Osteochondrosis, as the most common disease of the spine, today occurs in people of completely different ages, although not so long ago it was considered an exclusively age-related disease.It is characterized by the occurrence of degenerative-dystrophic changes in the intervertebral discs, which causes pain and creates conditions for the formation of protrusions and intervertebral hernias.The disease can affect any part of the spine, although osteochondrosis of the thoracic region is extremely rare.This causes significant difficulties in its diagnosis, as the symptoms of the disease mimic pathologies of the cardiovascular system.However, if a diagnosis is made, it is important to immediately begin treatment for thoracic osteochondrosis.Otherwise, it can cause extremely serious complications and loss of performance.
Expert opinion from a doctor
“As there are many nerve endings in the intervertebral discs, any change in their structure leads to the transmission of corresponding signals to the brain, resulting in the appearance of pain in the affected area.”
What is thoracic osteochondrosis and features of its treatment
Osteochondrosis of the thoracic spine occurs in less than 10% of all cases diagnosed with this disease.This is due to the low mobility of the thoracic spine.But this is the main insidiousness of thoracic osteochondrosis, since its symptoms are in many ways reminiscent of signs of diseases of the cardiovascular system.Therefore, patients often initially turn to a cardiologist or other specialist and undergo treatments that do not bring results, but end up going to a neurologist when the disease is already advanced.
There are 12 vertebrae in the thoracic spine.Between all of them there are intervertebral discs, but more often the first and last mobile segments of the spine of this department are affected by osteochondrosis.
In the future, the situation may be complicated by compression of the spinal roots, which leave the spinal cord in pairs at the level of each vertebra and are responsible for regulating the functioning of the lungs, the internal organs of the abdominal cavity and the pelvis.As a result, there will be signs of disturbances in its functioning, as well as pain radiating to the ribs, which is called radicular syndrome.
In general, thoracic osteochondrosis can manifest itself:
- pain in the shoulder blades, which intensifies with deep inspiration;
- pain behind the sternum in the region of the heart;
- the occurrence of cough, shortness of breath due to the development of bronchitis, bronchial asthma, pneumonia and other diseases of the lungs and bronchi;
- pain in the right hypochondrium, resulting from rupture of the liver, gallbladder and their ducts, which can be caused by the development of cholecystitis, metabolic disorders, etc.;
- pain in the left hypochondrium or herpes zoster due to pancreas dysfunction, which increases the risk of developing diabetes;
- decreased immunity, the occurrence of allergic reactions due to suppression of the innervation of the adrenal glands;
- urinary disorders due to poor functioning of the kidneys and the addition of infectious diseases, in particular pyelonephritis;
- disorders of the female and male genital organs, including infertility.
In this case, intense pain causes reflex tension in the back muscles, which causes them discomfort and increases the risk of pinching the nerve structures.
The risk of changes in the functioning of internal organs increases markedly in the later stages of the development of thoracic osteochondrosis, when protrusion of intervertebral discs is already observed, that is, the formation of intervertebral protrusions and hernias.In these situations, the pathological protrusion will compress the nerve roots, which will provoke disturbances in the innervation of the corresponding internal organs and the development of their diseases.
Thus, although thoracic osteochondrosis is a rather rare disease, it can affect the functioning of the entire body.Therefore, it requires immediate initiation of comprehensive treatment.To do this, you need to contact a neurologist who will assess the patient's condition, study the results of available tests and develop an individual treatment program.It will largely depend not only on the degree of thoracic osteochondrosis (there are 4 stages, of which the easiest is the 1st), but also on the nature of the manifestations of the diseases, the type of concomitant diseases present, age and a number of other factors.That is why, with the right approach, the treatment of patients with approximately the same degenerative changes in the discs can have significant differences.
The treatment of thoracic osteochondrosis is always complex.It aims to solve the following problems:
- elimination of unpleasant symptoms of the disease, which improves the patient's quality of life and restores full functionality;
- improve the quality of blood circulation in the affected area, which activates metabolic processes and will facilitate disc regeneration processes;
- eliminating the causes of osteochondrosis;
- reducing the likelihood of disease complications.
For this, patients may be prescribed:
- lifestyle correction;
- drug therapy;
- exercise therapy;
- manual therapy;
- traction therapy;
- physiotherapeutic treatment.
What specific methods will be recommended to the patient is determined by the attending physician depending on the severity of degenerative-dystrophic changes in the spine.So, if thoracic osteochondrosis is diagnosed at the 1st stage of development, which, unfortunately, is quite rare, it is usually enough to limit yourself to making some lifestyle adjustments, exercise therapy and manual therapy.
But if the disease has already progressed to the 2nd and especially the 3rd stage, additional drug therapy, traction therapy, etc. will certainly be recommended.In addition, if osteochondrosis has already provoked the formation of intervertebral hernias, especially large ones, and is accompanied by severe radicular syndrome, which cannot be eliminated by conservative methods, it is only possible to achieve an improvement in the patient's condition with the use of surgery.
So, in thoracic osteochondrosis, as well as similar injuries in other parts of the spine, treatment is aimed at stopping the progression of degenerative changes in the intervertebral discs and improving the patient's well-being.With existing injuries, especially large ones, it is not yet possible to achieve complete restoration of the cartilaginous tissue, not only of the intervertebral discs, but also of any other joints.So, let's look at the main methods of treating thoracic osteochondrosis and their features.
Lifestyle correction
After diagnosing thoracic osteochondrosis, the doctor necessarily recommends making some changes to your usual lifestyle.If the patient shows signs of being overweight, he or she is advised to take steps to reduce it.But any weight loss diets, especially monocomponent ones, are contraindicated.The diet must be complete and varied so that the body receives all the substances necessary for proper functioning and the metabolic processes in the intervertebral discs occur properly.Therefore, it must comply as fully as possible with the principles of rational nutrition.
It is also recommended that all patients increase their level of physical activity, especially those who lead a sedentary lifestyle.This could be daily walking, swimming, yoga or Pilates.But serious physical activity, in particular intense training on simulators, jumping sports and weight lifting, are contraindicated.
If the patient's profession involves heavy physical work, such as lifting weights, it is recommended to try to change it.This is due to the fact that increased load on the back in the presence of osteochondrosis can play the role of a trigger for the rapid progression of degenerative changes in the discs.
Absolutely all patients with thoracic osteochondrosis are recommended to change the mattress to an orthopedic one of medium hardness, as well as purchase an orthopedic pillow.This will ensure that the physiological curves of the spine are maintained and prevent further disc degeneration.
Drug treatment of thoracic osteochondrosis
When treating osteochondrosis, patients are often prescribed a complex of medications.Some of them are recommended to be taken only occasionally, mainly during an exacerbation of the disease, while others should be used in courses, the duration of which is selected by the doctor.
When prescribing specific medications, the neurologist must know whether the patient has concomitant diseases and their nature.This is necessary to exclude contraindications to the use of certain medications.
In general, for thoracic osteochondrosis, the following groups of medications can be prescribed:
- NSAIDs;
- corticosteroids;
- muscle relaxants;
- vitamins;
- chondroprotectors;
- products for topical use;
- means improving microcirculation.
NSAIDs
Non-steroidal anti-inflammatory drugs are one of the most extensive groups of drugs, as they have a huge list of indications for use, which includes thoracic osteochondrosis.They have anti-inflammatory and analgesic properties, therefore they are indicated for exacerbations of the disease and the occurrence of pain.
Today, there are 4 generations of NSAIDs, among which the most recent, 4th generation drugs are considered the safest and most effective.They are distinguished by their selective action and have practically no negative effect on the mucous membranes of the stomach and duodenum.At the same time, the previous drugs in this group should not be used, especially for a long time in the presence of gastritis and peptic ulcers of the stomach and duodenum, as they can cause their exacerbation.
NSAIDs are available in almost all possible dosage forms, which makes it possible to select the drug depending on the method of use.Therefore, in the initial stages of thoracic osteochondrosis, the use of ointments, gels or creams is indicated.For more severe pain, preference is given to capsules or tablets, and if there is no effect, intramuscular injections of medication are allowed.
Corticosteroids
Medicines in this group belong to the hormonal group and contain synthetic analogues of adrenal hormones.Therefore, they have a powerful anti-inflammatory effect and are indicated for severe inflammatory processes.But due to the possibility of causing a number of negative side effects, they are usually prescribed in the form of injectable solutions and only in short courses.
Additionally, corticosteroids in combination with local anesthetics are used to perform paravertebral blocks.They are indicated for very severe pain that deprives the person of the ability to work, but they can only be carried out in a medical institution.Blocks help to quickly relieve even very severe pain and consist of introducing a prepared solution into points close to the spine, in the area where the spinal roots pass.
It is recommended to carry out such procedures no more than 4 times a year.
Muscle relaxants
Muscle relaxants are a group of medications designed to relieve muscle spasms.Let us remember that they often act as a reflex response of the body to pain.Therefore, the use of muscle relaxants will help reduce the intensity of pain in thoracic osteochondrosis.
Vitamins
When treating thoracic osteochondrosis, vitamin complexes containing increased amounts of B vitamins can be additionally prescribed. This is necessary to improve the quality of the passage of bioelectric impulses along the nerves, which is especially important in the case of radicular syndrome.In this way, the development of disorders in the functioning of the organs innervated by the spinal roots of the intervertebral discs located at the level of the lesion is avoided.
Chondroprotectors
Chondroprotectors are a relatively new group of drugs that are actively prescribed for thoracic osteochondrosis.As active ingredients, they mainly contain compounds that are absolutely natural for the human body and used by it for the regeneration of intervertebral discs and other cartilage.
But at the same time, there is still no convincing evidence of the effectiveness of drugs from this group in advanced forms of osteochondrosis, although in the initial stages they work very well.At the same time, the natural origin of chondroprotectors guarantees a high level of safety.
These medications are available in different forms, including capsules, topical preparations, powders, and injectable solutions.The best results are observed with the administration of injectable chondroprotectors.But despite all the positive aspects of the drugs in this group, they are characterized by high cost, which, combined with the need to use them in courses of 30 days or more, makes their use not accessible to everyone.
Topical products
In addition to the ointments, creams and gels containing NSAIDs and chondroprotectants discussed above, treatment of thoracic osteochondrosis may include the use of warming and locally irritating agents.Its principle of action is based on irritation of skin receptors at the site of application.This leads to an active blood flow to the application area and thus an influx of nutrients.As a result, the quality of nutrition of the intervertebral discs improves and pain decreases.
Products to improve microcirculation
Medicines in this group are also used to improve the quality of blood circulation and activate metabolic processes.
Exercise therapy
Therapeutic physical education plays one of the main roles in the treatment of thoracic osteochondrosis, as it allows:
- strengthen the muscular corset, which will ensure the creation of high-quality support for the spine;
- normalize muscle tone;
- activate blood circulation, which will improve the course of metabolic processes in the affected intervertebral discs.
But patients should understand that the use of general sets of exercises can negatively affect the course of the disease and well-being, since they do not take into account individual characteristics, the degree of osteochondrosis and existing concomitant diseases.Therefore, for the effective treatment of thoracic osteochondrosis, it is necessary to develop an exercise therapy program on an individual basis.
Initially, in order for the patient to master the correct exercise technique, it is recommended to perform exercises under the supervision of a physiotherapy instructor.He will be able to correctly calculate the load in accordance with the level of physical development of a person and adjust his movements so that the exercises performed bring maximum benefit.The program will gradually become more complicated, and once fully mastered, the patient can practice at home.But for classes to give good results, they must be held daily.
When performing all therapeutic exercises, it is important to avoid sudden movements.
Manual therapy for thoracic osteochondrosis
One of the most effective ways to treat thoracic osteochondrosis is manual therapy, as it not only allows you to work the muscles well, but also involves influencing the spine.This is how it differs from therapeutic massage, which is also very useful in osteochondrosis, but cannot have the same effect as manual therapy, as it does not involve the spine.
But for manual therapy to bring only benefits, you need to be careful when choosing a specialist to carry it out, as the effect on the spine must be done with extreme precision.Otherwise, there is a high risk of complications.
Manual therapy sessions begin by stroking and relaxing the muscles.The doctor works well on each area of the back, eliminating spasms and preparing soft tissues for more active action.From then on, he starts to use mobilization and manipulation techniques, which can sometimes be accompanied by small discomforts and pops.
The manual therapy method, which is distinguished by the use of special techniques that have proven themselves over 20 years as one of the most effective, deserves special attention.They allow not only to have a beneficial effect on the affected intervertebral discs, but also to improve the quality of functioning of all internal organs, since, as mentioned above, they have a close relationship with the spine.
In general, a course of manual therapy sessions offers:
- restoration of the correct anatomy of the spine with the return of the vertebrae to their assigned places;
- increase the distance between the vertebral bodies, which has a beneficial effect on the condition of the intervertebral discs by reducing the pressure exerted on them;
- normalization of muscle tone;
- elimination of functional blocks;
- improve the functioning of the lungs, bronchi, heart and gastrointestinal tract;
- increasing immunity and reducing exposure to allergens.
At the same time, an improvement in well-being is observed after the first session.Subsequently, patients notice a progressive reduction in pain and an improvement in general condition, an increase in performance and mood.
Physiotherapy
Physiotherapeutic methods are widely used to treat thoracic osteochondrosis after the acute phase of the inflammatory process has ended.They can further reduce the severity of back discomfort and also have several other positive effects on the body.
Most often, for thoracic osteochondrosis, the following are prescribed:
- electrophoresis with the introduction of drugs - this method allows deeper penetration of drug components into tissues and enhances their therapeutic effect through the use of a weak electric current;
- magnetotherapy is a physiotherapeutic treatment method, which is based on the beneficial effects of a magnetic field on the body, which helps to stimulate blood circulation in the area of influence, which leads to the activation of metabolic processes, a decrease in pain and swelling;
- laser therapy is a method that allows you to obtain a pronounced anti-inflammatory and vasodilating effect, which will also lead to an improvement in the condition of the intervertebral discs and a reduction in pain;
- ultrasound is a physiotherapeutic procedure that provides anti-inflammatory and analgesic effects;
- diadynamic currents are an effective method of physical influence, thanks to which there is a decrease in pain intensity, an increase in metabolic rate and an improvement in the condition of muscle tissue.
As a rule, physiotherapeutic procedures are prescribed in courses of 10 to 15 sessions.But each of them has its own contraindications, which must be taken into account when choosing a particular type of exposure.
Traction therapy
Traction therapy allows you to increase the distance between the vertebrae of the thoracic spine, which will reduce pressure on the intervertebral discs affected by osteochondrosis.This will stop the progression of the disease and create ideal conditions for the restoration of cartilaginous tissue.Spinal traction or traction therapy is performed on a special table under the supervision of medical professionals.
Thus, although thoracic osteochondrosis is not a common disease, it can significantly reduce a person's quality of life and lead to the development of a number of pathologies of internal organs.At the same time, the difficulty in diagnosis harms the patient, as without adequate treatment the degenerative changes in the intervertebral discs continue to worsen.As a result, complications often arise in such situations, including the formation of protrusions and intervertebral hernias.Therefore, it is important not to ignore changes in well-being and immediately consult a doctor, and when diagnosing thoracic osteochondrosis, strictly follow the recommendations received from him.