Thoracic Osteochondrosis

What is thoracic osteochondrosis?

Thoracic osteochondrosis is a pathological condition of the bone-cartilage tissue of the thoracic spine, characterized by irreversible changes in the intervertebral discs. This condition is a common cause of back pain or chest pain (intercostal neuralgia), as well as nerve compression.
The danger of the disease lies in its subtle symptoms, often masquerading as completely different heart, lung, and stomach conditions. Due to the difficulty in diagnosing thoracic osteochondrosis, the disease is often detected at advanced stages, leading to serious impairments that significantly reduce the quality of life. That’s why it’s essential to undergo preventive check-ups and consult a specialist at the onset of the first symptoms of the disease.

It’s worth noting that osteochondrosis is not only prevalent in elderly individuals. With each passing year, the disease increasingly affects teenagers and young adults who lead sedentary lifestyles and spend a lot of time sitting at computers. Without treatment, the disease not only destroys intervertebral discs, joints, and ligaments of the spine but also negatively impacts vital organs such as the heart, spinal cord, stomach, lungs, liver, intestines, and so on.
Treatment of this condition is managed by:

Symptoms of thoracic osteochondrosis

Thoracic osteochondrosis exhibits less pronounced symptoms compared to other forms of osteochondrosis. The main manifestation of the disease is pain in the chest area, which worsens with exertion or prolonged periods in one position. Additionally, the pain may radiate to internal organs. Often, the discomfort intensifies at night and during sleep.
In addition to this, the disease presents with changes in the temperature of the upper and lower extremities. Patients may experience cold hands and feet, dry skin, and numbness.
Other symptoms of thoracic osteochondrosis include:

  • Pain between the shoulder blades, exacerbated by raising the arms or bending the torso;
  • Pain between the ribs during walking and body movement, worsening during deep inhalation and exhalation;
  • Sensation of stiffness and pressure in the chest area.
    Furthermore, nonspecific symptoms of the pathology include:
  • Numbness and tingling of certain areas of the skin;
  • Peeling of the skin on the extremities, brittle nails;
  • Digestive system disorders.
    Two important manifestations of thoracic osteochondrosis are dorsago and dorsal pain.
    Dorsago refers to sharp acute pain in the chest, usually occurring after prolonged periods in one position and worsening with torso rotation. These episodes are often accompanied by difficulty breathing.
    Dorsalgia is a mild pain in the area of the affected intervertebral discs. The discomfort begins gradually and persists for 2-3 weeks, periodically intensifying and subsiding. The patient may experience shortness of breath. Detecting any of these symptoms is a significant reason to seek medical attention.

Causes of thoracic osteochondrosis

Thoracic osteochondrosis occurs less frequently than other forms of the disease such as cervical, lumbar, and sacral osteochondrosis. This is due to the lower mobility of the thoracic region, its protection by the ribs, and the well-developed muscular corset. Consequently, this form of pathology rarely arises due to excessive physical exertion.
Additional factors contributing to the development of osteochondrosis include:

  • Sedentary lifestyle, desk jobs;
  • Chest injuries;
  • Hormonal disorders;
  • Scoliosis, kyphosis, and other postural abnormalities;
  • Genetic predisposition;
  • Autoimmune diseases;
  • Endocrine disorders, metabolic disturbances.

What can be applied during an osteochondrosis exacerbation?

The complex of therapeutic measures during an osteochondrosis exacerbation includes medication, physical therapy, massage, and physiotherapy.

Is it possible to prevent osteochondrosis exacerbations?

Yes, it is possible. Preventing spinal osteochondrosis plays an important role in reducing micro- and macro-traumatization of intervertebral discs, as well as static and dynamic overloads of the spine.

Particularly unfavorable is leaning forward from a standing position. When performing household chores involving leaning forward (such as laundry, rinsing, sweeping, and mopping floors), it is advisable to unload the spine by having some support available under the free hand. For vacuuming, it’s preferable to extend the vacuum cleaner tube in such a way that the torso does not bend forward because rhythmic movements in a semi-bent position while using an unadjusted vacuum cleaner can strain the spine. One should be especially cautious with tasks involving strenuous repetitive movements, such as chopping wood, gardening with a shovel and pickaxe, jerky movements when moving heavy objects, and washing clothes on a washboard, as they significantly increase the load on the vertebrae, ligaments, and muscles.

Incorrect body posture and uncoordinated muscle work when lifting and carrying weights can have particularly adverse effects. The best option is a straightened spine with the spine firmly supported against the pelvis. In this case, the intervertebral discs are loaded evenly and do not deform. Additionally, lifting or carrying even moderately heavy loads with a bent spine (e.g., in front of oneself and with arms outstretched) often leads to exacerbations. The load should be kept as close to the body as possible. When lifting weights from the ground, one should not bend forward and lift the load by straightening the torso. Instead, bend the knees, squat, keeping the back straight, and lift the load by straightening the legs at the knees. When driving a car, a roll should be placed under the lumbar region, and a headrest is essential to avoid neck injury during sudden car movements. When tying shoelaces, it’s advisable to kneel, touch the thigh with the torso, and only then tie the shoelaces.

However, even comfortable body positions can cause undesirable changes in the spine if the professional posture remains unchanged. Therefore, periodic changes in body position during work are necessary. For example, when standing, periodically shifting the weight from one leg to a small stool not only gives rest to the legs but also facilitates the lordosis of the lumbar spine under less strain.

When transporting in an elevator, it’s advisable to adopt a relieving posture to reduce vertical load on degenerated discs during elevator accelerations and decelerations. This posture should be adopted several times a day for 10-60 seconds as a physical exercise.

The rational selection of work furniture, especially chairs, also has a significant impact on spine overload. It is advisable to use chairs with low seats, an inward inclination, and a slightly convex backrest at the lumbar region. It’s better if the knees are slightly higher than the hip joints when sitting.

Wearing shoes with elastic soles is also recommended, as it reduces the shock load on degenerated discs. Prolonged driving in a car, especially on rough roads, is not recommended.

Factors that increase lumbar lordosis, such as wearing high-heeled shoes and excess weight, should be eliminated. Sleeping on a firm bed using a wooden board and a thin mattress is recommended.

Constant wearing of corsets of all kinds or a weightlifting belt in some cases has a good effect. Mechanical restriction of spinal mobility (especially in the lumbar region) is of considerable importance for preventing exacerbations, especially in the presence of spinal instability.

But most importantly, engaging in therapeutic exercises is crucial. Progressive weakness (detraining) of the torso muscles in patients not engaging in therapeutic gymnastics is quite common. A trained and well-developed muscular “corset” of the torso significantly facilitates and unloads the “spring” apparatus of the spine. Exercises strengthening the abdominal muscles, chest, large gluteal muscles, back muscles, especially extensors, create a muscular corset and thereby prevent osteochondrosis exacerbations.

If a limb injury occurs, when should physical exercises be performed?

First of all, it is necessary to consult a doctor. A rehabilitation treatment program is developed for each patient, taking into account:

  1. General condition of the patient;
  2. State of bone tissue (degree of bone callus formation, osteoporosis) and the correct alignment of bone fragments;
  3. Nature of immobilization (plaster cast, skeletal traction, osteosynthesis, etc.);
  4. Condition of the skin, tendons, capsular-ligamentous apparatus, muscle tissue, blood vessels, and nerves;
  5. Localization of the injury (upper, lower, extremities, pelvic bones, spine) and its nature (open or closed, intra-articular or periarticular damage);
  6. Disease period.