Chest osteochondrosis

Chest osteochondrosis is a degenerative change in the spine (depletion and destruction of the bone structure of the vertebrae). It begins with changes in posture, the onset of autonomic symptoms (shortness of breath, weakness, sweating, malaise) and the development of severe pain syndrome. Chest osteochondrosis mimics cardiovascular disease and therefore requires an accurate differential diagnosis. Therapy includes a wide range of treatments: medications, exercise, physiotherapy and massage.

Chest osteochondrosis is less common than cervical or lumbar. This is due to the peculiarities of the anatomical structure. The vertebral discs in the thoracic region occupy two-thirds of the entire spine and are also larger in diameter but smaller in size than the lumbar region. This area is strong and low in mobility, protected by ribs and ribs. The physiological curvature is directed towards the back. This leads to increased stress on the front of the spine. In addition, pathological bone structures that form on vertebral bodies (osteophytes) occur. Peripheral nerve endings are located between the ligaments and muscle tissue, and their tension leads to compression with the development of pain.

There are also polysegmental lesions of the osteochondrosis spine. However, degeneration of the neck, chest, and lumbar areas is combined with appropriate clinical symptoms.
The clinical symptoms of chest osteochondrosis are nearly the same in women and men and there are no significant differences.

Prevalence

The diagnosis can be made at any age. The disease is common in adolescents with poor musculoskeletal system and due to their active growth. The pathology often develops in pregnant women due to the load exerted on the chest region during pregnancy.

Everyone is prone to developing osteochondrosis of the chest region. This is due to the person’s vertical posture and the resulting high strain on the spine.

Classification

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

Grades of thoracic osteochondrosis:

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

According to the types of pain symptoms:

• Vertebral thoracalgia is caused by spinal pathology.
• Nonvertebrogenic thoracalgia is caused by the development of pathologies of the internal organs: cardiovascular diseases, gastroduodenal reflux, traumatic and inflammatory changes of the musculoskeletal system.
• Psychogenic thoracalgia is caused by panic attacks and damage to the organs of neurogenesis.

Causes and risk factors

Osteopondrosis does not develop without lesion factors. Several causes or a combination of these lead to the development of the disease in the chest region.

• Sedentary lifestyle. Lack of physical activity leads to weakness of the muscles of the back and intervertebral segment. Improper organization of sedentary work and the workplace acts as an additional factor in thoracic osteochondrosis.
• Improper lifting of weights and various injuries. Excessive stress that interferes with spinal function. In this situation, the muscles and intervertebral discs cannot withstand the load.
• Acquired lesions and spinal curvature. Against the background of these pathologies, the work of the spine is interrupted and the likelihood of developing osteochondrosis increases. The destruction is exacerbated if the doctor’s recommendations are not followed.
• Lack of necessary minerals and vitamins. Insufficient calcium concentration in bone tissue weakens the bones and increases the likelihood of damage to the musculoskeletal system.
• 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 a significant role. If changes in the musculoskeletal system are observed along a similar line, you should be careful about your health and prevent the changes. A competent system of preventive measures prevents the massive destruction of bone tissue.

Who is in danger

Factors required for the development of degenerative changes in the spine are often combined.

• Decreased immune status, which is associated with increased susceptibility to infections, which may increase the clinical manifestations of osteochondrosis due to myositis.
• Stressful effects that can cause psychogenic thoracalgia. This is due to the large release of catecholamines, which causes an increase in pain.
• Damage to the nervous system of non-infectious and infectious etiology.
• Physical overloads.
• Failure to comply with the principles of ergonomics (weight carrying).
• Spinal injuries of various origins.
• Muscle cramp.
• Osteoporotic degeneration of the musculoskeletal system.

Symptoms

Leading symptoms of chest osteochondrosis

• Burning sensation in the spaces between the ribs.
• Paroxysmal and persistent pains in the chest, especially stinging.
• With thoracalgia, the pain syndrome is stinging, contractile, and sore.
• Gingerle pain.
• Pain on one side of the trunk.
• During the movement, the cracking of the vertebrae is detected.
• Symptoms of pain increase significantly with movement, deep inhalation, coughing, and sneezing, which is the leading difference between chest osteochondrosis and angina pectoris.
• The affected areas are palpable, that is, felt and located along the affected nerves.
• Numbness of the skin along the intercostal spaces.
• The patient's condition worsens if he is exposed to low temperatures or is in a prolonged, uncomfortable position.

Types of pain syndromes in thoracic spinal osteochondrosis:

• Lesions of the lower neck. There is pain in the upper chest that can radiate to the neck, arms and left side of the body.
• Damage to the upper chest spine. The pain is painful, affecting the central part of the chest. A common combination with pain in the shoulder blades.
• Defeat of the shoulder-to-shoulder zone. Painful symptoms have a cutting, sore, and stinging nature. Long and short attacks. It occupies the lateral region and is also concentrated in the area of the scapulae.
• The appearance of pain in the anterior wall of the chest varies in duration. They occur between the peri-pectoral and frontal axillary lines.

In addition to the leading signs in chest osteochondrosis, there are two types of pain syndrome:

• Dorsago - intense but short-term pain at the site of the affected vertebral discs. Disruption of normal breathing.
• Dorsalgia - mild but prolonged pain in the area of the affected vertebrae.

Spondylogenic thoracalgiait is associated with damage to the musculoskeletal system, often accompanied by severe pain and instability of the vertebrae in the thoracic spine (increased mobility). Defeat is manifested in violation of chest spine mobility, suturing and cutting pains in the inter-rib spaces.

Vertebral thoracalgiamay cause the following symptoms:

• radical (symptoms of pain);
• violation of chest nerve innervation (visceral manifestations: many patients have stinging painful symptoms in the digestive system or cardiovascular system);
• radical syndrome with vegetative signs (pain in the intercostal spaces).

When diagnosing the problem, a distinction should be made between symptoms and cardiovascular disease and myalgia. Cardiac damage of ischemic etiology is distinguished by the regularity of events during physical or psycho-emotional stress and the alleviation of attack by the intake of nitrates.

A psychogenic seizure of thoracalgia is accompanied by panic, anxiety, suffocation, and mental disorders. It turned out that the disease was a consequence of the problem of psychological stability.

The clinical signs of osteochondrosis can be divided into two main parts:

1. Neuralgic symptoms:
   • In chest osteochondrosis, numbness and tingling may occur both in the upper extremities and along the intercostal spaces, spreading to the anterior surface of the chest.
   • The latissimus dorsi and pectoral muscles are in constant tension.
   • There are high emotional lability, tearful and irritable seizures.
   • In rare situations, the disease presents as pronounced intercostal neuralgia.
2. Different types of pain:
   • Dorsago: Sharp, acute pain in the spine of the chest, sometimes making it difficult to breathe. Movement of the cervical and thoracic spine is restricted. Manifesting or worsening when sitting in a twisted position.
   • Dorsalgia: the onset of pain symptoms lasts for two to three weeks, so it first progresses without clinical manifestations in the patient. There is a slight discomfort in the chest. The pain is exacerbated by the body turning sideways and deep breathing. With the permanent stabilization of the pathological process, a lasting pain syndrome develops.
   • Intervertebral neuralgia: belt pain radiating along the intercostal spaces. When you breathe sharply, stabbing pain appears in the region of the heart. As a result, the pathology is often confused with damage to the cardiovascular system.
   • Cardiac or pseudocoronary syndrome develops with lesions at the level of ThI segments with the development of reflex angina pectoris. Deviation from organ damage to the cardiovascular system is the appearance of pain when the spine is bent or rotated. They increase when they are in a state of emergency for a long time. Pain occurs during palpation of the spinal processes in the thoracic spine.
   • Radical syndrome: pain in the intercostal spaces (Erb points).
   • Visceral syndrome: abdominal dysfunction with lesions at the level of the V-XII pectoral vertebrae. This is manifested in belt pain, difficulty in the right hypochondrium, heartburn.

Clinical symptoms depending on the level of thoracic spine lesions:

* In thoracic osteochondrosis, defeat of nerve processes occurs when osteophytes - vertebrae appear on the vertebrae. This is due to the rate of destruction. Therefore, the following symptoms are not an integral part of the disease.

• Deformation of the neural process at the Th2 and Th3 levels. Cardiovascular damage is associated with the onset of arrhythmia attacks and coronary heart disease. Thus, chronic pain symptoms of thoracalgia can trigger cardiovascular organ dysfunctions.
• Defeat at Th4-Th5 level. Organs with damaged nerve fibers: pleurisy and bronchitis, pneumonia, bronchial asthma.
• Th5-Th6: bile ducts and gallbladder are affected. The absorption of fats in the body is reduced.
• Th6-Th7: affects the area of the liver and solar plexus. Hepatobiliary tract function is impaired.
• Th7-Th8: the stomach is affected. Main pathologies: ulcerative lesions of the duodenum and stomach, dyspepsia and gastritis.
• Th8-Th9: changes in duodenal and pancreatic function. Manifestations: duodenitis, pancreatitis and loose stools.
• Th9-Th10: damage to nerve cells in the internal organs (spleen and diaphragm). Hiccups and breathing problems occur.
• Th10-Th11: The adrenal glands are affected. The activity of the immune system decreases and allergies occur.
• Th11-Th12: impaired renal function leading to pyelonephritis and urolithiasis.
• Th12-L1 (level of the first lumbar vertebra). The kidneys and ureter are damaged. This leads to dysuria - urinary problems.

Diagnosis of thoracic osteochondrosis

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

The patient is examined by recording all clinical data. During the formation of stages 2-3, the skeleton undergoes significant deformation. A complete medical history of the patient should be collected to accurately identify or rule out factors leading to the development of osteochondrosis of the thoracic spine.

The very first diagnostic method is radiography. Further studies will be performed based on data from clinical history and the need for differential diagnosis.
All doctors can initially examine the patient. The key is a knowledgeable and fully collected clinical history. This allows the exact etiology of the disease to be determined and the therapeutic regimen to be selected. Therapist, neurologist, rheumatologist is involved in the treatment of chest osteochondrosis. Traumatologist consultation is required for traumatic effects on the spinal region.

• X-ray examination of the chest in two projections. It allows you to determine the presence and size of osteophytes, determine the contour and height of intervertebral discs, and change the shape of the disc.
• Discography allows the structure of the nucleus pulposus to be examined using contrast.
• Computed tomography is used to visualize nerve fibers, muscles, ligaments, and joints.
• Electromyography allows for differential diagnosis of neurological diseases.
• Endoscopic diagnostic methods may be prescribed for examination of the circulatory and digestive organs.
• An ECG is performed to determine the etiology of cardiovascular disease.
• Electroencephalography - diagnosis of pathologies of the nervous system.

Differential diagnosis

Chest osteochondrosis must be distinguished from a number of diseases.

• Anomalies in the formation of the spine, trauma, tumor, inflammation. These pathologies have many possibilities. For example, another congenital process, vertebral displacement or fusion (spondylolisthesis), osteomyelitis, ankylosing spondylitis, and others.
• Damage to the musculoskeletal system (lower limbs of various lengths, muscle cramps, muscle inflammation and others).
• It is not associated with damage to the musculoskeletal system, but is similar in the symptoms of disease of the internal organs. In particular, inflammation of the pancreas, inflammation of the appendages, gastric ulcer, coronary heart disease, angina pectoris, pleurisy.
• Neurosis-like disorders combined with migratory pain with increased fatigue, irritability, mood swings.

Chest osteochondrosis and ischemic heart disease

It is extremely important to perform a competent differential diagnosis with the most similar pathologies. Pain from vertebral thoracalgia and coronary heart disease (IHD) has a number of differences that allow an accurate diagnosis.

Nature of pain: in coronary artery disease, they have a burning and astringent nature, along with the fear of death.

According to the duration of pain:

• IHD: A short-term attack within a few minutes.
• Chest osteochondrosis is characterized by fading or prolonged pain, in some cases not abated during the day.

Change in body position:

• In ischemic heart disease, the strength and intensity of pain do not vary depending on physical activity.
• In thoracalgia, even relatively mild movements cause increased pain or a new seizure.

Response to physical activity:

• In ischemic heart disease, the pain appears during physical exertion and stops at rest.
• Thoracalgia, on the contrary, weakens but does not stop at rest.

Cupping for medication:

• In the event of an ischemic attack, the pain can be easily relieved by taking nitrates.
• Thoracalgia is relieved by the use of analgesics.

Effects of physiotherapy factors and manual therapy:

• It results in unstable and mild improvement in ischemic heart disease.
• In osteochondrosis, the patient's condition shows significant positive dynamics.

Treatment of osteochondrosis of the chest

Osteochondrosis is treated by a neurologist.

In order to organize a competent therapy, the etiological preconditions must first be established. Identifying the cause of the pathology allows the selection of the appropriate treatment regimen.

Bone tissue regeneration is prepared by taking into account all the functional characteristics of the body. It is advisable to clarify the body's collagen and elastane concentrations in advance. The individual characteristics of the body are taken into account when selecting a therapeutic regimen.

Usual therapeutic regimen

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

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

Anticonvulsants are also used.

B vitamins help stop inflammation in the affected nerves.

Formulations that preserve the concentration of collagen and elastane allow fluid to be retained in the intervertebral plates. This increases the elasticity of the tissue and prevents further degeneration.

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

Diuretics help relieve swelling of nerve endings in the acute period of the disease. Potassium-saving diuretics are preferred.

Anti-inflammatory ointments and gels. When the affected area of the back is rubbed, the local inflammatory process is reduced and the symptoms of highly active pain disappear.

Massage

The therapeutic effect of the massage alleviates the spasm of the thoracic spine and normalizes local blood circulation.

The effect of massage techniques:

• removal of muscle hypertension;
• strengthening the structure of the body of intervertebral discs.

The use of massage techniques is combined with a visit to a chiropractor, combined with a regular exercise system.

Physiotherapy

Acupuncture. It eliminates or reduces muscle cramps and also reduces the symptoms of pain.

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

Nutrition for osteochondrosis of the thoracic spine

Adherence to certain nutritional principles allows the maximum therapeutic effect to be achieved.

• Foods rich in vitamins A, B, C and E are recommended (greens, nuts, cereals).
• Omega-3, 6 fatty acids are found in fish.
• Stimulators of cartilage tissue regeneration in the form of food additives allow tissue strength to be maintained and tissue structures to remain flexible.

Complications

The possible cascade of probable organ pathologies over time should be considered when diagnosing osteochondrosis of the chest.

• Cardiovascular damage: Persistent pain syndrome leads to destabilization of myocardial ion exchange, which is a prerequisite for the development of coronary artery disease.
• Abdominal disorders: stomach, duodenum, pancreas. This is due to the high secretion of adrenaline and persistent pain syndrome leading to increased secretion of VIP (vasointestinal peptides).
• Gallbladder dyskinesia is justified by an increase in bile lithogenicity in the background of a chronic inflammatory process.

Through regular adherence to the principles of therapy, the training therapy system, maintaining posture, and eliminating risk factors, the course of the disease is reduced to regression. The prognosis is considered favorable if the pathology does not progress further and the disease is not actively manifested.

Prophylaxis

• Elimination of hypodynamics, therapeutic practices. Strength control exercises, perpendicular loads with displacement, spine stretching are selected.
• Selecting special exercises to relax the muscle frame when driving a long car.
• Pumping the muscles of the thoracic spine. Both the exercise complex and the use of myostimulation exist when self-training is impossible.
• Workplace organization: the back of the work chair should support the spine. In order not to increase the load on the spine, you should warm up every 30 minutes in the form of stretching or walking. This is because the sitting position puts more stress on the spine.
• The correct position of the spine at night: buy orthopedic accessories for sleep. A completely rigid surface is not rational due to a violation of the physiological curves of the spine.
• Adherence to the principles of ergonomics: do not lift weights that could injure the spine.
• Developing the right posture.
• Optimization of blood circulation and lymph flow through the system of stretch marks or using special procedures (pressotherapy).