The human spinal column is one of the most important components of the musculoskeletal system, and violations in its normal function always lead to negative consequences for the whole organism. Thoracic osteochondrosis refers to a degenerative-inflammatory disease of the spinal disc in the thoracic region. The disease most often strikes people over the age of 55, but can also occur in any adult. In men, the disease is registered half of women.
In general, although the department is the largest, consisting of 12 vertebrae in the center of the spinal column, it is less prone to pathology. This is due to lack of mobility and good protection on the muscular corset. This structural feature is a positive factor, but in the diagnosis of osteochondrosis of the thoracic region is difficult to identify and can be confused with other diseases for a long time, especially when there is a temperature.
There are criteria for the 10th revised International Classification of Diseases (ICD-10), according to which osteochondrosis belongs to the class of dorsopathy (M40-54). There is a separate class of ICD-10 for spinal osteochondrosis-M42 according to ICD-10 and equated with deformed dorsopathies. Diagnosis is made according to code M42. 0 ICD-10 for adolescents and M42. 1 ICD-10 for adult osteochondrosis. Code M42. 9 ICD-10 may occur with unspecified pathology.
The reasons
Thoracic osteochondrosis is less common than lesions of other parts of the spine. Many people do not seek medical help for a long time, thinking that they have other pathologies. According to statistics, this leads to the most frequent detection of the disease in advanced form.
The disease occurs as a result of impaired nutrition and blood supply to the intervertebral discs. Forming osteochondrosis can lead to disruption of the normal structure of the vertebrae. The elasticity and depreciation properties of the spine are lost, and all this leads to the destruction of discs, ligaments and other structural components. As a result of such disorders, nerve roots are pinched and unpleasant symptoms occur.
It is almost impossible to know the true cause of the pathology. There are risk groups among people and predisposing factors that lead to this disease. For people themselves, this age over 55 years, female gender and the presence of spinal pathology increase the risk of getting the disease. Deviations such as scoliosis, kyphosis, over time, violate the posture and normal arrangement of the spinal column. As a result, metabolic processes in the spine are disrupted and chondrosis is formed.
There are factors that depend directly on the person leading to the pathology. Let's highlight the main ones:
- overweight;
- abuse of bad habits: alcohol, smoking, fatty foods;
- sedentary lifestyle.
People who spend a lot of time in a sitting position are prone to this disease. This applies to office workers, tailors, operators, drivers. Someone with a back or spinal cord injury should also be careful in the future. There is a group of people with hereditary or acquired diseases who are prone to diseases of the musculoskeletal system. The main conditions are diabetes mellitus, muscle weakness, disruption of normal function of the glands.
Types and clinical picture
The signs of osteochondrosis of the thoracic spine depend on the degree of pathology and neglect of the process. In total, four degrees of disease were distinguished.
In the first stage, there is a violation of the elasticity of the intervertebral disc and a decrease in its height. The pain symptoms are not so sharp and pass quickly during rest. Basically, pain is felt in the middle of the back and in the chest. Often, the disease enters a passive state and clinical manifestations appear only during exacerbations, quickly stop and can be treated. Signs of intoxication are rare, sometimes the temperature may rise and weakness may occur. The temperature quickly becomes normal as the acute period passes.
The second stage is more dangerous and can cause severe neurological symptoms. With this stage, the height of the spinal disc is constantly reduced, the elasticity is damaged. The fibrous rings of the intervertebral disc can be damaged, and cracks form. This stage is fraught with the threat of the appearance of an intervertebral hernia.
The pain in the chest and back became stronger and eventually spread to the adjacent area. During deep breathing or sudden movement, an acute pain attack occurs. When nerve endings are damaged, symptoms spread along the ribs. During the period of exacerbation, there is an increase in temperature, general weakness. With this stage of the disease, numbness and "crawling" crawling at the site of the lesion merge. If the nerve fibers are damaged, then normal preservation in the upper or lower part of the foot is disrupted.
Osteochondrosis of the third degree thoracic region is characterized by the onset of intervertebral hernia formation. There is severe pain that occurs in certain situations. Often the pain can increase at night, when you are in the cold for a long time, in one position. Pain in the chest, back, along the ribs. When exposed to the spinal cord, the following symptoms may occur:
- violation of the conservation of the legs and arms;
- increased pain at night;
- pain in esophagus, right hypochondrium, stomach;
- increased body temperature;
- problems with normal function in the gastrointestinal tract.
In the last, fourth stage, the spinal bone tissue is destroyed. There is a violation of vertebral mobility, the nature of depreciation is reduced. Thoracic osteochondrosis in this stage is dangerous by damage to the spinal cord and impaired human performance. With deterioration, body temperature rises, there is severe pain in the chest, in the middle of the back.
Among the general clinical picture, two main symptoms are distinguished - these are dorsago and dorsalgia. Dorsago is characterized by sharp pain in the chest. Someone has a shooting feeling in the chest after staying a long time in one position. During an attack, breathing becomes difficult and the pain increases with the movement of the torso to the side. This condition raises the temperature.
With dorsalgia, there is little pain in the damaged vertebral area. Painful symptoms increase and last up to three weeks. The pain becomes stronger after inhaling or exhaling and with movement. Symptoms worsen at night and are relieved by walking. The 10th revised International Classification of Diseases (ICD-10) provides a separate code M54. 6 to dorsalgia with thoracic pain.
Diagnosis and treatment
Thoracic osteochondrosis with the right approach is not difficult to identify. The main thing is to carry out a differential diagnosis with cardiovascular pathology and exclude other diseases. The presence of certain pains, fevers and nervous disorders increases the skepticism of doctors.
The main diagnostic method is radiography. It is necessary to take pictures not only of the damaged department, but also to capture the adjacent to exclude complications. If it is impossible to fully examine the spine and if tissue and vascular damage is suspected, computed tomography and magnetic resonance imaging are prescribed.
Thoracic osteochondrosis in most cases is treated by conservative methods.
The main thing in treatment is the complexity and the individual approach.
Depending on the stage of the pathology, a treatment regimen at home or hospital is possible. In any case, it is necessary to apply certain principles - this is a gentle load regimen, limiting weight lifting and playing sports, preventing overwork and strict adherence to doctor's recommendations.
Thoracic osteochondrosis in the acute period of the disease, when there is pain, temperature, requires sleep rest. NSAIDs, analgesics are prescribed when pain and temperature syndromes are present. Maybe a combination of ointment, physiotherapy and massage. This combination will allow you to overcome the disease quickly and bounce back.
The basis of osteochondrosis treatment is local effects. Manual therapy will allow you to put the vertebrae in place, massage, physiotherapy (electrophoresis, ultrasound, magnetotherapy) and reflexotherapy can restore nutrition. It is important for both men and women to engage in therapeutic training and adhere to treatment regimens.
With complications, traction or surgery may be prescribed. Otherwise, symptomatic therapy is used.