The destructive process in the vertebrae of the thoracic spine is accompanied by the formation of osteophytes and dystrophy of the intervertebral disc. Thoracic spondylosis appears due to the natural processes of aging, injuries and deformity diseases of the musculoskeletal system. Signs of thoracic spondylosis include back pain, which intensifies when irreversible changes occur in segments of the spine. The treatment of pathology is conservative with the help of medications, physiotherapy, massage and exercise therapy.
Description of pathology
One of the causes of back pain is thoracic spondylosis. Pathology develops in the process of age-related wear of the segments of the spine and cartilage discs between them. Initial changes are not accompanied by painful symptoms, which greatly complicates early diagnosis.
Later stages with destructive changes in the bone tissue and fibrous membrane of the intervertebral disc are treated conservatively. Surgical intervention is resorted to only in the absence of a therapeutic effect from the traditional treatment of spondylosis.
The thoracic spine is represented by twelve vertebrae, which account for the main load during physical activity. The vertebral bodies form the spinal canal and reliably protect the spinal cord. The processes of the segment serve to connect the vertebrae with the help of facet joints, which make the spine flexible.
Between the vertebrae there is an intervertebral disc, consisting of elastic cartilage tissue. The spring function of the disk is the main one, providing smoothing of tremors of the spine during movement. With the development of spondylosis of the thoracic spine, the fibrous ring of the disk loses its elasticity and a protrusion of the gelatinous pulpous nucleus (protrusion) occurs, which is located in the center of the disk.
For a long time, the disk does not lose its anatomical height, which preserves the integrity of the spinal segments. With the development of dystrophic processes, the cartilage ceases to hold the vertebrae at a safe distance. A feature of spondylosis is pathological growths of bone tissue (osteophytes), gradually fused, which has a negative effect on nearby vessels, nerves and internal organs.
Classification of the disease
In orthopedic practice, three stages of the progression of spondylosis of the thoracic spine are distinguished:
- The first degree of spondylosis is characterized by initial changes in the cartilage, which are not symptomatic. Outwardly noticeable slight deformation of the spine, there is a slight stiffness during movements.
- The second degree of the disease includes the appearance of pain, movements in the thoracic region are limited. In the structure of the spine, persistent changes develop: osteophytes create painful friction during movement against the background of depletion of the intervertebral disc, an intervertebral hernia may form at the site of protrusion, which threatens with the addition of neurological manifestations.
- Thoracic spondylosis of the third degree is a serious condition when the vertebrae fuse together and form a fixed connection. At the same time, a person cannot fully move and feels constant pain. The development of a severe course causes disability.
Thoracic spondylosis is diagnosed in older and middle-aged people. According to statistics, deformational changes more often develop in women over fifty years of age.
This fact is associated with the characteristics of the hormonal background of the female body, which is rebuilt several times during life.
In people who have crossed the thirty-year milestone, pathology appears after intense physical activity during sports or professional activities. Deformational changes in the spine and feet contribute to the development of spondylosis due to an increase in the load, which leads to a violation of posture and flat feet.
The appearance of osteophytes is a compensatory condition, when bone growths fill the cracks that appeared as a result of trauma to the spine.
Additional provocative factors:
- violation of metabolic processes;
- osteochondrosis of the cervical spine;
- pathology of internal secretion organs (diabetes mellitus, thyrotoxicosis);
- sedentary lifestyle;
- violation of the innervation of the vertebrae.
The main symptom of spondylosis is pain and tension in the back, which appears when the nerve roots of the hernia are infringed, inflammatory reactions, degenerative diseases of the ligaments or joints of the spine. The pain syndrome is localized in the area of the shoulder blades and radiates to the chest. An increase in soreness is observed with prolonged physical inactivity.
Violation of the innervation of the thoracic spine leads to a violation of the sensitivity of the fingers, wrist joint, on the surface of the ribs. Degenerative changes affect the mobility of not only the body, but also of the upper limbs. Turns are at first difficult, and then completely impossible.
By the nature and strength of the manifestations of pain in spondylosis of the thoracic region, it can be divided into the following types:
- The first stage of the disease is asymptomatic, with a decrease in the intervertebral disc in size, a slight acute pain appears during physical exertion.
- The subsequent stages cause a chronic painful character, which gains strength during physical activity.
- When involved in the pathological process of internal organs – pressing pain with a tingling effect.
- Neurological manifestations when squeezing nerve trunks lead to widespread pain of herpes zoster.
With the fusion of the vertebrae of the chest, internal organs suffer:
- lungs – the physiological process of breathing will be difficult, stagnation in the bronchi and lungs may develop;
- heart – a violation of the cardiovascular system;
- urinary system – spontaneous urination.
The appearance of neurological symptoms on the lower extremities: numbness of the toes, tingling and “goose bumps” on the skin of the calves and hips, severe fatigue and pain during walking indicates the thermal stage of spondylosis of the chest.
The disease can be recognized by characteristic pain manifestations and visual examination. For a detailed study of the disease picture, instrumental studies will be required:
- Radiography – to detect bone tumors, changes in the parameters of the cartilage disc;
- CT – determines the presence of pathological narrowing of the spinal canal;
- MRI – to assess the condition of connective and cartilage tissue;
- Radioisotope scanning is a more detailed study of bone tissue of the spine.
Thoracic spondylosis is treated with medical, physiotherapeutic and non-traditional methods. The disease lends itself well to symptomatic treatment, but it is impossible to get rid of destructive processes.
At the initial stage, when anatomical changes did not occur in the vertebrae, recovery is possible, but early diagnosis is complicated by the absence of symptoms. Vertebral destruction can be stopped with long-term use of chondroprotectors (Structum, Teraflex, Alflutop).
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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Drug treatment of thoracic spondylosis begins with the removal of inflammation using a doctor’s prescription of non-steroidal anti-inflammatory drugs – Indomethacin, Diclofenac, Ketaprofen. In addition to NSAIDs, analgesics (Novocain, Lidocaine), which are used to perform paravertebral blockades, have a calming effect on pain receptors, but your doctor should prescribe drugs.
A decrease in muscle tone to reduce a pain symptom is carried out by the use of muscle relaxants (tizanidine, cyclobenzaprine). Sedatives (Afobazole, Tenoten, Persen) calm the psyche and relieve insomnia, if the emotional state worsens, it is possible to prescribe light antidepressants, the choice of drug and dosage of which the attending doctor is responsible for.
- Electrophoresis with drugs allows you to directly affect the site of degeneration, analgesics (Novocaine) or corticosteroids (Deprospan, Dexamethasone) can act as a drug base to relieve inflammation and pain.
- Magnetotherapy is the restorative effect of a pulsed magnetic field on damaged areas of the spine.
- Massage is a must for breast spondylosis. During the session, blood flow increases, trophism of tissues, the state of muscle fibers improves.
- Paraffin applications on the area of the affected vertebrae to saturate with chemical elements and prevent further destruction of the spinal tissue.
- Physical therapy is carried out in remission. A set of exercises with therapeutic load is compiled by a doctor after a functional examination of the patient.
Acupuncture is a method of oriental medicine, based on acupuncture in the area of treatment points on the surface of the entire human body. The setting of medical leeches (hirudotherapy) greatly facilitates the condition: reduces pain, lowers blood pressure.
The use of orthopedic products designed to get rid of pain and improve blood circulation is popular. Lyapko applicator with needles made of an alloy of metals, which, when in contact with the skin, form a galvanic current. A Tibetan Kuznetsov-style applicator with plastic needles triggers the natural production of hormones for an analgesic effect.
It is possible to prevent the appearance of pain in the back and chest by observing simple recommendations:
- avoid physical inactivity, lead an active lifestyle;
- eat right, take care of the sufficient intake of vitamins and minerals;
- properly dose physical activity;
- conduct timely treatment of concomitant pathologies;
- in the presence of flat feet, use orthopedic insoles for everyday walking.
If discomfort or soreness occurs in the area of the shoulder blades, which may indicate a disease, consult a medical specialist for diagnosis and the appointment of the right treatment.