various heavy objects;
• A sedentary lifestyle leads to congestion in the vertebral body and intervertebral disc area;
• Congenital or acquired structural abnormalities, such as accessory vertebrae, lordosis, and kyphosis;
• Back and/or chest injuries – broken bones, prolonged compression;
• Flat feet, clubfoot;
• Impaired circulation anywhere, not just the thoracic region;
• Frequent hypothermia;
• overweight;
• Endocrine pathology and metabolic disorders, such as diabetes, gout, hypothyroidism, and hyperthyroidism;
• Systemic diseases - rheumatoid arthritis, systemic lupus erythematosus, scleroderma;
• Ankylosing spondylitis.

The overall strength and mobility of the spine depend directly on the condition of its individual parts. The disease may be the result of untreated severe osteochondrosis of the lumbar or cervical spine.Smoking, alcoholism and intoxication, including occupational hazards, can easily lead to the destruction of intervertebral joints where the discs are mainly composed of cartilage. The incidence of thoracic osteochondrosis is higher in the elderly than in young and middle-aged people. This is due to the body's natural aging, slowed recovery processes, and the presence of one or more physical pathologies.

Symptoms and signs of disease

The main symptom of the degenerative process is pain. Unlike cervical and lumbar osteochondrosis, it is extremely rare to be acute, burning, and piercing. Patients often describe discomfort as a dull ache, pain, or pressure. The pain syndrome may be exacerbated by bending/turning the body, sudden awkward movements, coughing episodes, or temperature changes. It is worth noting that its radiation range extends beyond the affected area. Thoracic osteochondrosis also manifests as follows:

• Stiffness and constriction;
• A specific clicking sound, tightening sensation when changing body position;
• Loss of sensitivity, paralysis, burning sensation, numbness in the form of "goose bumps";
• Muscle spasms, further limiting range of motion;
• Adopting a forced posture that does not create or weakly express discomfort;
• Pathological changes in posture in later stages - gait;
• There is a slight decrease in growth due to the destruction of the intervertebral joints and the convergence of the vertebral bodies.

Due to the constant tension in the back muscles, the muscles in the neck and waist will also spasm, manifesting as pain in these areas.The clinical manifestations of thoracic osteochondrosis are a combination of multiple pain syndromes. In fact, the affected segments are located in common innervation areas with many internal organs. If a displaced disc pinches a nerve root near the spine, pain can be felt, simulating common pathologies:

• Severe heart pain similar to angina or even myocardial infarction;
• Breast pain becomes a cause of urgent differential diagnosis to rule out neoplastic processes;
• Persistent or periodic pain in the right ribs, stomach, or intestines, similar to the characteristics of gastritis, cholecystitis, and ulcerative lesions.

When osteochondrosis worsens, you may experience pain in your lower back or abdomen. Patients mistake discomfort for signs of renal pathology or gynecological disease. They turn to specialized specialists who, after examination, refer patients to neurologists or chiropractors.

Classification, main types

Common classification of thoracic osteochondrosis is based on the nature of the pain syndrome. It comes in two types:

• Back pain - severe pain in the sternum, occurring mainly when holding a certain position of the body for a long time, often compounded by a sensation of lack of air when inhaling;
• Back pain presents as a mild aching sensation in the back that appears periodically and subsides with rest.

This grouping of pathologies allows physicians to quickly decide on analgesic choice.

Stages of development of thoracic osteochondrosis

Thoracic osteochondrosis passes through four stages during its development. Each has its own symptoms and radiographic signs. The more deformed the discs and vertebrae are, the more severe the pain, stiffness of movement, and paresthesias will be. The stage of the disease determines the treatment strategy.

Stage I

X-rays have not revealed any changes. However, the intervertebral discs no longer retain moisture well, and timely recovery is impossible without moisture. It begins to gradually thin, losing strength and elasticity. Mild discomfort in the chest area may occur only in some cases. People dismiss it as muscle fatigue and don't consult a doctor. Therefore, disease at this stage is often discovered incidentally during examination for other reasons.

second stage

The structure of the annulus fibrosus becomes loose and fibrous. When the nucleus pulposus bulges in this direction, a crack in the disc can expand. As the disc height decreases, the distance between adjacent vertebrae also decreases, which is clearly visible on radiographic images. To compensate for the distribution of load, muscle tissue is always under tension. Stiffness increased and pain remained moderate in severity.

The third phase

The annulus fibrosus ruptures and the nucleus pulposus is extruded beyond its borders. A herniated disc can cause severe symptoms and serious complications. The vertebral bodies are significantly deformed and develop single osteophytes (compensatory bone growth). The pain syndrome persists and back movement is significantly limited.

Stage 4

At this stage, diagnosing thoracic osteochondrosis is not difficult. The connective tissue grows and forms multiple osteophytes. Adjacent vertebrae in this segment are blocked, fully or partially immobilized. Nerve roots are often compressed by inflammation, swelling, bone growth, and muscle spasms. This manifests as burning, stinging pain. The patient cannot handle household chores well and has difficulty moving around.

complication

Discogenic myelopathy is a dystrophic disease of the spinal cord caused primarily by compression by a herniated disc, and its progression is dangerous. Of note, this complication is rare in thoracic osteochondrosis. However, in clinical practice, there have been cases in which discogenic myelopathy was localized to a certain lower segment. As the neurological deficit gradually worsens, muscle strength decreases and tendon reflexes change. Ischemic areas form and nerve cells die (spinal cord infarction). It is characterized by movement disorders, loss of sensitivity, and nutritional disorders.

diagnostic measures

During the first consultation, the doctor will listen to the patient's chief complaint, examine the patient, assess sensitivity levels, check tendon reflexes, and study medical history and spinal injury. His diagnosis was confirmed by laboratory and instrumental studies:

• Radiography of two projections as directed - target image of a segment;
• Magnetic resonance imaging;
• evoked potential;
• electroneurography;
• EMG;
• General clinical blood and urine tests.

To find the cause of specific symptoms and to rule out medical disorders with similar clinical presentations, electrocardiograms, structural ultrasound scans of the heart, and electroencephalograms may be performed.

Treatment of thoracic osteochondrosis

The therapy is comprehensive and aims to eliminate symptoms and prevent the spread of pathological processes to other spinal segments. In the acute stage, excruciating burning pain can be eliminated by injecting medications, including directly into the affected area. Glucocorticoids are often used in combination with anesthetics (drug blockade). In other cases, medical treatment involves taking tablets, capsules, and applying ointments and balms. Medications from the following groups have been shown to be effective:

• Muscle relaxants to relieve muscle spasms;
• Non-steroidal anti-inflammatory drugs with significant analgesic activity;
• Antispasmodics used to relieve nervous tension;
• Means improved blood circulation;
• Preparation containing vitamin B6, which improves the transmission of nerve impulses and activates regeneration.

If radiculopathy develops and other complications develop, the person lives in constant fear of experiencing severe pain again, which can lead to psychiatric disorders. Taking sedatives and antidepressants can prevent this from happening. In addition to medication, the following methods may be used to treat thoracic osteochondrosis:

• Therapeutic massage, including vacuum massage and acupuncture;
• Physiotherapy procedures - electrophoresis/ultrasonic electrophoresis, magnet therapy, pulsed current, UHF therapy, ozokerite or paraffin application, acupuncture, leech therapy;
• physical therapy and gymnastics;
• Spinal traction.

In cases of severe disc damage and myelopathy, surgical treatment is always performed immediately. Hernia protrusions are removed, microdiscectomy, stabilization or laser disc reconstruction is performed, implants are installed or spinal segments are stabilized.

Prevention of thoracic osteochondrosis

The primary goal of primary prevention of thoracic osteochondrosis is to eliminate factors that may trigger disc thinning and rupture. Doctor's advice:

• Avoid putting excessive pressure on your back;
• Prompt treatment of all diseases - infectious, endocrine, inflammatory;
• If you have a back injury, even if it appears minor at first, seek medical help immediately;
• Quit drinking and smoking or at least limit them;
• Supplement your diet with fatty fish, fresh vegetables, fruits and dairy products;
• Avoid hypothermia;
• Do physical therapy for at least 15 minutes every day.

This preventive measure is effective for already diagnosed thoracic, cervical, or lumbar spine disease. With their help, it will be possible to prevent the worsening and progression of degenerative dystrophic processes.If you have signs of thoracic osteochondrosis and want to get rid of it, contact the clinic for comprehensive, effective treatment.

FAQ

What is the difference between intercostal neuralgia and thoracic osteochondrosis?

In fact, intercostal neuralgia is a lesion of the intercostal nerves that can complicate the course of osteochondrosis. There are two main differences between these pathological processes. Neuralgia is characterized by episodic stinging or burning pain that can even be worsened by inhalation. If thoracic osteochondrosis does not invade sensitive nerve endings, it will appear as a dull pain, as if it is pain in the distance.The second difference is prediction. After the cause of intercostal neuralgia is eliminated, it disappears without a trace. Osteochondrosis responds well to treatment only in the initial stages of development.