Thoracic osteoarthritis is a chronic disease in which the vertebrae and the intervertebral discs between them undergo degenerative changes. Destructive injuries in this area are quite rare due to its low mobility and good protection by the rib cage. Thoracic spondylosis develops unnoticed, progresses slowly but persistently and is also characterized by a number of specific symptoms, masquerading as diseases of internal organs. In this regard, it is very important to seek medical help at the first, still mild, signs of back problems. Timely treatment helps prevent serious complications.
Causes and triggers
Degenerative-dystrophic processes in the thoracic segments of the spine occur due to endogenous disruptions and under negative external influences. Their development is often stimulated by the following factors:
- genetic predisposition, the presence of a certain defective set of genes;
- excessive physical exertion, especially lifting and carrying various heavy objects;
- sedentary lifestyle, causing blockage of the vertebral body and intervertebral disc;
- congenital or acquired structural abnormalities, such as accessory vertebrae, kyphosis, kyphosis;
- back and/or chest injuries - fractures, prolonged compression;
- flat feet, club feet;
- Blood circulation is impaired anywhere, not just the thoracic spine;
- frequent hypothermia;
- overweight;
- endocrine diseases, metabolic disorders such as diabetes, gout, hypothyroidism, hyperthyroidism;
- Systemic diseases - rheumatoid arthritis, systemic lupus erythematosus, scleroderma;
- ankylosing spondylitis.
The strength and mobility of the spine in general depends directly on the condition of each part. The disease can be the result of severe osteoarthritis of the lumbar or neck that is left untreated.
Smoking, alcoholism and intoxication, including occupational hazards, risk destroying the joints between the intervertebral discs consisting mainly of cartilage. Thoracic osteochondrosis is diagnosed more often in the elderly than in young and middle-aged people. This is due to the natural aging of the body, slowed recovery and the presence of one or more somatic pathologies.
Symptoms and signs of the disease
The leading symptom of the degenerative process is pain. Unlike cervical and lumbar spondylosis, it is extremely rarely acute, burning, penetrating. Patients often describe the discomfort as dull, painful, or pressing. The pain syndrome can increase when bending/turning, sudden movements, coughing or temperature changes. Its irradiation is noted - spreading beyond the affected area. Thoracic spine degeneration also manifests as follows:
- stiffness, feeling of tightness;
- a specific clicking, crunching sound when changing body position;
- loss of sensitivity, paralysis in the form of a feeling of "goosebumps", burning, numbness;
- muscle spasms, further limiting range of motion;
- adopting a forced position where discomfort does not arise or is expressed weakly;
- pathological changes in posture, in later stages - gait;
- growth is slightly reduced due to destruction of the vertebral joints and convergence of the vertebral bodies.
Due to constant tension in the back muscles, the muscles in the neck and lower back also contract, causing pain in these parts.
The clinical picture of thoracic osteoarthritis is a combination of pain syndromes. The fact is that the affected segments are located in the common nerve area with many internal organs. If a displaced disc has compressed a nerve root located near the spine, you may feel pain there, simulating common pathologies:
- severe heart attack resembling angina and even myocardial infarction;
- pain in the mammary gland becomes the reason for urgent differential diagnosis to exclude tumor processes;
- Continuous or periodic pain in the right lower quadrant, in the stomach or intestines, resembling features of gastritis, cholecystitis and ulcerative lesions.
As osteonecrosis becomes more severe, the lower back or abdomen may become painful. Patients mistake the discomfort for signs of kidney disease or gynecological disease. They seek out specialist specialists, who will then refer the patient to a neurologist or spine specialist after the examination.
Classification, main types
The common classification of osteochondrosis of the thoracic spine is based on the nature of the pain syndrome. There are two types of it:
- dorsago - an acute pain in the sternum, occurring mainly when the body is in a prolonged position, often complicated by a feeling of lack of air when inhaling;
- Back pain is a mild pain in the back that appears periodically and gradually subsides after rest.
Dividing pathologies into groups allows the doctor to quickly decide on the choice of painkillers.
Staged development of thoracic osteonecrosis
During development, thoracic spine cartilage degeneration goes through four stages. Each type has its own symptoms and radiological signs. The more pronounced the deformation of the intervertebral disc and vertebrae, the more intense the pain, stiffness and paresthesia. The stage of the disease determines the treatment method.
Phase I
There have been no changes on the X-ray. However, the disc can no longer retain moisture well, so timely recovery is impossible. It begins to thin out, losing strength and elasticity. Only in some cases does mild discomfort occur in the chest area. One person considered it muscle fatigue and did not consult a doctor. Therefore, disease at this stage is often an incidental diagnostic finding during examination for another reason.
Phase II
The structure of the annulus becomes loose and fibrous. Widening of a disc fracture occurs when the nucleus pulposus protrudes in this direction. The distance between adjacent vertebrae gradually decreases as the height of the intervertebral disc decreases, which is clearly shown on X-ray images. To compensate for the load distribution, muscle tissues are constantly in tension. Stiffness increases, pain level remains moderate.
Phase III
The annulus fibrosus ruptures with the nucleus pulposus being forced beyond its boundaries. Disc herniation occurs, causing severe symptoms and serious complications. There is significant deformity of the vertebral body and the formation of isolated bone spurs (compensatory bone growth). The pain syndrome becomes constant, movements in the back are significantly limited.
stage IV
At this stage, diagnosing osteochondrosis of the chest is not difficult. Connective tissue has developed and many bone spurs have formed. Adjacent vertebrae in that segment are completely or partially blocked or immobilized. Nerve roots are often compressed by swelling, bone growth, and muscle spasms. This manifests as a burning, burning pain. The patient copes poorly with household tasks and has difficulty moving.
symptoms
The development of discogenic myelopathy, a spinal dystrophy caused primarily by disc herniation, is very dangerous. It is worth noting that with osteoarthritis of the thoracic spine, such complications are rare. However, in clinical practice there have been cases of localized disc myelopathy in one of the lower segments. As neurological deterioration progresses, muscle strength gradually decreases and tendon reflexes change. Ischemic areas form and nerve cells die (spinal cord infarction). This is characterized by movement disorders, loss of sensitivity and nutritional disorders.
Diagnostic measures
At the first consultation, the doctor listens to the patient's complaints, examines him, evaluates the level of sensitivity, checks tendon reflexes, studies medical history and history of spinal injury. His diagnosis was confirmed by laboratory and instrumental studies:
- X-ray in two projections, as directed - targeted image of a certain segment;
- magnetic resonance imaging;
- evoked potential;
- electronics;
- electromechanical;
- General clinical blood and urine tests.
To find the cause of specific symptoms and exclude somatic diseases with similar clinical manifestations, an electrocardiogram, ultrasound of cardiac structures and electroencephalogram may be prescribed.
Treatment methods for thoracic osteoarthritis
This therapy is comprehensive, aimed at eliminating symptoms and preventing the spread of the pathological process to other spinal segments. In the acute stage, unbearable burning pain is eliminated by injecting drugs, including drugs directly into the affected area. The use of glucocorticosteroids in combination with anesthetics (blockade drugs) is often performed. In other cases, drug treatment includes taking pills, capsules, applying ointments and balms. The use of drugs from the following groups has proven effective:
- muscle relaxants to reduce muscle spasms;
- Nonsteroidal anti-inflammatory drugs have a pronounced analgesic effect;
- antispasmodic medication for pinched nerves;
- means improving blood circulation;
- preparations with vitamin B6, which improves the transmission of nerve impulses and activates regeneration processes.
If nerve root syndrome has formed and other complications arise, the person lives in constant fear of experiencing severe pain again and this can cause mental disorders. Prescribing sedatives and antidepressants can prevent such developments. In addition to medications, the following methods are used in the treatment of osteoarthritis of the thoracic spine:
- therapeutic massage, including vacuum and acupuncture;
- physiotherapeutic procedures - electrophoresis/ultrasound, magnetic therapy, pulsed current, UHF therapy, application with ozokerite or paraffin, acupuncture, hirudotherapy;
- physical therapy and gymnastics;
- spinal traction.
In cases of significant damage to the vertebral disc and myelopathy, immediate surgical treatment is always indicated. The herniated protrusion is removed, microdiscectomy, puncture or laser disc reconstruction is performed, implantation or stabilization of the spinal segment is performed.
Prevent breast bone degeneration
The primary goal of primary prevention of thoracic osteochondrosis is to eliminate factors that can cause disc thinning and cracking. What doctors recommend:
- avoid excessive stress on the back;
- Timely treatment of all diseases - infectious, endocrine, inflammatory;
- immediately seek medical help if you have a back injury, even injuries that seem minor at first glance;
- give up alcohol and smoking or at least limit them;
- Supplement your diet with fatty fish, fresh vegetables, fruits and dairy products;
- avoid hypothermia;
- Practice physical therapy for at least 15 minutes every day.
Such preventive measures are effective for diagnosed diseases of the thoracic, cervical or lumbar spine. With their help, it will be possible to prevent the exacerbation and progression of the degenerative-dystrophic process.
If you have signs of thoracic spine osteoarthritis and want to remove it, contact the clinic for complete, appropriate treatment.
Answer the question
What is the difference between intercostal neuralgia and thoracic osteochondrosis?
In fact, intercostal neuralgia is a damage to the intercostal nerves, which can complicate the process of osteoarthritis. There are two main differences between these pathological processes. Neuralgia is characterized by paroxysmal or burning pain, which intensifies even when inhaling. Osteochondrosis of the chest without violating sensitive nerve endings is manifested by dull pain, as if at a distance.
And the second difference is forecasting. After eliminating the cause of intercostal neuralgia, it will disappear without a trace. Osteoarthritis only responds well to treatment in the initial stages of development.