Osteochondrosis of the thoracic spine: symptoms and treatment

Chest spinal osteochondrosis is a degenerative-dystrophic chronic process that damages intervertebral discs and vertebral bodies. This disease is slightly less common than in osteochondrosis of the cervical or lumbosacral spine. However, this does not mean that it is not a problem for the person. Osteochondrosis of the thoracic spine mainly manifests pain in the back and chest, but it can also cause pain in the heart and abdomen, similar to angina pectoris or liver colic. In rare cases, osteochondrosis of the thoracic spine causes paresis of the muscles of the lower extremities, deterioration of sensitivity in them, disorders of the pelvic organs. The treatment of the disease involves the use of pharmacological and non-medicinal methods and sometimes even surgery is required. In this article, you can learn about the symptoms of osteochondrosis of the thoracic spine and the methods of treating it.

Chest Spine

The thoracic spine is represented by 12 vertebrae with intervertebral discs between their bodies. The plates consist of a nucleus pulposus and an annulus fibrosus. Abnormal changes in these plates as well as adjacent facet joints, proliferation of snail spines along the edges of vertebral bodies, dystrophic processes in the ligaments of the spine, and direct causes of back pain.

It should be understood that osteochondrosis, as a disease, rarely affects a single part of the spine. In general, this process is diffuse, more or less pronounced in different parts of the spine.

Due to some structural features of the thoracic spine, osteochondrosis is less commonly affected than other parts. List these features:

• lower chest spinal mobility;
• the presence of joints between the vertebrae and ribs (which, in combination with the sternum, creates a strong frame in the chest, less prone to injury);
• small thickness of intervertebral discs;
• physiological kyphosis (with the anteroposterior-leaning, posterior bulge) of the thoracic spine, so the maximum axial load falls on the anterior rather than the posterior parts of the plates.

It is not the structure but the development of thoracic spinal osteochondrosis, which also determines the lower incidence of thoracic spinal pain, that the existing morphological basis of this part of osteochondrosis may remain clinically "dumb" in this part for a long time. That is, there are changes, but they do not bother the patient.

And yet, in the presence of provocative factors such as a sedentary lifestyle (including working at a desk or driving a car), injuries, poor posture, sagging back muscles, hard physical work in a forced position, osteochondrosis of the chest spine shows the true face.

Symptoms of Chest Spinal Osteochondrosis

The main clinical symptom of osteochondrosis of the thoracic spine as well as other parts is pain. Back pain, chest pain, even pain in the internal organs. In medicine, it is customary to distinguish between multiple pain (and not just pain) syndromes of thoracic spinal osteochondrosis. In total, they can be divided into two groups:

• reflex;
• compression.

reflex syndromes are clinical manifestations of spinal receptor stimulation. These are the receptors on the ligaments, the capsules of the intervertebral joints, the intervertebral discs that receive abnormal impulses in osteochondrosis. In addition to pain, reflex syndromes may be accompanied by muscle tension, vegetative disorders in soft tissues and internal organs. Such changes are based on the fact that stimulation of receptors leads to the spread of excitation to nearby structures in the spinal cord (more specifically, segments of the spinal cord). And these can be neurons that are responsible for sweating a certain area of ​​the skin, regulating the temperature of the same area, helping to ensure the activity of internal organs (heart, liver, intestines, etc. ), maintaining the muscles and blood vessels that supply thesestructures. And when the excitement spreads to these neurons, it has corresponding symptoms of violation of the activity of certain formations. Therefore, such a situation is entirely possible if the pain in the abdominal or cardiac region is caused by osteochondrosis of the thoracic spine.

Compression syndromes occur when the nerve root is compressed (less often stretched) when it leaves the intervertebral forament, the tissue of the spinal cord, or the blood vessels that feed it. Compression syndromes are almost always caused by an existing herniated disc. The most common are hernias of the lower chest segments. Depending on the direction and location of the hernia, one experiences certain symptoms. This can be represented as follows:

• Median (median) hernias are developed symmetrically by muscle weakness in both legs, their sensitivity decreases. However, the pain syndrome characteristic of nerve root compression is missing;
• lateral (lateral) hernias represent pain accompanied only by compression of the nerve root;
• medio-lateral hernias combine the clinical symptoms of the two previous groups, with only muscle weakness and sensory disturbances dominating the side of the protruding plate.

What syndromes are considered in osteochondrosis of the thoracic spine? Let’s talk in more detail about the types of reflex and compression syndromes at this level.

Reflex syndromes

Dorsago- sudden sudden pain in the spine of the chest. It is sharp in nature, often described by patients as a blow with a dagger. It is basically felt between the shoulder blades, can be given to the heart, the sternum. Patients are afraid of movement and even take a deep breath as the pain increases (as if shooting again). Often, similar symptoms occur after a long, fixed uncomfortable posture during monotonous work. Following this, a sudden movement triggers a rash in people with osteochondrosis of the chest spine. When the chest spine is felt, the roller-like tension and pain of the paravertebral muscles appear.

Sometimes such pain is considered a heart attack, as severe and sudden as if it appears to the patient. However, there is no abnormality on the recorded electrocardiogram, and the use of nitroglycerin under the tongue does not eliminate the pain.

dorsalgiais ​​another type of reflex chest level syndrome. It is a pain syndrome that occurs gradually. The pain can be localized to any part of the back, the chest. Painfully sore, with a dull, sometimes burning tinge (associated with irritation of vegetative structures). It is aggravated by spinal movement, bending, rotation about its axis, coughing or sneezing, driving on uneven roads.

Pain can be felt along the intercostal spaces on one or both sides. This property is due to the course of the nerve conductors (intercostal nerves and blood vessels are located in the intercostal space). In this case, the pain is called intercostal neuralgia, in a manner analogous to shingles pain.

If the pain is localized on the front wall of the chest, it is also called pectalgia. However, this can only be felt with an intact back in some places. For example, in the area of ​​the xiphoid process or at the site of attachment of the sternocleidomastoid muscle. Often, because of the sore and dull nature of the pain, it’s hard to guess exactly where it hurts: either something inside the chest or an area of ​​soft tissue on the surface.

Dorsalgia may be accompanied by reflex tension in the paravertebral muscles, which is more pronounced on the pain side. In this case, of course, muscle tension is not as pronounced as in a similar position of the lumbar spine. But still, when you feel it, the muscle constriction is felt, and the touch itself causes discomfort or pain. It is also painful to feel the interspinous spaces and paravertebral points in the area affected by osteochondrosis.

In osteochondrosis of the thoracic spine, reflex syndrome is much more common than compression.

Compression syndromes

Nerve root compressionis ​​first and foremost accompanied by pain. The pain is shooter in nature. The direction of pain propagation corresponds to the course of nerve fibers. In chest osteochondrosis, these are the intercostal spaces. Because some of the nerve fibers form the plexuses involved in innervating the internal organs, there is pain in the chest, in the abdomen. The pain increases when you move, tilting your body, coughing, sneezing, laughing (because the root tension increases in these moments). Sensitivity disorders can be observed in the nerve zone of the compressed root: climbing, numbness, tingling sensation. You may not feel well in this area. In cases where the nerve root is subjected to compression for a long time, movement disorders may occur, i. e. , weakness of the muscles it innervates. The muscles gradually atrophy. However, movement disorders are very rare because they are the most recent in the chronology of all symptoms. Usually, a person seeks medical help during the stages of pain and sensory disorders.

Compression of the

spinal cordmanifests as weakness of the legs with a concomitant increase in muscle tone (if the spinal cord is compressed in the lower chest spine, muscle tone decreases). Abnormal leg symptoms may occur (Babinsky et al. ). The sensitivity of the lower limbs is lost, the touch of cold and warm is no different, the only difference between touch and injection. Severe spinal cord compression may cause urinary disorders.

Compression of blood vessels,supplying the spinal cord, leads to the development of myeloischemia, i. e. malnutrition of the spinal cord tissue. This, along with spinal cord compression, leads to the development of muscle weakness (patients say "legs failed"), loss of sensation, and pelvic abnormalities.

It is true that compression of the spinal cord and blood vessels in osteochondrosis of the thoracic spine is very, very rare.

Vegetative components of osteochondrosis of the thoracic spine

Due to the fact that nerve fibers from the thoracic spine contain autonomic conductors, irritation or injury to these fibers can cause autonomic symptoms. These can be:

• dryness and exfoliation of the skin in the area of ​​nerve innervation;
• local violation of sweating and thermoregulation (also according to the innervation zone);
• lower limb coolness, brittle nails;
• pain that simulates diseases of the gastrointestinal tract (e. g. , gastritis, gastric ulcer, cholecystitis, etc. );
• kidney pain, which actually has nothing to do with kidney pathology (no change in urine and ultrasound);
• pain in the heart region, very similar to angina pectoris and even myocardial infarction.

Such pain may be characterized by a person not feeling pain in his back. This is initially misleading for both the patient and the medical staff when seeking medical attention. However, the performance of several additional research methods makes it possible to rule out pathology of the internal organs, and then osteochondrosis of the thoracic spine is considered to be the cause of such pain.

Treatment of osteochondrosis of the thoracic spine

All methods for treating osteochondrosis of the thoracic spine are divided into drug therapy and non-drug therapy. In most cases, only a combination of the two groups has an effect and the disease recedes. Although you need to understand that it is simply impossible to get rid of osteochondrosis of the chest spine completely. The degenerative process can be suspended, slowed down, but there is no reverse development.

Medication

The main directions of drug exposure in osteochondrosis of the thoracic spine are the elimination of pain, the elimination of muscle tension, the improvement of microcirculation and tissue trophism.

Non-steroidal anti-inflammatory drugs have been successfully used to eliminate pain syndrome. Drugs in this group have the ability to reduce the process of inflammation, eliminate pain, and block platelet aggregation. Medications are prescribed for an average of 7-14 days. This is usually enough to relieve the pain. Many of them are available in different forms (tablets, capsules, solution for injection, suppository), which ensures ease of use. In the first days of treatment, the medicines are used in the form of injections and then switched to tablets or suppositories. The same drugs can be applied topically at the same time: in the area of ​​the thoracic spine. Moreover, for this purpose there are various forms of release: creams, ointments, gels, plasters.

Sometimes non-steroidal anti-inflammatory drugs are not enough to relieve pain. In such cases, analgesic mixtures should be used. The mixtures are injected intravenously into saline or glucose.

Paravertebral blockade has a fairly good and rapid analgesic effect. It is a form of medical manipulation in which a medicinal substance is injected intracutaneously, subcutaneously, into the thickness of muscle tissue near the spine, perineurally (immediately near the nerve or root). The procedure requires certain skills and experience from the doctor.

Topical irritating and bothersome ointments can also be used in osteochondrosis of the chest spine to relieve pain. These are ointments containing snake venom, bee venom and pepper extracts.

Muscle tension is resolved by non-pharmacological methods.

Diuretics, hormones, Escina Lysinat are used to relieve nerve root edema.

Pentoxifylline, Dipyridamole, Complamin, Nicotinic acid are used to normalize blood circulation, improve tissue nutrition and restore trophism.

In osteochondrosis of the thoracic spine, B vitamins are shown to have analgesic and neurotrophic effects.

When an exacerbation of osteochondrosis of the thoracic spine is arrested, you may be taking medications that improve the metabolism of the intervertebral discs and joints. These are called chondroprotectors. These drugs stimulate the regeneration of articular cartilage, suspending the degenerative process in the intervertebral discs. They are prescribed for a long time (3-6 months).

Non-pharmacological methods

These are:

• massage (classical, point, reflex-segmental);
• physiotherapy exercises;
• stretching spasmodic muscles (there are special techniques, stretching is not done "as you want");
• acupuncture;
• swimming (very useful for patients with any localization of osteochondrosis);
• physiotherapy (ultrasound, electrophoresis, pulse, diadynamic currents, mud therapy and so on).

If a hernia resulting from osteochondrosis of the thoracic spine compresses the spinal cord, its blood vessels or nerve roots, but at the same time causes muscle weakness, dysfunction of the pelvic organs, treatment of severe pain syndrome.

Chest spinal osteochondrosis is not a fatal disease, but it causes a lot of damage to a sick person. It limits your life, interferes with work and good rest. The main symptom of osteochondrosis of the thoracic spine is pain. It is impossible to get rid of this disease completely, but it is possible to suspend the degenerative process and minimize the manifestations.