Osteochondrosis, as the most common spinal disease, 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 appearance of degenerative-dystrophic changes in the intervertebral discs, which lead to pain and create the prerequisites for the formation of intervertebral protrusions and hernias.The disease can affect any part of the spine, although osteochondrosis of the thoracic region is extremely rare.This poses significant difficulties for its diagnosis, since 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 lead to extremely serious complications and loss of performance.
Expert opinion from a doctor
"Since the intervertebral discs contain a large number of nerve endings, any change in their structure results in the transmission of corresponding signals to the brain, leading to 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 the total number of cases diagnosed with this disease.This is due to poor mobility of the thoracic spine.But this is the main insidiousness of thoracic osteochondrosis, since its symptoms are in many ways reminiscent of the signs of diseases of the cardiovascular system.Therefore, patients often first turn to a cardiologist or other specialist and undergo treatments that do not bring results, but end up consulting a neurologist when the disease is already advanced.
There are 12 vertebrae in the thoracic spine.Between them are all intervertebral discs, but most often osteochondrosis affects the first and last segment of movement of the spine of this department.
In the future, the situation may be complicated by compression of the spinal roots, which come out in pairs at each vertebra of the spinal cord and are responsible for regulating the functioning of the lungs, internal organs of the abdominal cavity and pelvis.As a result, there will be signs of disturbances in their functioning, as well as pain radiating to the ribs, called radicular syndrome.
Generally speaking, thoracic osteochondrosis can manifest itself:
- pain in the shoulder blades, which intensifies with deep inspiration;
- pain behind the breastbone in the heart area;
- the appearance 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 dysfunction of the liver, gallbladder and its ducts, which may be due to the development of cholecystitis, metabolic disorders, etc.
- pain in the left hypochondrium or shingles due to dysfunction of the pancreas, which leads to an increased risk of developing diabetes;
- decrease in immunity, occurrence of allergic reactions due to suppression of innervation of the adrenal glands;
- urinary disorders due to kidney dysfunction and the addition of infectious diseases, including pyelonephritis;
- disorders of the female and male genitalia, including infertility.
In this case, severe pain causes reflex tension in the back muscles, which causes unpleasant sensations and increases the risk of pinching of nerve structures.
The risk of changes in the functioning of internal organs increases sharply in the late stages of the development of thoracic osteochondrosis, when protrusion of the intervertebral discs is already observed, that is, the formation of protrusions and intervertebral hernias.In such situations, the pathological protrusion will compress the nerve roots, which will cause disorders of the innervation of the corresponding internal organs and the development of their diseases.
So, although thoracic osteochondrosis is a fairly rare disease, it can affect the functioning of the entire body.Therefore, this requires immediate implementation of comprehensive treatment.To do this, you need to contact a neurologist who will assess the patient's condition, study the results of available examinations and develop an individual treatment program.This will largely depend not only on the degree of thoracic osteochondrosis (there are 4 stages, the simplest of which is the 1st), but also on the nature of the manifestations of 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.
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;
- eliminate the causes of osteochondrosis;
- reduce the risk of complications of the disease.
For this, patients may be prescribed:
- lifestyle correction;
- drug therapy;
- exercise therapy;
- manual therapy;
- traction therapy;
- physiotherapeutic treatment.
The specific methods that will be recommended to the patient are 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 certain lifestyle adjustments, exercise therapy and manual therapy.
But if the disease has already progressed to the 2nd and especially the 3rd stage, additional drug treatment, traction therapy, etc. are recommended.will definitely be recommended.In addition, if osteochondrosis has already caused the formation of intervertebral hernias, especially large ones, and is accompanied by severe radicular syndrome, which cannot be eliminated by conservative methods, it is possible to achieve improvement in the patient's condition only by using the operation.
So, in the case of thoracic osteochondrosis, as well as similar lesions 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, especially large lesions, it is not yet possible to completely restore 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 certain changes to your usual lifestyle.If a patient shows signs of excess weight, he or she is advised to take steps to reduce it.But all weight loss diets, especially one-component diets, are contraindicated.Nutrition must be complete and varied so that the body receives all the substances necessary for its proper functioning and the metabolic processes of the intervertebral discs take place correctly.Therefore, it should adhere as much as possible to 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 activities, including intense training on simulators, jumping sports and weightlifting, are contraindicated.
If the patient's occupation involves heavy physical labor, such as lifting heavy objects, it is recommended to try changing.This is due to the fact that increased load on the back in the presence of osteochondrosis can act as a trigger for the rapid progression of degenerative changes in the discs.
Absolutely all patients with thoracic osteochondrosis are recommended to replace the mattress with an orthopedic mattress 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 usually prescribed a complex of medications.It is recommended to take some of them only occasionally, especially during exacerbations of the disease, while others should be used as part of courses, the duration of which is chosen by the doctor.
When prescribing specific medications, the neurologist must determine whether the patient suffers from concomitant diseases and their nature.This is necessary to exclude contraindications to taking certain medications.
In general, for thoracic osteochondrosis, the following groups of drugs can be prescribed:
- NSAIDs;
- corticosteroids;
- muscle relaxers;
- vitamins;
- chondroprotectors;
- products for topical use;
- means improving microcirculation.
NSAIDs
Nonsteroidal anti-inflammatory drugs are one of the most extensive groups of drugs, as they have a long list of indications for use, including thoracic osteochondrosis.They have anti-inflammatory and analgesic properties, therefore they are indicated in cases of exacerbations of the disease and the appearance of pain.
Today there are 4 generations of NSAIDs, among which the most recent drugs, 4th generation, are considered the safest and most effective.They are distinguished by their selective action and practically have no negative effect on the mucous membranes of the stomach and duodenum.At the same time, previous drugs of 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 provoke their exacerbation.
NSAIDs are available in almost all possible dosage forms, which allows you to select the drug based on the mode of use.Therefore, in the early 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 drugs 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 in severe inflammatory processes.But due to the possibility of causing a number of negative side effects, they are usually prescribed in the form of solutions for injection and only in short courses.
In addition, corticosteroids combined with local anesthetics are used to perform paravertebral blocks.They are indicated for very severe pain that deprives a person of their ability to work, but can only be performed in a medical facility.Blockages help to quickly relieve even very intense pain and consist of introducing a prepared solution into points located in the immediate vicinity of the spine, in the area where the spinal roots pass.
It is recommended to perform these procedures no more than 4 times a year.
Muscle relaxers
Muscle relaxers are a group of medications designed to relieve muscle spasms.Remember that they often act as a reflex response of the body to pain.Therefore, the use of muscle relaxants will help reduce the severity of pain associated with thoracic osteochondrosis.
Vitamins
When treating thoracic osteochondrosis, vitamin complexes containing increased amounts of B vitamins may also be prescribed.This is necessary to improve the quality of the passage of bioelectric impulses along the nerves, which is especially important in cases 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 actively prescribed for thoracic osteochondrosis.As active ingredients, they mainly contain compounds that are absolutely natural for the human body and are 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 of this group in advanced forms of osteochondrosis, although they work quite well at first.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 drugs in this group, they are characterized by a high cost, which, combined with the need to use them in courses of 30 days or more, makes their use inaccessible to everyone.
Topical products
In addition to the ointments, creams and gels containing NSAIDs and chondroprotectors discussed above, the treatment of thoracic osteochondrosis may include the use of warming and locally irritating agents.Their principle of action is based on irritation of the skin receptors at the site of application.This results in active blood flow to the application area, and therefore an influx of nutrients.As a result, the quality of nutrition of the intervertebral discs improves and pain decreases.
Products to improve microcirculation
Medicines of 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 primary roles in the treatment of thoracic osteochondrosis, since 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 effective treatment of thoracic osteochondrosis, it is necessary to develop an exercise therapy program on an individual basis.
Initially, so that the patient can master the correct exercise technique, it is recommended to train under the supervision of an exercise therapy instructor.He will be able to correctly calculate the load depending on 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 conducted daily.
When performing any therapeutic exercises, it is important to avoid sudden movements.
Manual therapy of thoracic osteochondrosis
One of the most effective ways to treat thoracic osteochondrosis is manual therapy, since it not only allows you to work out the muscles well, but also involves influencing the spine.This is how it differs from therapeutic massage, which is also very useful for osteochondrosis, but cannot have the same effect as manual therapy, since it does not involve the spine.
But in order for manual therapy to bring only benefits, one must be careful when choosing a specialist to carry it out, because the effect on the spine must be carried out with extreme precision.Otherwise, the risk of complications is high.
Manual therapy sessions begin with stroking and muscle relaxation.The doctor works well on each area of the back, eliminating spasms and preparing soft tissues for more active action.After that, he begins to use mobilization and manipulation techniques, which can sometimes be accompanied by slight discomfort and crunching.
The method of manual therapy, 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.
Generally speaking, a course of manual therapy sessions allows:
- 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 on them;
- normalization of muscle tone;
- elimination of functional blocks;
- improve the functioning of the lungs, bronchi, heart and gastrointestinal tract;
- increase immunity and reduce exposure to allergens.
At the same time, an improvement in well-being is observed from the first session.Subsequently, patients notice a gradual reduction in pain and an improvement in general condition, an increase in performance and mood.
Physiotherapy
Physiotherapeutic methods are widely used for the treatment of thoracic osteochondrosis after the end of the acute phase of the inflammatory process.They can further reduce the severity of back pain and also have a number of other positive effects on the body.
Most often, for thoracic osteochondrosis, the following are prescribed:
- electrophoresis with the introduction of drugs - this method provides deeper penetration of drug components into tissues and enhances their therapeutic effect through the use of a weak electric current;
- magnetotherapy is a method of physiotherapeutic treatment based on the beneficial effects of a magnetic field on the body, which helps to stimulate blood circulation in the zone of influence, which leads to the activation of metabolic processes, a reduction in pain and swelling;
- laser therapy is a method that allows you to achieve a pronounced anti-inflammatory and vasodilator effect, which will also lead to an improvement in the condition of the intervertebral discs and a reduction in pain;
- ultrasound therapy is a physiotherapeutic procedure that provides anti-inflammatory and analgesic effect;
- diadynamic currents are an effective method of physical influence, due 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 10-15 sessions.But each of them has its own contraindications, which must be taken into account when choosing a specific type of exposure.
Traction therapy
Traction therapy helps 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 optimal conditions for the restoration of cartilage tissue.Traction therapy or spinal traction is carried out on a special table under the supervision of medical professionals.
So, 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 of diagnosing it plays to the patient's disadvantage, because without proper treatment, degenerative changes in the intervertebral discs continue to worsen.As a result, complications often develop 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.