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Scoliosis of the chest is a dangerous curvature of the spine in any direction relative to the frontal plane. Often it manifests itself at a fairly young age, and then progresses as the body grows directly. In medicine, there are two main types of disease. This is a simple scoliosis, characterized by one bend, and a complex scoliosis, which has several bends at the same time.
Scoliosis of the chest is recognized when the curvature of the spinal axis reaches more than 10 ° C. A curvature of more than 20 °C and a dangerous progression of 5 °C per year is an indication for an X-ray examination at least three times a year. Special treatment in this case is not prescribed. Specialists recommend a corset if the scoliosis of the chest is between 35 and 40 °C. Surgical treatment is necessary for readings over 40 °C.
It should also be noted several types of the disease, subdivided depending on the specific age. Infantile scoliosis is diagnosed in young children under three years of age. The second type – juvenile scoliosis is detected at the age of three to ten years. The third type is adolescent, which is typical for 10-15 years old, and dangerous adult scoliosis, detected after the cessation of the main growth of the spine. It is known that the spinal column includes vertebrae and discs.
Normally, the spine of each person should have certain physiological curvatures, which include thoracic kyphosis. It is a special bend in the thoracic spine of a person. With even a slight deformity in the chest, a pathological curvature and a serious asymmetry of nearby muscle tissues are diagnosed. This disease not only leads to an uneven volume, but also has an extremely negative effect on the internal organs.
With thoracic scoliosis, curvatures are right- and left-sided. Thoracic scoliosis can be presented in its pure form, or it can be a combined pathology, in which the cervical or lumbar region is involved in the process. With cervicothoracic scoliosis, the apex of the curvature is localized at the level of 4-5 vertebrae. This type of scoliosis is dangerous because the patient develops deformities in the chest area early. Significant changes in the skeleton of the face are possible.
Also distinguish lumbothoracic scoliosis, in which the top of the primary curve of curvature is concentrated at the level of 10-11 thoracic vertebrae.
Combined scoliosis should be considered separately. Such scoliosis always has an S-shape, while the patient is diagnosed with two primary arcs of curvature. The apex of the first is concentrated at the level of Th8-Th9 of the thoracic vertebrae, and the apex of the second is at the level of Th1-Th2 of the lumbar vertebrae.
Causes of the formation of scoliosis of the chest
A variety of factors can lead to the appearance of scoliosis of the chest. These include incorrect posture, underdevelopment of an important muscular-ligamentous apparatus, scoliosis of neurogenic etiology, little physical activity, as well as all kinds of injuries and age-related changes.
In the phase of accelerated growth in children, idiopathic scoliosis is not uncommon. It is much easier to prevent the onset of a disease than to treat it in the future.
Since scoliosis of the chest is always classified according to certain degrees of severity, first of all, experts recommend taking an x-ray of the spine. Often the first signs of the disease are not visible to the naked eye.
Symptoms of scoliosis of the thoracic spine
The clinical picture of scoliosis will vary, depending on how much the spine is curved:
Symptoms of the first degree. At the first degree of scoliosis, the angle of curvature will be in the range from 5 to 10 ° C. A person will not be able to detect the disease on his own, he will not be disturbed by any health disorders. It is possible to identify this stage of the development of the disease only with the help of an X-ray examination.
Symptoms of the second degree. With the second degree of scoliosis, the bend in the thoracic region becomes more noticeable. A compensatory arch appears in the lower back. During the examination, a muscle roller and a costal hump are visible.
Symptoms of the third degree. With thoracic scoliosis of the third degree, the deformation becomes even more pronounced, the costal hump acquires impressive dimensions, and the chest is deformed.
Symptoms of the fourth degree. The fourth stage of scoliosis of the thoracic spine is expressed in the distortion of the trunk. The pelvis is deformed, the upper body is strongly deviated. Human movements are constrained, the chest undergoes permanent changes. The costal hump is formed not only from behind, but also from the front.
Complications
The main danger of scoliosis is that the disease can develop rapidly. Scoliosis progresses during periods of growth of the child: at 6-8 years and at 10-12 years.
Thoracic scoliosis, as it develops, is accompanied by deformities of the chest, the formation of a costal hump, and a violation of the function of external respiration. The patient’s circulatory system also suffers.
Dysplastic scoliosis is accompanied by a sharp torsion of the vertebrae, the formation of a pronounced costal hump. The costal hump is represented not only by twisted ribs, but also by spinous processes. The chest is disfigured, the respiratory function is disturbed, the vital capacity of the lungs decreases.
With scoliosis of the thoracic region, all organs that are located in the chest are affected.
Therefore, the disease is associated with the risk of developing the following complications:
Pinched nerve endings.
Syndrome of the vertebral artery.
Displacement of internal organs.
Violation of metabolic processes.
The development of various diseases of internal organs.
If the consequences of scoliosis of the first and second degrees can still be leveled, then the complications of scoliosis of the 3rd and 4th degrees often cannot be corrected at all.
All body systems suffer with scoliosis of the thoracic region. Starting from the second stage of the development of the disease, a person has signs of respiratory failure. Then comes heart failure. The fact is that the ribs have strong connections with the spine. With a curvature of the thoracic region, they are also deformed and begin to put pressure on the lungs. The person will not be able to take a full breath. With lateral deformity of the chest, the risk of developing a pathology of the heart muscle increases, with disturbances in the work of its right section.
It is not possible to notice malfunctions in the functioning of the lungs or heart immediately, pathological symptoms increase gradually. The first signal of a malfunction in the body is shortness of breath, which occurs even against the background of minor physical effort. Blood pressure rises, heart rate increases. During the examination of the work of the heart, it is possible to identify signs of damage to the myocardium.
People with thoracic scoliosis are prone to coronary heart disease. High blood pressure cannot be corrected with medication. Therefore, cardiologists should pay attention to the condition of the spine of those people who do not respond to antihypertensive therapy.
Severe curvature of the spine contributes to a decrease in the volume of the pleural cavity, a violation of the mechanics of breathing, and a deterioration in external respiration. As a result, arterial blood receives less oxygen, which affects all tissues of the body. In medicine, there is even such a thing as “kyphoscoliotic heart”. It combines the pathological symptom complex of pulmonary and heart failure, which develops against the background of scoliosis of the thoracic spine.
Treatment of scoliosis of the chest
Scoliosis can be completely cured up to a maximum of 14 years of age in girls and up to 16 years of age in boys. In the future, a complete elimination of the disease will not be achieved. It is important not only to treat the patient for scoliosis, it is necessary to try to establish the cause of the pathology.
The main directions in the conservative treatment of scoliosis of the thoracic spine are:
Physiotherapy.
Massotherapy.
Physiotherapy.
Swimming. Swimming allows you to strengthen the muscles of the back and the whole body, but at the same time the spine does not experience serious stress. If it is not possible to engage in water with a trainer, then you just need to perform as many different movements as possible in it.
Schroth therapy.
Wearing corrective devices.
Surgical intervention is indicated for patients with 3-4 degrees of scoliosis.
Massage for scoliosis of the thoracic region
Massage helps to strengthen muscles and tendons.
Principles of its implementation in scoliotic disease:
Tense and shortened back muscles require relaxation and stretching. From the side of the convexity, tonic and stimulating techniques are implemented (in these places the muscles are stretched).
Be sure to work out not only the muscles of the back, but also the abdomen, buttocks, upper and lower extremities.
Muscles that have the form of strands and knots are subjected to acupressure massage.
The massage therapist must know the patient’s medical history, be familiar with the results of the studies. Only under the condition of cooperation of the massage therapist with the attending orthopedist will it be possible to achieve positive results. The massage course involves the use of a variety of procedures that are constantly repeated.
If at the very beginning of treatment the massage is more intense, with the study of surface tissues (the goal is to increase the overall tone of the body), then the stage of correcting deformities and consolidating the achieved result is characterized by deep and prolonged study of the muscles.
The masseur must necessarily take into account the level of physical development of the patient, his general state of health. It is unacceptable for the patient to have hematomas on the skin, or that he suffers from pain during the massage.
A patient with thoracic scoliosis must undergo 2 massage courses per year, which include at least 20 procedures. If at the initial stages of treatment the massage lasts an average of a quarter of an hour, then in the future its duration is increased to 40 minutes. This happens around the 10th session.
Exercise therapy for scoliosis of the thoracic region.
Therapeutic-physical complex for scoliosis is selected individually. Its main purpose is to strengthen the muscles of the back, which should support the spine in a normal physiological position. Also, exercise therapy is designed to correct the existing deformation of the spinal column, correct posture, and normalize the functioning of the lungs and heart.
You should not count on a miracle that after a few sessions a person’s scoliosis will be completely cured. Physical therapy alone is not enough to achieve this goal. An integrated approach is required with the passage of physiotherapy, massage courses, water aerobics, etc.
The doctor selects the complex for each patient individually.
Below are some exercises that are recommended for patients with thoracic scoliosis more often than others:
You need to lie on your stomach. The left arm is bent at the elbow joint, the outstretched right arm and left leg are lifted and held in weight for several minutes. Then the position of the arms and legs is changed. As they train, they take loads in their hands.
It is necessary to lie on your stomach, stretch your arms and legs. At the same time, you should raise your arms and legs, giving your body the shape of a “boat”. In this position, you need to withstand a few seconds.
Get on all fours, raise and pull your right hand forward, and your left leg back. Limbs should be parallel to the floor. They remain in this position for 3-5 seconds, after which the arm and leg are changed.
Pull-ups on the crossbar allow you to strengthen all the muscles of the back. If at the initial stages of training it is not possible to raise your body up, then you can simply try to hang on the horizontal bar, bending your arms as much as possible.
Lie on your back. Pull your knees and head towards your chest. In this position, you should roll on your back back and forth. You need to complete the exercise at least 5 times.
Operative therapy
Surgery for scoliosis is required if the patient is worried about severe pain. It is performed only if the deformation angle exceeds 40 °C. Necessarily surgical intervention with the rapid progression of the curvature. An urgent need for surgery arises in patients with scoliosis of 60 ° C or more. Otherwise, it will not be possible to avoid pronounced disturbances in the functioning of the heart and lungs.
Sometimes the operation is performed to eliminate a cosmetic defect, although the patient has no other indications for its implementation. Surgical intervention can be of two types: staged and one-stage. A staged operation involves the installation of a metal structure designed to support the spine for a certain time. Then it is lengthened and corrected. Such operations are indicated for children who continue to grow. With a single operation, a solid metal structure is immediately installed, which will hold the vertebrae in one position.
It should be understood that any surgical intervention is associated with risks of complications, so before deciding on it, you should carefully study all the possible pros and cons of various techniques.
Prevention
The early stages of the development of scoliosis in childhood can be successfully corrected by simple methods. Sometimes it is enough to correct the child’s posture in order to prevent the development of the disease.
The spine will be healthy if all conditions are created for this, namely: a person sits, lies and stands correctly.
People in the modern world are forced to spend a long time in a sitting position. Moreover, this statement is true not only for adults, but also for children. Therefore, if this cannot be avoided, then at least you need to learn how to sit correctly.
The back of the chair should be firm and straight. The buttocks should be placed as close to it as possible. The lower back is slightly pressed against the back, the stomach is pulled in, the back is kept straight. The shoulders should be slightly straightened and lowered slightly. Shoulders should not be kept in tension, they should be relaxed. It is important to ensure that the head is not tilted forward, it must be kept in a natural position. Feet are placed on the floor without waving them in the air.
It is important to periodically get up from a chair, making small “walks”. This allows you to relieve tension from the muscles of the back, in which they are located during a static position.
You should also pay attention to the quality of night rest. The mattress should not be too hard or too soft. It is designed to support the body, slightly springing under it. The pillow in the form of a roller is recognized as the best today. It allows you to maintain the cervical vertebrae at the required level, and the thoracic spine will not be curved. For sleep, it is best to choose the fetal position, when the legs are slightly bent, and the person himself lies on his side.
It is important not only to sit correctly, but also to stand. The shoulders should be horizontal, the shoulder blades should be pressed to the back. It is important to ensure that the stomach does not protrude forward, and the left and right halves of the body remain symmetrical.
So, the prevention of scoliosis is reduced to the following recommendations:
A pregnant woman should take folic acid and vitamin B12, which will prevent defects in the formation of the neural tube of the fetus.
The child should not be planted or raised to his feet before the allotted time. Everything should be done according to age norms.
It is important to monitor posture during dynamic and physical exertion. The child should be taught from childhood to keep his back straight.
It is important to observe the regime of work and rest. You should take breaks in work every 40-60 minutes, unloading your back.
It is useful to do gymnastics, swimming, walk more and spend time outdoors.
Any diseases of the spine and muscle tissue should be treated in a timely manner.
Prevention of scoliosis should be carried out in children from the first days of life. If there are risk factors, you should visit an orthopedist more often, or be registered with him.