The human spinal column is one of the most important components of the musculoskeletal system, and a disorder in its normal functioning always causes 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 it can also affect any adult. In men, the disease is registered half as much as in women.
In general, although the department is the largest, it consists of 12 vertebrae in the middle of the spine, it is less prone to pathologies. This is due to less mobility and good protection of the muscular corset. This characteristic of the structure is a positive factor, but in the diagnosis of osteochondrosis of the thoracic region it is difficult to identify and can be confused with other diseases for a long time, especially when there is a fever.
There are criteria for the International Classification of Diseases 10th revision (ICD-10), according to which osteochondrosis belongs to the class of dorsopathy (M40-54). There is a special class MKB-10 for osteochondrosis of the spine - M42 according to ICD-10 and it is equated with deforming dorsopathies. The diagnosis is made according to the code M42. 0 ICD-10 for Youth and M42. 1 ICD-10 for adult osteochondrosis. Code M42. 9 ICD-10 may occur with unspecified pathology.
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 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 spine. 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 tighten and unpleasant symptoms appear.
It is almost impossible to discover the exact causes of the pathology. There is a risk group among people and predisposing factors that lead to the disease. As for the people themselves, this age is over 55, the female sex and the presence of spinal pathologies increase the risk of getting the disease. Deviations such as scoliosis, kyphosis, over time, disrupt the posture and normal layout of the spine. Consequently, metabolic processes in the spine are disrupted and chondrosis is formed.
There are factors that directly depend on the person leading to the pathology. Let's highlight the main ones:
- excess 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 illness. 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, disruption of normal glandular function.
Types and clinical picture
Signs of osteochondrosis of the thoracic spine depend on the degree of pathology and neglect of the process. There are four degrees of disease in total.
In the first stage, the elasticity of the intervertebral discs is violated and their height is reduced. The symptoms of pain are not so severe and pass quickly at rest. Basically, 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, are quickly stopped and treated. Signs of intoxication are rarely present, sometimes there may be a rise in temperature and weakness. 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 constantly decreases, the elasticity is impaired. The fibrous ring of the intervertebral disc may be damaged and a crack may form. This phase is filled with the threat of intervertebral hernia.
The pain in the chest and back becomes stronger and eventually spreads to the adjacent area. An acute attack of pain occurs during deep breathing or sudden movement. When nerve endings are damaged, symptoms spread along the ribs. In the period of exacerbation there is fever, general weakness. This stage of the disease is accompanied by a feeling of numbness and creeping "skin crowds" at the site of the lesion. If the nerve fibers are damaged, then the normal innervation in the upper or lower extremities is disturbed.
Osteochondrosis of the thoracic region of the third degree characterizes the beginning of the formation of an intervertebral hernia. There is severe pain that occurs under 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. The following symptoms may occur during exposure to the spinal cord:
- violation of innervation of legs and arms;
- increased pain at night;
- pain in esophagus, right hypochondrium, stomach;
- increased body temperature;
- problems with normal functioning in 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 cushioning properties are reduced. Thoracic osteochondrosis in this degree is dangerous due to damage to the spinal cord and impaired human abilities. With worsening, body temperature rises, there is severe pain in the chest, in the middle of the back.
Among the general clinical picture, there are two main symptoms - dorsago and dorsalgia. Dorsago is characterized by sharp chest pain. The person has a feeling of being shot in the chest after a long stay in one position. During the attack, breathing becomes difficult, and the pain is intensified by the movements of the torso to the side. This condition raises the temperature.
With dorsalgia, there is mild pain in the area of the damaged vertebrae. The symptoms of the pain intensify and last for up to three weeks. The pain becomes stronger after deep inhalation or exhalation and during movements. Symptoms worsen at night and are alleviated by walking. The International Classification of Diseases 10th revision (ICD-10) 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 conduct a differential diagnosis with cardiovascular pathologies and exclude other diseases. The presence of specific pains, fevers and neurological disorders increase the doctor's doubts.
The main diagnostic method is radiography. It is necessary to record not only the damaged department, but also to record the neighboring ones in order to exclude complications. If it is impossible to fully examine the spine and if tissue and blood vessel damage is suspected, computed tomography and magnetic resonance imaging are prescribed.
Thoracic osteochondrosis is in most cases treated with conservative methods.
The main thing in treatment is complexity and individual approach.
Depending on the degree of pathology, a treatment regimen at home or in the hospital is possible. In any case, it is necessary to apply certain principles - this is a mild load regime, limiting weight lifting and playing sports, preventing overload 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 and fever syndrome is present. Maybe a combination of fat, physiotherapy and massage. This combination will allow you to quickly overcome the disease and get back on your feet.
The basis of osteochondrosis treatment is local effect. Manual therapy will allow you to put your vertebrae in place, massage, physiotherapy (electrophoresis, ultrasound, magnetotherapy) and reflexology can restore nutrition. It is important that both men and women engage in therapeutic exercises and adhere to a treatment regimen.
With complications, traction or even surgery may be prescribed. Otherwise symptomatic therapy is used.