Osteonecrosis is the aging process of the spine and surrounding tissues. Experts replace osteochondrosis with a more precise term - "degenerative-dystrophic changes". With age, such changes occur in each person's spine to different degrees.
In the early stages, osteochondrosis has almost no symptoms at all. Back pain means changes in the spine have begun and are progressing. In this article we will talk about osteonecrosis of the thoracic spine, its symptoms and treatment.
Due to its stability, the chest area is less painful than the neck and lumbar area. Women are more susceptible to thoracic osteoarthritis. People at high risk are those who spend a lot of time sitting. Degenerative-dystrophic changes in the spine occur in 30% of people after 35 years of age and in 50–90% of older people.
In order not to waste time and avoid the consequences of osteonecrosis, it is important to consult a competent doctor as soon as the first symptoms appear.
How the spine ages: mechanism of development of osteoarthritis
The vertebral bodies are separated from each other by intervertebral discs. The intervertebral disc consists of a central nucleus and a peripheral ring of fibers. As we age, the discs receive less oxygen and nutrients, and cartilage tissue gradually breaks down. The disc loses its hardness and elasticity. This is how osteoarthritis begins; With an unhealthy and sedentary lifestyle, it will progress and lead to complications. Cracks appear on the surface of the annulus fibrosus and the nucleus pulposus protrudes through them - protrusion and hernia develop. The damage process involves the vertebrae, ligaments, intercostal nerves, muscles and fascia. There is a feeling of back pain, crunching when moving the body, the intervertebral joints lose mobility.
Stages of spondylosis and its complications
- Early stage
Discs produce less collagen and reduce water concentration. It becomes flatter. Cracks begin to form on its surface. Discomfort and fatigue appear in the back. X-rays usually show no initial changes.
- Second stage
The surface of the disc cracks, the nucleus moves away from the center, and the annulus loses its elasticity. This leads to disc protrusion: it protrudes into the spinal canal in the form of a cone and puts pressure on the paraspinal ligaments. The pain just happened. The surrounding muscles are often tense and limit the range of motion in the chest area. On the X-ray, you can see how the height of the intervertebral space has decreased.
- Third stage
Through the fissure of the annulus fibrosus, the nucleus or part of it enters the lumen of the spinal canal. The vertebrae are closer together and bone spurs—bony overgrowths—appear on their bodies. Osteoporosis limits mobility and increases the surface area of the vertebrae so that loads are more evenly distributed. The affected spinal roots cause back pain to become more intense and spread along the ribs. X-rays showed bone spurs and a sharp decrease in the space between vertebrae.
- Fourth stage
At this stage, back pain is severe and constant. Posture changes and it is difficult for a person to perform normal actions. The psycho-emotional sphere is affected. X-rays show a deformed spine.
Causes of breast bone degeneration
The main cause of osteochondrosis is the degenerative-dystrophic changes that occur in the spine with age. There are many factors and diseases that influence the development of osteonecrosis:
- sedentary lifestyle
- overweight
- Frequent hypothermia
- bad habits
- Lifting weights incorrectly
- Uneven load on one shoulder when carrying heavy objects
- genetic tendency
- flat feet
- pregnancy
- Breastfeeding
- spinal deformity, poor posture - scoliosis, kyphosis
- Metabolic disorders in endocrine diseases - diabetes, gout, thyroid disease
- autoimmune diseases - systemic lupus erythematosus, rheumatoid arthritis
- wear high heels
- back injury
Signs of thoracic spondylosis in women and men
The clinical picture of osteoarthritis includes the following syndromes: pain, muscle tone, roots and sometimes faces.
- Pain syndrome
Protrusions, hernias and bone spurs put pressure on the paraspinal ligaments and cause pain. In the early stages of osteonecrosis, it appears only after heavy lifting or physical activity and disappears with rest. As the disease progresses, pain continues even without exercise.
- Myotonia syndrome
Persistent muscle spasms occur in response to pain. Muscles often spasm throughout the spine, so pain occurs not only in the chest but also in the neck and lower back.
- Nerve root syndrome
Protrusions and hernias can compress nerve roots, causing pain and burning along the ribs. The pain often occurs at night and intensifies with movement.
- Facial syndrome
It develops with osteoarthritis of the small joints between the vertebral arches. With this syndrome, back pain occurs in the chest area. The pain can last for years and limit mobility.
A characteristic sign of thoracic osteochondrosis is pain between the shoulder blades. It strengthens when a person turns, bends, straightens or arches their back. Pain can be acute or chronic:
- Acute pain occurs suddenly, after sudden movement or turning. The attack is short-lived: it usually disappears after changing body position, but sometimes it lasts several days.
- Chronic pain lasts for 12 weeks. A person cannot stand for a long time, standing up after sitting for a long time will be very painful.
Other manifestations of osteonecrosis include:
- pain, burning, constriction feeling in the chest
- Pain behind the sternum, in the middle of the chest, can spread to the collarbone, neck, ribs, arms, simulating cardiovascular disease
- constantly crunching in the back when moving
- difficulty breathing due to pain when inhaling and exhaling deeply
- difficulty moving the spine
- weak back muscles
- depression, depression due to chronic pain
- feeling of a lump in the chest
Differential diagnosis is carried out with pathology of the lungs, cardiovascular system, mammary glands, exacerbation of diseases of the gastrointestinal tract.
Diagnosis of osteoarthritis of the thoracic spine
At the first episodes of back pain, it is better to contact a neurologist. The doctor will make an accurate diagnosis, rule out similar diseases and find out why osteonecrosis developed.
At the first appointment, the doctor collects a history: asks the patient to talk about complaints, current medications, hereditary and chronic diseases, injuries, surgeries and working conditions. In women, neurologists learn about pregnancy and breastfeeding.
During the examination, the doctor pays attention to the patient's appearance: posture, weight-to-height ratio, body proportions. Check neurological status: muscle strength, sensitivity in the limbs, tendon reflexes, range of motion in the spine. The doctor also evaluates the pain using a special scale.
Specific diagnostic methods help establish the diagnosis:
- X-ray. This is a simple study that shows the curvature of the spine, fractures and dislocations of the vertebrae as well as the narrowing of the spaces between the vertebrae.
- CT scan. This is a more informative method, revealing pathology of the vertebrae and discs that cannot be seen on X-rays. Allows you to assess the extent of spinal damage and monitor how your treatment is progressing.
- Magnetic resonance imaging. It helps diagnose protrusions, herniated discs and pathologies of spinal nerve roots.
To rule out heart and organ diseases, the doctor may refer the patient for an abdominal ultrasound, gastroscopy or ECG.
Treatment: what to do when you have thoracic osteoarthritis
You should not self-medicate, prescribe drugs or procedures for yourself - this can lead to dangerous side effects and complications. The doctor must treat the patient and monitor the progress of the patient's condition.
How long treatment will last depends on the stage of the process and the main symptoms. To conservatively treat osteoarthritis, doctors use the following methods:
Treatment with medication
Patients are prescribed the following main groups of drugs:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) - relieve pain, reduce inflammation and tissue swelling.
- Muscle relaxants - relax muscles and relieve pain.
- Glucocorticoids - slow down disc destruction and reduce inflammation. They are prescribed when NSAIDs and muscle relaxants do not help.
Physical therapy
The instructor selects exercises to strengthen the chest muscles, correct posture and improve spinal mobility.
Different typesphysical therapy. Apply:
- Magnetic therapy - improves tissue metabolism, reduces pain and swelling.
- Laser therapy - promotes nutritional and tissue recovery, eliminates inflammation.
- Shock wave therapy - destroys calcium salt deposits on the vertebrae, accelerates the regeneration of bone and cartilage tissue.
Acupuncture
It stimulates blood circulation in the tissues in the affected vertebrae, relaxes muscles, and reduces pain and swelling.
Record
Apply a special adhesive bandage to the back pain area. The tape regulates muscle tone and correctly distributes the load.
Massage, manual therapy
As a complementary therapy to relax muscles and improve spinal mobility.
Doctors do everything possible to conservatively treat patients. If available treatments do not help, the patient will be referred to a neurosurgeon for advice.
Complications: the dangers of breast cartilage degeneration in men and women
If you contact specialists in time and lead a healthy lifestyle, changes in the spine can be stopped. If the patient consults a doctor at the last stage, even full treatment does not always guarantee a good prognosis.
If left untreated, osteoarthritis can lead to bulging or herniated discs, chronic pain in the back or other parts of the body, poor spinal mobility, and deformity.
Prevent osteoarthritis
To prevent the development of osteoarthritis in the chest, neck and other parts, it is important to follow the following rules:
- sleep on an orthopedic mattress and pillow
- When lifting weights, do not bend over, but squat so that the load falls on your hips
- Carry your bag or backpack alternately on your left and right shoulders so you don't load just one side
- Avoid injury
- Quit smoking and drinking too much alcohol
- drink enough water
- Warm up when sitting for a long time, playing sports, swimming, walking
- Monitor body weight
- Timely treatment of infectious and chronic diseases
- wear comfortable shoes
If you have back pain in the chest area or other parts of the spine, don't delay getting examined until later. Make an appointment with a neurologist. Your doctor will conduct a full diagnosis and create a treatment plan. You will get rid of pain and maintain the health of your spine.