Degenerative disc disease of the thoracic spine (osteochondrosis) is a relatively rare condition compared to other spines. This is because the rib cage stabilizes the pectoral vertebrae, limiting movement and injury due to constant bending and stretching, as occurs in the rest of the spine. If osteochondrosis develops in the thoracic spine, it is most often associated with trauma.
Degeneration, destruction, and inflammation of the disc area can cause a number of problems, depending on the severity of the problem. Disc pathology can lead to symptoms such as decreased back movement, back pain that can radiate into the intercostal space, numbness, tingling, muscle cramps, or certain combinations of these symptoms. The most common manifestation of osteochondrosis of the thoracic region occurs at the T8-T12 level. As a general rule, the manifestation of osteochondrosis in the thoracic region: protrusion, plate extrusion, herniated plate with sequestration, spondylolisthesis.
Treatment of osteochondrosis of the thoracic spine is most often conservative, but surgical treatment is possible for complications such as spinal cord compression.
Osteochondrosis (degenerative disc disease) is not actually a disease, but a term used to describe the progressive changes associated with progressive disc wear and the development of secondary symptoms due to disc degeneration. Disc degeneration is a normal involutionary process, but in some situations the process of degeneration can be accelerated due to, for example, trauma, overload, and locomotor imbalance such as scoliosis. Disc degeneration is not a problem in itself, but the conditions associated with it can lead to the development of advanced symptoms.
Plate degeneration stages
The progression of disc degeneration can be divided into the following stages:
Failure
- There may be tears in the area of annular fibrosis, with irritation of the facet joints at the appropriate level of the spine.
- Loss of joint mobility, local back pain, muscle cramps, and limitations in torso mobility, especially prolongation.
Instability
- Fluid loss on a disc with dehydration and decrease in disc height. Weakness of the facet joints and capsules can develop, leading to instability.
- The patient will experience shooting pain, straightening of the spine, and a sharp decrease in the range of motion of the trunk.
Re-stabilization
- The human body responds to instability by forming additional bone formations in the form of osteophytes, which to some extent contribute to spinal stabilization. But excess bone formation can lead to spinal stenosis.
- Back pain usually decreases but remains less intense. Some people may experience stenosis-like symptoms.
The reasons
- The most common cause of disc degeneration is changes in the body. As the body ages, the discs gradually lose their fluid portion and dry out. The discs begin to narrow and lose their height, which impairs their ability to absorb shock and stress.
- The outer annular fibrous structures of the disc may crack and crack, weakening the wall of the disc.
- Individuals who smoke, are obese, and engage in strenuous activities are more likely to experience disc degeneration.
- Damage to the spine or disc due to a fall or impact can trigger the degeneration process.
- The herniated disc can initiate the development of disc degeneration.
- Unlike muscles, the plates have minimal blood supply and therefore have no reparative ability.
Symptoms
The symptoms associated with osteochondrosis of the thoracic spine depend on the location and structures involved in the process. Degeneration of the discs in the thoracic spine can affect the back, the area under the shoulder blade, or along the ribs.
- In many cases, patients with degenerative disc disease of the thoracic spine may not have symptoms.
- Chronic chest pain with or without irradiation of the ribs.
- Sensory changes such as numbness, tingling, or paraesthesia in cases of nerve compression.
- Muscle cramps and body changes on the back of the chest.
- Loss of range of motion, reduced ability to move the boot, especially when turning sideways or bending.
- Prolonged sitting can cause back pain and pain in the arms.
- It’s hard to lift weights and raise your arms above your head.
- In later stages, spinal stenosis may develop, leading to weakness of the lower limbs and loss of coordination of movements. In these cases, surgery will be needed.
Diagnostics
In addition to performing a thorough examination, your doctor may order the following tests to confirm your diagnosis:
- X-ray,helps determine if there is joint degeneration, fractures, bone malformations, arthritis, tumors, or infection.
- MRIdetermination of morphological changes in soft tissues, including imaging of plaques, spinal cord, and nerve roots.
- CT scanscanning, which can provide cross-sectional images of spinal structures.
- EMG,this diagnostic method is used to determine nerve damage and the extent of damage.
- Myelogramin general, this research method is needed to elucidate morphological changes in the magnitude of the effect on the roots and spinal cord and to plan surgical intervention.
Treatment
Treatment of osteochondrosis of the thoracic spine depends on the severity of the condition.
Treatment of acute pain syndrome:
- Rest: Avoid painful activities (bending, lifting, twisting, twisting or stretching backwards).
- Anti-inflammatory drugs (anti-inflammatory and analgesic).
- Ice in acute cases can relieve cramps, relieve pain.
- Local heat can help relieve pain and muscle tension.
- Easy gymnastic exercises to eliminate biomechanical disorders associated with osteochondrosis and to improve joint mobility, normal spinal configuration, posture, and range of motion.
- It may be necessary to use a brace to relieve stress on the facet joints and muscles of the chest spine.
- Corticosteroids are used to reduce inflammation in moderate to severe cases.
- Epidural injections directly into the area of the damaged disc.
In mild cases, local cold and medication may be sufficient to relieve pain. After pain relief, exercise therapy (physiotherapy) and exercises to stretch and strengthen the back muscles are recommended. Normal activity should return gradually to prevent recurrence of symptoms.
The main conservative methods of treating osteochondrosis of the thoracic spine
Drug treatment
The use of drugs in the treatment of osteochondrosis of the thoracic spine, especially in acute pain syndrome, is to reduce pain, inflammation, and muscle cramps.
- OTC medications for mild to moderate pain.
- Narcotic analgesics for intense pain that cannot be controlled by other treatments.
- Muscle relaxants to reduce acute muscle cramps.
- Prescription painkillers.
- Injections such as faceted joint injections, occlusions, or epidural injections. This may involve injecting corticosteroids into specific areas to reduce local inflammation.
- Hand therapies, including soft tissue massage, stretching and mobilizing joints by a professional, improve the geometry, mobility and range of motion of the chest spine. The use of mobilization techniques also helps in modulating pain.
- Exercise therapy (therapeutic exercises), including stretching and muscle strengthening exercises, to restore the range of movement and to strengthen the muscles of the back and abdomen, to support, stabilize and reduce discs and the back. An exercise program, especially exercises with weights or weights, should be started after the pain, muscle cramps, and inflammation have stopped. An incorrectly selected exercise program can aggravate the symptoms. Therefore, the selection of exercises should be done by a gymnastician.
- Neuromuscular retraining to improve posture, restore stability, teach the patient the correct biomechanics of movement to protect damaged plates and spine.
- Physiotherapy, including the use of ultrasound, electrical stimulation, and a cold laser, helps reduce pain and inflammation in the structure of the spine.
- Homemade workouts, including muscle strengthening, stretching and stabilizing exercises, and lifestyle changes to reduce spinal 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 of the hernias located in the spinal disc of the chest can be successfully treated without surgery. However, if conservative treatment of thoracic spinal osteochondrosis is ineffective, surgery is recommended, especially if the patient has one of the following symptoms:
- Increased radical pain.
- Increased pain and nerve damage.
- Development or increase of muscle weakness.
- Increased numbness or paraesthesia.
- Loss of control of intestinal and bladder function.
The most common surgery with disc degeneration is discectomy, in which the disc is removed by incision. However, a number of surgical procedures are recommended for osteochondrosis and disc degeneration. The choice of surgical method depends on the cause of the symptoms. Basic surgical techniques - these include foraminotomy, laminotomy, spinal laminectomy, spinal decompression, and spinal fusion.
Forecast
Most problems with osteochondrosis of the thoracic spine can be solved without surgery, and people return to normal work. Due to anatomical rigidity, osteochondrosis of the thoracic spine develops less than in other parts. The duration of treatment usually does not exceed 4-12 weeks and depends on the severity of the symptoms. Patients should continue the stretching, strengthening and stabilizing exercise program. A good long-term prognosis requires the application of appropriate movement and body mechanics and an awareness of the importance of maintaining spinal health.