Osteochondrosis of the thoracic spine is a degenerative-dystrophic process in the thoracic spine, as a result of which pathological changes occur in the bone and cartilage tissue of the spine, intervertebral discs, joints and ligaments of the spine are destroyed.
Manifestations of osteochondrosis in the thoracic spine are usually not as acute as with cervical or lumbar osteochondrosis. The fact is that the thoracic spine is less mobile, and the connections of the vertebrae, ribs and sternum form a fairly strong structure that is less susceptible to injury as a result of external influences. Therefore, the clinical manifestations of this disease bring the patient to the doctor much less often, and as a result, the impression arises that this type of osteochondrosis is less common. But that's not true. Almost everyone who, due to the nature of their work, is forced to continuously sit at a desk or behind the wheel of a car for years, experiences changes in the spine. And in the presence of risk factors (poor posture, scoliosis, injuries, weak back muscles), thoracic osteochondrosis is practically inevitable.
Causes of osteochondrosis of the thoracic spine
The causes of pain syndromes in osteochondrosis of the thoracic region, as well as in other types of osteochondrosis, are pathological changes in the intervertebral discs (thinning of the disc due to dystrophy of the nucleus pulposus, protrusion; intervertebral hernia) and spinal joints (destruction of cartilaginous surfaces, formation of osteophytes).
As a result of these changes, compression of the radicular structures of the spinal nerves (radiculopathy), compression of the spinal cord (thoracic compression myelopathy), damage to the spinal cord due to impaired blood supply due to constriction, narrowing of the supply arteries and veins (compression-vascular myelischemia) may occur.
Arthrosis of the uncovertebral joints of the cervical spine
This type of osteoarthritis is a condition associated with wear and tear of the bones, discs, and joints of the cervical spine. With age, intervertebral discs gradually dry out and collapse. The disease usually appears in middle or old age. As discs and other cartilage degenerate, growths called osteophytes appear. Uncovertebral arthrosis of the cervical spine is the most common cause of pain and heaviness in the neck.
Appears most often in people over 50 years of age. In addition to the discs drying out, the bones and ligaments become thicker and take up more space in the spinal canal. Another cause of cervical arthrosis can be long-term damage to the neck. For people with certain professions that involve a constant workload, the prognosis may not be encouraging. They may be susceptible to earlier onset of neck disease. Poor posture can also play a role in the future occurrence of arthrosis of the uncovertebral joints.
Symptoms of osteochondrosis of the thoracic spine
The main symptoms of osteochondrosis of the thoracic spine are as follows:
- pain in the chest, increasing with prolonged stay in one position and with physical activity;
- dull pain in the interscapular space;
- pain when lifting your right or left arm;
- pain with inclined movements of the body, with rotational movements of the upper part of the body;
- increased pain with deep inhalation and exhalation;
- pain in the intercostal spaces that appears while walking;
- a feeling of squeezing of the chest or back (as if by a hoop);
Signs of thoracic osteochondrosis can also be:
- a feeling of goosebumps crawling across the body, numbness in certain areas of the skin;
- itching, burning and coldness of the lower extremities;
- increased brittleness of nails and peeling of the skin (a sign of vascular disorders);
- causeless disorders of the gastrointestinal tract: constipation, diarrhea, flatulence, nausea.
Symptoms of osteochondrosis of the thoracic spine are often very similar to the symptoms of other diseases - in particular, angina pectoris, myocardial infarction, gastrological diseases, pneumonia. Therefore, it is very important to carry out differential diagnosis using additional instrumental and laboratory examination methods.
Symptoms of spinal osteoarthritis
Features of the anatomical structure of the facet joints determine the most common development of osteoarthritis of the cervical and lumbar spine. Patients experience pain that increases with extension and decreases with flexion. It can radiate along the spine, into the buttock or shoulder. Sometimes the pain radiates to the limb, but does not extend below the popliteal fossa or the elbow.
Facet pain can be cramping. Patients note the appearance of short-term morning stiffness. Its duration varies from 30 to 60 minutes. The pain increases towards the end of the day, intensifies from prolonged standing, extension, especially if it is combined with bending or turning to the painful side, when changing body position. Pain will decrease when unloading the spine - bending it slightly, taking a sitting position, using support (stand, railing).
Dorsago and dorsalgia as manifestations of osteochondrosis of the thoracic spine
Symptoms of osteochondrosis of the thoracic region depend on the degree of changes and their location in the spine. Thoracic osteochondrosis is characterized by two vertebral syndromes - dorsago and dorsalgia.
Dorsago is a sudden, sharp pain in the thoracic spine. It is usually observed in people whose work involves sitting in one position for a long time, being in an uncomfortable position, or performing monotonous work. A dorsago attack (“chest lumbago”) is an acute attack of “dagger” pain between the shoulder blades. During an attack, the muscles are so tense that it can even be difficult to breathe. In this case, pain in the thoracic spine can spread like intercostal neuralgia (along the ribs) towards the sternum, sometimes radiating to the scapula. These symptoms are similar to those of myocardial infarction. But unlike myocardial infarction with dorsago, the patient’s electrocardiogram is within the age norm, and taking nitroglycerin or other similar medications does not lead to an improvement in the condition. In addition, pain intensifies with rotational movements of the upper body, and when palpating (feeling) the thoracic spine in patients with osteochondrosis, pain may be observed at the exit site of the spinal nerve (nerve root).
Dorsalgia begins gradually, imperceptibly and lasts up to two to three weeks. Characterized by mild pain in the affected part of the spine and various phenomena of discomfort. The pain intensifies with deep breathing and bending forward or to the sides. Muscle tension and limitation of range of motion in the cervicothoracic (upper dorsalgia) or lumbar-thoracic regions (lower dorsalgia) are determined. In this case, muscle spasm can also be very pronounced, so patients also experience a feeling of lack of air. Unpleasant sensations intensify when the body bends sideways and forward, which limits any movements in the adjacent parts of the spine. The pain is usually worse at night, and after waking up the pain goes away on its own with a short walk. The pain intensifies with deep breathing and prolonged forced positioning of the body.
There are: upper dorsalgia, accompanied by pain in the cervicothoracic region, and lower dorsalgia, in which pain in the thoracolumbar region is noted. Dorsalgia can last up to 3 weeks.
This type of dorsalgia must be differentiated from pneumonia, which also has similar symptoms, but they are supplemented by pulmonary symptoms: cough, shortness of breath, fever.
Osteoarthritis of the facet joints
Facet joint syndrome (spondyloarthrosis)
- a disease associated with degeneration and damage to the facet joints, manifested by back pain, usually without neurological disorders. The facet joints have a typical structure and consist of articular cartilage, synovial membrane, synovial fluid and capsule.
Facet joints are formed when the inferior articular process of the overlying vertebra connects with the superior articular process of the underlying vertebra. Each articular process is covered with a layer of hyaline cartilage 2-4 mm thick. This thickness is necessary to withstand heavy loads. The ability of articular cartilage to deform and return the convex-concave shape of the articular surface helps to carry out movements in several planes. The main function of the facet joints is to support and stabilize the spine during all possible movements.
In this case, the intervertebral disc and facet joints at the same level constitute a single spinal motion segment or “three-joint complex.” In this case, the disc accounts for 60-70% of the load, and the joints 15-40%. Degenerative changes in the intervertebral disc lead to increased stress on the facet joints, and conversely, damage to the facet joints can accelerate disc degeneration.
Pathophysiology of the development of pain in lesions of the facet joints.
In the vast majority of cases, damage to the facet joints is the result of many years of repeated trauma associated with a suboptimal range of motion in them and an increase in the load on these joints due to degeneration of the intervertebral discs.
In some cases, damage to the facet joints can develop acutely, for example, with a whiplash injury to the neck or with sports injuries, but basically the process is chronic in nature. With damage to the discs, from which degenerative changes in the spine most often begin, the weight load gradually shifts to the intervertebral joints, reaching from 47 to 70%.
Such overload of the joints leads to successive changes in them: synovitis with the accumulation of synovial fluid between the facets; degeneration of articular cartilage; stretching of the joint capsule and subluxation in them. Aseptic inflammation develops in the affected area with the release of a large number of inflammatory mediators such as interleukin-1, interleukin-6, substance 3 and others. Which enhance inflammatory and degenerative changes. Continued degeneration leads to the development of periarticular fibrosis and the formation of bone outgrowths on the surface of the joint - osteophytes, which increase the size of the upper and lower facets, which become pear-shaped. Eventually, the joints degenerate dramatically, losing almost all cartilage.
Quite often, this process of degeneration occurs asymmetrically, which is manifested by uneven loads on the facet joints. The combination of changes in the disc and facet joints leads to a sharp limitation of movements in the corresponding motion segment of the spine.
Clinical picture.
Before moving on to considering the clinical picture of facet joint syndrome, it is necessary to dwell on the features of the innervation of the facet joints (intervertebral joints). The facet joints have a large number of encapsulated and non-encapsulated nerve endings that have proprioceptive (sense of position in space) and nociceptive (pain) sensitivity. Each facet joint and periarticular space is innervated from two or three adjacent levels - ensuring mutual overlap of the spread of pain from adjacent lumbar facet joints. Pain from the L5-S1 joint is reflected in the coccyx, hip joint, back of the thigh, and sometimes in the groin area. Irritation of the L4-L5 joint is characterized by pain radiating from the site of irritation to the buttock, the back of the thigh and hip joint and, only occasionally, to the tailbone. From the L3-L4 joint, pain spreads to the chest area, the lateral surface of the abdomen, the groin, reaches the front surface of the thigh and, very rarely, the tailbone and perineum. Irritation of higher level facet joints (Th12–L1, L1-L2, L2-L3) is limited to the appearance of pain in the upper back and abdomen, thoracic and even cervical regions. Separately, Meijn syndrome is distinguished - a type of facet syndrome with damage to the Th12-L1 intervertebral joint. Dysfunction of this joint leads to the appearance of referred pain in the area of the iliac crest on the affected side.
In facet joint syndrome, pain increases with extension and decreases with flexion. The pain can radiate paravertebrally (near the vertebral column), into the buttock. Referred pain emanating from the intervertebral joints is lateral, diffuse, difficult to localize, sometimes it radiates along the back of the thigh, but never spreads below the popliteal fossa. It is limited to the lumbosacral region above the affected joint, radiating to the gluteal region and upper thigh. Facet pain may be more or less cramping. Characteristic is the appearance of short-term morning stiffness and an increase in pain towards the end of the day. The pain intensifies from prolonged standing, extension, especially if it is combined with bending or rotation to the painful side, when changing body position from lying to sitting and vice versa. Unloading the spine - bending it slightly, taking a sitting position, using support (stand, railing) - reduces pain.
Characteristic signs of pain caused by “facet syndrome” (spondyloarthrosis):
• THE ONset OF PAIN IS ASSOCIATED WITH ROTATION AND EXTENSION OF THE SPINE; • PAIN HAS A LATERAL DIFFUSE CHARACTER; • PAIN DOES NOT RADIATE BELOW THE KNEE JOINT; • MORNING STICKNESS IS CHARACTERISTIC; • THE ONset OF PAIN IS ASSOCIATED WITH ROTATION AND EXTENSION; • PAIN INCREASES IN STATIC POSITIONS; • WARM-UP, UNLOADING THE SPINE REDUCE PAIN.
Treatment of facet joint syndrome
When treating facet syndrome, a multilevel approach is most effective. Heat treatments and relaxing massage in combination with NSAIDs (eg, nimesulide, lornoxicam) and muscle relaxants (eg, mydocalm) are a reasonable start to treatment
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The next logical step is to inject steroidal anti-inflammatory drugs mixed with local anesthetic intra-articularly or parafacetically. This ensures stable relief of inflammation in the affected area and thereby has a long-lasting therapeutic effect. If the disease progresses and these techniques are ineffective, radiofrequency denervation of the joints is performed. Share this post on social networks:
Other features of the symptoms of osteochondrosis of the thoracic spine
With osteochondrosis of the thoracic region, gastrological syndrome is often observed, which is often defined as a disease of the gastrointestinal tract. The main complaint of patients who often turn to a gastroenterologist is pain in the epigastric region, which, as a rule, intensifies in the afternoon after physical work and subsides (or completely disappears) after a full night's rest. Its appearance and intensification are practically unrelated to seasonality (as is known, in true patients with gastritis and peptic ulcers, autumn and spring rarely pass without serious exacerbations), food quality, and diet. These features of the manifestation of the syndrome help to establish the correct diagnosis.
With osteochondrosis, the intervertebral discs at the level of the 7-11th vertebrae suffer, the pain - sometimes strong, paroxysmal, sometimes dull, aching - spreads to the right hypochondrium. During an attack, patients are often admitted to the hospital with a variety of diagnoses: acute calculous cholecystitis, kidney prolapse, pancreatitis, colitis, urolithiasis. And only as a result of a detailed medical examination is it possible to make the correct diagnosis - osteochondrosis of the thoracic spine.
Vascular disorders caused by osteochondrosis can be suspected if the skin peels off for no apparent reason, the nails become very brittle, and the feet often feel chilly.
Often, osteochondrosis of the thoracic spine is complicated by intercostal neuralgia. Pain along the ribs extends to the sternum. Any movement increases the discomfort, including coughing, sneezing, even inhaling. Occasionally, pain may be felt in the anterior abdominal wall. An attack of intercostal neuralgia caused by thoracic osteochondrosis can last from several hours to several weeks. It can go away without treatment, but later long-term relapses occur. Provoking factors for such an attack of intercostal neuralgia can be heavy lifting, prolonged uncomfortable posture, hypothermia, colds and stress.
Causes of uncovertebral arthrosis
The main reasons for the development of this dystrophic process are: congenital (Olenik syndrome or occipitalization of the atlas), as well as acquired (spinal injuries, infectious diseases, such as polio, physical work with increased load).
Predisposing factors include: excess body weight, decreased physical activity, dislocation of the hip joint, flat feet.
Uncovertebral arthrosis, the main symptom of which is a decrease in the height of the cartilaginous plate between the vertebral bodies, is a dangerous disease.
The signs of uncovertebral arthrosis are quite specific: a decrease in the height of the cartilaginous plate, the growth of osteophytes (bone outgrowths) on adjacent vertebrae that meet each other, as well as ossification (calcification) of the spinal ligaments.
Treatment of osteochondrosis of the thoracic spine
Drug treatment of osteochondrosis
For osteochondrosis of the thoracic spine, the usual symptomatic treatment is carried out to relieve pain: NSAIDs, analgesics, as well as pain-relieving ointments and gels. If necessary, muscle relaxants and antidepressants are prescribed.
At any stage of osteochondrosis, treatment involves the administration of chondroprotectors (drugs that restore cartilage tissue), vitamins and minerals (to increase the strength of ligaments and restore the structure of bone tissue).
Drug therapy should be combined with other treatment methods:
- gymnastics for thoracic osteochondrosis (performed daily several times a day);
- physiotherapy;
- massage;
- exercise therapy;
- acupressure (tactile influence on acupuncture points, which has a stimulating and calming effect on the body)
- acupuncture (or acupuncture) is the insertion of special needles into biologically active points for therapeutic purposes.
Acupressure and acupuncture reduce pain, normalize blood pressure, and stimulate the immune system.
Exercise therapy for osteochondrosis of the thoracic region is aimed at strengthening the back muscles, shoulder girdle muscles and respiratory muscles, restoring the physiological curves of the spine, and forming correct posture.
Massage helps relieve muscle hypertonicity, pain, improves blood supply to the paravertebral tissues and nutrition of cartilage. Massage in combination with exercise therapy for thoracic osteochondrosis gives the maximum positive effect.
The NANOPLAST forte therapeutic plaster showed very good results in the treatment of osteochondrosis of the thoracic spine.
Osteopathic procedures for arthrosis of the cervical spine
Competent osteopathic or complex treatment can stop or slow down the development of pathology even in late stages. If you consult a doctor when the first signs of the disease are detected, there is a high probability of getting rid of arthrosis completely - without any consequences.
Manual osteopathic techniques are aimed not only at the cervical spine, but also at areas of the patient’s head. At the same time, the position of the vertebrae is corrected and obstacles in the cerebral circulatory system are removed, which also prevent the natural micro-oscillations of the skull bones. In most cases, after the blood supply is restored and spasmodic blocks are removed, the body begins to heal itself and arthrosis recedes. Further influence of an osteopath no longer treats so much as helps the human body to recover faster, eliminating the disorders accumulated during the illness.
Osteopathic methods must be combined with proper nutrition and a healthy lifestyle - both during and after treatment - to avoid the return of symptoms of the disease and the development of complications. It is mandatory to consume foods that support the development and restoration of cartilage tissue (cottage cheese, milk, eggs, jellied meat); sleeping on an orthopedic pillow and mattress, moderate physical activity, wearing an orthopedic collar - all in accordance with the recommendations of a specialist.
Treatment of osteochondrosis of the thoracic spine using the NANOPLAST forte patch
Medicines prescribed for the treatment of spinal osteochondrosis, such as NSAIDs, muscle relaxants, etc., can cause harm to the body when used for a long time. And in the presence of certain diseases of the gastrointestinal tract, many of these drugs are generally contraindicated.
A new generation drug, the therapeutic pain-relieving anti-inflammatory patch NANOPLAST forte, helps to minimize the side effects of drugs and increase the effectiveness of treatment of osteochondrosis.
The therapeutic plaster NANOPLAST forte has shown high effectiveness in the treatment of various diseases of the spine, including the treatment of osteochondrosis of the thoracic region. It allows you to relieve pain and inflammation, improve blood circulation in the affected area, and reduce the dose of painkillers and anti-inflammatory drugs.
To relieve acute symptoms in the treatment of thoracic osteochondrosis of the spine, a therapeutic patch is used for 3 to 5 days. The duration of the course of treatment is from 9 days. It is usually recommended to use the treatment patch in the morning for 12 hours, but it can also be used at night.
High efficiency, unique composition, long-term (up to 12 hours!) therapeutic effects, ease of use and affordable price make NANOPLAST forte the drug of choice in the treatment of osteochondrosis of the thoracic spine.
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