Degenerative disc disease (osteochondrosis) in the thoracic spine is a relatively rare condition compared to other spines. This is because the thoracic cage stabilizes the thoracic vertebrae, limiting movement and damage from continuous flexion and extension, as occurs in the rest of the spine. If osteochondrosis develops in the thoracic spine, then most often its development is accompanied by trauma.
Degeneration, destruction, and inflammation in the disc area can cause a variety of symptoms, depending on the severity of the problem. Disc pathology can lead to symptoms such as decreased back movement, back pain that may radiate to the intercostal space, numbness, tingling sensation, muscle spasms or certain combinations of these symptoms. The most common manifestations of osteochondrosis in the chest region occur at the T8-T12 level. As a rule, the manifestations of osteochondrosis in the chest region are: elongation, disc herniation, disc herniation with sequestration, spondylolistema.
Treatment of thoracic spine osteochondrosis is most often conservative, but in the presence of complications such as spinal cord compression, surgical treatment is possible.
Osteochondrosis (degenerative disc disease) is not actually a disease, but a term used to describe progressive changes in discs associated with progressive consumption and the development of secondary symptoms after disc degeneration. Disc degeneration is a normal involuntary process, but in certain situations, the degeneration process can accelerate, for example, as a result of trauma, overuse, and musculoskeletal imbalances such as scoliosis. Disc degeneration in itself is not a problem, but the conditions associated with it can lead to the development of advanced symptoms.
Stages of disc degeneration
The progression of disc degeneration can be classified into the following stages:
malfunction
- Tears are possible in the area of anal fibrosis, with irritation of the cheek joints at the respective level of the spine.
- Loss of joint mobility, local back pain, muscle spasms and restrictions on trunk movement, especially elongation.
Instability
- Fluid loss from a dehydrated disc and a decrease in disc height. Weakness of external joints and capsules can develop, leading to instability.
- The patient will experience pain of a shooting nature, running the spine and a sharp decrease in range of motion in the trunk.
Re-stabilization
- The human body reacts to instability by forming additional bone formations in the form of osteophytes, which, to some extent, help stabilize the spine. But excessive bone formation can lead to spinal stenosis.
- Back pain usually decreases, but remains less severe. Some people may develop symptoms similar to stenosis.
reason
- Involutionary changes in the body are the most common cause of disc degeneration. As the body ages, the discs gradually lose their fluid portion and become dehydrated. The discs begin to narrow and lose their height, impairing their ability to absorb shock and stress.
- The fibrous outer ring structures of the disc may begin to rupture and rupture, weakening the disc walls.
- People who smoke, are obese and engage in strenuous activities are more likely to experience disc degeneration.
- Spinal cord or disc injury from a fall or impact can cause the degeneration process.
- A herniated disc may begin to develop disc degeneration.
- Unlike muscles, discs have minimal blood supply, so they do not have a repair ability.
Symptoms
The symptoms associated with osteochondrosis of the thoracic spine will depend on the location and structures involved in this process. Degeneration of the discs in the thoracic spine can affect the back, the area under the shoulder, or along the ribs.
- Many patients with degenerative disease of the thoracic spine may have no symptoms.
- Chronic thoracic pain with / without radiation to the ribs.
- Sensory changes such as numbness, tingling, or paresthesia in cases of nerve compression.
- Muscle spasms and changes in posture in the back of the chest.
- Loss of movement space, with reduced ability to move luggage, especially when turning or leaning sideways.
- Sitting for long periods of time can cause back pain and arm pain.
- Difficulty in lifting weights and lifting the arms up.
- In later stages, spinal stenosis can develop, leading to weakness in the lower extremities and loss of coordination of movements. In these cases, surgery will be required.
Diagnosing
In addition to performing a thorough examination, the doctor may order the following tests to verify the diagnosis:
- X-rays,helps determine if there is joint degeneration, fractures, bone malformations, arthritis, tumors or infection.
- MRIto determine morphological changes in soft tissues, including visualization of discs, spinal cord, and nerve roots.
- CT scana scan that can provide cross-sectional images of spinal structures.
- EMG, this diagnostic method is used to determine nerve damage and the level of damage.
- Myelogramas a rule, this method of research is necessary to clarify morphological changes in the degree of impact on the roots and spinal cord and to plan surgical intervention.
treatment
Treatment of thoracic spine osteochondrosis will depend on the severity of the condition.
Treatment of acute pain syndrome:
- Rest: Avoid activities that cause pain (bending, lifting, twisting, twisting or stretching the back).
- Medications to reduce inflammation (anti-inflammatory and pain relievers).
- Ice in acute cases can relieve spasm, relieve pain.
- Local exposure to heat can help relieve pain and muscle tension.
- Light gymnastic exercises to eliminate biomechanical disorders associated with osteochondrosis and improve joint movement, normal spinal configuration, posture, and movement radiation.
- It may be necessary to use a brace to relieve stress on the facial joints and chest muscles.
- Corticosteroids are used to reduce inflammation in moderate to severe cases.
- Epidural injections directly into the area of the damaged disc.
In mild cases, the use of local colds and medications may be sufficient to relieve the pain. After relieving the pain, exercise therapy (physical therapy) and exercises to stretch and strengthen the back muscles are recommended. Return to normal activity should be gradual to prevent recurrence of symptoms.
The main conservative methods of treating osteochondrosis of the thoracic spine
Medication treatment
The task of using medications in the treatment of osteochondrosis of the thoracic spine, especially in acute pain syndrome, is to reduce pain, inflammation, and muscle spasm.
- OTC medications for mild to moderate pain.
- Narcotic analgesics for severe pain that cannot be controlled by other methods of treatment.
- Muscle relaxants to reduce acute muscle spasm.
- Prescription analgesics.
- Injections such as joint facial injections, blockages or epidural injections. These may include injecting corticosteroids into specific areas to reduce local inflammation.
- Manual therapies, including soft tissue massage, joint extension, and mobilization performed by a specialist, improve the geometry, mobility, and range of motion of the thoracic spine. The use of mobilization techniques also helps in modulating pain.
- Exercise therapy (therapeutic exercises), including stretching and muscle strengthening exercises, to restore range of motion and strengthen the back and abdominal muscles, support, stabilize, and reduce stress on the discs and spine. An exercise program, especially weight-bearing or weight-bearing exercises, should begin after the pain, muscle spasm, and inflammation have subsided. An improperly chosen exercise program can worsen symptoms. Therefore, exercise selection should be performed with an exercise therapy physician.
- Neuromuscular retraining to improve posture, restore stability, teach the patient the exact biomechanics of movement to protect damaged discs and spine.
- Physical therapy, including the use of ultrasound, electrical stimulation, and cold lasers, helps reduce pain and inflammation of spinal structures.
- Home exercise programs, including muscle strengthening, stretching and stabilization exercises, and lifestyle changes to reduce back stress.
- Acupuncture. This method of treatment can be used in the presence of sensory disturbances or to restore conduction and reduce pain.
Surgical treatments
Most hernias located in the thoracic spine of the thoracic disc can be successfully treated without surgery. However, when conservative treatment of thoracic spine osteochondrosis is ineffective, surgery may be recommended, especially if the patient has some of the following symptoms:
- Increased radicular pain.
- Increased pain and nerve damage.
- Development or increase of muscle weakness.
- Increased numbness or paresthesia.
- Loss of control of intestinal and bladder function.
The most common surgery associated with disc degeneration is discectomy, in which the disc is removed through an incision. However, there are some surgical procedures that may be recommended in cases of osteochondrosis and disc degeneration. The choice of surgical method depends on the cause of the symptoms. Basic surgical techniques - include foraminotomy, laminotomy, spinal laminectomy, spinal decompression and spinal fusion.
prediction
Most of the problems associated with osteochondrosis of the thoracic spine can be solved without surgery and people return to normal work. Osteochondrosis in the thoracic spine due to anatomical stiffness develops less than in other parts. The duration of treatment, as a rule, does not exceed 4-12 weeks and depends on the severity of symptoms. Patients should continue with the exercise, strengthening and stabilization program. Good long-term prognosis requires the use of proper movement and body mechanics and awareness of the importance of maintaining spinal health.