Diseases of the thoracic spine, signs, treatment in Moscow

Diseases of the thoracic spine are not uncommon today. With many of them, undesirable changes occur in bone and cartilage tissues, and they are not isolated. Deformations of one of the anatomical structures of the spine inevitably affect all the others, so a complex of diseases affecting intervertebral discs, facet joints, vertebrae and their position is often diagnosed. In this case, infringement of the spinal roots and the nerve fibers extending from them is often observed, which leads to the occurrence of neurological disorders, including in the functioning of internal organs that are innervated by the affected nerves.

Often such changes are natural in nature with age. But the peculiarities of modern lifestyle have led to the fact that diseases of the spine are becoming younger and today they are often diagnosed not only in adults over 25–30 years old, but also in adolescents. Most often, Schmorl's hernias, spondylosis, and scoliosis are found in the thoracic spine, and they are all closely interconnected and create the prerequisites for the development of each other.

The structure of the thoracic spine and its connection with internal organs

The thoracic spine is formed by 12 vertebrae, to which 12 pairs of ribs are attached. This is the longest section of the spine, the average length of which is 25–30 cm. Between all the vertebrae there are intervertebral discs, which are cartilaginous layers of ellipsoidal shape, designed to serve as natural shock absorbers, as well as providing flexibility and mobility of the spine. The processes of the vertebrae also connect to each other, forming facet joints. Along the back surface of the spine runs a canal that contains the spinal cord.

In the thoracic region, the spinal canal is quite narrow, which significantly increases the risk of developing spinal cord stenosis in the event of spinal diseases.

From the spinal cord there are many nerve roots that regulate the functioning of most organs of the abdominal cavity and chest. They form two sympathetic trunks (right and left), which, together with all their nerve ganglia, are one of the parts of the peripheral autonomic nervous system. They run along the sides of the spine, including in the thoracic region, and their nodes are connected to each other by internodal branches. Gray connecting branches depart from the nodes, as well as nerves that regulate the functioning of internal organs, blood vessels and intertwine into large prevertebral plexuses of the abdominal cavity.

The white connecting branches, which are a bundle of nerve fibers, on the contrary, approach the sympathetic trunks, but only at the level of the last cervical, all thoracic vertebrae and 2 lumbar vertebrae. They pass through all 10–12 thoracic nodes. From them, in turn, depart thin sympathetic nerves responsible for the functioning of the lungs, organs of the digestive system, blood vessels, heart, etc.

The largest branches of the sympathetic trunk in the thoracic region are the greater and lesser splanchnic nerves. The first is formed by branches originating at the level of 5-9 thoracic nodes, the second - by nerves originating at the level of 10-11 thoracic nodes. Both of them flow into the nodes of the celiac plexus. It is the largest and most important plexus, which is also often called the solar plexus. It consists of several large nodes and numerous nerves that are responsible for:

lungs, diaphragm, covering its peritoneum and their blood and lymphatic vessels;
spleen, stomach, gall bladder, liver, pancreas, intestines;
adrenal glands, kidneys;
heart, aorta;
bladder.

Thus, the occurrence of disorders in the thoracic spine can lead to compression or damage to the white and gray connecting branches, as well as the thoracic nodes, which will lead to disruption of the transmission of nerve impulses to the nerves of the celiac plexus. The direct consequence of this will be disruption of the functioning of the organs and structures innervated by them and, accordingly, the appearance of characteristic symptoms:

sharp or aching pain in the area of the shoulder blades, slightly above or below them, which can radiate to the shoulders, arms, and also intensify during movement, bending, coughing, sneezing;
impaired mobility and sensitivity of the hands;
respiratory failure, shortness of breath, cough, frequent inflammatory diseases of the lungs and bronchi;
arrhythmia, increased blood pressure, pain in the heart area, radiating to the shoulder blades and arms;
bleeding disorders;
increased blood sugar levels, changes in appetite;
stomach pain, hiccups, heartburn;
metabolic disorders of fats, carbohydrates, proteins, which leads to rapid weight loss or gain while maintaining the usual diet;
discomfort in the liver area, formation of gallstones;
frequent constipation, diarrhea;
pain in the kidney area;
loss of control over urination and bowel movements;
increased fatigue, weakness, etc.

Thus, if the celiac node is damaged, there is a risk of developing asthma, coronary heart disease, bronchitis, gastritis, ulcers, diabetes, irritable bowel syndrome, pyelonephritis, infertility and a number of other seemingly unrelated diseases.

Therefore, patients often turn to doctors with pain in the heart, high blood pressure and other symptoms of damage to the nerves of the celiac plexus. But a complete comprehensive diagnosis is not always carried out to reveal the true causes of the condition. Therefore, a diagnosis that does not entirely correspond to reality is often made, for example, angina pectoris or hypertension, and appropriate treatment is carried out. As a result, it turns out to be ineffective in the long term and allows only temporary improvement in the patient’s condition. Since the cause in the form of a violation of nerve conduction along the nerves of the celiac ganglion has not been eliminated, the corresponding symptoms will occur again and again, gradually progressing.

Thus, if the above symptoms appear, it is recommended to consult a competent neurologist, who will be able to prescribe a set of necessary examinations, including MRI of the spine, and track their relationship between the detected changes and the nerves of the celiac ganglion and existing disorders. As a result, an optimal treatment regimen will be developed that will eliminate pathological changes in the spine, normalize the transmission of nerve impulses and, therefore, lead to the elimination of diseases of the cardiovascular, respiratory, digestive systems and other disorders arising from damage to the celiac plexus.

Scoliosis

Almost every person has heard about scoliosis, and this disease is usually associated with childhood and adolescence. But in reality, it often occurs in adults (most often it is a consequence of the lack of adequate correction in adolescence). It is often not possible to find the causes of scoliosis, but the main causes of spinal curvature in the lateral plane are considered to be:

hereditary predisposition;
flat feet;
buying shoes with a large supply of “for growth”;
incorrect position of the child at the table;
muscle weakness;
uneven distribution of load when carrying heavy objects and bags;
congenital and acquired disorders, including different leg lengths, increased joint mobility, absence of a rib;
osteoporosis;
tumors and back injuries;
damage to the spine due to infectious diseases.

The child’s workplace should be arranged so that the feet fully touch the floor and the elbows rest on the table. It is important to pay attention to your posture while working at a desk: your back should be straight and supported by the back of the chair.

The first signs of thoracic scoliosis are:

discomfort in the area of curvature;
uneven position of the shoulder blades and shoulders;
increased fatigue;
headaches and dizziness;
neurological disorders.

In order to diagnose pathology in schoolchildren in a timely manner, it is recommended to undergo annual preventive examinations with an orthopedist and neurologist. If symptoms of the disease are detected, treatment should be started immediately, since in the early stages of the formation of spinal deformity it is much easier to cope with it.

Treatment of scoliosis is always complex. Its tactics depend on the stage of development of the disease and may include:

individual sessions with a rehabilitation specialist;
manual therapy;
osteopathy;
massage;
physiotherapy;
wearing an orthopedic corset;
swimming.

In the most advanced cases, grade 3 and 4 scoliosis may cause severe changes in the functioning of internal organs, in particular the heart, respiratory system and gastrointestinal tract. This is due to the fact that the curvature of the spine leads to their displacement from the anatomically correct position, which cannot but affect the quality of their functioning. In addition, such scoliosis is accompanied by severe pain.

In such cases, it is impossible to correct the situation in a conservative way. Therefore, such patients are prescribed surgical intervention, during which the position of the vertebrae is brought closer to normal with the help of special metal structures. But such operations are very traumatic and involve high intraoperative risks. Therefore, it is better to avoid such situations and begin treatment for scoliosis in a timely manner, while manual therapy and exercise therapy can completely correct the situation.

Spondylosis

Spondylosis is a disease in which degenerative-dystrophic changes occur in the vertebrae. It is a consequence of a sedentary lifestyle, scoliosis and osteochondrosis of the thoracic spine, which initially causes thinning of the intervertebral discs. Often the situation goes so far that the disk is almost completely destroyed. As a result, the vertebrae come closer together and friction occurs between them. Almost inevitably, the nerves suffer, as there is a narrowing of the spinal openings through which they pass. This is accompanied by severe, sometimes unbearable pain.

Gradually, bone outgrowths called osteophytes begin to form on the surface of the vertebrae. If this process is not intervened in a timely manner, osteophytes grow, the outgrowths of the upper and lower vertebrae begin to come into contact with each other and eventually grow together. The result of such processes is complete fusion of the vertebrae. This leads to loss of mobility, which affects a person's flexibility and ability to perform a variety of movements. But since the thoracic region is the least mobile part of the spine, limited mobility does not bother patients much, which cannot be said about severe pain and disruption of the internal organs.

Symptoms of spondylosis of the thoracic spine include:

severe pain between the shoulder blades, intensifying with any movement and especially walking;
shooting pains in the heart area, similar to signs of angina pectoris, which often causes incorrect diagnosis of the causes of their occurrence;
impaired hand sensitivity;
reflex muscle tension in the area of the affected spinal motion segment;
numbness, loss of sensitivity and weakness of the hands;
increased fatigue.

In the most severe cases, osteophytes in spondylosis reach such sizes that they compress the spinal canal, i.e., its stenosis occurs. Such a complication requires immediate surgery, otherwise compression of the spinal cord can lead to irreversible consequences and disability.

How is lumbar massage performed?

If osteochondrosis has affected the lumbar spine, you need to place the patient on his stomach and place a small cushion under the sore area. Your arms should be along your body and your head should be turned to the side. You need to try to relax as much as possible.

First, the massage therapist will warm up your lower back. He will work the massaged area with gentle rubbing movements. For the next 5 minutes, the specialist uses kneading movements that improve blood flow in the lumbar region, allowing you to stretch and warm up not only the skin, but also the muscles.

It is also necessary to treat the gluteal area near the lower back with intense circular movements. You can end the session with stroking.

Schmorl's hernia

Schmorl's hernia is a special type of intervertebral hernia, which is formed not in the horizontal, but in the vertical plane and, accordingly, presses the vertebral body. Under the pressure of the forming protrusion, the vertebral bone is pressed up or down (depending on whether the hernia is located on the lower or upper surface of the disc), and the hernia fills the resulting space. Thus, Schmorl's hernia causes a kind of compression fracture of minor severity.

It can occur in both elderly and quite young people and is a consequence of degenerative processes in the structures of the spinal column. Often, the formation of a Schmorl's hernia is painless and is often discovered by chance during an MRI of the spine for another reason.

The thoracic spine is the main place where a Schmorl's hernia can form. Moreover, most often it occurs in adolescence and subsequently leads to the development of complications, including scoliosis and other degenerative diseases of the spine.

The main reason for its formation is hereditary predisposition, but the following can lead to an increase in hernia:

rapid growth of a child during adolescence;
age-related changes;
spinal injuries leading to intervertebral disc deformations;
insufficient intake of calcium from food or disturbances in its metabolism;
professional participation in certain sports;
regularly lifting heavy objects.

The disease causes noticeable discomfort or even pain when the hernia enlarges so much that the intervertebral disc almost completely collapses into the body of the vertebra located above or below it. This leads to a decrease in the space between the vertebrae and, therefore, pinching of nerves and sometimes blood vessels.

In such situations, pain in the area of its localization occurs when:

prolonged physical activity;
lifting and carrying heavy objects;
prolonged standing or sitting;
blows to the back or chest.

If a Schmorl's hernia is not diagnosed in time and measures are not taken to reduce the rate of its growth, other symptoms may occur:

soreness and tingling in the back muscles;
limited mobility of the thoracic spine;
numbness of hands;
dizziness and headaches;
inability to sit on a chair for a long time without back support.

Schmorl's hernia increases the risk of getting a compression fracture of the spine by 10%, which, combined with the fact that at least 1 hernia of this type is found in 75% of older people, is a very dangerous combination of circumstances.

Symptoms of thoracic osteochondrosis

Thoracic osteochondrosis can cause problems with the heart and intestines; it has a negative effect on the liver, kidneys, and pancreas. However, the manifestations of this disease are very diverse, so it is impossible to identify a clear set of symptoms that would make it possible to unambiguously diagnose thoracic osteochondrosis.

The most common symptoms of thoracic osteochondrosis are:

intercostal pain;
pain when inhaling and exhaling deeply;
pain when raising your right or left arm;
difficulty with any tilt of the body.

Thoracic osteochondrosis is characterized by intercostal pain that causes difficulty breathing. The pain is most intense at night, intensifies with vibration, cooling, turning the body, and less often when bending to the side. Radiating to the anterior surface of the chest, such pain is similar to pain in the heart, but, unlike true cardialgia, it is prolonged and does not decrease when taking nitroglycerin. With an exacerbation of thoracic osteochondrosis, pain in the sternum is felt, which is perceived by women as a pathology of the mammary gland. Pain during exacerbation of thoracic osteochondrosis can last for several weeks.

Diagnostics

If the disorders described above occur, you should contact a neurologist. If necessary, he will refer the patient for additional consultations to other specialists (gynecologist, gastroenterologist, urologist, cardiologist) depending on the nature of the patient’s complaints. He will also prescribe a set of examinations that allow you to get a complete picture of the condition of the patient’s body and develop optimal treatment tactics.

For diseases of the thoracic spine, the following is indicated:

MRI;
CT;
Ultrasound;
ECG;
blood tests, urine tests, etc.

In our clinic, you can also learn in more detail about the composition of your body and the state of the vascular system, which is involved in the blood supply to internal organs, skeletal muscles, and the brain. Our experienced doctors will explain the data obtained to you in detail. Bioimpendansometry calculates the ratio of fat, muscle, bone and skeletal mass, total fluid in the body, and basal metabolic rate. The intensity of recommended physical activity depends on the state of muscle mass. Metabolic processes, in turn, affect the body's ability to recover. Based on the indicators of active cell mass, one can judge the level of physical activity and nutritional balance. This simple and quick test helps us identify disturbances in the endocrine system and take the necessary measures. In addition, it is also very important for us to know the condition of blood vessels for the prevention of diseases such as heart attacks, hypertension, heart failure, diabetes and much more. Angioscan allows you to determine such important indicators as the biological age of blood vessels, their stiffness, stress index (which indicates heart rate), and blood oxygen saturation. Such screening will be useful for men and women over 30, athletes, those undergoing long-term and severe treatment, as well as everyone who monitors their health.

In this case, body composition analysis gives us information that adipose tissue predominates in the body, and the bone-muscle component is in relative deficiency. These data will help the rehabilitation doctor competently draw up a physical activity plan, taking into account the individual characteristics of the patient.

Conservative treatment

Treatment is selected for the patient based on the diagnosis and the severity of neurological disorders caused by damage to the spinal roots and, consequently, disruption of the transmission of impulses along the celiac plexus nerves. But patients are always prescribed a set of measures aimed at eliminating spinal pathology, eliminating pinched nerves, blood vessels and diseases of internal organs that arise as a result. Therefore, often part of the treatment is prescribed by a neurologist, and the second by another specialist whose scope of work includes the resulting disorders of internal organs.

Drug therapy

Most patients are recommended to take a number of medications designed to improve their general condition, eliminate pain and improve the quality of transmission of nerve impulses. This:

NSAIDs in the form of tablets, injection solutions, and topical agents help reduce pain and have an anti-inflammatory effect;
corticosteroids - have a pronounced anti-inflammatory effect and are used in the most difficult cases when the use of NSAIDs has not led to the desired results;
muscle relaxants - drugs that help relax overly toned muscles, which in turn increases pain;
B vitamins – improve the conduction of nerve impulses along compressed spinal roots;
Vitamin D is a remedy responsible for the condition of bone tissue, as well as for higher brain functions, such as memory, memory, attention, and speech.
chondroprotectors are drugs aimed at activating the restoration of cartilage tissue, but giving positive results only when used at the very first stage of the development of osteochondrosis. To prevent diseases of the musculoskeletal system, we recommend to our patients the most effective drug Mermaids Marine Collagen;

However, this list is far from complete. But other drugs are selected strictly individually based on the nature of the existing disorders.

Physiotherapy and exercise therapy

Physiotherapeutic treatment is widely used for diseases of the thoracic spine, but it is indicated only outside the period of exacerbation. Using various methods of physical influence, it is possible to reduce the severity of pain, inflammation, swelling of soft tissues, and also improve microcirculation.

Most often, patients are recommended to undergo courses of 10–15 procedures, the frequency of which is selected individually. It could be:

electrophoresis;
UHF;
phonophoresis;
electrical stimulation;

Not least important in the conservative treatment of diseases of the thoracic spine is physical therapy. Exercise therapy helps strengthen the muscle corset, improve blood circulation and normalize the tone of the back muscles. But for each patient, a set of exercises is selected strictly individually, taking into account the diagnosis, concomitant diseases, and level of physical fitness.

Manual therapy

For diseases of the spine, especially those complicated by neurological disorders, manual therapy can give excellent results, but only if performed correctly. One of the most effective methods of manual therapy is the Gritsenko method, with the help of which, using a non-surgical method, it is possible to restore the correct position of the vertebrae, increase the distance between them, eliminate compression of the nerves and normalize the transmission of nerve impulses to internal organs, muscles, skin, etc.

Literally a few sessions of manual therapy conducted by a qualified specialist help to significantly improve the general condition, reduce or completely eliminate pain, and also normalize the functioning of internal organs. But to consolidate the results obtained, you must complete a course of sessions.

Thus, despite the fact that the thoracic spine is not very mobile, it is also susceptible to the development of diseases. But if you pay attention to the problems that have arisen when their first signs appear, you can non-surgically restore the health of the spine and normal well-being.

0 0 votes

Article rating

Benefits and effects of massage

Massage has a relaxing effect on the muscles. When we experience pain, the muscles tense, numbness, a feeling of tightness, and discomfort occur. An experienced massage therapist will help eliminate muscle tension, relax muscles and improve blood circulation in the affected area.

With the help of classic therapeutic massage (provided that it is performed by a professional), you can achieve the following results:

Restoring mobility of the affected segments of the spine;
Removing tissue swelling;
Elimination or reduction of pain;
Strengthening individual muscle groups;
Increasing the overall tone of the body;
Improved well-being;
Relieving chronic fatigue

A massage session lasts 30-40 minutes. The course includes 8-10 sessions, after which you need to take a break.