Thoracic back pain is a chronic disease, which is based degenerative-dystrophic defeat of the intervertebral discs of cartilage, which causes a reaction changes on the part of the vertebral bodies and their soft tissues. The disease is widespread and affects mainly people in working age (25-45 years).
Thoracic back pain occurs much more rarely than the lumbar or cervical spine. This is due to the fact that this section of the spine represent less static and motor load of others. However, osteochondrosis of the vertebral column is much more difficult to diagnose, as it is in most of the cases it is, by simulating a disease of the lungs, of the heart, of the organs of the first department of the digestive system.
Causes and risk factors
At the time, the cause of developing osteoarthritis is not appropriate. Professionals prompted many theories (infectious diseases, allergic, hereditary, mechanical, hormonal, vascular), but none of them gives a clear and complete explanation of the pathological changes that occur in the spine and lead to degeneration of the tissue. Probably, in the pathological mechanism of the development of the osteoarthritis is broken involving different factors. But the main meaning belongs to the long-static-dynamic-overload spinal segment.
Factors that cause such overload, are:
- structural abnormalities of the vertebral column;
- the asymmetrical position of the articulated cracks in joints, intervertebral;
- the congenital narrowing of the spinal canal;
- spondylogenic muscle (myofascial, reflections) and/or somatic (reflections arising in the background of a number of diseases of the blood vessels and internal organs) pain;
- prolonged exposure to the spinal column vibrations, for example, the drivers of motor vehicles;
- physical over-voltage;
- obesity;
- structure;
- sedentary lifestyle (lack of exercise);
- the psychosocial factors.
The mobility of the spinal column is guaranteed by means of the intervertebral discs, which play also and cushioning role. At their center is the elastic nucleus gelatinous, and in a large amount of water. Osteochondrosis of the nucleus begins to lose water as a consequence of demineralization polysaccharides. With time, the core flattens, and together with him, flattens and the same intervertebral disc. Under the influence of the mechanical load of the ring the fibrous protrude, this process is called protrusion. After the disc slots, through which the fall down the steps kind of jelly kernel, that is, occurs the formation of hernia of the intervertebral disc.
Reduction in height of the disc leads to the convergence of the adjacent vertebrae, the violation of the anatomy the articular facets. All of this triggers inflammation reactive to facet joints and their soft tissues. In addition to this, the convergence of the vertebral bodies is accompanied by a distortion of the articular capsules, and hit the segment of the spine becomes unstable. The body of the vertebrae receive the excess of mobility, which can be the cause of the violation, spinal roots, and create the development of the syndrome.
Background osteoarthritis gradually grow the bone tissue of the vertebral bodies and form bone outgrowths (osteophytes). They can also cause create the syndrome or myelopathy compression (compression of the spinal cord).
Classification
Based on the classification of nursing degenerative disc disease is posindromnoy principle. Depending on what neural training affected the structure of the spine have an impact, are the following syndromes:
- compression – on the basis of its development is the tension, the deformation or compression of the nerve root, of the phase of the spinal cord or the blood vessel, depending on what you develop spinal, vascular or radicular syndromes;
- reflection is connected with the reflex tension of the muscles innervated, the degenerative and vascular disorders;
- bioadaptive.
The symptoms of breast degenerative disc disease
The main characteristic of osteoarthritis is pain. In most cases, wearing stupid moderate.
Long irritation of the spinal roots due to disorders of the innervation of the internal organs. Depending on the level of the lesion thoracic back pain can flow under the mask of disease somatic:
| The level of defeat | Innervate the organs | The clinical symptoms |
| C7-Th1 | Hand, wrist, palm of the hand, the trachea, the esophagus, | Pain in hands and arms, and bronchial asthma |
| Th2-Th3 | The heart, pericardium, and coronary artery | Coronary artery disease, arrhythmias |
| Th4-Th5 | The bronchi, lungs, pleura, breasts, nipples | Bronchitis, pneumonia, pleurisy>[!@#$], bronchial asthma |
| Th5-Th6 | The common bile duct, the gallbladder | Cholelithiasis, the violation of a process of assimilation of fats |
| Th6-Th7 | The liver, the solar plexus | Liver dysfunction |
| Th7-Th8 | The stomach | Dyspepsia, gastritis, gastric ulcer and duodenal ulcer |
| Th8-Th9 | Reflux the duodenum, the pancreas | Digestive disorders and of the chair, duodenite, pancreatitis |
| Th9-Th10 | The spleen, the diaphragm, | Hiccups, respiratory disorders, |
| Th10-Th11 | The adrenal glands | Allergic reactions, decreased immunity |
| Th11-Th12 | Kidney | Pyelonephritis, urolithiasis |
| Th12-L1 | The kidneys and the ureters | Disorders of urination |
In this regard, the most frequent symptoms of the osteoarthritis are:
- pain in the area of the chest (behind the sternum, at the side, back, intercostal, medium) – may be sharp and pains, stupid; often radiant in-hand;
- pain on the epigastrium – occur regardless of the nature of power, characteristics of the diet; often combined with heartburn, nausea, vomiting;
- pain in the right hypochondrium-rarely – are amplified when you change the position of the patient's body, sneezing, cough;
- pain in the lumbar region – simulate an attack of renal colic, often in combination with dysuric disorders.
During compression of the nerve root of the patient's breast osteochondrosis develops an attack of pain in the throat. For him, it is characterized by the appearance of acute pain in one half of the chest (torakalgiya). The sensation of pain carry the herpes and apply to the movement of one of the intercostal nerves from the spine to the sternum. Patients describe it as "electrocution" or "back pain". The pain can give in the area of the epigastrium, retrosternal area, shoulder, hand, and can be combined with other symptoms (such as local hyperhidrosis, pallor or redness of the skin), connected with the defeat of the sympathetic fibres intercostal nerve.
For the pain in the throat is characterized by pain paroxysms, lasting from a few seconds to a few minutes. During an attack of pain becomes unbearable attacks. Trying somehow to relieve their condition, the patients dying in a particular location of the body, avoiding deep breaths, coughing, sneezing, twists.
Outside of pain attack in the patients observed paresthesia (subjective to the violation of sensitivity of skin in the shape of a crawling chills, tickling, tingling needles) to the movement intercostal space.
Diagnostics
To diagnose osteoarthritis is conducted on the basis of the data of objective inspection of the patient, laboratory and instrumental investigation, including:
- complete blood count (mild leukocytosis, increased erythrocyte sedimentation rate);
- the serum electrolytes (by lowering the level of calcium);
- analysis of the urine;
- the biochemical analysis of blood;
- the the x-ray examination of the spinal column (detectable flattening of the intervertebral disc, the warp of the lp of the bodies of the adjacent vertebrae, the displacement of the bodies of the adjacent vertebrae with respect to one another);
- the scintigraphy of the spine (identifies the active process of bone mineralization of the vertebral bodies);
- myelography;
- computer tomography magnetic resonance imaging.
Thoracic back pain requires a differential diagnosis with the following diseases and pathological states:
- dishormonal spondylopathy;
- spondylolisthesis;
- inflammatory processes;
- ankylosing spondylitis;
- osteomyelitis spine;
- rheumatoid arthritis;
- neoplastic processes (metastatic or primary tumors of the chest);
- fractures of the spinal column;
- gastrointestinal disease (chronic pancreatitis, gastric ulcer and duodenal ulcer, diverticulitis, irritable bowel syndrome);
- diseases of the genitourinary system (urolithiasis, pyelonephritis);
- diseases of the cardiovascular system (ischemic heart disease, arrhythmias).
Treatment for osteoarthritis
Treatment for osteoarthritis takes place as an outpatient procedure. The expression pain syndrome patient for 2-3 days of prescribed bed rest. Show traction hit the segment of the spinal column, which eliminates the compression of the nerve root and stop the pain. The expression pain syndrome spend the infiltration of soft tissues 2% solution of novocaine. The short course may be assigned as non-steroidal anti-inflammatory drugs.
The schema of complete treatment breastfeeding degenerative disc disease are also included:
- antihistamines;
- vitamins of the group b;
- tranquilizers;
- acupuncture;
- massage;
- chiropractic.
After the improvement of the condition of the patient the head of the therapeutic exercise. Regular exercise when breastfeeding osteochondrosis promotes the formation of well-developed core musculature, which allows you to keep your spine in the correct physiological position, delete unnecessary static loads.
Of great importance in the treatment of breast degenerative disc disease relegated to regular moderate physical activity (swimming, yoga, tai-chi), the normalization of body weight. Jumping, running, lifting weights and other sports, accompanied by high loads on the vertebral column, are contraindicated.
The surgical treatment of breast degenerative disc disease is only indicated in the case of a significant compression of the spinal cord. In these cases, according to indications running:
- spine stabilization of a segment;
- replacement of the affected disc prosthesis system;
- the laser light for reconstruction of the disc;
- puncture vaporization hit the disk;
- microdiscectomy.
The possible consequences and complications
Along irritation or compression of the nerve roots can trigger the development of somatic diseases of the chest, the upper part of the digestive system, the kidneys. The biggest danger to the thoracic back pain represents myocardial.
Also the consequences of osteoarthritis can become diseases of the esophagus, stomach, reflux the duodenum, pancreas, gall-bladder, the lungs, the formation of hernia of the disc.
Forecast
Thoracic back pain characterized by the representation of the waveform in the course of, in which the remission accompanied by aggravations. When timely treatment is started the, respect for the patient all the doctor's directions, concerning both the treatment of the disease, and lifestyle changes, the prognosis is favorable.
Prevention
Prevention of mother degenerative disc disease includes:
- normalization of body weight;
- stop smoking;
- living an active lifestyle.