Treatment of osteochondrosis of the thoracic spine

Degenerative disc disease (osteochondrosis) of the thoracic spine is a relatively rare disease compared to other spinal columns. This is because the rib cage stabilizes the thoracic vertebrae and restricts movement and injury from constant bending and stretching, as occurs in the rest of the spine. Most often, when osteochondrosis develops in the thoracic spine, its development is associated with trauma.

Degeneration, destruction, and inflammation in the disc area can cause a number of symptoms, depending on the severity of the problem. Disc pathology can lead to symptoms such as restricted mobility in the back, back pain that can radiate into the intercostal space, numbness, tingling, muscle spasms, or certain combinations of these symptoms. The most common manifestations of osteochondrosis in the chest area occur at the T8-T12 level. Manifestations of osteochondrosis in the chest area are usually: protrusion, extrusion of the disc, herniated disc with sequestration, spondylolisthesis.

Treatment for thoracic spine osteochondrosis is mostly conservative, but surgical treatment is possible for complications such as spinal cord compression.

Osteochondrosis (degenerative disc disease) is actually not a disease, but a term used to describe progressive changes in the intervertebral discs that are associated with the progressive wear and tear and the development of symptoms as a result of disc degeneration. The degeneration of the intervertebral disc is a normal involutionary process, but in certain situations the degeneration process can be accelerated, for example by trauma, overuse and musculoskeletal imbalances like scoliosis. Disc degeneration in and of itself is not a problem, but the conditions associated with it can lead to the development of more advanced symptoms.

Stages of degeneration of the intervertebral disc

The progression of intervertebral disc degeneration can be divided into the following stages:

Malfunction

• In the area of the annulus fibrosus, cracks with irritation of the facet joints at the corresponding level of the spine are possible.
• Loss of joint mobility, local back pain, muscle cramps and restrictions in trunk mobility, especially extension.

instability

• Loss of fluid through a disc with dehydration and a decrease in disc height. There may be weakness of the facet joints and capsules that lead to instability.
• The patient experiences shooting pains, straightening of the spine and a sharp decrease in the range of motion in the trunk.

Restabilization

• 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 spinal stenosis.
• Back pain usually subsides but remains less intense. Some people can develop symptoms similar to stenosis.

The reasons

• Involutional changes in the body are the most common cause of intervertebral disc degeneration. As the body ages, the intervertebral discs gradually lose their fluid content and become dehydrated. The intervertebral discs begin to narrow and lose height, reducing their ability to absorb shocks and loads.
• The outer annular fibrous structures of the intervertebral disc can begin to tear and tear, weakening the walls of the intervertebral disc.
• People who smoke, are obese, and engage in strenuous activities are more likely to have disc degeneration.
• Injuries to the spine or intervertebral disc from a fall or impact can trigger the degeneration process.
• A herniated disc can trigger the development of disc degeneration.
• Unlike muscles, intervertebral discs have a minimal blood supply, so they have no reparative capacity.

Symptoms

Symptoms associated with thoracic spine osteochondrosis depend on the location and structures involved in this process. Degeneration of the intervertebral discs in the thoracic spine can affect the back, the area under the shoulder blade, or along the ribs.

• Many patients with degenerative disc disease of the thoracic spine may not have symptoms.
• Chronic chest pain with / without radiation to the ribs.
• Sensory changes such as numbness, tingling or paresthesia with nerve compression.
• Muscle cramps and changes in posture in the chest.
• Loss of freedom of movement, with impaired ability to move the trunk, especially when twisting or bending to one side.
• Sitting for long periods of time can cause back pain and pain in your arms.
• Difficulty lifting weights and lifting arms overhead.
• In later stages, spinal stenosis can develop, leading to weakness in the lower extremities and loss of coordination of movements. Surgery is required in these cases.

diagnosis

In addition to a thorough examination, the doctor may order the following tests to verify the diagnosis:

• Roentgen,helps determine whether there are joint degeneration, fractures, bone malformations, arthritis, tumors or infections.
• MRIto determine morphological changes in soft tissues, including visualization of intervertebral discs, spinal cord and nerve roots.
• CT scana scan that can provide cross-sectional images of spinal structures.
• EMG,This diagnostic procedure determines the damage to the nerves and the extent of the damage.
• MyelogramAs a rule, this examination method is necessary to clarify morphological changes in the degree of influence on the roots and spinal cord and to plan surgical interventions.

treatment

Treatment for thoracic spine osteochondrosis depends on the severity of the condition.

Treatment of acute pain syndrome:

• Rest: Avoid activities that cause pain (bending, lifting, twisting, twisting, or stretching backwards).
• Medicines to relieve inflammation (anti-inflammatory drugs and pain relievers).
• Ice can relieve cramps and relieve pain in acute cases.
• Local exposure to heat can help relieve pain and muscle tension.
• Light gymnastics exercises designed to eliminate biomechanical disorders associated with osteochondrosis and improve joint mobility, the normal configuration of the spine, posture and range of motion.
• To relieve the facet joints and muscles of the thoracic spine, it may be necessary to use an orthosis.
• Corticosteroids are used to reduce inflammation in moderate to severe cases.
• Epidural injections directly into the damaged disc area.

In mild cases, the application of topical cold and medication may be sufficient to relieve the pain. After pain relief, exercise therapy (physiotherapy) and exercises to stretch and strengthen the back muscles are recommended. Return to normal activity should be gradual to prevent symptoms from recurring.

The main conservative methods of treatment of osteochondrosis of the thoracic spine

Medication

The use of drugs in the treatment of osteochondrosis of the thoracic spine, especially acute pain syndrome, has the task of reducing pain, inflammation and muscle spasms.

• OTC medication for mild to moderate pain.
• Narcotic analgesics for severe pain that other treatments cannot control.
• Muscle relaxants to reduce acute muscle spasms.
• Prescription analgesics.
• Injections such as facet joint injections, blockages, or epidural injections. This may include injecting corticosteroids into specific areas to reduce localized inflammation.
• Manual therapies, including soft tissue massage, stretching, and mobilization of the joints by a specialist, improve the geometry, mobility, and range of motion of the thoracic spine. Using mobilization techniques also helps modulate pain.
• Exercise therapy (therapeutic exercises), including stretching and muscle strengthening exercises, to restore freedom of movement and strengthen the back and abdominal muscles, to support, stabilize and relieve the intervertebral discs and the back. An exercise program, particularly weight or weight exercises, should be initiated after the pain, muscle cramps, and inflammation have subsided. An incorrectly chosen exercise program can make symptoms worse. Therefore, the choice of exercises must be done with a movement therapist.
• Neuromuscular retraining to improve posture, restore stability, teach the correct biomechanics of movement to protect the intervertebral discs and spine.
• Physiotherapy, including the use of ultrasound, electrical stimulation, and cold lasers, helps reduce pain and inflammation in the structures of the spine.
• Home exercise programs, including muscle strengthening, stretching and stabilizing exercises, and lifestyle changes to reduce stress on the spine.
• Acupuncture. This treatment method can be used for sensory disorders or to restore the conduction of stimuli and to relieve pain.

Surgical treatments

Most thoracic hernias can be treated successfully without surgery. However, if conservative management of thoracic spine osteochondrosis is ineffective, surgery may be recommended, especially if the patient has some of the following symptoms:

• Increased radicular pain.
• Increased pain and nerve damage.
• Development or increase in muscle weakness.
• Increased numbness or paresthesia.
• Loss of control over bowel and bladder function.

The most common surgery associated with disc degeneration is discectomy, which involves removing the disc through an incision. However, there are several surgical procedures that can be recommended for osteochondrosis and disc degeneration. The choice of the surgical method depends on the cause of the discomfort. Basic surgical techniques - include foraminotomy, laminotomy, spinal laminectomy, spinal decompression, and spinal fusion

forecast

Most of the problems associated with thoracic spine osteochondrosis can be resolved without surgery and people return to their normal jobs. Osteochondrosis in the thoracic spine due to anatomical rigidity develops less than in other parts. The duration of treatment is usually not 4-12 weeks and depends on the severity of the symptoms. Patients must continue with the stretching, strengthening, and stabilization program. A good long-term prognosis requires the use of the correct movement and body mechanics and an awareness of the importance of keeping the spine healthy.