Chest osteochondrosis

Thoracic osteochondrosis is a degenerative lesion of the spine (depletion and destruction of the bone structure of the spine). A lesion in the posture begins with the appearance of vegetative symptoms (shortness of breath, weakness, sweating, weakness) and the development of severe pain syndrome. Thoracic osteochondrosis mimics cardiovascular disease, so an accurate differential diagnosis is required. Therapy includes a wide range of treatments: medications, sports therapy, physiotherapy and massage.

Thoracic osteochondrosis is less common than cervical or lumbar. This is due to the characteristics of the anatomical structure. The thoracic region occupies two-thirds of the entire spine in terms of the number of vertebral discs, and is larger in diameter but smaller in size than the lumbar region. This area is strong and has low mobility and is protected by ribs and ribs. Physiological curvature is directed backwards. This causes increased stress on the front of the spine. In addition, pathological bone structures form and grow in vertebral bodies (osteophytes). Peripheral nerve endings are located between the ligaments and muscle tissue, causing tension to contract with the development of pain.

Polysegmental lesions of the spine are also present with osteochondrosis. At the same time, degeneration of the cervical, thoracic and lumbar regions is associated with relevant clinical symptoms.
The clinical symptoms of thoracic osteochondrosis are approximately the same and do not differ between women and men.

Don't spread

The diagnosis can be made at any age. The disease is common among adolescents with a weak musculoskeletal system and as a result of their active growth. Pathology often occurs in pregnant women due to the load placed on the thoracic region during pregnancy.

Everyone has a tendency to develop osteochondrosis of the thoracic region. This is because a person stands upright and as a result has a large load on his spine.

Classification

Thoracic pain syndrome is characterized by severe chest pain of an intense nature. The syndrome is associated with peripheral nerve damage. Defeat is associated with compression of nerves by muscles and ligaments.

Degrees of thoracic osteochondrosis:

• The first degree is characterized by the absence of clear clinical manifestations. There is a loss of elasticity by the intervertebral discs and protrusions are formed.
• The second degree is characterized by a greater loss of elasticity and a decrease in the length of the intervertebral discs. The likelihood of a hernia increases. Pain syndrome appears, accompanying pain symptoms are possible.
• In the third degree, the pain syndrome increases. It is possible to see a herniated disc located between the vertebrae. The severity of symptoms depends on the location of the hernia.
• Fourth degree, complete loss of elasticity and loss of function of the intervertebral discs, destruction of the bone structure of the vertebrae. Nerve diseases are the most common.

According to the types of pain symptoms:

• Vertebral thoracic is justified by the pathology of the spine.
• Nonvertebrogenic thoracic is caused by pathologies of the internal organs: cardiovascular disease, gastroduodenal reflux, traumatic and inflammatory lesions of the musculoskeletal system.
• Psychogenic thoracic, panic attacks and damage to the organs of nervous genesis.

Causes and risk factors

Osteochondrosis does not occur without lesion factors. A number of causes, or a combination of them, lead to the development of the disease in the chest area.

• Sedentary lifestyle. Lack of physical activity leads to weakness of the back muscles and intervertebral segment. Sedentary work and improper workplace placement are additional factors in thoracic osteochondrosis.
• Improper lifting of weights and various injuries. Excessive stress that disrupts the work of the spine. In this condition, the muscles and intervertebral discs cannot withstand the load.
• Acquired lesions and curvature of the spine. Against the background of these pathologies, the function of the spine is impaired and the likelihood of developing osteochondrosis increases. When the doctor's advice is not followed, the destruction intensifies.
• Deficiency of required minerals and vitamins. Insufficient concentration of calcium in bone tissue weakens the bones and increases the likelihood of damage to the musculoskeletal system.
• Pregnancy as a combination of key factors: increased spinal load and mineral and vitamin deficiencies.

It is important!Hereditary predisposition plays an important role. If lesions of the musculoskeletal system are observed along an appropriate line, you should be careful about your health and the prevention of lesions. A competent system of preventive measures prevents the mass destruction of bone tissue.

Who is at risk

Factors are often combined to cause degenerative changes in the spine.

• Decreased immune status associated with greater susceptibility to infections that may increase the clinical manifestations of osteochondrosis due to muscle inflammation.
• Stressful effects that can lead to psychogenic thoracic pain. This is due to the release of large amounts of catecholamines, which cause increased pain.
• Damage to the nervous system of non-infectious and infectious etiology.
• Physical overload.
• Non-compliance with ergonomic principles (carrying weight).
• Spinal injuries of various origins.
• Muscle spasm.
• Osteoporotic degeneration of the musculoskeletal system.

Symptoms

Leading symptoms of thoracic osteochondrosis

• Burning sensation in the intercostal spaces.
• Paroxysmal and persistent chest pain, mainly stabbing.
• Pain syndrome with thoracic pain is stabbing, narrowing and pain.
• Belt pain.
• Pain in one side of the trunk.
• Vertebral compression is noted during movement.
• Pain symptoms increase significantly with movement, deep inhalation, coughing, and sneezing, which is the leading difference between thoracic osteochondrosis and angina pectoris.
• Affected areas are felt, that is, felt and located along the affected nerves.
• Coagulation of the skin along the intercostal spaces.
• The patient's condition worsens when exposed to low temperatures or if he stays in a restless state for a long time.

Types of pain syndromes in thoracic osteochondrosis:

• Injury of the lower neck. There is pain in the upper part of the chest that can spread to the neck, arms and left half of the body.
• Injury to the upper part of the spine. The pain is painful in nature, affecting the central part of the chest. Frequent association with pain in the area of the shoulder blades.
• Defeat of the scapular-costal zone. Painful symptoms are cutting, painful and stabbing. It has the appearance of both long and short attacks. It occupies the lateral region and is also concentrated in the area of the shoulder blades.
• The appearance of pain in the anterior chest wall differs in duration. They occur between the peri-pectoral and frontal axillary lines.

In addition to the leading symptoms, there are two types of pain syndrome in thoracic osteochondrosis:

• Dorsago - strong but short-term pain at the site of localization of the affected intervertebral discs. Disorders of normal breathing.
• Dorsalgia - a mild but long-lasting pain in the area of the affected intervertebral discs.

Spondylogen thoracicassociated with damage to the musculoskeletal system, often accompanied by severe pain and instability (increased mobility) of the vertebrae in the chest. Defeat is characterized by impaired mobility of the thoracic spine, stitching and cutting pain in the intercostal spaces.

Vertebral thoracicmay provoke the following symptoms:

• radical (pain symptoms);
• violation of the innervation of the thoracic region (visceral manifestations: some patients have painful symptoms of a stabbing nature in the digestive system or cardiovascular system);
• radicular syndrome with vegetative symptoms (pain in the intercostal spaces).

When diagnosing a problem, the symptoms must be distinguished from cardiovascular disease and myalgia. The damage to the heart of ischemic etiology is characterized by the regularity of occurrence during physical or psycho-emotional stress and the relief of the attack by taking nitrate.

A psychogenic attack of thoracic pain results in panic, anxiety, suffocation, and mental disorders. The disease turned out to be a result of psychological stability problems.

The clinical signs of osteochondrosis are divided into two main parts:

1. Neuralgic symptoms:
   • With thoracic osteochondrosis, numbness and tingling may occur both in the upper extremities and along the intercostal spaces, spreading to the anterior surface of the chest.
   • The latissimus dorsi and chest muscles are under constant tension.
   • There is high emotional lability, tearfulness and irritability.
   • In rare cases, the disease manifests itself as convex intercostal neuralgia.
2. Different types of pain:
   • Dorsago: Acute, sharp pain in the chest, sometimes making it difficult to breathe. Movement in the cervical and thoracic spine is limited. It manifests itself or worsens while sitting in a folded position.
   • Dorsalgia: The onset of pain symptoms takes two to three weeks, so it initially continues without clinical manifestations for the patient. There is a small discomfort in the chest. The pain is aggravated by turning the body to the sides and taking a deep breath. With the final stabilization of the pathological process, a persistent pain syndrome occurs.
   • Intercostal neuralgia: lumbar pain that spreads along the intercostal spaces. When you take a deep breath, a stabbing pain occurs in the heart area. As a result, the pathology is often confused with damage to the cardiovascular system.
   • Cardiac or pseudocoroner syndrome occurs with lesions at the level of ThI segments with the development of reflex angina pectoris. The difference from organ injuries in the cardiovascular system is the appearance of pain when the spine bends or turns. They are strengthened by a long stay in a forced situation. There is pain on palpation of spinal processes in the thoracic chest.
   • Radicular syndrome: pain in the intercostal spaces (Erb points).
   • Visceral syndrome: Abdominal dysfunction with damage at the level of the V-XII thoracic vertebrae. Belt pain is expressed by heaviness in the right hypochondrium, heartburn.

Clinical symptoms depending on the level of thoracic lesion:

* Defeat of neural processes in thoracic osteochondrosis occurs in cases of osteophytes - bone growth in the vertebrae. This is due to the speed of destruction. Therefore, the following symptoms are not an integral part of the disease.

• Deformation of the nervous process at the levels of Th2 and Th3. Damage to the cardiovascular system occurs with arrhythmia attacks and cardiovascular disease. Thus, symptoms of chronic pain in thoracic pain can lead to organ dysfunction of the cardiovascular system.
• Defeat at the level of Th4-Th5. Organs with damaged nerve fibers: pleurisy and bronchitis, pneumonia, bronchial asthma.
• Th5-Th6: Affects the bile ducts and gallbladder. The absorption of fats in the body is reduced.
• Th6-Th7: Affects the liver and solar plexus area. The function of the hepatobiliary tract is impaired.
• Th7-Th8: affects the stomach. Major pathologies: ulcerative lesions of the duodenum and stomach, dyspepsia and gastritis.
• Th8-Th9: changes in the function of the duodenum and pancreas. Manifestations: duodenitis, pancreatitis and loose stools.
• Th9-Th10: damage to nerve cells of internal organs (spleen and diaphragm). Hiccups and breathing problems occur.
• Th10-Th11: Affects the adrenal glands. The activity of the immune system decreases and allergies occur.
• Th11-Th12: impaired renal function, leading to pyelonephritis and urolithiasis.
• Th12-L1 (level of the first lumbar vertebra). Kidneys and urinary tract are damaged. This leads to dysuria - problems with urination.

Diagnosis of thoracic osteochondrosis

If you suspect osteochondrosis, you can contact a therapist or neurologist.

The patient is examined with all clinical data recorded. During the formation of 2-3 stages, the skeleton undergoes significant deformation. A complete history of the patient should be collected to accurately identify or rule out the factors that contribute to the development of thoracic osteochondrosis.

The first diagnostic method is radiography. Additional research is needed based on clinical history and the need for a differential diagnosis.
Any doctor can examine the patient first. The key is a competent and fully collected clinical history. This will allow you to accurately determine the etiology of the disease and choose a therapy regimen. Therapist, neurologist, rheumatologist are involved in the treatment of thoracic osteochondrosis. In case of traumatic impact on the spine, consultation with a traumatologist is required.

• Chest X-ray examination in two projections. It allows you to determine the presence and size of osteophytes, determine the contours and height of the intervertebral discs, create changes in the shape of the disc.
• Discography allows the study of the structure of the pulposus nucleus using contrast.
• Computed tomography is used to visualize nerve fibers, muscles, ligaments, and joints.
• Electromyography allows differential diagnosis of neurological diseases.
• Endoscopic diagnostic methods may be prescribed for examination of the circulatory and digestive organs.
• An ECG is performed to determine the etiology of cardiovascular disease.
• Electroencephalography - to create pathologies of the nervous system.

Differential diagnosis

Thoracic osteochondrosis should be distinguished from a number of diseases.

• Anomalies in the spine, trauma, tumors, inflammation. There are several options for these pathologies. For example, an additional congenital process, vertebral displacement or fusion (spondylolisthesis), osteomyelitis, ankylosing spondylitis and others.
• Damage to the musculoskeletal system (different lengths of the lower extremities, muscle spasms, muscle inflammation, etc. ).
• It is not associated with damage to the musculoskeletal system, but is similar to the symptoms of diseases of the internal organs. Especially pancreatitis, inflammation of the appendages, gastric ulcer, cardiovascular disease, angina pectoris, pleurisy.
• Diseases such as neurosis associated with increased fatigue, irritability, mood swings and migratory pain.

Chest osteochondrosis and coronary heart disease

It is extremely important to make a competent differential diagnosis with the most similar pathologies. Pain from vertebral thoracic and coronary heart disease (IHD) has a number of differences that make it possible to make an accurate diagnosis.

Nature of pain: with coronary artery disease, they have a burning and depressing nature, accompanied by fear of death.

According to the duration of pain:

• IHD: Short-term, attack in a few minutes.
• Osteochondrosis of the breast is characterized by paleness or prolonged pain, and in some cases does not subside during the day.

Changes in body condition:

• With ischemic heart disease, the intensity and intensity of pain do not change with physical activity.
• Even relatively light movements with thoracic pain cause increased pain or a new attack.

Reaction to physical activity:

• With coronary heart disease, pain during physical exertion appears to stop at rest.
• Thoracic, on the contrary, weakens, but does not stop at rest.

Packaging for medication:

• With an ischemic attack, pain is easily relieved by taking nitrate.
• Relieves thoracic pain with the use of analgesics.

Influence of physiotherapeutic factors and manual therapy:

• Gives an unstable and slight development with ischemic heart disease.
• There is a significant positive dynamics in the condition of the patient with osteochondrosis.

Treatment of thoracic osteochondrosis

Osteochondrosis is treated by a neurologist.

The organization of competent therapy requires the creation of etiological preconditions. Determining the cause of the pathology allows you to choose the right treatment regimen.

Preparations for bone regeneration are selected taking into account all the functional features of the body. It is advisable to determine the concentration of collagen and elastin in the body in advance. Individual characteristics of the organism are taken into account when choosing a therapy regimen.

Standard therapy regimen

Non-steroidal anti-inflammatory drugs help relieve chest pain caused by inflammatory reactions. This increases the volume of chest mobility and at the same time the movement of the sternum.

Drugs that affect the production of interleukins. They allow to stop the inflammatory cascade and normalize the balance of enzymes that cause the destruction of the myelin sheaths of nerves.

Antispasmodics are also used.

B vitamins help stop inflammation of the affected nerves.

Drugs that maintain the concentration of collagen and elastin allow fluid retention in the intervertebral discs. This increases tissue elasticity and prevents further degeneration.

Hormonal (steroid) drugs. They have a strong anti-inflammatory effect, but are used only for acute thoracic pain, as they adversely affect the body as a whole.

In the acute phase of the disease, diuretics help to eliminate swelling of the nerve endings. Potassium-sparing diuretics are preferred.

Anti-inflammatory ointments and gels. Rubbing the affected part of the back reduces the local inflammatory process and eliminates the symptoms of highly active pain.

Massage

The therapeutic effect of the massage is to relieve spasms in the thoracic lumbar muscle corset and normalize local blood circulation.

The effect of massage techniques:

• elimination of muscular hypertension;
• strengthening the structure of the trunk of the intervertebral discs.

The use of massage techniques is combined with a regular exercise therapy system by visiting a chiropractor.

Physiotherapy

Acupuncture. Eliminates or reduces muscle spasms, while reducing pain symptoms.

Manual therapy. Allows normalization of systemic blood circulation in the intercostal space. It regulates the supply of nutrients to the tissues, improves trophism and stimulates blood oxygenation.

Nutrition for thoracic spinal osteochondrosis

Adherence to certain nutritional principles allows you to achieve maximum therapeutic effect.

• Foods rich in vitamins A, B, C and E are recommended (greens, nuts, cereals).
• Omega-3 in fish. 6 fatty acids.
• Stimulants of cartilage tissue regeneration in the form of food additives allow to maintain the strength of tissues and maintain the elasticity of tissue structures.

Complications

When diagnosing thoracic osteochondrosis, it is necessary to take into account the possible cascade of possible organ pathologies that develop over time.

• Cardiovascular damage: persistent pain syndrome leads to stabilization of ion exchange in the myocardial muscle, which is a prerequisite for the development of cardiovascular disease.
• Disorders of the abdominal organs: stomach, duodenum, pancreas. This is due to the high secretion of adrenaline, which is a persistent pain syndrome, which leads to increased secretion of VIP (vasoint intestinal peptides).
• Dyskinesia of the gallbladder is justified by an increase in bile lithogenicity against the background of a chronic inflammatory process.

The course of the disease is reduced to regression by regular adherence to the principles of therapy, sports therapy system, posture protection and elimination of risk factors. If the pathology does not develop further and the disease does not manifest itself actively, the prognosis is considered favorable.

Prophylaxis

• Elimination of hypodynamics, therapeutic exercises. Anti-strength exercises, vertical loads with displacement, lumbar extension are selected.
• When driving a car for a long time, special exercises are chosen to relax the muscle frame.
• Injection of thoracic lumbar muscles. Both exercise therapy and myostimulation are available when independent learning is not possible.
• Workplace organization: the back of the work chair should support the waist. You should warm up in the form of a stretch or walk every 30 minutes to avoid increasing the load on your waist. This is because sitting position puts more stress on the spine.
• Proper position of the spine at night: Get orthopedic accessories for sleep. A completely hard surface is not rational due to the disruption of the physiological curves of the spine.
• Compliance with the principles of ergonomics: do not lift weights that will injure the spine.
• Formation of the correct posture.
• Optimization of blood circulation and lymph flow through a system of stretch marks or the use of special procedures (pressotherapy).