Degenerative disc disease (osteochondrosis) of the thoracic spine is a relatively rare condition compared to other spines. This is because the rib cage stabilizes the thoracic vertebrae, limiting movement and injury due to constant flexion and elongation, as is the case in other parts of the spine. If osteochondrosis develops in the thoracic spine, then often its development is associated with trauma.
Degeneration, destruction, and inflammation in the disc area can cause a variety of symptoms, depending on the severity of the problem. Disc pathology can cause symptoms such as decreased movement in the back, back pain that may radiate to the intercostal space, numbness, tingling, muscle spasms, or certain combinations of these symptoms. The most common manifestation of osteochondrosis in the thoracic region occurs at the T8-T12 level. As a rule, the manifestations of osteochondrosis in the thoracic region are: protrusion, disc extrusion, herniated disc with resorption, spondylolisthesis.
Treatment of osteochondrosis of the thoracic spine is most often conservative, but if there are complications such as spinal cord compression, surgical treatment may be performed.
Osteochondrosis (degenerative disc disease) is actually not a disease, but a term used to describe progressive changes in the disc associated with progressive wear and development of symptoms secondary to disc degeneration. Disc degeneration is a common inclusion process, but in certain situations, the degeneration process can be accelerated, for example, as a result of trauma, overuse, and musculoskeletal imbalances such as scoliosis. Disc degeneration by itself is not a problem, but conditions associated with it can lead to the development of further symptoms.
The degree of disc degeneration
The development of disc degeneration can be classified into the following stages:
Dysfunction
- Tears may occur in the area of the annulus fibrosus, with irritation of the facet joints at the corresponding spinal level.
- Loss of joint mobility, localized back pain, muscle spasm and limitation of trunk movement, especially prolongation.
Instability
- Loss of fluid by the disc with dehydration and decrease in disc height. Weakness of the joints and facet capsules can develop, causing instability.
- The patient will experience pain such as shooting, straightening of the spine and a sharp decrease in the distance of movement in the trunk of the body.
Re -stabilization
- The human body responds 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 cause spinal stenosis.
- Back pain is usually reduced but still not strong. Some people may experience symptoms such as stenosis.
The reasons
- Changes in inclusion in the body are the most common cause of disc degeneration. As it ages, the disc gradually loses its liquid part and becomes dry. The discs begin to narrow and lose height, impairing their ability to absorb shock and stress.
- The outer annular fibrous structure of the disc can begin to crack and rupture, weakening the walls of the disc.
- People who smoke, are obese, and do strenuous activity tend to experience disc degeneration.
- Injuries to the spine or discs as a result of a fall or impact can trigger a degenerative process.
- A herniated disc can initiate the development of disc degeneration.
- Unlike muscle, discs have a minimal blood supply, so have no reparative capacity.
Symptoms
The symptoms associated with thoracic spine osteochondrosis will depend on the location and structure involved in this process. Disc degeneration in the thoracic spine can affect the back, the area under the scapula, or along the ribs.
- Many patients with degenerative disc disease of the thoracic spine may not experience symptoms.
- Chronic thoracic pain with / without irradiation to the ribs.
- Sensory changes such as numbness, tingling, or paresthesia in cases where there is nerve compression.
- Muscle spasms and postural changes in the back of the thorax.
- Loss of range of motion, with reduced ability to move the rod, especially when twisting or bending to the side.
- Sitting for long periods of time can cause back pain and pain in the arms.
- Difficulty lifting weights and lifting hands above head.
- At a later stage, spinal stenosis can develop, resulting in weakness in the lower leg and loss of coordination of movement. In this case, surgery will be required.
Diagnostics
In addition to performing a thorough examination, the doctor may order the following tests to ensure the diagnosis is confirmed:
- X-ray,helps determine if there is joint degeneration, fracture, bone malformation, arthritis, tumor, or infection.
- MRIto determine morphological changes in soft tissues, including visualization of discs, spinal cord and nerve roots.
- CT scana scan that can provide a cross -sectional picture of the spinal structure.
- EMG,this diagnostic method is used to determine damage to the nerve and the degree of damage.
- Myelogramas a method, this research method is needed to elucidate the morphological changes of the level of impact on the roots and spinal cord and to plan surgical interventions.
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 stretching backwards).
- Medicines to reduce inflammation (anti-inflammatory and painkillers).
- Ice in acute cases can relieve cramps, relieve pain.
- Local exposure to heat can help relieve muscle pain and tension.
- Light gymnastic exercises to eliminate biomechanical disorders associated with osteochondrosis and improve joint mobility, normal configuration of the spine, posture and range of motion.
- It may be necessary to use braces to relieve pressure on the joints and muscles of the thoracic spine.
- Corticosteroids are used to reduce inflammation in moderate to severe cases.
- Epidural injection directly into the damaged disc area.
In mild cases, the use of colds and topical medications may be sufficient to relieve the pain. After pain relief, exercise therapy (physical therapy) and exercises to stretch and strengthen the back muscles are recommended. Return to normal activity should be done gradually to avoid recurrence of symptoms.
The main conservative method 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 acute pain syndrome, is to reduce pain, inflammation and muscle spasm.
- OTC medications for mild to moderate pain.
- Narcotic analgesics for intense pain that cannot be controlled with other treatment methods.
- Muscle relaxation to reduce acute muscle spasm.
- Prescription analgesics.
- Injections such as facet joint injections, blockages, or epidural injections. This includes injecting corticosteroids into specific areas to reduce local inflammation.
- Manual therapy, including soft tissue massage, stretching and mobilization of joints performed by specialists, improves geometry, mobility and range of motion in the thoracic spine. Using mobilization techniques also helps modulate pain.
- Exercise therapy (therapeutic exercise), including stretching and muscle strengthening exercises, to restore range of motion and strengthen the back and abdominal muscles, supporting, stabilizing and reducing pressure on the discs and buttocks. Exercise programs, especially exercises with weights or weights, should be started after pain, muscle cramps, and inflammation have subsided. Improperly chosen exercise programs can worsen symptoms. Therefore, exercise selection must be made with an exercise therapy physician.
- Neuromuscular retraining to improve posture, restore stability, teach patients proper biomechanical movements to protect damaged discs and spine.
- Physical therapy, including the use of ultrasound, electrical stimulation, and cold lasers, helps reduce pain and inflammation of spinal structures.
- Home training programs, including muscle strengthening exercises, stretching and stabilization, and lifestyle changes to reduce stress on the spine.
- Acupuncture. This method of treatment can be used if there is a sensory disturbance or to restore conduction and reduce pain.
Surgical treatment
A large number of hernias located in the 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 some of the following symptoms:
- Radicular pain increased.
- Increased pain and nerve damage.
- Development or increase in muscle weakness.
- Increased numbness or paresthesia.
- Loss of control of bowel and bladder function.
The most common surgery associated with disc degeneration is dysectomy, in which the disc is removed through an 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.
Prediction
A large number of problems associated with osteochondrosis of the thoracic spine can be solved without surgery and people return to normal work. Osteochondrosis in the thoracic spine due to anatomical stiffness develops less 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 a program of stretching, strengthening, and stabilization exercises. A good long -term prognosis requires the use of proper movement and body mechanics and an awareness of the importance of maintaining a healthy spine.