Osteochondrosis of the breast

Thoracic osteochondrosis is a degenerative lesion of the spine (exhaustion and destruction of the bone structure of the vertebrae). It begins with a postural lesion, the appearance of autonomic symptoms (shortness of breath, weakness, sweating, malaise) and the development of severe pain syndrome. Thoracic osteochondrosis mimics cardiovascular disease and therefore requires an accurate differential diagnosis. Therapy includes a wide range of treatments: medication, exercise therapy, physiotherapy and massage.

Thoracic osteochondrosis is less common than cervical or lumbar. This is due to the peculiarities of the anatomical structure. The intervertebral discs in the chest area numerically two-thirds of the total spine, and they are also larger in diameter but smaller in size than the lumbar spine. This area is strong and has little mobility and is protected by the rib cage and ribs. The physiological curvature is directed backwards. This leads to an increased load on the front part of the spine. Furthermore, pathological bone structures (osteophytes) form and grow on the vertebral bodies. Peripheral nerve endings are located between the ligaments and muscle tissue, their tension leads to compression with the development of pain.

There are also polysegmental lesions of the spine with osteochondrosis. At the same time, degeneration of the neck, chest and lumbar area is combined with corresponding clinical symptoms.
The clinical symptoms of thoracic osteochondrosis in women and men are approximately the same and do not show any significant differences.

frequency

The diagnosis can be made at any age. The disease often occurs in adolescents with weak musculoskeletal systems, as well as due to their active growth. Often pathology is formed in pregnant women due to the pronounced load on the chest region during pregnancy.

Everyone has a tendency to develop osteochondrosis of the chest region. This is due to the upright posture of the person and thus to a great deal of stress on the spinal column.

classification

The thoracic pain syndrome is characterized by severe chest pain of an intense nature. The syndrome is associated with peripheral nerve damage. The defeat is due to the compression of the nerves by muscles and ligaments.

Degree of thoracic osteochondrosis:

• The first degree is characterized by the absence of pronounced clinical manifestations. The intervertebral discs lose elasticity and their protrusions are formed.
• The second degree is characterized by a further loss of elasticity of the intervertebral discs and a decrease in their height. The likelihood of a hernia increases. Pain syndrome occurs, accompanying pain symptoms are possible.
• In the third degree, the pain syndrome increases. The appearance of a herniated disc between the vertebrae is possible. The severity of symptoms depends on the location of the hernia.
• The fourth degree with a complete violation of elasticity and loss of function of the intervertebral discs, destruction of the bone structure of the vertebrae. Neurological disorders are most pronounced.

According to the types of pain symptoms:

• Vertebral thoracic algia is justified by the pathology of the spine.
• Non-vertebrogenic thoracic algia is caused by the formation of pathologies of the internal organs: cardiovascular diseases, gastroduodenal reflux, traumatic and inflammatory lesions of the musculoskeletal system.
• Psychogenic thoracic algia is caused by panic attacks and damage to organs of neural genesis.

Causes and Risk Factors

Osteochondrosis does not arise without lesion factors. A number of reasons or their combination leads to the development of the disease in the chest area.

• Sedentary lifestyle. Lack of physical activity leads to weakness in the back muscles and the intervertebral segment. Sedentary work and improper workplace organization act as an additional factor in thoracic osteochondrosis.
• Improper lifting of weights and a variety of injuries. Excessive stress that disrupts the functioning of the spine. In this situation, muscles and intervertebral discs cannot withstand the load.
• Acquired lesions and curvature of the spine. Against the background of these pathologies, the work of the spine is disrupted and the likelihood of the formation of osteochondrosis increases. The destruction increases if the doctor's recommendations are not followed.
• Lack of required minerals and vitamins. If the calcium concentration in the bone tissue is insufficient, the bones become weaker and the likelihood of damage to the musculoskeletal system increases.
• Pregnancy as a combination of the main factors: an increase in the load on the spine and a lack of minerals and vitamins.

Important!Hereditary predisposition plays an important role. If musculoskeletal system lesions are observed along a similar line, care should be taken with your health and lesion prevention. A competent system of preventive measures prevents massive destruction of bone tissue.

Who is at risk

Often the factors responsible for the development of degenerative changes in the spine are combined.

• A decrease in the immune status associated with an increased susceptibility to infections, which can exacerbate the clinical manifestations of osteochondrosis due to muscle inflammation
• Stressful influences that can cause psychogenic thoracicgia. This is due to the large release of catecholamines, which provokes an increase in pain.
• Damage to the nervous system of non-infectious and infectious etiology.
• Physical overload.
• Failure to observe the principles of ergonomics (carrying weights).
• Spinal injuries of various origins.
• Muscle cramp.
• Osteoporotic degeneration of the musculoskeletal system.

Symptoms

Key symptoms of thoracic osteochondrosis

• Burning in the intercostal spaces.
• Seizure-like and persistent chest pain, mostly stabbing.
• In thoracic pain, the pain syndrome is sharp, constricting, and painful.
• Belt pain.
• Pain in one side of the trunk.
• The crunch of the vertebrae is noticed during the movement.
• The pain symptoms increase significantly with exercise, deep breaths, coughing, and sneezing, which is the main difference between thoracic osteochondrosis and angina pectoris.
• The affected areas are palpable, that is, palpable, and are located along the affected nerves.
• Numbness of the skin along the intercostal spaces.
• The patient's condition worsens if the temperature is low or if they stay in an uncomfortable position for a long time.

Types of pain syndromes in osteochondrosis of the thoracic spine:

• Lesion of the lower neck. There is upper chest pain that can radiate to the neck, arms, and even the left half of the body.
• Damage to the upper thoracic spine. The pain is inherently painful, affects the central part of the chest. Frequent combination with shoulder blade pain.
• The defeat of the scapula cost zone. Painful symptoms have a cutting, aching, and stabbing character. Has the appearance of attacks, both long and short. It occupies the lateral area and is also concentrated in the area of the shoulder blades.
• The appearance of pain in the anterior chest wall, which differ in duration. They arise between the peripectoral and frontal axillary lines.

In addition to the main symptoms, there are two types of pain syndromes in thoracic osteochondrosis:

• Dorsago - intense but short-term pain in the localization of the affected intervertebral discs. Disruption of normal breathing.
• Dorsalgia - slight but persistent pain in the area of the affected intervertebral discs.

Spondylogenic thoracic diseaseassociated with damage to the musculoskeletal system is often accompanied by severe pain and instability of the vertebrae in the thoracic spine (their increased mobility). The defeat is manifested in a violation of the mobility of the thoracic spine, stabbing and cutting pain in the intercostal spaces.

Vertebral thoracic algiacan cause the following symptoms:

• radicular (pain symptoms);
• violation of the innervation of the chest zone (visceral manifestations: a number of patients have painful symptoms of a sharp nature in the digestive tract or in the cardiovascular system);
• radicular syndrome with vegetative signs (sore in the intercostal spaces).

When diagnosing a problem, it is necessary to distinguish symptoms from cardiovascular disease and myalgia. Heart damage of ischemic etiology is characterized by the regularity of occurrence during physical or psycho-emotional stress and the relief of an attack by taking nitrates.

A psychogenic attack of thoracic algia is accompanied by the appearance of panic, anxiety, suffocation and mental disorders. It turns out that the disease is a consequence of problems with mental stability.

The clinical signs of osteochondrosis are divided into two main parts:

1. Neuralgic symptoms:
   • With thoracic osteochondrosis, numbness and tingling can occur both in the upper extremities and along the intercostal spaces and spread to the anterior surface of the chest.
   • The latissimus dorsi and chest muscles are constantly tense.
   • There is high emotional lability, tearing fits, and irritability.
   • In rare cases, the disease manifests itself as pronounced intercostal neuralgia.
2. Different types of pain sensations:
   • Dorsago: sharp, sharp pain in the thoracic spine that sometimes makes breathing difficult. The mobility of the cervical and thoracic spine is restricted. It manifests itself or worsens when sitting in a twisted position.
   • Dorsalgia: The development of pain symptoms takes two to three weeks, so it initially proceeds without clinical manifestations for the patient. There is slight discomfort in the chest. The pain is aggravated by turning the body sideways and breathing deeply. With the final stabilization of the pathological process, a persistent pain syndrome is formed.
   • Intercostal neuralgia: girdle pain radiating into the intercostal spaces. If you breathe in sharply, a sharp pain occurs in the area of the heart. As a result, the pathology is often confused with damage to the cardiovascular system.
   • Cardiac or pseudocoronary syndrome is formed with lesions at the level of the ThI segments with the development of reflex angina pectoris. The difference to organ damage to the cardiovascular system is the occurrence of pain when bending or rotating the spine. They increase when you stay in a forced position for a longer period of time. There is pain when palpating the spinous processes in the thoracic spine.
   • Radicular syndrome: pain in the intercostal spaces (hereditary points).
   • Visceral syndrome: dysfunction of the abdominal organs with lesions at the level of the thoracic vertebrae V-XII. It is manifested in belt pain, heaviness in the right hypochondrium, heartburn.

Clinical symptoms depending on the degree of lesion of the thoracic spine:

* The defeat of the nervous processes in thoracic osteochondrosis occurs with the appearance of osteophytes - bone outgrowths on the vertebrae. This is due to the destruction rate. Therefore, the following symptoms are not an integral part of the disease.

• Deformation of the nerve process on the Th2 and Th3 levels. Damage to the cardiovascular system occurs with the appearance of cardiac arrhythmias and coronary heart diseases. Chronic pain symptoms in thoracic aliases can cause organ dysfunction of the cardiovascular system.
• Defeat at Rh4-Rh5 levels. Organs with damaged nerve fibers: pleurisy and bronchitis, pneumonia, bronchial asthma.
• Th5-Th6: The bile ducts and the gallbladder are affected. The absorption of fats in the body decreases.
• Th6-Th7: affects the liver and solar plexus area. The function of the hepatobiliary tract is impaired.
• Th7-Th8: The stomach is affected. Main pathologies: ulcerative lesions of the duodenum and stomach, dyspepsia and gastritis.
• Th8-Th9: changes in the function of the duodenum and pancreas. Manifestations: duodenitis, pancreatitis and loose stools.
• Th9-Th10: damage to the nerve cells of internal organs (spleen and diaphragm). Hiccups and breathing problems occur.
• Th10-Th11: adrenal glands are affected. The activity of the immune system decreases and allergies occur.
• Th11-Th12: Kidney function is impaired, which leads to the formation of pyelonephritis and urolithiasis.
• Th12-L1 (level of the first lumbar vertebra). Kidneys and ureters are damaged. This leads to dysuria - problems urinating.

Diagnosis of thoracic osteochondrosis

If you suspect osteochondrosis, you can contact a therapist or neurologist.

The patient is examined with the record of all clinical data. During the formation of stages 2-3, the skeleton undergoes significant deformation. A full patient history should be obtained to accurately determine or rule out the factors that lead to the formation of thoracic osteochondrosis.

The very first diagnostic method is radiography. Further studies will be conducted based on the data of the medical history and the need for a differential diagnosis.
Any doctor can examine the patient first. The main thing is to have a competent and complete medical history. This allows you to accurately determine the etiology of the disease and choose a regimen of therapy. Therapist, neurologist, rheumatologist are involved in the treatment of thoracic osteochondrosis. Consultation with a traumatologist is required in the event of traumatic effects on the spinal region.

• X-ray examination of the chest in two projections. Allows you to determine the presence and size of osteophytes, determine the contours and height of intervertebral discs, and detect changes in the shape of the intervertebral disc.
• Discography enables the structure of the nucleus pulposus to be examined using contrast media.
• Computed tomography is used to visualize nerve fibers, muscles, ligaments and joints.
• Electromyography enables differential diagnosis in neurological diseases.
• Endoscopic diagnostic methods can be prescribed to examine the circulatory and digestive organs.
• An EKG is done to determine the etiology of the cardiovascular disease.
• Electroencephalography - used to determine pathologies of the nervous system.

Differential diagnosis

Thoracic osteochondrosis should be distinguished from a number of diseases.

• Abnormalities in the formation of the spine, trauma, tumor, inflammation. There are several options for these pathologies. For example, an additional congenital process, displacement or fusion of the vertebrae (spondylolisthesis), osteomyelitis, ankylosing spondylitis and others.
• Damage to the musculoskeletal system (various lengths of the lower limbs, muscle spasms, muscle inflammation and others).
• Not associated with damage to the musculoskeletal system, but similar in symptoms of diseases of the internal organs. In particular, pancreatitis, inflammation of the limbs, stomach ulcers, coronary artery disease, angina pectoris, pleurisy.
• Neurosis-like disorders, combined with wandering pain with increased fatigue, irritability, mood swings.

Breast osteochondrosis and ischemic heart disease

It is extremely important to conduct a competent differential diagnosis with the most similar pathologies. Vertebral thoracic pain and coronary artery disease (IHD) pain have a number of differences that allow for an accurate diagnosis.

The nature of the pain: with coronary artery disease, it has a burning and constricting character, accompanied by a fear of death.

According to the duration of the pain:

• IHD: Short-term attack within a few minutes.
• Chest osteochondrosis is characterized by decreasing or persistent pain, in some cases it does not go away as the day progresses.

Change of posture:

• In ischemic heart disease, the severity and intensity of pain does not vary with physical activity.
• In the case of thoracic pain, even relatively slight movements cause increased pain or the occurrence of a new seizure.

Response to physical activity:

• With ischemic heart disease, pain occurs with physical exertion and stops at rest.
• Thoracic algia, on the other hand, diminishes, but does not stop at rest.

Cupping for taking medication:

• If you have an ischemic attack, taking nitrates will ease the pain slightly.
• Thoracic algia is relieved with the use of analgesics.

Influence of physiotherapeutic factors and manual therapy:

• In ischemic heart disease, it leads to unstable and slight improvement.
• With osteochondrosis, there is a significant positive dynamic in the patient's condition.

Treatment of osteochondrosis of the breast

Osteochondrosis is treated by a neurologist.

In order to organize a competent therapy, it is necessary to first create the etiological prerequisites. Identifying the cause of the pathology allows you to choose the correct treatment regimen.

Preparations for the regeneration of bone tissue are selected taking into account all the functional characteristics of the body. It is advisable to clarify the concentration of collagen and elastane in the body in advance. When choosing a therapy regimen, the individual characteristics of the organism are taken into account.

Standard therapy regimen

Nonsteroidal anti-inflammatory drugs help relieve chest pain caused by inflammatory reactions. This increases the volume of movement of the rib cage as well as the range of motion of the thoracic spine.

Drugs that affect the production of interleukins. They make it possible to stop the inflammatory cascade and normalize the balance of the enzymes that destroy the myelin sheaths of nerves.

Antispasmodic agents are also used.

B vitamins help stop inflammation in the affected nerves.

Preparations that maintain the concentration of collagen and elastane allow you to retain fluid in the intervertebral discs. This increases tissue elasticity and prevents further degeneration.

Hormonal (steroid) drugs. They have a strong anti-inflammatory effect, but are only used in acute thoracic pain, as they negatively affect the entire body.

Diuretics in the acute phase of the disease help relieve swelling on the nerve endings. Potassium-sparing diuretics are preferred.

Anti-inflammatory ointments and gels. When rubbing the affected back area, the local inflammatory process decreases and highly active pain symptoms are eliminated.

massage

The therapeutic effect of massage is to relieve cramps in the muscular corset of the thoracic spine and normalize local blood circulation.

Effect of massage techniques:

• Removal of muscle hypertension;
• Strengthening the structure of the body of the intervertebral discs.

The use of massage techniques is combined with a visit to the chiropractor in combination with a regular exercise therapy system.

physical therapy

Acupuncture. Eliminates or reduces muscle spasms and also reduces pain symptoms.

Manual therapy. Allows you to bring the systemic circulation in the intercostal space to a normal state. This conditions the supply of nutrients to the tissues, improves their trophism and stimulates the supply of oxygen to the blood.

Diet for osteochondrosis of the thoracic spine

Compliance with certain nutritional principles will allow you to get the maximum therapeutic effect.

• We recommend foods that are rich in vitamins A, B, C and E (vegetables, nuts, grains).
• Omega-3, 6 fatty acids in fish.
• Stimulants of cartilage tissue regeneration in the form of dietary supplements allow the maintenance of the strength of tissues and the maintenance of the elasticity of the tissue structures.

Complications

When diagnosing thoracic osteochondrosis, account should be taken of the possible cascade of likely organ pathologies that develop over time.

• Damage to the cardiovascular system: The persistent pain syndrome leads to the destabilization of the ion exchange of the heart muscle, which is a prerequisite for the development of coronary heart disease.
• Functional disorders of the abdominal organs: stomach, duodenum, pancreas. This is due to the high levels of adrenaline and persistent pain syndrome, which leads to an increased release of VIP (vasointestinal peptides).
• Dyskinesia of the gallbladder is justified by an increase in the lithogenicity of bile against the background of a chronic inflammatory process.

With regular adherence to the principles of therapy, the movement therapy system, maintenance of posture and the elimination of risk factors, the course of the disease is reduced to a regression. The prognosis is considered favorable if the pathology does not develop further and the disease does not actively manifest itself.

prophylaxis

• Elimination of hypodynamia, therapeutic exercises. Anti-strength exercises, vertical loads with displacement, stretching the spine are selected.
• When driving for a long time, the choice of special exercises to relax the muscle frame
• Pumping the muscles of the thoracic spine. There is both an exercise therapy complex and the use of myostimulation when independent training is not possible.
• Organization of the workplace: The backrest of the work chair should support the spine. So that the load on the spine does not increase, you should warm up every 30 minutes in the form of stretching or walking. This is because the sitting position puts more strain on the spine.
• Correct position of the spine at night: buy orthopedic accessories for sleep. A completely rigid surface is not rational due to the violation of the physiological curves of the spine.
• Compliance with ergonomic principles: do not lift weights that could injure the spine.
• Forming the right posture.
• Optimization of the blood and lymph flow through a system of stretch marks or the use of special procedures (pressotherapy).