The cause of the thoracic spinal osteochondrosis is not sufficiently explained.The greatest importance is attached to the descent tendency and age -related changes in the intervertebral disc.
Osteochondrosis of the thoracic spine: symptoms.
The first stage of neurological complications of thoracic spinal osteochondrosis.
Clinical manifestations are associated with reflex muscle tension.Dorxago (Thoracic background).Acute pain in the thoracic region related to movement.Exacerbation starts suddenly.The amount of movement in the thoracic spine is limited.Paravertebral muscle density "stone".Dorsago proliferation with adequate treatment does not exceed 7-10 days.
Dorsalgia (back pain).Paceners complain of moderate pain in the thoracic region, increasing during movement or in certain positions, after long sitting.The beginning is usually gradual.Clinically, curvature in the thoracic spine, tension and paravertebral muscle pain are often determined.In most cases, the pain is to undergo 2-3 weeks, but without treatment, a chronic course may be taken.
Pectallgy (chest pain).Breast pain is one of the most common complaints in which the patient goes to the doctor.The diagnosis of differentiation in this case is done with cardiological disease (angina pectoris, myocardial infarction).
Usually chest pain occurs in the background of thoracic spinal osteochondrosis.Deep pain, fracture, pain, increasing, with movement or with prolonged accommodation in one position.In the thoracic region, this movement is limited, tense and painful in the parenting paralyzal muscles.
With anterior chest wall syndrome, stupid, pain, prolonged pain in the front surface of the chest, increases during hand movements, with body turn.Taking nitroglycerin under the tongue does not stop the pain.Kurular points are found in large and small chest muscles.
The second stage of neurological complications of thoracic spinal osteochondrosis.
The thoracic spinal disc hernia with radicular syndrome is extremely rare.This is due to the structure of the thoracic spine.Spinal compression (or intercostal neuralgia) is accompanied by shooting, burning character pain around the back along the intercostality.The pain is increasing as it moves, when breathing.
Usually breast -sized radio syndrome is accompanied by pain in various internal organs.In the event of damage to the upper thoracic roots, the patient complains of pain and paresthesia in the throat and esophagus, on a coma in the throat or behind the sternum.The presence of unpleasant sensations in the field of pharynx or esophagus for a long time, many exams and additional consultations lead to the development of neurotic reactions.
In patients with damage to medium -sized roots, pain occurs in the stomach.The pain is often accompanied by numbness in the anterior abdominal wall.With lower root pathology, pain can simulate intestinal pathology.Sometimes the pain in the stomach is so intense that the patient performs improper surgery for pseudo -appendicitis.
The defeat of the 7th, to -8 or 9th spine on the right can mimic the pathology of the gall bladder or liver.Approach, stupid pain localized in the right hypochondrium.Boli and paresthesia when breast damage is clearly related to the movement of the thoracic spine, increasing with a long chair, while lying on the back, with cough or sneezing.
The third stage of neurological disorders of the thoracic spinal osteochondrosis.
Vascular-brown conflict.With small chest muscle syndrome, shoulder plexus, subclavian artery and veins are compressed.Compression of this formation can be caused by a strong arm abduction.The patient suffers from brushing, burning pain in the anterior chest wall during movement, at night.In this case, paresthesia, numbness, weakness and pain in the hands occur.On palpation, the trigger point in the small breast muscle area is determined.An important differential diagnostic test is the elimination of pain after muscle restriction.
The fourth stage of neurological complications of thoracic spinal osteochondrosis.
Violation of blood supply to the spinal cord.Chronic myelopathy in the thoracic stage is rare, which is associated with the features of the spinal anatomy.But with a narrow spinal cord, the disc hernia can squeeze the artery and spinal cord.The disease begins gradually, weakness in the legs, decreased sensitivity to the lower body, impaired function of the pelvic organs.
Acute cerebrovascular disorders are the worst complications of breast osteochondrosis.Suddenly, against the background of the pain syndrome, the paralysis, numbness, the impaired function of the pelvic organs occurs.
Examination of patients with thoracic area osteochondrosis.Complaint and history analysis is very important in excluding serious pathology.Neurological examination is performed to exclude damage to the roots and spinal cord.Manual examination allows you to determine the source of pain, mobility limitations, muscle cramps.
Additional examination methods are indicated if it is suspected to have certain back pain.If somatic pathology is suspected, a comprehensive clinical examination is performed (ECG, X -ray lung, FGD, abdominal cavity ultrasound, etc.).
Thoracic radiography is prescribed to exclude tumors, spinal injuries, infections, and Shoyerman-Mau disease.Signs of osteochondrosis X has no clinical value, as all seniors and elderly people have it.
With radicular or spinal symptoms, MRI or CT of the thoracic spine is indicated.In MRI, hernia and spinal cord are better visible, and bone structure on CT.The level of clinical damage and MRI discovery must fit each other.
Osteochondrosis of thoracic spine: treatment.
During the acute period, with the presence of intense pain, restrictions on physical activity are indicated.With the severity of the pain, the development of the motor regime is gradually recommended.Sudden rotation movements in the thoracic spine should be avoided.
Intranic electrical stimulation, acupuncture, hirudotherapy, massage, manual therapy is effective.Drug treatment.With acute pain, anti -anti -non -ssteroid medications are indicated.In combination with anti -inflammatory drugs, miradelaxants can be prescribed in the presence of muscle cramps.
With thoracic spinal osteochondrosis, therapeutic restrictions with local anesthetics (lidocaine, prokain), anti -non -ssteroid drugs (loroxes or meloxicams), corticosteroids (betamethasons) are effective.The mixture of medicine is introduced as close as possible for the focus of pain.
With intercostal neuralgia, antidepressants, anticonvulsants, patch versathis are indicated.Porty medications (pentoxyphillin, aminophylline) are prescribed, group B. Surgical treatment is performed with symptoms of spinal cord compression (lower leg paresis, urine and impaired stool).
PreventionThe thoracic area osteochondrosis is reduced to avoid a long and uncomfortable position while working at the table.It is important to complete your workplace properly, labor and rest, regularly engaged in physiotherapy training, visiting the pool 1-2 times a week.