Degenerative disc disease (osteochondrosis) in the thoracic spine is a relatively rare condition compared to other spines. This is because the rib cage stabilizes the thoracic spine, limiting movement and injuries from constant bending and stretching, as happens in the rest of the spine. If osteochondrosis develops in the thoracic spine, then its development is most often 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 can radiate to the intercostal space, numbness, tingling, muscle cramps, or certain combinations of these symptoms. The most common manifestations of osteochondrosis in the thoracic region occur at the level of T8-T12. As a rule, the manifestations of osteochondrosis in the thoracic region are: bulge, disc displacement, disc herniation with sequestration, spondylolisthesis.
Treatment of osteochondrosis of the thoracic spine is usually conservative, but in the presence of complications such as spinal cord compression, surgical treatment is possible.
Osteochondrosis (degenerative disc disease) is not actually a disease, but a term used to describe the progressive changes on the discs associated with progressive wear and the development of secondary symptoms after disc degeneration. Disc degeneration is a normal involuntary process, but in certain situations the degeneration process can be accelerated, for example, as a result of trauma, overuse, and musculoskeletal imbalance such as scoliosis. Disc degeneration in itself is not a problem, but the conditions associated with it can lead to the development of advanced symptoms.
Stages of disc degeneration
The progress of disc degeneration can be classified into the following stages:
Dysfunction
- Tears are possible in the area of annular fibrosus, with irritation of the facet joints at the appropriate level of the spine.
- Loss of joint mobility, local back pain, muscle cramps and limitations in torso mobility, especially extensions.
Instability
- Fluid loss due to disc with dehydration and disc height reduction. Weakness of the facet joints and capsules may develop, leading to instability.
- The patient will feel the pain of shooting, straightening the spine and a sudden decrease in the range of motion in the torso.
Re-stabilization
- The human body responds to instability by creating additional bone formations in the form of osteophytes, which to some extent helps to stabilize the spine. But excess bone formation can lead to spinal stenosis.
- Back pain usually decreases, but remains less intense. Some people may develop symptoms similar to stenosis.
Reasons
- Involutional changes in the body are the most common cause of disc degeneration. As the body ages, the discs gradually lose their fluid portion and become dehydrated. The discs begin to narrow and lose height, diminishing their ability to absorb shock and stress.
- The outer annular fibrous structures of the disc may begin to crack and crack, weakening the walls of the disc.
- People who smoke, are obese, and engage in strenuous activities are more likely to experience disc degeneration.
- Injury to the spine or disc from a fall or impact can trigger the degeneration process.
- A disc herniation can initiate the development of 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. Disc degeneration in the thoracic spine can affect the back, the area under the shoulder blade, or along the ribs.
- Many patients with degenerative thoracic disc disease may not have symptoms.
- Chronic thoracic pain with and without radiation to the ribs.
- Sensory changes such as numbness, tingling or paresthesias in cases of nerve compression.
- Muscle spasm and changes in posture in the thoracic back.
- Loss of range of motion, with reduced ability to move the torso, especially when turning or bending to the side.
- Prolonged sitting can cause back and arm pain.
- Difficulty lifting weights and raising your arms above your head.
- In the later stages, spinal stenosis can develop, which leads to weakness of the lower extremities and loss of coordination of movements. In these cases, surgery will be required.
Diagnosis
In addition to a thorough examination, your doctor may order the following tests to confirm the diagnosis:
- X-ray,helps determine if there is joint degeneration, fractures, bone malformations, arthritis, tumors or infections.
- MRIto determine soft tissue morphological changes, including visualization of discs, spinal cord, and nerve roots.
- CT scannera scan that can provide cross-sectional images of spinal structures.
- EMG,this diagnostic method is used to determine nerve damage and damage levels.
- Myelogramas a rule, this research method is necessary to clarify morphological changes in the degree of impact on the roots and spinal cord and to plan surgical intervention.
Treatment
Treatment of osteochondrosis of the thoracic spine will depend on the severity of the condition.
Treatment of acute pain syndrome:
- Rest: Avoid activities that cause pain (bending, lifting, twisting, twisting, or spreading backwards).
- Inflammatory drugs (anti-inflammatory drugs and painkillers).
- Ice in acute cases can relieve cramps, relieve pain.
- Local heat exposure can help relieve pain and muscle tension.
- Light gymnastic exercises to eliminate biomechanical disorders associated with osteochondrosis and improve joint mobility, normal spine configuration, posture and range of motion.
- It may be necessary to use a brace to relieve stress on the facet 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 milder cases, a local cold and medication may be sufficient to relieve the pain. After relieving the pain, exercise (physical therapy) and exercises to stretch and strengthen the back muscles are recommended. The return to normal activity should be gradual to prevent recurrence of symptoms.
The main conservative methods of treatment of osteochondrosis of the thoracic spine
Drug treatment
The task of using drugs in the treatment of osteochondrosis of the thoracic spine, especially in the syndrome of acute pain, is to reduce pain, inflammation and muscle spasms.
- OTC medications for mild to moderate pain.
- Narcotic analgesics for severe pain that cannot be controlled by other methods of treatment.
- Muscle relaxants to reduce acute muscle spasm.
- Prescription analgesics.
- Injections such as facet joints, blockades or epidural injections. This may involve injecting corticosteroids into specific areas to reduce local inflammation.
- Manual therapies, including soft tissue massage, stretching and joint mobilization performed by a specialist, improve the geometry, mobility and range of motion in the thoracic spine. The use of mobilization techniques also helps in modulating pain.
- Exercise therapy (therapeutic exercises), including stretching and muscle strengthening exercises, to restore range of motion and strengthen back and abdominal muscles, 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 cramps, and inflammation have subsided. Improperly chosen exercise program can worsen symptoms. Therefore, the selection of exercises must be carried out by an exercise physician.
- Neuromuscular retraining to improve posture, restore stability, teach the patient the correct biomechanics of movement to protect damaged discs and spine.
- Physical therapy, including the use of ultrasound, electrical stimulation and a cold laser, helps reduce pain and inflammation of the spinal structures.
- Home exercise programs, including exercises to strengthen muscles, stretch and stabilize, and make lifestyle changes to reduce stress on the spine.
- Acupuncture. This method of treatment can be used in case of sensory disorders or to restore conduction and reduce pain.
Surgical treatments
Most hernias located in the thoracic spine of the thoracic disc can be successfully treated without surgery. However, when conservative treatment of thoracic spine osteochondrosis is ineffective, surgery may be recommended, especially if the patient has any 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 operation associated with disc degeneration is discectomy, in which the disc is removed by incision. However, there are several surgical procedures that can be recommended 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 problems associated with osteochondrosis of the thoracic spine can be solved without surgery, and people return to normal work. Osteochondrosis in the thoracic spine develops less due to anatomical rigidity than in other parts. The duration of treatment, as a rule, does not exceed 4-12 weeks and depends on the severity of symptoms. Patients should continue with a stretching, strengthening, and stabilization exercise program. A good long-term prognosis requires the use of proper movements and body mechanics and an awareness of the importance of maintaining a healthy spine.