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 appearance of degenerative-dystrophic changes in the intervertebral discs, which causes pain and creates preconditions for the formation of intervertebral bulges and hernias.The disease can affect any part of the spine, although osteochondrosis of the thoracic region is extremely rare.This causes significant difficulties with its diagnosis, because the symptoms of the disease imitate 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 of a doctor.
"Since there are many nerve endings in the intervertebral discs, any change in their structure leads to the transmission of corresponding signals to the brain, which causes the appearance of pain in the affected area."
What is thoracic osteochondrosis and the 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 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 go to a cardiologist or other specialist and undergo treatments that do not work, but end up seeing a neurologist when the disease is already advanced.
There are 12 vertebrae in the thoracic spine.Among all of them are the intervertebral discs, but more often the first and last spinal segments of this section 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, internal organs of the abdominal cavity and pelvis.As a result, signs of alterations in its functioning will appear, as well as pain that radiates 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 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, as a result of disruption of the liver, gallbladder and its ducts, which may be due to the development of cholecystitis, metabolic disorders, etc.;
- pain in the left upper quadrant or shingles due to dysfunction of the pancreas, which increases the risk of developing diabetes;
- decreased immunity, the appearance 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, severe pain causes reflex tension in the back muscles, which causes unpleasant sensations in them and increases the risk of pinching of nerve structures.
The risk of changes in the functioning of internal organs sharply increases in the later stages of the development of thoracic osteochondrosis, when a protrusion of the intervertebral discs is already observed, that is, the formation of intervertebral protrusions and hernias.In such situations, the pathological protrusion will compress the nerve roots, which will lead to disturbances in the innervation of the corresponding internal organs and the development of their diseases.
Thus, although thoracic osteochondrosis is a fairly rare disease, it can affect the functioning of the entire body.Therefore, it requires the immediate start of comprehensive treatment.To do this, you should contact a neurologist who will evaluate the patient's condition, study the results of available examinations 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 first), but also on the nature of the manifestations of the disease, the type of concomitant diseases present, age and a number of other factors.Therefore, 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 is aimed at solving the following problems:
- elimination of unpleasant symptoms of the disease, which improves the patient's quality of life and restores his full functionality;
- improve the quality of blood circulation in the affected area, which activates metabolic processes and will facilitate regeneration processes in the disc;
- eliminate the causes of osteochondrosis;
- reducing the likelihood of complications of the disease.
To do this, patients can be prescribed:
- lifestyle correction;
- drug therapy;
- exercise therapy;
- manual therapy;
- traction therapy;
- physiotherapy treatment.
The treating doctor determines what specific methods will be recommended to the patient, depending on the severity of degenerative-dystrophic changes in the spine.So, if thoracic osteochondrosis is diagnosed at the first stage of development, which, unfortunately, is quite rare, it is usually enough to limit yourself to making certain lifestyle adjustments, exercise therapy and manual therapy.
But if the disease has already progressed to the second and especially the third stage, additional drug therapy, traction therapy, etc. will definitely be recommended.In addition, if osteochondrosis has already led to the formation of intervertebral hernias, especially large ones, and is accompanied by severe root syndrome that cannot be eliminated with conservative methods, it is possible to achieve an improvement in the patient's condition only by operation.
Therefore, in thoracic osteochondrosis, as well as in 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.In case of existing injuries, especially large ones, it is not yet possible to achieve a complete restoration of the cartilaginous tissue, not only of the intervertebral discs, but also of other joints.So, let's look at the main methods of treating thoracic osteochondrosis and its features.
Lifestyle correction
After the diagnosis of 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 recommended to take steps to reduce it.But any diet to lose weight, especially monocomponent ones, is contraindicated.Nutrition must be complete and varied so that the body receives all the substances necessary for its proper functioning and the metabolic processes in the intervertebral discs develop correctly.Therefore, you must fully respect 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 walking, swimming, doing yoga or Pilates daily.But intense 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 heavy objects, it is recommended to try changing it.This is due to the fact that the 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.
Pharmacological treatment of thoracic osteochondrosis.
In the treatment of osteochondrosis, patients are usually prescribed a complex of medications.Some of them are recommended to be taken only occasionally, in particular during 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 find out whether the patient has 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 relaxants;
- vitamins;
- chondroprotectors;
- products for topical use;
- It means improving microcirculation.
NSAIDs
Non-steroidal anti-inflammatory drugs are one of the most extensive groups of drugs, since they have a huge list of indications for use, which includes thoracic osteochondrosis.They have anti-inflammatory and analgesic properties, so they are indicated for exacerbations of the disease and the appearance of pain.
Currently, there are 4 generations of NSAIDs, among which the most recent, fourth-generation drugs are considered the safest and most effective.They are distinguished by their selective action and practically do not have any negative effects on the mucous membranes of the stomach and duodenum.At the same time, the above drugs from 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, allowing the drug to be selected based on the method of use.Therefore, in the early stages of thoracic osteochondrosis, the use of ointments, gels or creams is indicated.For more intense pain, preference is given to capsules or tablets, and if no effect occurs, 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 injectable solutions and only in short courses.
Additionally, corticosteroids are used in combination with local anesthetics to perform paravertebral blocks.They are indicated for very severe pain that deprives a person of his or her ability to work, but they can only be performed in a medical institution.Blocks help to quickly relieve even very intense pain and consist of introducing a prepared solution into points near 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 many times they 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
In the treatment of thoracic osteochondrosis, vitamin complexes containing increased amounts of vitamin B 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 radicular syndrome.In this way, the development of alterations in the functioning of the organs innervated by the spinal roots of the intervertebral discs located at the level of the injury is prevented.
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 that it uses 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 phases they work quite 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 drugs from 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 chondroprotectors discussed above, the treatment of thoracic osteochondrosis may include the use of warming agents and local irritants.Its principle of action is based on the irritation of the 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 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 exercise under the supervision of a physiotherapy instructor.You will be able to correctly calculate the load in accordance with the level of physical development of a person and adjust your movements so that the exercises performed bring maximum benefit.The program will gradually become more complicated and, once completely mastered, the patient can practice at home.But for the classes to have good results, it is necessary to do them 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, since it not only allows you to exercise the muscles well, but also involves influencing the spine.In this it differs from therapeutic massage, which is also very useful for osteochondrosis, but does not have the same effect as manual therapy, since it does not affect the spine.
But for manual therapy to only bring benefits, care must be taken when choosing a specialist to perform it, since the effect on the spine must be carried out with millimeter 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.Subsequently, he begins to use mobilization and manipulation techniques, which can sometimes be accompanied by minor discomfort and crunching.
The manual therapy method deserves special attention, which is characterized by the use of special techniques that have proven to be one of the most effective for 20 years.They allow not only to have a beneficial effect on the affected intervertebral discs, but also to improve the quality of the functioning of all internal organs, because, as mentioned above, they have a close relationship with the spine.
In general, a course of manual therapy sessions provides:
- restoration of the correct anatomy of the spine with the return of the vertebrae to their assigned places;
- increasing 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;
- removal 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 after the first session.Subsequently, patients notice a progressive reduction in pain and an improvement in general condition, increased performance and mood.
Physiotherapy
Physiotherapeutic methods are widely used for the treatment of thoracic osteochondrosis after the end of the acute stage of the inflammatory process.They can further reduce the severity of back discomfort and also have 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 the drug components into the tissues and enhances their therapeutic effect through the use of a weak electric current;
- magnetotherapy is a method of physiotherapy treatment, 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 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 an anti-inflammatory and analgesic effect;
- Diadynamic currents are an effective method of physical influence, thanks to the use of which there is a decrease in the severity of pain, 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 specific 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 optimal conditions for the restoration of cartilage tissue.Spinal traction or traction therapy is performed on a special table under the supervision of medical professionals.
Therefore, 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 works against the patient, since without adequate treatment the degenerative changes in the intervertebral discs continue to worsen.As a result, complications often develop in such situations, including the formation of intervertebral protrusions and hernias.Therefore, it is important not to ignore changes in well-being and immediately consult a doctor, and when diagnosing thoracic osteochondrosis, strictly follow his recommendations.