Symptoms and treatment of osteonecrosis of the thoracic spine

Osteoma of the thoracic spine is much less common than a similar pathology affecting adjacent segments. This is due to the strengthening effect of the ribcage - a strong and flexible frame made of ribs that provides good support for the intervertebral disc joints. Even when osteonecrosis develops in this segment, it rarely reaches the late stage. The ribs release some of the load from the cartilage discs, which prevents them from collapsing under stress and stretching.

Chest bone tumors often develop in men - they naturally have to do the harder and more harmful jobs. But if a woman were in similar working conditions, her risk of osteonecrosis would increase significantly. Women's ligaments and muscles are naturally more flexible and expandable, helping to protect women from degenerative damage to the breasts.

In contrast, in men, already in adulthood, there is "chemical"ization of all movable joints - first of all, such changes are observed in the intercostal joints. Thus, the clinical picture develops gradually, as it is associated with slow damage to the joints between the ribs and vertebrae. The sooner a person identifies the first symptoms of osteonecrosis of the chest, the shorter and more effective the follow-up treatment will be.

The symptoms

Fibroids in the chest rarely occur without minor symptoms, but in the early stages, patients often simply do not notice any signs of the disease. Any discomfort is attributed to trivial fatigue, arising from prolonged work or uncomfortable posture. But the symptoms of osteonecrosis of the thoracic spine have an insidious nature - develop in a leap.

That is, the progression of manifestations does not occur gradually, but suddenly - under the influence of any external factors. Their development depends on a certain mechanism that occurs in the joints between the vertebrae and the ribs:

• During a person's life, the mobility of the chest decreases - this is due to the thickening of the connective tissue that connects adjacent bones.
• From a long and heavy load, metabolic products accumulate in it, which leads to damage to "soft" structures - ligaments and cartilage.
• In the intercostal joints, they begin to be replaced by bone tissue, forming small foci at the defect site.
• First, these spikes begin to stimulate nerve roots emerging from the spinal cord in the vicinity. From the impact on them, a spasm reflex of the surrounding muscles occurs - spasm.
• It aggravates mobility impairment by making the ribcage less flexible and elastic. From these changes, the nutrition of the surrounding tissues changes, as their blood supply is reduced.
• A vicious cycle gradually forms - impaired blood flow deprives soft tissues of the ability to rapidly regenerate. If the load continues to act, then osteochondrosis of the thoracic spine gradually develops.

The rate at which the disease progresses depends on the severity of the damaging factors and the ability of the body - in most patients, the disease remains in its early stages until old age.

First level

In the early stages, it is difficult to form thoracic osteonecrosis - the symptoms of the disease are still too nonspecific. Most patients miss the first degree of the disease, only going to the doctor when severe symptoms develop. But with a careful attitude to one's health, the signs of pathology can be easily recognized:

1. Because soft tissues are concentrated in the joint area between the ribs and vertebrae, their flexibility and elasticity are reduced. Therefore, when stretching or performing exercises, there is pain and crunching in the chest area, which occurs between the shoulder blades.
2. A similar sound can be heard in the collarbone or sternum, where cartilage and connective tissue also thicken.
3. With them, the flexibility of the shoulders is disturbed, manifested by the difficulty of placing the hands behind the back. The patient becomes difficult to perform certain movements - scratching the back, pulling the shoulder blades together.
4. There is discomfort in any part of the chest, but more often in the interstitial area. On it, most of the nerve roots emerging from the spinal cord in this section are projected.
5. Resistance during prolonged manual labor and maintaining posture is reduced - a feeling of back fatigue quickly appears.
6. There is a decrease in the depth of the breath - when you try to take a deep breath, it is limited.

At this stage, the disease can be safely treated at home, since irreversible changes in the soft tissues in the joint area have not yet formed.

Second level

While the influence of negative factors remains, the signs of osteonecrosis in the chest begin to increase - it is at this stage that patients often seek help. The disease begins to significantly limit a person's activities - symptoms interfere not only during work, but also at rest. Their appearance is associated with the formation of persistent changes that lead to the hardening of the vertebral-vertebral joints:

1. Pain, as a result of pressure on the nerve roots, was at the top of the list of symptoms. It has several features - a burning or shooting character, connection to physical activity or a prolonged uncomfortable posture.
2. Discomfort is usually located between the shoulder blades, from where they spread along the path of the ribs. The impulse to pain is always one-way.
3. The intensity of this symptom is completely dependent on the movement of the body or the rate of breathing - even with calm breathing, pain is observed.
4. The disease is distinguished from common intercostal neuralgia by the persistence of symptoms - in the first case, the pain syndrome disappears on its own and quickly (within minutes). Osteomas of the thoracic spine are distinguished by the duration of pain - they are continuous, which subside only with rest.
5. Increased discomfort and tightness in the chest leads to a decrease in exercise tolerance. It becomes more difficult for the patient to perform tasks that involve prolonged stress.

At home, it is almost impossible to eliminate symptoms at this stage - they try to use a long course of drugs, in combination with physiotherapeutic procedures, for treatment.

The third level

In the late stages of the disease, there is a sharp deformity of the joints between the ribs and vertebrae. This puts pressure on surrounding vessels and nerves, leading to internal organs. Therefore, the symptoms of the disease have unusual features characteristic of another pathology:

1. Persistent pain syndrome, acquires an intense and constant character. Lumbar pain between the shoulder blades and along the ribs, which bothers the patient even at rest, is associated with constant pressure on the nerve roots.
2. There are areas of decreased sensitivity in the abdomen and chest - they look like stripes along the direction of the ribs. They are characterized by a feeling of numbness, tingling, or "crawling ants".
3. There is a reflex cyclic abdominal muscle contractions, accompanied by discomfort.
4. Since the nerves of the internal organs are involved in this process, symptoms of their failure can occur. Angina attacks, hepatic or renal colic are often observed, simulating diseases of the same organs.
5. Chest bone tumor often leads to the formation of irritable bowel syndrome - a gastrointestinal disorder, the cause of which is not determined during the examination.

Even long-term treatment will not allow you to permanently get rid of symptoms if the patient has kept the disease at this level. Supportive treatment will only reduce signs of firmly fixed disease in the thoracic spine.

Treatment

How to treat thoracic osteonecrosis? Supportive tactics are based on the duration of the disease - the more pronounced the symptoms, the more stages there are including treatment of osteonecrosis of the thoracic spine. Despite the frequent difficulties in prescribing medication, many patients prefer to do all the treatment procedures at home. Patients do not want to waste the extra time needed to get to the hospital or clinic.

In addition, the disease is rarely issued, which forces people to quickly abandon activities they have begun. After feeling some improvement, the patient recently returned to his normal activities. But incomplete treatment of osteonecrosis of the breast will lead to a rapid return of previous symptoms. Therefore, patients who are too "busy" can perform some procedures at home - the main thing is that they do not give up what they have started.

At home

You can do it without going to the hospital only in the early stages of the disease, when any changes in the spine are reversible. With the help of a number of measures, it is possible to eliminate muscle spasms, which are the cause of the manifestations:

• It is necessary to change the place of rest - the bed, on which the soft tissues of the spine are restored during sleep. To do this, you need to make it stronger, buy an orthopedic mattress to eliminate the wrong position of the back.
• For any activity, you need to use support for the spine - a soft corset to hug the waist and chest area. It should be regularly worn to work, only taken off when resting or sleeping.
• It is recommended to use warming ointments to eliminate symptoms. They are applied between the shoulder blades before an upcoming load to artificially warm up the muscles.
• You need to get into a good habit - doing exercises at home after waking up. Plus, don't just do it in the morning - for any discomfort in your back, you need to find a few minutes to warm up.
• You need to change your diet, increase the amount of vegetables and fruits in your diet - vitamins that contain them slow down the destruction of connective tissues.

Patients who have enough free time should engage in physical activity - walking or swimming.

Careful

With the development of pronounced signs, the treatment of osteonecrosis of the thoracic spine begins with the help of drugs. They allow you to eliminate pain and other manifestations that interfere with normal activity:

• First of all, anti-inflammatory drugs are prescribed, which have an analgesic effect. They inhibit the destruction of soft tissues, which inevitably leads to the development of bone formation.
• Also used are muscle relaxants - drugs that eliminate painful muscle contractions. Their use allows the chest to return to its former flexibility and mobility.
• Moreover, vitamin complexes are prescribed, which are aimed at protecting nerve tissue. They allow you to quickly restore the roots of the spinal cord, which have been subjected to pressure.
• Pain relievers and anti-inflammatory drugs can also be used as a cream between the shoulder blades. But they are usually only combined with drugs to ensure synergy.

The course of medication usually lasts 2 to 3 weeks, after which the patient is transferred to home treatment.

Surgery

Surgical treatments are often used when medications are not effective. Furthermore, the intervention is not always radical in nature:

• The most commonly used blockade method is to deliver medication directly to the lesion with a needle. Local anesthetics are often used to relieve symptoms. After the procedure, its effect lasts for several days.
• Blockade performed with the help of glucocorticosteroids is more effective - they provide a therapeutic effect that lasts for several weeks. The composition contains hormones that stop the inflammatory process in the administered area.
• In the most severe cases, a surgery is performed - removal of deformed areas of the joint between the ribs and vertebrae. In this way, it is possible to eliminate pressure on nerve roots and blood vessels, leading to the elimination of most manifestations.

Surgical correction does not completely cure the disease, but only makes the patient's condition easier. Therefore, after any manipulation, it is necessary to continue conservative treatment, aimed at slowing the progression of the disease.

Rehabilitation

Elimination of major signs of osteonecrosis does not mean the end of treatment. During the period after treatment, the patient will undergo recovery measures:

1. In the initial period, prescribed procedures have a reflective effect. Electrophoresis and phonophoresis, UHF, and laser can eliminate the muscle contraction reflex in the thoracic spine.
2. After that, more active procedures begin - massage, therapeutic exercises. They help strengthen the musculature of the chest.
3. Recovery ends with independent training, which will take place in continuous mode. They allow you to slow down the progression of osteonecrosis.

Such patients are advised to choose sports that allow them to simultaneously develop endurance and muscle strength. Therefore, the patient should participate in swimming and jogging races, which allows you to create an even load on all muscles. Daily workouts are optional - three sessions per week should suffice.