The human spine is one of the most important components of the musculoskeletal system and the violation of its normal functioning always leads to negative consequences for the whole organism. Thoracic osteochondrosis refers to degenerative-inflammatory diseases of the spinal discs in the thoracic region. The disease most often affects people over the age of 55, but can affect any adult. In men, the disease is registered half as often as in women.
In general, although the department is the largest, consisting of 12 vertebrae in the middle of the spine, it is less prone to pathology. This is due to less mobility and good protection of the muscular corset. This feature of the structure is a positive factor, but in the diagnosis of osteochondrosis of the chest is difficult to identify and can be confused with other diseases for a long time, especially when there is fever.
There are criteria for the International Classification of Diseases 10th Revision (ICD-10), according to which osteochondrosis belongs to the class of dorsopathies (M40-54). There is a separate class ICD-10 for osteochondrosis of the spine - M42 according to ICD-10 and is equated to deforming dorsopathies. The diagnosis is made according to the code M42. 0 ICD-10 for youth and M42. 1 ICD-10 for osteochondrosis in adults. Code M42. 9 ICD-10 may occur with unspecified pathology.
The reasons
Thoracic osteochondrosis is less common than lesions of other parts of the spine. Many people do not seek medical help for a long time, thinking that they have other pathologies. According to statistics, this leads to the detection of the disease most often in advanced form.
The disease occurs due to impaired nutrition and blood supply to the intervertebral discs. The formation of osteochondrosis can lead to disruption of the normal structure of the vertebrae. The elasticity and cushioning properties of the spine are lost and all this leads to the destruction of discs, ligaments and other structural components. As a result of such disorders, the nerve roots are compressed and unpleasant symptoms appear.
It is almost impossible to find the exact causes of the pathology. There is a risk group among people and predisposing factors leading to the disease. As for the people themselves, this age is over 55 years, the female sex and the presence of spinal pathologies increase the risk of disease. Deviations such as scoliosis, kyphosis over time disrupt posture and normal alignment of the spine. As a result, metabolic processes in the spine are disrupted and chondrosis is formed.
There are factors directly dependent on the person that lead to pathology. Let's emphasize the main:
- overweight;
- abuse of bad habits: alcohol, smoking, fatty foods;
- sedentary way of life.
People who spend a lot of time in a sitting position are prone to the disease. This applies to office workers, seamstresses, operators, drivers. A person who has suffered an injury to the back or spine should also be careful in the future. There is a group of people with inherited or acquired diseases who are predisposed to diseases of the musculoskeletal system. The main conditions are diabetes, muscle weakness, dysfunction of the glands.
Types and clinical picture
The signs of osteochondrosis of the chest depend on the degree of pathology and neglect of the process. There are a total of four degrees of the disease.
In the first degree there is a violation of the elasticity of the intervertebral discs and a decrease in their height. The symptoms of pain are not so acute and quickly pass at rest. Generally, the pain is felt in the middle of the back and in the chest. Often the disease progresses to a passive state and clinical manifestations appear only during exacerbation, rapid cessation and treatability. Signs of intoxication are rare, sometimes the temperature may rise and weakness may occur. The temperature quickly normalizes when the acute period passes.
The second degree is more dangerous and can cause severe neurological symptoms. With this degree, the height of the discs of the spine is constantly decreasing, the elasticity is impaired. The fibrous ring of the intervertebral disc can be damaged and a crack may form. This stage is fraught with the threat of an intervertebral hernia.
The pain in the chest and back becomes more severe and eventually spreads to the adjacent area. Acute pain occurs with deep breathing or sudden movement. When nerve endings are damaged, symptoms spread to the ribs. In the period of exacerbation there is fever, general weakness. With this degree of disease joins the feeling of tingling and creeping "goosebumps" at the site of the lesion. If the nerve fibers are damaged, then the normal innervation in the upper or lower limbs is disrupted.
Third-degree osteochondrosis of the thoracic region is characterized by the onset of intervertebral hernia formation. There is severe pain that occurs under certain circumstances. Often the pain can intensify at night when you are cold for a long time, in one position. Pain in the chest, back, along the ribs. The following symptoms may occur with spinal cord exposure:
- violation of the innervation of the legs and arms;
- increased pain at night;
- pain in the esophagus, right hypochondrium, stomach;
- fever;
- problems with the normal functioning of the gastrointestinal tract.
In the last, fourth degree, the bone tissue of the spine is destroyed. There is a violation of the mobility of the vertebrae, the depreciation properties are reduced. Thoracic osteochondrosis in this degree is dangerous from damage to the spinal cord and impaired human performance. With exacerbation, body temperature rises, there is severe pain in the chest, in the middle of the back.
Among the general clinical picture, two main symptoms are distinguished - dorsago and dorsalgia. Dorsago is characterized by acute chest pain. One has a feeling of shooting in the chest after a long stay in one position. During an attack, breathing becomes difficult and the pain is intensified by torso movements to the side. This condition raises the temperature.
In dorsalgia there is mild pain in the area of the damaged vertebrae. The symptoms of pain increase and last up to three weeks. The pain becomes stronger after deep inhalation or exhalation and during movements. Symptoms worsen at night and are relieved by walking. The International Classification of Diseases 10th Revision (ICD-10) defines a separate code M54. 6 of dorsalgia with chest pain.
Diagnosis and treatment
Thoracic osteochondrosis with the right approach is not difficult to identify. The main thing is to conduct a differential diagnosis with cardiovascular pathologies and to exclude other diseases. The presence of specific pain, fever and neurological disorders increase the doctor's doubts.
The main diagnostic method is radiography. It is necessary to take a picture not only of the damaged department, but also to photograph the neighboring ones to rule out complications. In case of impossibility for complete examination of the spine and in case of suspicion of damage to the tissues and vessels, computed tomography and magnetic resonance imaging are prescribed.
Thoracic osteochondrosis in most cases is treated with conservative methods.
The main thing in the treatment is the complexity and the individual approach.
Depending on the degree of pathology, a home treatment or hospital regimen is possible. In any case, it is necessary to apply certain principles - this is a gentle regime of exercise, limiting weightlifting and exercise, preventing fatigue and strict adherence to the recommendations of the doctor.
Thoracic osteochondrosis in the acute period of the disease, when there is pain, fever, requires bed rest. In the presence of pain and fever, NSAIDs and analgesics are prescribed. Maybe a combination of ointments, physiotherapy and massage. This combination will allow you to quickly overcome the disease and get back on your feet.
The basis of treatment of osteochondrosis is a local effect. Manual therapy will allow you to put the vertebrae in place, massage, physiotherapy (electrophoresis, ultrasound, magnetic therapy) and reflexology can restore nutrition. It is important for both men and women to engage in therapeutic gymnastics and adhere to the treatment regimen.
In case of complications, traction or even surgery may be prescribed. Otherwise, symptomatic therapy is used.