Degenerative disc disease (osteochondrosis) in the thoracic spine is a relatively rare condition compared to other spines. This is because the cage stabilizes the thoracic vertebrae, limiting movement and injury from constant flexion and extension, as in the rest of the spine. If osteochondrosis develops in the thoracic spine, then most often its development is associated with trauma.
Degeneration, destruction and inflammation in the area of the disc can cause a number of symptoms, depending on the severity of the problem. Disc pathology can lead to symptoms such as reduced range of motion in the back, back pain that may radiate to the intercostal space, numbness, tingling, muscle spasm or certain combinations of these symptoms. The most common manifestations of osteochondrosis in the thoracic region occur at the T8-T12 level. Typically, the manifestations of osteochondrosis in the thoracic region are: protrusion, disc ejection, herniated disc with occlusion, vertebral slip.
Treatment of osteochondrosis of the thoracic spine is more often conservative, but in the presence of complications such as compression of the spinal cord, surgical treatment is possible.
Osteochondrosis (degenerative disc disease) is not really a disease, but a term used to describe progressive changes in the discs associated with progressive wear and tear and development of symptoms secondary to disc degeneration. Disc degeneration is a normal process involuntarily, but in some cases, the degeneration process can be accelerated, for example, as a result of trauma, overuse, and musculoskeletal imbalances such as scoliosis. Disc degeneration on its own 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 the fibrous ring, by irritating the joints of the faces at the corresponding level of the spine.
- Loss of joint mobility, local back pain, muscle spasm and limitations in torso mobility, especially extension.
Instability
- Disk fluid loss with dehydration and reduction of disc height. Weakness of the joints and capsules may develop, leading to instability.
- The patient will experience shooting pain, straightening the spine and a sharp reduction in range of motion in the torso.
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 narrowing of the spine.
- Back pain usually decreases but remains less severe. Some people may experience symptoms that look like stenosis
The reasons
- Abnormal changes in the body are the most common cause of disc degeneration. As the body grows, the discs gradually lose their fluid portion and become dehydrated. The discs begin to shrink and lose their height, reducing their ability to absorb shock and stress.
- The outer annular structures of the disc may begin to break and break, weakening the walls of the disc.
- People who smoke, are obese, and engage in strenuous activity are more likely to develop disc degeneration.
- Injury to the spine or disc from a fall or impact can cause the degeneration process.
- A herniated disc can start developing disc degeneration.
- Unlike muscles, discs have a minimal blood supply, so they do not have the ability to repair.
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 below the shoulder blade or along the sides.
- Many patients with degenerative disc disease of the thoracic spine may have no symptoms.
- Chronic chest pain with / without radiation to the ribs.
- Aesthetic changes such as numbness, tingling or hallucinations in cases where there is nervous compression.
- Muscle spasm and changes in the posture of the chest in the back.
- Loss of range of motion, with reduced ability to move the trunk, especially when rotating or bending to the side.
- Sitting for extended periods of time can cause back pain and hand pain.
- Difficulty lifting weights and lifting arms from above.
- In later stages, stenosis of the spine can develop, leading to weakness in the lower extremities and loss of coordination of movements. In these cases, surgery is required.
Diagnostics
In addition to the thorough examination, the doctor may order the following tests to verify the diagnosis:
- X-ray,helps determine if there is joint degeneration, fractures, bone malformations, arthritis, tumors or infection.
- Magnetic resonanceto identify morphological changes in soft tissues, including disc visualization, spinal cord, and nerve roots.
- Computed tomographya scan that can provide cross-sectional images of the vertebral structures.
- EMG,This diagnostic method is used to determine nerve damage and the level of damage.
- MyelogramAs a rule, this research method is necessary for the clarification of morphological changes in the degree of effect on the roots and spinal cord and for the planning of surgery.
Treatment
Treatment of osteochondrosis of the thoracic spine depends on the severity of the condition.
Treatment of acute pain syndrome:
- Rest: Avoid activities that cause pain (bending, lifting, twisting, twisting, or extending backwards).
- Drugs to reduce inflammation (anti-inflammatory drugs and pain relievers).
- Ice in acute cases can relieve spasm, relieve pain.
- Local exposure to heat can help relieve pain and muscle tension.
- Light exercise to eliminate the industrial disorders associated with osteochondrosis and improve joint mobility, normal spine shaping, posture and range of motion.
- You may need to use a brace to relieve stress on the joints and muscles of the thoracic 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, the use of topical colds and medications may be sufficient to relieve the pain. After relieving the pain, exercise (physiotherapy) and exercises for stretching and strengthening the back muscles are recommended. The return to normal activity should be gradual to avoid the recurrence of symptoms.
The main conservative methods of treatment of osteochondrosis of the thoracic spine
Drug treatment
The task of using drugs to treat 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.
- Analgesic drugs for severe pain that can not be controlled with other methods of treatment.
- Muscle relaxants to reduce acute muscle spasm.
- Prescription analgesics.
- Injections such as joint injections, obstruction or epidural injections. These may include injecting corticosteroids into specific areas to reduce local inflammation.
- Manual therapies, such as soft tissue massage, stretching and mobilization of the joints performed by a specialist, improve the geometry, mobility and range of motion in the thoracic spine. The use of mobilization techniques also helps to regulate pain.
- Exercise therapy (therapeutic exercises), including stretching and muscle strengthening, to restore range of motion and strengthen the muscles of the back and abdomen, support, stabilize and reduce stress on the discs and back. An exercise program, especially exercises with weights or weights, should begin after the pain, muscle spasm and inflammation have subsided. An improperly selected exercise program can worsen the symptoms. Therefore, the choice of exercises should be made with an exercise therapy physician.
- Neuromuscular retraining to improve posture, restore stability, teach the patient the correct industrial 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 the vertebral structures.
- Home exercise programs such as muscle strengthening exercises, stretching and stabilization and lifestyle changes to reduce stress on the spine.
- Acupuncture. This method of treatment can be used in the presence of sensory disturbances or to restore treatment and reduce pain.
Surgical treatments
Most hernias located in the thoracic spine can be successfully treated without surgery. However, when conservative treatment of osteochondrosis of the thoracic spine is ineffective, surgery may be recommended, especially if the patient has some of the following symptoms:
- Increased nasal pain.
- Increased pain and nerve damage.
- Development or increase of muscle weakness.
- Increased numbness or hallucinations.
- Loss of control of bowel 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 several surgeries that can be suggested 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.
Forecast
Most of the problems associated with osteochondrosis of the thoracic spine can be solved without surgery and people return to normal work. Osteochondrosis of the thoracic spine due to anatomical stiffness develops less than elsewhere. The duration of treatment, as a rule, does not exceed 4-12 weeks and depends on the severity of the symptoms. Patients should continue with the stretching, strengthening and stabilization program. Good long-term prognosis requires the use of proper movement and body mechanics and awareness of the importance of maintaining spine health.