Diagnosis torakalgiya — types, symptoms and syndromes, treatment

Vertebral and spinal torakalgiya — pain in the chest

Thoracalgia (code according to ICD 10 — М54.6.) – disease of the peripheral nerves, accompanied by severe pain.

Breaking torakalgiya as pain in the chest, sometimes associated with manifestation of other disorders: heart attack, angina, etc.

Most often disease indicates problems with the spine.

The causes of the disease

Causes of pain:

  • osteochondrosis;
  • scoliosis and kyphoscoliosis;
  • damage to the thoracic portion of the spine, some disorders of the nervous system;
  • hernia or protrusion of a vertebral disk of the sternum to the vertebral column;
  • overload of the spine;
  • muscle spasm;
  • stress, low immunity, herpes, etc.

The impact of such processes, and violations of the nerve compressed by nearby tissues.

The affected nerve does not perform its standard functions, which you may experience pain in the affected part.

Chest pain at a young age is often connected with the violation of Scheuermann—May, which is increasing kyphosis and deformity of the vertebrae. Cause of pain in the lower part of the sternum of older people may be osteoporosis with the presence of compressive vertebral fractures.

Girdle pains in the chest can appear due to herpes zoster, nerve damage due to diabetes, vasculitis.

Those at risk include people regardless of age with injuries and diseases of the spine, hernias and disc protrusions, degenerative disc disease, radiculopathy with the centre in the thoracic part of the spine.

The risk of thoracalgia increases low physical activity, harmful habits, heavy lifting, prolonged repetitive work, etc.

Types and clinical variants of thoracalgia

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Types of violations:

  • vertebral and spinal thoracalgia;
  • during pregnancy;
  • psychogenic;
  • chronic;
  • musculoskeletal;
  • pain localized to the left and the right.

Vertebrogenic torakalgiya

There are 4 clinical variants of violations:

  1. Low cervical Department – the pain in upper part of sternum, clavicular region with spreading to the neck, left shoulder, arms.
  2. Vermehrung Department – continued aching pain in the center behind the breastbone. Can be combined with pain between the shoulder blades.
  3. The shoulder rib torakalgiya– different pain: aching or sharp, short or long. Often the pain is centered between the shoulder blades, on the left hand side. The pain may be felt when you inhale and exhale.
  4. Pain in the anterior chest wall – pain a long, aching, in the area between the anterior axillary and allogrooming lines, increases with movement.
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The nature of the pain syndrome

When degenerative disc disease pain occurs in this way. At the initial stage are violations of the structure of vertebral disk tissue of the kernel lose moisture and disc, respectively, loses elasticity.

In the next stage there is a disc protrusion.

Part of the disk bulging into the cavity of the canal, puts pressure on the posterior longitudinal vertebral ligament, innervated by the cerebrospinal nerves. Irritation of the nerves of the ligament causes pain in the back, which is called thoracalgia.

In the future, violated the integrity of the capsule of the disk and destroyed — enters the vertebral canal intervertebral hernia appears.

Basically, the hernial protrusion is observed in the lateral parts of the disc, where the nerve roots. At this stage, added to the irritation of these nerves, which also causes pain.

Vertebrogenic pain syndrome bilateral sciatica cause problems in the lumbosacral region. What you should know in this case.

Symptoms and syndromes, characteristic of the pathology

The main manifestations include:

  1. Constant, piercing, paroxysmal pain concentrated in the right or left half of the sternum. It is distributed in intervals between the ribs, increasing during inspiration, coughing, movements of the torso.
  2. The pain is accompanied by numbness, a burning sensation along the nerve or its branches. Therefore, the violation is sometimes manifested by pain in the back, under the shoulder blade in the back.
  3. Pain in the chest, provoked by excessive muscle tension. It is often the extensors of the back, shoulder muscles and scapula. Muscle pains tend to increase under the influence of tension on the affected muscle.
  4. The manifestation of the chronic form is expressed in low but constant action of the symptoms and the progression of the disease. Chronic condition tolerable for the patient. Pain may appear on 3 months, after which subside for an indefinite period. After some time they come back, but with more power and consequences. To protect yourself from a chronic form of the disorder, you should seek help and begin treatment immediately.
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Syndromes of thoracalgia:

  1. Or radicular pain syndrome.
  2. Visceral syndrome. Lesions of the thoracic part of the spine is always combined with the violation of innervation of the organs of the chest, which can cause problems in these organs.
  3. Radicular syndrome with autonomic States. Often this instability pressure, anxiety, feeling short of breath, feeling of a lump in the throat when swallowing.

The violation should be differentiated from myalgia associated with spasms of the muscles of the shoulder, scapula and back.

Sometimes the pain of this nature is confused with heart problems. Pain when heart disease is continuous, and the attack is removed by taking nitroglycerin.

If while taking the drug the pain does not disappears, then it is a manifestation of osteochondrosis.

Intercostal neuralgia, in contrast to the thoracalgia, is characterized by superficial pain along the spaces between the ribs.

Diagnostic methods

When the pain in the sternum is necessary to exclude a different origin pain associated with the need for medical assistance. If it is suspected to acute disease, the patient must be immediately placed in the hospital.

Applied methods of investigation for diagnosis:

  • x-rays;
  • MRI;
  • scintigraphy;
  • densitometry;
  • ENMG;
  • laboratory studies.


If the symptoms indicate that the patient thoracalgia, it is better to start treatment immediately.

For different variants of the syndrome, is used for the treatment:

  1. When the shoulder-rib lesions affect the costal-transverse joints, restore mobility of the ribs and muscle, levator scapulae.
  2. The syndrome of the anterior chest perform post isometric exercises for the chest muscles and massage.
  3. In disorders of low cervical Department restore his limbs and muscles.
  4. In disorders of the upper part of the breast attention to the restoration of thoracic disc segments through methods postisometric relaxation. As a rule, the therapeutic effect is achieved after 2-4 sessions.

Treatment of rejection drugs are ineffective without physiotherapy, massage and therapeutic exercises.

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Neurologist prescribes these drugs:

  • anti-inflammatory: diclofenac, celebrex;
  • when violations of muscle tone — sirdalud, mydocalm;
  • the neuroprotectors: vitamins of group B.

Physical therapy:

  • cryotherapy;
  • hivamat;
  • laser treatment;
  • electrophoresis.

All these activities improve the microcirculation of the tissues, recovery, reduce inflammation.

Massage is performed only after physical therapy. During the massage the doctor affects the shoulder muscles and paravertebral area of the thoracic part.

With the appearance of acute pain massage need to stop.

Moderate exercise is the main method of treatment of breast pain. LFK gives you the opportunity to recover the biomechanics of the movements that allows you to pause the development of pathological processes.

Traditional medicines

Traditional treatments:

  • warming up mustard, a heater, salt, sand;
  • rubbing tinctures on alcohol;
  • herbal teas with chamomile, Melissa.

Folk remedies to temporarily neutralize the pain, but not cure the disease completely.

Gentle chiropractic is performed for the mobilization of motor segments, removal of muscular blocks, the elimination of subluxations of the facet joints, reducing pain, restoring range of motion in the spine.

Acupuncture allows you to restore the conductivity of the nerve fibers and relieve pain.

Preventive measures

Prevention needs to take care of the spine, be careful with the weights, to observe temperature, to relax on comfortable furniture, mattress, good nutrition.

It is very important to exercise that will keep muscles toned, develop a spine, damage or other irregularities of the spine is to see a doctor.

Note that infections and other diseases can also trigger pain.

Societally treatment allows to achieve a positive outcome in quite a short time, slowing the development of disorders for a long time.

Of thoracalgia is a complex problem and for diagnosis, and the treatment requires the efforts of a large number of competent professionals.