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 lead to pain and create the conditions 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 causes significant difficulties in 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 cause extremely serious complications and loss of performance.
Expert opinion from a doctor
"Since there are many nerve endings in the intervertebral discs, any change in their structure leads to the transmission of the 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 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 in many ways resemble signs of diseases of the cardiovascular system.Therefore, patients often initially turn to a cardiologist or other specialist and undergo courses of treatment that do not bring results, but end up consulting a neurologist when the disease is already in an advanced stage.
There are 12 vertebrae in the thoracic spine.Among all there are intervertebral discs, but most often the first and last segments of movement 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 come out in pairs at the level of each vertebra from the spinal cord and are responsible for regulating the functioning of the lungs, internal organs of the abdominal cavity and pelvis.As a result, signs of disturbances in their functioning will appear, as well as pain radiating to the ribs, 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 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 rupture 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 pancreatic dysfunction, leading to an increased risk of developing diabetes;
- decreased immunity, appearance of allergic reactions due to suppression of the innervation of the adrenal glands;
- urinary disorders due to malfunction of the kidneys and the addition of infectious diseases, especially 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 and increases the risk of pinching the nerve structures.
The risk of changes in the functioning of internal organs increases significantly in the later stages of the development of thoracic osteochondrosis, when protrusion of the intervertebral discs is already observed, that is, the formation of intervertebral protrusions and hernias.In such situations, pathological protrusion will compress the nerve roots, causing disturbances in the innervation of the corresponding internal organs and the development of their diseases.
Therefore, although thoracic osteochondrosis is a fairly rare disease, it can affect the functioning of the entire body.Therefore, immediate initiation of comprehensive treatment is necessary.To do this, you need to contact a neurologist who will evaluate the patient's condition, study the available examination results 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 simplest is the 1st), but also on the nature of the manifestations of the disease, 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 disc changes 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 regeneration processes in the disc;
- eliminate the causes of osteochondrosis;
- reducing the likelihood of complications of the disease.
For this, patients may be prescribed:
- lifestyle correction;
- drug therapy;
- physical therapy;
- manual therapy;
- traction therapy;
- physiotherapy treatment.
What specific methods 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 in the early stage of development, which, unfortunately, is quite rare, it is usually enough to limit yourself to making some changes in your lifestyle, physical 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 definitely 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 possible to achieve an improvement in the patient's condition only with the use of the operation.
Therefore, with thoracic osteochondrosis, as well as with similar lesions in other parts of the spine, treatment is aimed at stopping the further progression of degenerative changes in the intervertebral discs and improving the patient's well-being.With existing lesions, 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 treatment of thoracic osteochondrosis and their features.
Lifestyle correction
After diagnosing thoracic osteochondrosis, the doctor necessarily recommends making some changes to your usual lifestyle.If a patient shows signs of excess weight, it is recommended to take measures to reduce it.But any slimming diet, especially one-component, is contraindicated.Nutrition must be complete and varied so that the body receives all the substances necessary for correct functioning and the metabolic processes in the intervertebral discs proceed correctly.Therefore, it should 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 walks, swimming, yoga or pilates.But serious physical activity, especially intense training on simulators, jumping sports and weight lifting are contraindicated.
If the patient's profession involves heavy physical work, such as heavy lifting, 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 advised 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 degeneration of the disc.
Pharmacological treatment of thoracic osteochondrosis
When treating osteochondrosis, patients are usually prescribed a complex of drugs.Some of them are recommended to be taken only occasionally, especially during exacerbation of the disease, while others should be used in courses, the duration of which is selected by the doctor.
When prescribing specific drugs, the neurologist must find out whether the patient has concomitant diseases and their nature.This is necessary to exclude contraindications to taking certain drugs.
In general, the following groups of drugs can be prescribed for thoracic osteochondrosis:
- NSAIDs;
- corticosteroids;
- muscle relaxants;
- vitamins;
- chondroprotectors;
- products for topical use;
- it means improving microcirculation.
NSAIDs
Nonsteroidal anti-inflammatory drugs are one of the most extensive groups of drugs, as they have an extensive list of indications for use, which includes thoracic osteochondrosis.They have anti-inflammatory and analgesic properties, therefore they are indicated in case 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 have practically no negative effect on the mucous membranes of the stomach and duodenum.At the same time, the first drugs of this group should not be used, especially for a long time in the presence of gastritis and peptic ulcer of the stomach and duodenum, as they can cause their exacerbation.
NSAIDs are available in almost all possible dosage forms, which allows you to select the drug 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 severe pain, preference is given to capsules or tablets, and if there is no effect, intramuscular injections of drugs are allowed.
Corticosteroids
Drugs of 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 in combination with local anesthetics are used to perform paravertebral blocks.They are indicated for very severe pain that deprives a person of his ability to work, but can only be performed in a medical institution.The blocks help to quickly relieve even very severe pain and consist of introducing a prepared solution into points in the immediate vicinity of 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.Remember that they often act as the body's reflex response to pain.Therefore, the use of muscle relaxants will help reduce the severity of pain in thoracic osteochondrosis.
Vitamins
In the treatment of thoracic osteochondrosis, vitamin complexes containing increased quantities of B vitamins can also be prescribed. This is necessary to improve the quality of the passage of bioelectric impulses along the nerves, which is especially important in 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 prevented.
Chondroprotectors
Chondroprotectors are a relatively new group of drugs actively prescribed for thoracic osteochondrosis.As active ingredients they mainly contain absolutely natural compounds 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 from this group in advanced forms of osteochondrosis, although in the initial stages they work quite well.At the same time, the natural origin of chondroprotectors guarantees a high level of safety.
These medicines are available in several 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 of this group, they are characterized by a high cost, which, combined with the need to use them in cycles 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, treatment of thoracic osteochondrosis may include the use of warming and irritating agents locally.Their principle of action is based on irritation of skin receptors at the application site.This leads to an active blood flow to the application area and thus to an influx of nutrients.As a result, the quality of nutrition of the intervertebral discs improves and pain decreases.
Products to improve microcirculation
Drugs from this group are also used to improve the quality of blood circulation and activate metabolic processes.
Physical therapy
Therapeutic physical education plays one of the main roles in the treatment of thoracic osteochondrosis, as it allows:
- strengthen the muscle 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 a physical 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 physical therapy instructor.He will be able to correctly calculate the load based 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 the lessons to give good results, they should be carried out 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 train the muscles well, but also involves influencing the spine.In this it differs from therapeutic massage, which is also very useful for osteochondrosis, but is not able to have the same effect as manual therapy, since it does not involve the spine.
But in order for manual therapy to bring only benefits, it is necessary to be careful when choosing the specialist who will carry it out, because the effect on the spine must be carried out with millimeter precision.Otherwise the risk of complications is high.
Manual therapy sessions begin with stroking and relaxing the muscles.The doctor works well on every area of the back, eliminating spasms and preparing the soft tissues for more active action.Subsequently he begins to use mobilization and manipulation techniques, which can sometimes be accompanied by slight discomfort and creaking.
The method of manual therapy deserves special attention, which is distinguished by the use of special techniques that have proven to be among 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 functioning of all internal organs, because, as mentioned above, they have a close relationship with the spine.
In general, a cycle of manual therapy sessions includes:
- 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;
- increase immunity and reduce exposure to allergens.
At the same time, an improvement in well-being is observed after the first session.Subsequently, patients note a progressive 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 completion 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.
Very 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 improves its therapeutic effect through the use of a weak electric current;
- magnetotherapy is a method of physiotherapeutic 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 obtain 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 which there is a decrease in the severity of pain, an increase in the metabolic rate and an improvement in the condition of muscle tissue.
As a rule, physiotherapeutic procedures are prescribed in cycles 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 allows you to increase the distance between the vertebrae of the thoracic spine, thus reducing the 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 performed on a special table under the supervision of medical professionals.
Therefore, although thoracic osteochondrosis is not a common disease, it can significantly reduce the quality of a person's life and lead to the development of a number of pathologies of internal organs.At the same time, the difficulty of diagnosing it is to the detriment of the patient, since without adequate treatment, degenerative changes in the intervertebral discs continue to worsen.As a result, complications often develop in such situations, including the formation of intervertebral bumps 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 the recommendations received from him.