Thoracic lumbar osteochondrosis is a degenerative-dystrophic pathology. Problems with the chain take the 5th place in the structure of all diseases of the musculoskeletal system. They are more common in people over 45 years of age. Timely diagnosis and initiation of treatment can slow the progression of the disease.
Development mechanism
Degenerative-dystrophic pathology, including osteochondrosis, is characterized by several main connections of the pathological process, including:
- Nutritional (trophism) dystrophy of cartilage tissue, which occurs against the background of excessive load or other stimuli.
- Gradual destruction of cartilage tissue cells and intercellular substance resulting from nutrition.
- The development of an inflammatory reaction, the severity of which depends on the degree of damage to the structures of cartilage tissue.
- Disorders of the articular or spinal structure (intervertebral discs) with cartilage tissue.
Osteochondrosis involves the defeat of the joints of the intervertebral discs and a series of processes in different parts. The discs between the vertebrae are straightened, which leads to compression of the motor and sensory nerve fibers of the spinal roots. The mechanism of development of the disease is always accompanied by the addition of neurological symptoms.
Causes of the disease
Osteochondrosis of the chest is a polyetiological disease. This means that the process of cartilage tissue dystrophy and degeneration is caused by a number of stimuli:
- Hereditary predisposition that determines the nutritional properties of cartilage tissue with subsequent disturbances against the background of normal loads. In this case, young people may develop osteochondrosis.
- Congenital defects and anomalies in the development of the structures of the musculoskeletal system lead to changes in blood flow to the tissues and deterioration of the nutrition of cartilage components.
- Delayed injuries of various parts of the chain (fractures, bruises, dislocations and subluxations of joints), which leads to a change in the proportion of different structures with the development of subsequent degenerative-dystrophic processes.
- Inadequate physical activity (sedentary lifestyle) causes tightness in the tissues.
- Systematically increasing loads on the thoracic spine (heavy physical labor, long-term static loads).
- Disruption of the metabolism of mineral salts in the body, which leads to a decrease in the nutritional capacity of bone processes, intervertebral discs and subsequent cartilaginous structures.
- Deterioration of blood supply to the spinal tissues, which occurs against the background of narrowing of the main vessels or arteries.
- Bad habits - nicotine and alcohol are vascular toxins that worsen blood flow to the tissues and impair nutrition.
Finding the causes of the pathological process is an important part of the diagnostic process. This is necessary for the subsequent appointment of effective treatment and prevention of recurrence of osteochondrosis.
Symptoms of thoracic spinal osteochondrosis
The development of the degenerative-dystrophic process is accompanied by the appearance and subsequent intensification of the following symptoms of osteochondrosis:
- Chest pain at the level of the chest - the pain first appears after the force, the human body remains in one position for a long time. Then the feelings of anxiety intensify and become permanent. Often the pathological process is accompanied by a dull aching back pain between the shoulder blades.
- Unpleasant feeling of "squeezing" in the back, which does not allow you to breathe fully.
- Disorders of skin sensitivity in the form of numbness in various parts of the body due to compression of the sensitive nerve fibers of the spinal cord roots (changes involve the skin of the upper or lower extremities on one side of the body).
- Muscle weakness in one arm or leg is usually on one side of the body.
- Disorders of the digestive system, accompanied by heartburn, abdominal pain, flatulence (swelling), unstable stools.
- Changes in the back and arms, including dry skin, increased fragility of the nails (as a result of disruption of the autonomic nerve fibers when the spinal cord is compressed).
- Changes in the functional state of the pelvic organs are manifested in men with urination, constipation, impotence, and in women with an unusual menstrual cycle.
Manifestations appear gradually, a person can not accurately indicate the period of development. For a long time the intensity of symptoms increases, new signs of the pathological process are added. Due to the nature and duration of back discomfort, there are 2 types of pain in osteochondrosis of the sternum:
- Dorsago - pain manifests itself in the form of convulsions, which restrict the movement of the back and interfere with full breathing.
- Dorsalgia is a persistent aching pain localized in the area of the spine affected by the pathological process.
Osteochondrosis of the breast causes constant anxiety and reduced quality of life. Depending on the degree of change, there are 4 stages in the development of pathology:
- Stage 1 - minimal changes, increased mobility of the joints between the vertebrae, no symptoms.
- Stage 2 - protrusion (correction) of the intervertebral disc, mainly a slight pain after tension.
- Stage 3 - the formation of a herniated disc, damage to the spinal cord, persistent pain, the development of neurological symptoms.
- Stage 4 - obvious changes that lead to acute persistent pain, numbness of the skin in various parts of the body, a decrease in muscle strength, especially in the upper muscles.
Determining the course of the pathological process is based on the clinical manifestations of the disease. To clarify the nature and severity of the changes, additional objective diagnostics is prescribed using spinal imaging techniques.
Diagnostics
Based on the clinical picture, the doctor gives an initial result. To determine the location and nature of the change, as well as the stage of the pathological process, an additional examination is performed with visualization of the chest:
- Spinal radiography is the most common instrumental diagnostic method that allows the detection of gross changes in the structure of the spine.
- Computed tomography is an X-ray method of layer-by-layer tissue scanning, which has a high resolution and allows you to visualize minimal changes in the chest.
- Magnetic resonance imaging - the phenomenon of resonance of the nuclei of compounds occurring in a magnetic field is used for visualization. The technique involves scanning the body, the human body is not exposed to radiation.
Laboratory tests (clinical, biochemical blood test, urine test) are prescribed to determine the functional status of various organs and systems. After diagnosis, the doctor has the opportunity to choose the optimal treatment.
Treatment of osteochondrosis of the thoracic spine
Treatment of thoracic osteochondrosis is always complicated. It aims to restore the nutrition of cartilage components, normalize their properties, correct the functional state of the spinal cord and spinal cord roots. For this purpose, 2 main areas of therapeutic measures are used:
- Conservative treatment.
- Surgical invasive intervention.
Often both directions of therapeutic measures are combined.
Conservative treatment
The basis of conservative treatment is the use of drugs of several groups:
- Non-steroidal anti-inflammatory drugs - reduce the severity of inflammatory reactions and pain.
- Adrenal hormones - Reduces inflammation and neurological pain.
- Muscle relaxants - drugs reduce the tone of the skeletal muscles of the spine, thereby reducing the compression of the spinal cord.
- Diuretics - reduce tissue swelling and compression of the spinal cord due to increased urination.
- Chondroprotectors - reduce the severity of degenerative processes, destroy cartilage tissue, help partial recovery.
- B vitamins - improve the course of metabolic processes in nerve tissue, help in the early restoration of the functional state of the spinal cord.
- Vitamin C (ascorbic acid) - strengthens blood vessels, has an antioxidant effect (binds and neutralizes free radicals that "break down" non-member molecules and damage the membrane structures of cells).
During remission (improvement of the condition and reduction of acute inflammatory phenomena) exercise therapy (physiotherapy exercises with special exercises), back massage, physiotherapy procedures (magnetotherapy, mud baths, electrophoresis) are prescribed. During the implementation of therapeutic measures, it is important to follow the recommendations of diet (avoid fatty fried foods, alcohol) and general (adequate sleep, rational work and rest). Conservative therapy allows to significantly improve the condition.
Surgical interventions
In the absence of the necessary therapeutic effect in the background of the use of drugs, invasive surgical intervention is prescribed in the event of the development of a pathological process to radically eliminate the problem. Several techniques are included:
- Microdiscectomy is the subsequent removal of a herniated disc with plastic surgery of the hernia mouth.
- Foraminectomy - removal of bone growths by narrowing the canal at the exit of the spinal cord roots.
- Laminectomy is an enlargement of the outlet canal of the spinal cord.
In modern hospitals, surgery uses minimally invasive endoscopic techniques. Plastic openings of the hernia are usually made of special mesh made of durable material that does not cause inflammatory reactions.
Prevention
To prevent the development of a pathological process, you should follow a few simple preventive recommendations, which include the following.
- Enough eight hours of sleep.
- Limiting the impact of stress factors (chronic stress can lead to the development of pathological processes).
- Normalization of work and rest.
- Limitation of heavy physical work.
- Give up bad habits.
- A rational diet that receives enough vitamins and plant fiber.
- Enough motor mode with dynamic exercises (charging), walking in the fresh air.
Thoracic spinal osteochondrosis is characterized by a chronic progressive course. The disease requires long-term therapy, so it is easier and more accessible to prevent its development.