Severe chest pain today is one of the most common causes forcing people to seek medical help. They may be associated with cardiovascular disease or spinal problems. Thoracalgia - what is it? What is its cause and how to protect yourself from these pains, we learn in more detail.
Types of Chest Pain
Thoracalgia syndrome, manifested by severe, sometimes unbearable pain in the chest, is closely associated with damage to the peripheral nerves. The reason for this may be the compression of their muscles and ligaments surrounding them. It should be noted that this can occur not only in the body of a mature person, but also observed in adolescents during the period of active growth, as well as in pregnant women, when the load on the spine increases due to the growth of the fetus. As a rule, the type of disease varies:
- vertebrogenic thoracalgia, that is, associated with pathology of the spine;
- non-vertebrogenic thoracalgia - in this case, chest pain can be associated with various diseases of internal organs: heart (most often coronary pathologies), gastrointestinal tract (gastroduodenal reflux), respiratory system diseases, musculoskeletal disorders;
- psychogenic thoracalgia - most often it is an organ neurosis and panic attack.
Causes of Chest Pain
Chest pain can result from many causes. A feature of such a syndrome as thoracalgia is that this disease can be the result of completely different pathological processes. The most common causes are:
- osteochondrosis;
- hernias and protrusions of the intervertebral discs of the thoracic spine;
- muscle spasm;
- spinal injuries;
- weight lifting, physical overload;
- infectious and non-infectious diseases of the nervous system;
- allergies, viral diseases;
- osteoporosis;
- stress, reduced immunity.
Symptoms of Thoracalgia
Symptoms of this disease are not very diverse. As a rule, it comes down to the following symptoms:
- persistent or paroxysmal pain in the chest, burning sensations in the intercostal spaces;
- pains can be concentrated in one half of the body or have a girdling character;
- painful areas are well palpable (muscle-tonic thoracalgia), they are usually located along the affected nerve, in addition, numbness of the skin is often observed in the area of its innervation;
- increased pain during sudden movements, coughing, sneezing, deep breaths;
- crunching of the vertebrae during movement;
- the patient's condition worsens after exposure to cold or a long stay in a static position.
Since thoracalgia on the left with its symptoms is very similar to the pains characteristic of heart pathology, a thorough diagnosis is necessary, because an erroneous diagnosis will come to an ineffective treatment.
Differences between pain in coronary heart disease (coronary heart disease) and vertebrogenic thoracalgia
Signs | Ischemic heart disease | Thoracalgia vertebrogenic |
Nature of pain | Pain behind the sternum, constricting, burning, often accompanied by fear of death | Pain of aching, stitching, constricting, burning character |
Pain duration | Short-term, the duration of the attack is limited to minutes | It can be both short-term, fading over several minutes, and long, unremitting throughout the day |
Effect on positional pain | Does not affect | Movements, especially sharp ones, provoke or intensify a pain attack |
Exercise Response | Pain becomes a reaction to physical activity, often at rest often | After the cessation of physical activity, the pain subsides or completely stops |
Reaction to taking analgesics and nitrates | Nitrates easily relieve pain | Decreases after taking analgesics, taking nitrates has no effect |
Physiotherapeutic response and manual therapy | There is a slight, unstable improvement. | Significant improvement has been observed after several sessions |
Clinical picture
Today, doctors distinguish four clinical options for the development of such a pathological phenomenon as thoracalgia. That this disease is directly related to the functional state of the spine, this classification explains:
- Thoracalgia caused by disorders in the lower cervical spine. It is characterized by pain in the upper chest (supra- and subclavian region), radiating to the neck, shoulder, arm. On examination, soreness in the joints on the affected side, areas of soreness and increased tone of the trapezoid and intercostal muscles is noted.
- Vertebrogenic thoracalgia associated with pathological processes in the upper thoracic spine. In this case, constant diffuse pains of aching, pulling nature, often having a sternal or interscapular localization, are noted. Usually pain is not associated with movement or physical activity.
- Shoulder-rib version of thoracalgia. This syndrome is characterized by a variety of pains, localized most often on the left in the interscapular, paranasal region or along the lateral line of the chest, below the armpit. The pain may be prolonged or paroxysmal. Often it is associated with the act of breathing. Another characteristic feature is the migration of pain along the ribs with pressure.
- Syndrome of the anterior chest wall, characterized by dull, aching, prolonged pain, often aggravated by movement and localized in the periosternal and anterior axillary regions.
Diagnostics
Pain in the chest can be caused by many reasons, and therefore the diagnosis of thoracalgia is made only after cardiac and pulmonary pathologies are excluded, that is, after consultation with a cardiologist and pulmonologist. If on the part of these specialists no deviations from the norm were found, then, in addition to laboratory tests, a detailed examination is carried out, ideally including:
- magnetic resonance imaging;
- roentgenography;
- densitometry (study of the structure of bone tissue);
- scintigraphy (research using radioisotopes);
- electroneuromyography (examination to evaluate the functioning of the peripheral nervous system).
And already on the basis of these examinations, such a diagnosis as thoracalgia is made. Symptoms and treatment of the disease will also have their own characteristics in each individual case. This stage is also important because an incorrect diagnosis often leads to a long, often costly and completely useless treatment.
Thoracalgia: treatment
The treatment of this pathology cannot consist in any one action. To achieve the optimal result, a whole range of therapeutic measures is required, including physiotherapy, massage, manual therapy, drug treatment, physiotherapy exercises. If necessary, this list includes spinal traction (traction) and reflexology.
Drug therapy in this case is used in the acute period of the disease. Its goal is to relieve acute pain and inflammation. For this, drugs of the following pharmacological groups are used:
- anti-inflammatory - "Diclofenac", "Meloxicam", "Aertal";
- muscle relaxants - "Midokalm", "Sirdalud";
- neuroprotectors - B vitamins, Mexidol;
- chondroprotectors - "Chondrogard", "Chondrolon".
However, it should be remembered that only medication can not radically solve the problem. In order to restore the function of the spine and to ensure decompression of the nerve endings, it is necessary immediately after stopping the pain syndrome to do massage and exercise therapy.
Physiotherapy
With a disease such as thoracalgia, the symptoms and treatment of which often depend on many factors, physiotherapy is a real magical tool. The basis of this method is the use of physical phenomena, such as ultrasound, magnetic fields, laser, low-frequency currents. Along with drug treatment, they allow you to quickly and effectively relieve pain symptoms and neutralize inflammation. Another advantage of these procedures is, with rare exceptions, the absence of contraindications.
Manual therapy
Manual therapy has gained wide popularity in the treatment of spinal diseases. It represents a whole complex of medical methods that allows using the influence of hands to correct violations in the spine, joints, muscles and ligamentous apparatus. Outwardly, these actions resemble massage, but the difference is in limiting the localization of sites and the strength of the effect.
In the case of vertebrogenic thoracology, the impact of the chiropractor is aimed at improving the volume of movement in the intervertebral joints and increasing the elasticity of muscles and ligaments. Together, this reduces compression on the affected nerve, and, as a result, the condition improves. It should be noted that very often professional manual exposure allows you to solve problems that did not respond to treatment with other methods.
Chronic form
As a rule, if you do not start timely treatment or do not fully carry out it, then the process is chronized. It must be remembered if a disease such as thoracalgia is established, that this can threaten the appearance of an intervertebral hernia and subsequently lead to disability.
Yes, the chronic form is characterized by a weaker pain syndrome, and often it is simply “tolerated”. However, even if the pain does not bother for a long time, then, having returned, it will become even more intense, which means that its cause is not defeated, but continues to destroy the body. To avoid this, it is necessary, as soon as the first signs of the disease appear, not to self-medicate and not to wait for “to pass by itself”, but to seek qualified help. After all, the sooner measures are taken, the more chances there are to completely get rid of the disease.