Treatment of osteochondrosis of the thoracic spine

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 vertebrae, limiting movement and constant flexion and extension injuries, as occurs in the rest of the spine. If osteochondrosis develops in the thoracic spine, most often its development is associated with trauma.

Degeneration, destruction, and inflammation in the disc area can cause a range 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 spasm, or some combination of these symptoms. The most common manifestations of osteochondrosis in the thoracic region occur at the T8-T12 level. As a rule, the manifestations of osteochondrosis in the thoracic region are: protrusion, extrusion of the disc, herniated disc with seizure, spondylolisthesis.

Treatment of osteochondrosis of the thoracic spine is often 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 in the discs associated with progressive wear and the development of symptoms secondary to disc degeneration. Disc degeneration is a normal involutionary process, but in certain situations the degeneration process can be accelerated, for example, due to trauma, overuse, and musculoskeletal imbalances such as scoliosis. Disc degeneration itself 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:

Dysfunction

• Tears are possible in the area of the fibrous ring, with irritation of the joint facets at the corresponding level of the spine.
• Loss of joint mobility, local back pain, muscle spasm and limitations in trunk mobility, particularly in extension.

Instability

• Fluid loss from a disc with dehydration and decreased disc height. Weakness of the facet joints and capsules may develop, leading to instability.
• The patient will experience pain of a stabbing nature, straightening of the spine and a sharp decrease in the range of motion in the trunk.

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 excess bone formation can lead to spinal stenosis.
• Back pain usually subsides but remains less intense. Some people may develop stricture-like symptoms.

The reasons

• Involutionary changes in the body are the most common cause of disc degeneration. As the body ages, the discs gradually lose their liquid part and become dehydrated. The discs begin to shrink and lose their height, compromising their ability to absorb shock and stress.
• The outer annular fibrous structures of the disc can begin to crack and break, weakening the disc walls.
• 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 herniated disc can begin the development of disc degeneration.
• Unlike muscles, discs have minimal blood supply, so they don't have a restorative ability.

Symptoms

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 thoracic spine degenerative disc disease may have no symptoms.
• Chronic chest pain with / without irradiation to the ribs.
• Sensory changes such as numbness, tingling or paraesthesia in cases where there is nerve compression.
• Muscle spasm and posture changes in the thoracic back.
• Loss of mobility, with reduced ability to move the trunk, especially during rotation or lateral flexion.
• Sitting for long periods of time can cause back pain and arm pain.
• Difficulty lifting weights and lifting the arms above the head.
• In the later stages, spinal stenosis can develop, leading to weakness in the lower limbs and loss of movement coordination. In these cases, surgery will be required.

Diagnostics

In addition to conducting a thorough examination, the doctor may order the following tests to obtain verification of the diagnosis:

• X-ray,helps determine if there is joint degeneration, fractures, bone malformations, arthritis, tumors or infections.
• magnetic resonanceto determine morphological changes in soft tissues, including visualization of discs, spinal cord, and nerve roots.
• CT scana scan capable of providing cross-sectional images of the spinal structures.
• EMG,this diagnostic method is used to determine nerve damage and the level of damage.
• 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 backward extension).
• Medicines to reduce inflammation (anti-inflammatory and pain relieving drugs).
• Ice in acute cases can relieve spasm, relieve pain.
• Local heat exposure can help relieve pain and muscle tension.
• Light gymnastics exercises to eliminate biomechanical disorders associated with osteochondrosis and improve joint mobility, normal spine configuration, posture and range of motion.
• You may need 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 damaged disc area.

In mild cases, the use of topical colds and medications may be sufficient to relieve pain. After pain relief, physical therapy (physical therapy) and exercises to stretch and strengthen the back muscles are recommended. Return to normal activity should be gradual to prevent recurrence of symptoms.

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

Pharmacological treatment

The task of the use of drugs in the treatment of osteochondrosis of the thoracic spine, especially in acute pain syndrome, is to reduce pain, inflammation and muscle spasm.

• Over-the-counter medications for mild to moderate pain.
• Narcotic analgesics for severe pain that cannot be controlled with other treatment methods.
• Muscle relaxants to reduce acute muscle spasm.
• Prescription analgesics.
• Injections such as facet joint injections, blocks or epidural injections. These can include 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 of the thoracic spine. The use of mobilization techniques also helps modulate pain.
• Physical therapy (therapeutic exercises), including stretching and muscle strengthening exercises, 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 weight or weight exercises, should be started after the pain, muscle spasm, and inflammation have subsided. An improperly selected exercise program can aggravate symptoms. Therefore, exercise selection should be done with a physical therapy doctor.
• Neuromuscular retraining to improve posture, restore stability, teach the patient the correct biomechanics of movement to protect damaged discs and spinal column.
• Physical therapy, including the use of ultrasound, electrical stimulation, and cold laser, helps reduce pain and inflammation of the spinal structures.
• Exercise programs at home, including muscle strengthening, stretching and stabilization exercises, 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 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 some of the following symptoms:

• Increased radicular pain.
• Increased pain and nerve damage.
• Development or increase of muscle weakness.
• Increased numbness or paraesthesia.
• 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 surgical procedures that can be recommended for osteochondrosis and disc degeneration. The choice of the surgical method depends on the cause of the symptoms. Basic Surgical Techniques: These include foraminotomy, laminotomy, spinal laminectomy, spinal decompression, and spinal fusion.

Forecast

Most of the problems associated with osteochondrosis of the thoracic spine can be resolved 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 the symptoms. Patients should continue with the stretching, strengthening and stabilization exercise program. A good long-term prognosis requires the use of proper body movements and mechanisms, and an awareness of the importance of maintaining spinal health.