The human spine is one of the most important components of the musculoskeletal system and a violation of its normal functioning always causes negative consequences for the whole organism. Thoracic osteochondrosis refers to degenerative-inflammatory diseases of the spinal discs in the chest region. The disease most often affects people over 55, but can also occur in any adult. In men, the disease is recorded in half of women.
In general, although the department is the largest, consisting of 12 vertebrae in the middle of the spine, it is less prone to pathologies. This is due to the less mobility and better protection of the muscular corset. This feature of the structure is a positive factor, but in diagnosing osteochondrosis of the chest region it 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 10th review of the International Classification of Diseases (ICD-10), according to which osteochondrosis belongs to the class of dorsopathy (M40-54). There is a special class of ICD-10 for spinal osteochondrosis - M42 according to ICD-10 and equates to deforming dorsopathies. Diagnosis is made according to code M42. 0 ICD-10 for youth and M42. 1 ICD-10 for adult osteochondrosis. Code M42. 9 ICD-10 can occur with an unspecified pathology.
reason
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 they have other pathologies. According to statistics, this leads to the detection of the disease more often in an 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 become entangled and unpleasant symptoms appear.
It is almost impossible to discover the exact causes of the pathology. There is a risk group between people and predisposing factors that lead to disease. As for the persons themselves, this age is over 55 years old, female gender and the presence of spinal pathologies increase the risk of getting sick. Deviations such as scoliosis, kyphosis, over time, affect the normal posture and regulation of the spine. Consequently, metabolic processes in the spine are disturbed and chondrosis is formed.
There are factors that depend directly on the person leading to the pathology. Let us distinguish the main ones:
- excess body weight;
- abuse of bad habits: alcohol, smoking, fatty foods;
- sedentary lifestyle.
People who spend a lot of time in a sitting position are prone to the disease. This applies to office workers, tailors, operators, drivers. A person who has suffered a back or spine injury should also be careful in the future. There is a group of people with inherited or acquired diseases who are prone to diseases of the musculoskeletal system. The main conditions are diabetes mellitus, muscle weakness, dysfunction of normal glands.
Types and clinical overview
Signs of osteochondrosis of the thoracic spine depend on the degree of pathology and neglect of the process. In total, four degrees of the disease are distinguished.
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 sharp and pass quickly to rest. Basically, the pain is felt between the back and the chest. Often, the disease passes into a passive state and clinical manifestations appear only during exacerbation, stopping quickly and treatable. Signs of intoxication are rarely present, sometimes the temperature may rise and weakness may appear. The temperature normalizes quickly when the acute period passes.
The second degree is more dangerous and can cause severe neurological symptoms. With this degree, the height of the spinal discs is constantly reduced, the elasticity is broken. The fibrous ring of the intervertebral disc can be damaged and a crack created. This stage is fraught with the threat of developing an intervertebral hernia.
The pain in the chest and back becomes stronger and eventually spreads to the adjacent area. During deep breathing or sudden movement, an acute attack of pain occurs. When nerve endings are damaged, symptoms spread along the ribs. During the period of deterioration, there is an increase in temperature, general weakness. With this degree of disease, a feeling of numbness and crawling "goosecumps" at the site of the lesion joins. If the nerve fibers are damaged, then normal innervation in the upper or lower extremities is disrupted.
Osteochondrosis of the third-degree thoracic region is characterized by the onset of the formation of an intervertebral hernia. There is severe pain that occurs in certain circumstances. Often the pain can intensify at night, when you are in the cold for a long time, in one position. Pain in the chest, back, along the ribs. When exposed to the spinal cord, the following symptoms may occur:
- violation of the innervation of the legs and arms;
- increased pain at night;
- pain in the esophagus, right hypochondrium, stomach;
- increase in body temperature;
- 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 damping properties are reduced. Thoracic osteochondrosis to this degree is dangerous from spinal cord injury and impaired human performance. With a worsening, the 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 - these are dorsago and dorsalgia. Dorsago is characterized by sharp pain in the chest. A person has a feeling of shooting in the chest after a long stay in one position. During an attack, breathing becomes difficult and the pain intensifies with torso movements to the sides. This condition raises the temperature.
With dorsalgia, there is a slight pain in the area of the damaged vertebrae. Pain symptoms increase and last up to three weeks. The pain becomes stronger after a deep breath or exhalation and with movement. Symptoms worsen at night and are relieved by walking. The 10th International Disease Classification (ICD-10) review assigns a special code M54. 6 dorsalgia with thoracic pain.
Diagnosis and treatment
Thoracic osteochondrosis with the right approach is not difficult to identify. The main thing is to carry out a differential diagnosis with cardiovascular pathologies and to exclude other diseases. The presence of specific pains, fevers and neurological disorders add to the doctor's suspicions.
The main diagnostic method is radiography. It is necessary to take a picture not only of the damaged department, but also to capture them next to each other in order to rule out complications. If it is impossible to fully examine the spine and if tissue and vascular damage is suspected, computed tomography and magnetic resonance imaging are prescribed.
Thoracic osteochondrosis in most cases is treated with conservative methods.
The main thing in treatment is the complexity and individual approach.
Depending on the degree of pathology, a home or hospital treatment regimen is possible. In any case, it is necessary to apply certain principles - this is a gentle load regime, limiting weight lifting and playing sports, preventing overwork and strict adherence to the doctor's recommendations.
Thoracic osteochondrosis in the acute period of the disease, when there is pain, fever, requires bed rest. NSAIDs, analgesics are prescribed when pain syndrome and fever are present. 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 place the vertebrae in place, massage, physiotherapy (electrophoresis, ultrasound, magnetotherapy) and reflexology can restore food. It is important for men and women to engage in therapeutic exercises and adhere to the treatment regimen.
With complications, withdrawal or even surgery may be prescribed. Alternatively, symptomatic therapy is used.