Thoracic degenerative disc disease is not as often discussed as lumbar or lumbosacral ones. This diagnosis is relatively rare. The reason is that there is less load on the thoracic spine, and the muscular corset in this area is much better developed than in the lumbar spine.
Diagnosis and treatment of thoracic degenerative disc disease is difficult because the symptoms of the disease are often hidden and similar to those of heart problems. Therefore, correct and timely choice of diagnostic methods in this case is especially important.
What isthoracic degenerative disc disease
Thoracic degenerative disc diseaseis one of the degenerative diseases of osseocartilaginous apparatus. Degeneration (aging and destruction) is caused by insufficient nutrition and dehydration of the intervertebral disc. The tissues weaken, become thinner, and bony overgrowths may appear on the vertebrae.
Under the influence of mechanical stresses, the central gel-like part of the disc can leak through the fractured structure of the outer disc ring. As the process develops, disc herniation occurs.
The distance between the vertebrae decreases, the spinal nerve roots or blood vessels get pinched, and sharp shooting pain occurs. The pathological process can spread to other parts of the spine. Without timely treatment, the condition worsens and can lead to disability.
Curvature of the spine (scoliosis) is one of the main causes of thoracic degenerative disc disease. And since the main processes of bone and cartilage tissue formation occur in childhood and adolescence, the prerequisites for this degenerative disease occur at the age of 15-16 years.
Genetic factors give rise to both scoliosis and thoracic degenerative disc disease.Hereditary weakness of bone, cartilage, and muscle tissues leads to premature aging of the spine and destruction of the intervertebral discs.
Traumatic spinal cord injury, excessive strength training can also lead to thoracic degenerative disc disease
Metabolic and circulatory disorders, endocrine disorders contribute to the deterioration of intervertebral disc nutrition. This leads to the development of degenerative disc disease.
Excess weight in general negatively affects body organs and tissues. Increased constant strain on the spine and sedentary lifestyle are risk factors of thoracic degenerative disc disease.
Early signs and main symptoms
- Back pain near the shoulder blades is the main symptom and one of the early signs of thoracic degenerative disc disease. This condition is characterized by aching and dull pain that increases with movement and breathing. The pain may be girdling and may be worse at night.
- Pain in the heart area. Thoracic degenerative disc disease can cause sharp, burning pain on the left side of the sternum similar to angina and heart attack.
- Numbness, cold sensation, tingling, itching in the back and extremities.
- Abdominal pain. Thoracic degenerative disc disease often masquerades as other diseases because at first glance the symptoms are not at all related to degenerative disc disease. For example, when the upper part of the thoracic spine is affected, there is pain in the throat and esophagus, and a lumpy feeling in the throat. The middle section of the thoracic spine is characterized by pain in the right side of the subcostal area, similar to the symptom of pancreatic diseases. In the lower thoracic region there is pain similar to that of a bowel disorder.
Stages of thoracic degenerative disc disease
There are 4 stages:
First stage. The intervertebral disc loses elasticity and flexibility. There may be a feeling of overall discomfort, worsened pain with certain positions and movements.
Second stage. Fissures and cracks appear in the intervertebral disc. The process of hernia formation begins. Spasms can be observed in the muscles due to compensation for instability of the thoracic spine. Severe pain in the chest, limbs, and back occurs.
Third stage. Because of the physical disruption of the intervertebral disc, a hernia occurs. It can squeeze the spinal roots and vessels. The pain becomes constant, intense, can be nagging or intensify with movement.
Fourth stage. Cartilage is replaced by bone in the intervertebral disc, and the disc is no longer able to perform its cushioning function. Bony growth may form on the surface of the intervertebral disc (osteophytes). Degenerative disc disease development may affect the neighboring discs. Severe pain and limited mobility in the thoracic spine significantly reduce the quality of life. Deterioration can lead to disability.
Different stages of degenerative changes in the spine (stages of degenerative disc disease)
Often thoracic degenerative disc disease is not detected immediately because of vague symptoms, so there is a high risk of an initial misdiagnosis.
If you have chest or back pain that occurs when you breathe, you should first consult a cardiologist and a neurologist. When the cardiologist rules out heart disease, the neurologist will offer diagnostic tests. If degenerative disc diseaseis suspected, magnetic resonance imaging is used to confirm the diagnosis.
Magnetic resonance imaging (MRI). It is the gold standard in the diagnosis of degenerative disc disease, because it allows detailed examination not only of bone damage, but also of the surrounding soft tissue.
Treatment of thoracic degenerative disc disease
Treatment of thoracic degenerative disc disease usually involves conservative methods. These are medications and physical therapy. Surgical treatment is required only if absolutely necessary.
Non-operative treatment of degenerative disc disease
Treatment of degenerative disc disease is a complicated and long process. Patience is essential here. Conservative treatment involves both therapeutic methods and lifestyle changes.
The main focus is on eliminating pain syndrome, removing inflammation, restoring the functions of the spinal roots, strengthening the muscular corset and ligamentous apparatus.
Pain relief can be achieved by using medications. Drug therapy is carried out during the period of exacerbation of the disease.
Complex non-operative treatment includes various physical therapy procedures aimed at triggering self-healing mechanisms of the body. Protective mechanisms localize and replenish the functions impaired by the pathological process.
The recovery is gradual, so you should not expect a quick effect. The process of development of thoracic degenerative disc disease is long, so its treatment requires time.
Physiotherapy is a treatment based on natural and artificial physical factors (cold, heat, electric current, magnetic radiation, laser, etc.). Physiotherapy uses special apparatuses, devices, and manual techniques.
Kinesiotherapy is movement therapy. It can be active (physical therapy) and passive (massage, traction). Movement therapy is tailored to the individual patient and is aimed to strengthen the muscular framework of the back. Traction helps to relieve pain and muscle tension.
Chiropractic care and massage are methods of working upon soft tissues and joints to restore balance to the body and synchronize processes. These methods restore mobility and eliminate pain.
Taping, kinesiology taping is a method of placing special patches on the skin to affect muscle receptors through stretching and compression. A way of relaxing or strengthening the tone of the muscles.
Laser therapy (light therapy) is based on biological activation of regeneration processes. It helps to trigger tissue regeneration and repair.
Plasma therapy (prp-therapy) uses injections of a patient’s own purified plasma to trigger regeneration processes.
Reflexology, acupuncture is the stimulation of nerve endings using special needles. The metabolism of the affected areas is improved and pain is relieved.
Shockwave therapy uses extremely high-frequency waves that causes resonance. It allows to initiate self-healing processes.
Sometimes an orthopedic medical corset is used. If the muscles are underdeveloped, the corset partially compensates for the load on the spine and relieves the acute condition.
It is important to change the lifestyle of a patient, increase physical activity and start following a balanced diet. A positive effect of conservative treatment is achieved in 2-3 months. If such treatment proves ineffective, surgical treatment is required.
Surgical treatment for degenerative disc disease
Surgery in the case of thoracic degenerative disc disease is an extreme measure. Special indications are needed for neurosurgical intervention. Most often, surgery is performed in extremely severe and life-threatening cases. If a patient does not respond to therapeutic treatment and when a range of motion is even more decreased, the hernia is surgically removed. Complications are possible during and after surgery. Postoperative rehabilitation includes conservative therapy and orthopedic techniques and may take an indefinite period of time.
It is important to remember that if not treated properly, degenerative diseases of the musculoskeletal system can lead to disability. Pain can become chronic and degenerative disc disease can affect several parts of the spine. Timely prevention of the symptoms and treatment of thoracic degenerative disc disease in its early stages can prevent further development of the disease.
Prevention of thoracic degenerative disc disease should begin in adolescence, when the bone and cartilage apparatus is formed and such abnormalities as scoliosis may appear. Physical development during this period is important, but without overloading. Exercises targeting all muscle groups are recommended as well as coordination development.
When the disease is age-related, it is necessary to participate in some kind of sports activities, but without intensive strength training. Swimming is considered the optimal type of physical activity.
Doctors at Tkachev & Epifanov Clinic will choose the optimal treatment option. The clinic has helped more than 1200 patients. More about the results you can read in sections Clinical Cases and Patient Reviews
They can offer free preliminary consultations. They evaluate the condition of the spine using MRI scans, report on the likelihood of resorption and offer treatment options. Preliminary prognosis can be obtained online.