Osteochondrosis of the chest

Thoracic osteochondrosis is a degenerative lesion of the spine (thinning and destruction of vertebral bone structures). It begins with lesions on posture, the appearance of autonomic symptoms (shortness of breath, weakness, sweating, malaise) and the development of severe pain syndrome. Therefore, thoracic osteochondrosis mimics cardiovascular disease, therefore, requires accurate differential diagnosis. Therapy involves many different types of treatments: medications, exercise therapy, physiotherapy and massage.

Thoracic osteochondrosis is less common than cervical or lumbar. This is due to the specifics of the anatomical structure. The vertebral discs in the thoracic region occupy two -thirds of the entire spine in volume, and they are also 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 leads to an increase in pressure on the anterior part of the spinal space. Furthermore, the formation and growth of pathological bone structures in the vertebral body (osteophytes) occurs. The peripheral nerve endings are located between the ligaments and the muscle tissue, their tension causing compression with the development of pain.

There are also polysegmental lesions on the spine with osteochondrosis. At the same time, degeneration of the cervical, thoracic and lumbar regions is combined with appropriate clinical symptoms.
The clinical symptoms of thoracic osteochondrosis in women and men are almost the same and have no significant differences.

Prevalence

Diagnosis can be made at any age. The disease commonly occurs in adolescents with a weakened musculoskeletal system, also as a result of their active growth. Pathology often forms in pregnant women due to significant load on the thoracic region during pregnancy.

Everyone has a predisposition to the formation of osteochondrosis of the thoracic region. This is due to a person’s upright posture and, as a consequence, a large load on the spine.

Welding

Thoracalgic pain syndrome is characterized by severe and intense chest pain. This syndrome is associated with peripheral nerve damage. The defeat was caused by nerve stress by muscles and ligaments.

Stages of thoracic osteochondrosis:

• The first degree is characterized by the absence of obvious clinical manifestations. There is a loss of elasticity by the intervertebral discs, and their protrusion is formed.
• The second stage is characterized by a loss of elasticity of the intervertebral disc and a decrease in its height. The chances of a hernia increase. Pain syndrome appears, concomitant pain symptoms may occur.
• In the third degree, the pain syndrome increases. The appearance of a herniated disc located between the vertebrae is possible. The severity of symptoms depends on the location of the hernia.
• The fourth stage with complete violation of elasticity and loss of function of the intervertebral disc, destruction of vertebral bone structure. The most notable neurological disorders.

According to the type of pain symptoms:

• Vertebral thoracalgia is justified by spinal pathology.
• Nonvertebrogenic thoracalgia is caused by the pathological formation of internal organs: cardiovascular disease, gastroduodenal reflux, traumatic lesions and inflammation of the musculoskeletal system.
• Psychogenic thoracalgia is caused by panic attacks and damage to the nerve genesis organs.

Causes and risk factors

Osteochondrosis does not form without lesion factors. A number of causes or a combination of them lead to the development of disease in the thoracic region.

• Non -settled lifestyle. Lack of physical activity causes weakness of the back muscles and intervertebral segments. Irregular work and improper workplace arrangement act as additional factors in thoracic osteochondrosis.
• Improper weight gain and various injuries. Excessive stress that interferes with spinal function. In this condition, the muscles and intervertebral discs are unable to withstand the load.
• Getting cuts and curvature of the spine. Against the background of this pathology, the work of the spinal canal is disrupted and the likelihood of the formation of osteochondrosis increases. The devastation escalates if the doctor’s recommendations are not followed.
• Lack of necessary minerals and vitamins. With insufficient calcium concentrations in bone tissue, bones become weak, and the likelihood of damage to the musculoskeletal system increases.
• Pregnancy as a combination of key factors: increased load on the spine and a lack of minerals and vitamins.

Important!Hereditary tendencies play an important role. If lesions of the musculoskeletal system are observed along the relevant lines, then you should be careful with your health and lesion prevention. An efficient prevention system prevents mass destruction of bone tissue.

Who is at risk

Often the factors for the formation of degenerative changes in the spine are combined.

• Decreased immune status is associated with greater susceptibility to infection that may increase the clinical manifestations of osteochondrosis due to muscle inflammation.
• The influence of stress that can cause psychogenic thoracalgia. This is due to the large release of catecholamines, which causes an increase in pain.
• Damage to the nervous system of non -infectious and infectious etiology.
• Physical load.
• Failure to adhere to ergonomic principles (heavy loads).
• Spinal cord injuries of various origins.
• Muscle cramp.
• Osteoporotic degeneration of the musculoskeletal system.

Symptoms

The main symptoms of thoracic osteochondrosis

• A burning sensation arises in the intercostal space.
• Paroxysmal and persistent pain in the chest, especially stabbed.
• With thoracalgia, the pain syndrome is stabbing, narrowing and aching.
• Girdle pain.
• Pain in one part of the trunk.
• During movement, vertebral fractures were observed.
• Pain symptoms increase significantly with movement, deep inhalation, coughing and sneezing, which are the main differences between thoracic osteochondrosis and angina pectoris.
• The affected area is clearly felt, that is, can be felt, and is located along the affected nerve.
• Numbness of the skin along the intercostal space.
• The patient's condition worsens when exposed to low temperatures or prolonged stay in an uncomfortable position.

Varieties of pain syndrome in osteochondrosis of the thoracic spine:

• Lesions on the lower neck. There is pain in the upper part of the chest, which can radiate to the neck, arms, and even the left side of the body.
• Damage to the upper thoracic spine. The pain was felt in the middle of the chest. Frequent combination with pain in the shoulder blade area.
• Defeat of the scapular-costal zone. Painful symptoms have the character of cuts, pains and stabs. Has an attacking appearance, long and short. It occupies the lateral area, and is also concentrated in the shoulder blade area.
• The appearance of pain in the anterior chest wall, varies in duration. They arise between the peri-pectoral and frontal axillary lines.

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

• Dorsago - intense, but short -term pain at the location of localization of the affected intervertebral disc. Normal respiratory disorders.
• Dorsalgia - mild, but prolonged pain in the affected area of the intervertebral disc.

Thoracalgia spondylogenicassociated with damage to the musculoskeletal system, often accompanied by severe pain and vertebral instability in the thoracic spine (increased their mobility). Defeat is expressed in violation of the movement of the thoracic spine, sutures and wounds in the intercostal space.

Thoracalgia vertebracan trigger the following symptoms:

• radicular (pain symptoms);
• violation of the preservation of the thoracic zone (visceral manifestations: some patients have painful painful symptoms in the gastrointestinal tract or cardiovascular system);
• radicular syndrome with vegetative signs (pain in the intercostal space).

When diagnosing a problem, it is necessary to distinguish symptoms from cardiovascular disease and myalgia. Damage to the heart of ischemic etiology is distinguished by the fragility of events during physical or psycho-emotional stress and relieving attacks by taking nitrates.

Psychogenic attacks of thoracalgia are accompanied by the appearance of panic, restlessness, shortness of breath and mental disorders. It turns out that the disease is the result of problems with psychological stability.

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

1. Neuralgic symptoms:
   • With thoracic osteochondrosis, numbness and tingling can occur in the upper limbs and along the intercostal space, spreading to the anterior surface of the chest.
   • The latissimus dorsi and chest muscles are always tense.
   • There is high emotional weakness, tear attacks and irritability.
   • In rare situations, the disease manifests itself as intercostal neuralgia.
2. Different types of pain sensations:
   • Dorsago: sharp and acute pain in the thoracic spine, sometimes making breathing difficult. Movement in the cervical and thoracic spine is limited. It manifests itself or worsens when sitting in a swaying position.
   • Dorsalgia: the formation of pain symptoms lasts from two to three weeks, therefore, initially it occurs without clinical manifestations for the patient. There is a slight discomfort in the chest. The pain is increased by turning the body to the side and taking a deep breath. With the final stabilization of the pathological process, a persistent pain syndrome is formed.
   • Intercostal neuralgia: girdle pain radiates along the intercostal space. As you inhale, a stabbing pain appears in the heart area. As a result, pathology is often confused with damage to the cardiovascular system.
   • Cardiac or pseudocoronary syndrome is formed with lesions at the level of the ThI segment with the development of angina pectoris reflex. The difference from organ damage to the cardiovascular system is the appearance of pain when bending or twisting the spine. They increase with prolongation under compulsion. There is pain on palpation of the rotational process in the thoracic spine.
   • Radicular syndrome: pain in the intercostal space (Erb point).
   • Visceral syndrome: dysfunction of the abdominal organs with lesions at the level of the thoracic vertebrae V-XII. It is expressed in low back pain, heaviness in the right hypochondrium, heartburn.

Clinical symptoms depend on the extent of the thoracic spine lesion:

* Defeat of neural processes in thoracic osteochondrosis occurs in cases of the appearance of osteophytes - bone growths on the vertebrae. This is due to the rate of destruction. Therefore, the symptoms below are not an important part of the disease.

• Deformation of neural processes at the Th2 and Th3 stages. Damage to the cardiovascular system occurs with the onset of arrhythmias and coronary heart disease. Therefore, the symptoms of chronic pain in thoracicgia can lead to dysfunction of the organs of the cardiovascular system.
• Defeat at the Th4-Th5 level. Organs with damaged nerve fibers: pleurisy and bronchitis, pneumonia, bronchial asthma.
• Th5-Th6: bile ducts and gallbladder affected. The absorption of fat in the body decreases.
• Th6-Th7: affects the liver and solar plexus area. Hepatobiliary tract function is impaired.
• Th7-Th8: stomach affected. Primary pathology: 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: affected adrenal glands. Immune system activity decreases and allergies appear.
• Th11-Th12: impaired renal function, which leads to the formation of pyelonephritis and urolithiasis.
• Th12-L1 (first lumbar vertebral stage). The kidneys and ureters are damaged. This leads to dysuria - a problem with urination.

Diagnosis of thoracic osteochondrosis

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

Patients were examined with recordings of all clinical data. During level 2-3 formation, the skeleton undergoes significant deformation. A complete history of the patient should be collected to accurately determine or exclude the factors that lead to the formation of thoracic spine osteochondrosis.

The first diagnostic method is radiography. Further studies were performed based on clinical history data and the need for differential diagnosis.
Any doctor can initially examine the patient. The main thing is an efficient and fully accumulated clinical history. This will allow you to accurately determine the etiology of the disease and choose a therapeutic regimen. Therapists, neurologists, rheumatologists are involved in the treatment of thoracic osteochondrosis. If there is a traumatic effect on the spinal area, consultation with a traumatologist is required.

• X-ray examination of the chest in two projections. Allows you to determine the presence and size of osteophytes, to determine the contour and height of the intervertebral disc, to determine the deformation of the disc.
• Discography makes it possible to study the structure of the nucleus pulposus through the use of contrast.
• Computed tomography is used to visualize nerve fibers, muscles, ligaments and joints.
• Electromyography allows differential diagnosis with neurological diseases.
• Endoscopic diagnostic methods can be prescribed for the purpose of examining blood circulation and digestive organs.
• An ECG is performed to determine the etiology of cardiovascular disease.
• Electroencephalography - to establish the pathology of the nervous system.

Differential diagnosis

Thoracic osteochondrosis must be distinguished from a number of diseases.

• Anomalies in the formation of the spine, trauma, tumors, inflammation. There are several options for this pathology. For example, additional congenital processes, displacement or fusion of the vertebrae (spondylolisthesis), osteomyelitis, ankylosing spondylitis, and others.
• Damage to the musculoskeletal system (lower limb length, muscle spasms, muscle inflammation etc. ).
• Not related to damage to the musculoskeletal system, but similar in symptoms of diseases of internal organs. In particular, pancreatitis, complement inflammation, stomach ulcers, coronary heart disease, angina pectoris, pleurisy.
• Disorders such as neurosis, combined with migratory pain with increased fatigue, irritability, mood swings.

Chest osteochondrosis and ischemic heart disease

It is very important to make a competent differential diagnosis with the most similar pathology. Pain arising from vertebral thoracalgia and coronary heart disease (IHD) have a number of differences, making it possible to establish an accurate diagnosis.

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

With duration of pain:

• IHD: Short term, within minutes of attack.
• Chest osteochondrosis is characterized by fading or prolonged pain, in some cases they do not subside during the day.

Body position changes:

• With ischemic heart disease, the strength and intensity of pain do not differ from physical activity.
• With thoracalgia, relatively light movements cause increased pain or the occurrence of new attacks.

Response to physical activity:

• With ischemic heart disease, pain appears during physical exercise, stopping at rest.
• Thoracalgia, on the other hand, is debilitating, but does not stop at rest.

Cupping to take medicine:

• With an ischemic attack, the pain can be easily overcome by taking nitrates.
• Thoracalgia is relieved with the use of analgesics.

Effects of physiotherapeutic factors and manual therapy:

• With ischemic heart disease, it gives an unstable and slight improvement.
• With osteochondrosis, there are significant positive dynamics in the patient’s condition.

Treatment of chest osteochondrosis

Osteochondrosis is treated by a neurologist.

For a competent therapeutic organization, it is necessary to first establish the etiological prerequisites. Identifying the pathological cause allows you to choose the right treatment regimen.

Preparations for the regrowth of bone tissue are selected taking into account all the functional features of the body. It is best to explain the beginning of the concentration of collagen and elastane in the body. When choosing a therapeutic regimen, the individual characteristics of the organism are taken into account.

Standard therapy regimen

Non-steroidal anti-inflammatory drugs help relieve chest pain caused by inflammatory reactions. This increases the amount of chest movement, as well as the distance of movement in the thoracic spine.

Drugs that affect interleukin production. They make it possible to stop the inflammatory cascade and normalize the balance of enzymes that cause the destruction of the myelin sheath.

Antispasmodics are also used.

Vitamin B helps stop inflammation in the affected nerves.

Preparations that maintain the concentration of collagen and elastane allow you to store fluid in the intervertebral disc. This increases tissue elasticity and prevents further degeneration.

Hormone drugs (steroids). They have a strong anti-inflammatory effect, but are used only for acute thoracalgia, as they negatively affect the body as a whole.

Diuretics in the acute period of the disease help relieve swelling of the nerve endings. Preference is given to potassium -sparing diuretics.

Anti-inflammatory ointments and gels. While rubbing the affected back, the local inflammatory process decreases and the very active pain symptoms are eliminated.

Sort

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

The effect of massage techniques:

• removal of muscular hypertension;
• strengthens the body structure of the intervertebral disc.

The use of massage techniques is combined with visits to a chiropractor in combination with a regular exercise therapy system.

Physiotherapy

Acupuncture. Eliminates or reduces muscle spasms, and also reduces pain symptoms.

Manual therapy. Allows you to bring systemic circulation to normal in the intercostal space. This makes the supply of nutrients to the tissues, increases trophism and stimulates blood oxygenation.

Nutrition for osteochondrosis of the thoracic spine

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

• Foods rich in vitamins A, B, C and E are recommended (greens, nuts, grains).
• Omega-3 fatty acids. 6 are found in fish.
• Stimulus of cartilage tissue regeneration in the form of food additives allows to maintain tissue strength and maintain the elasticity of tissue structure.

Complications

When setting the diagnosis of thoracic osteochondrosis, one should take into account the possible cascade of organ pathology that may develop over time.

• Damage to the cardiovascular system: persistent pain syndrome causes instability of myocardial muscle ion exchange, which is a prerequisite for the development of coronary heart disease.
• Disorders of the function of the abdominal organs: stomach, duodenum, pancreas. This is due to high adrenaline secretion with persistent pain syndrome, which results in increased secretion of VIP (vasointestinal peptides).
• Gallbladder dyskinesia is allowed by increased bile lithogenicity against the background of chronic inflammatory processes.

With regular adherence to the principles of therapy, exercise therapy system, maintaining posture and eliminating risk factors, the course of the disease is reduced to regression. The prognosis is considered good if the pathology does not progress further and the disease does not manifest itself actively.

Prophylaxis

• Elimination of hypodynamia, therapeutic exercises. Anti-strength training, vertical load with displacement, spinal stretching are selected.
• When driving a car for a long time, the selection of special exercises to relax the skeletal muscles.
• Pumping the muscles of the thoracic spine. There is both a complex of exercise therapy and the use of myostimulation when independent exercise is not possible.
• Workplace organization: the back of the work chair should provide support for the spine. In order for the load on the spine not to increase, you should warm up every 30 minutes in the form of stretching or walking. This is because the sitting position puts more pressure on the spine.
• Proper position of the spine at night: buy orthopedic accessories for sleep. A completely stiff surface is irrational due to a violation of the physiological curvature of the spine.
• Adhere to the principle of ergonomics: do not lift weights that can injure the spine.
• Proper posture formation.
• Optimization of blood circulation and lymph flow through the stretch mark system or the use of special procedures (pressotherapy).