Treatment of thoracalgia (chest pain)
Thoracalgia is one of the most common symptoms in the practice of a neurologist and general practitioner. In a broad sense, this term means any manifestation of chest pain, in a narrower sense - chest pain associated with diseases of the spine. This symptom can occur in a number of diseases, often in life-threatening conditions. Therefore, even a doctor is not always able to "on the fly" establish the cause of thoracalgia and often have to resort to additional methods of examination.
Pain in the chest can occur in diseases of the heart, lungs, stomach and esophagus, musculoskeletal system, intercostal nerves, skin, and neoplasms of the chest cavity. Chest pain appears with such formidable diseases as ischemic heart disease (angina attack or myocardial infarction), pulmonary embolism, aortic dissection, spontaneous pneumothorax, perforation (rupture) of internal organs. However, fortunately, these conditions almost never arise from scratch and the doctor, who has competently interviewed and examined the patient, can correctly outline the direction of the diagnostic search. Shingles (herpes zoster) is a common cause of chest pain. In this disease, the herpes virus affects the fibers of the intercostal nerves and in the clinic, the manifestations of shooting or burning pain dominate along their course, and a characteristic herpetic rash appears.
However, the most common causes of chest pain are still the pathology of the musculoskeletal system:
- injuries to muscles, ribs and vertebrae;
- osteochondrosis of the thoracic spine;
- damage to the intervertebral joints;
- herniated intervertebral discs;
- inflammatory processes in the spine (for example, ankylosing spondylitis);
- some hereditary diseases.
Thoracalgia Clinic (chest pain)
The clinic of thoracalgia is quite variegated, therefore, even an experienced neurologist or therapist often finds it difficult to establish its cause without additional examination methods. The nature of the chest pain can be either dull, aching, or burning, stabbing. Different kinds of stress can intensify the pain: cough, deep breath, side bending. The localization of pain can also be very diverse: under the scapula, along the ribs, in the right or left half of the chest.
The doctor and the patient with thoracalgia should be alerted to certain concomitant signs that may indicate a severe, life-threatening pathology:
- the patient's age is up to 20 or older than 55;
- persistent progressive pain that is not relieved by pain relievers;
- pressing or burning pain behind the sternum;
- history of trauma;
- taking steroids for more than 6 months;
- a history of oncological pathology, chronic obstructive pulmonary disease, ischemic heart disease, rheumatic diseases;
the presence of neurological deficits (numbness and paralysis of the limbs, urinary and defecation disorders).
- Diagnosis of thoracalgia (chest pain)
Diagnosis of chest pain is primarily aimed at excluding a medical emergency (for example, myocardial infarction, spinal fracture, etc.). In addition to the doctor's examination and physical examination, such additional examination methods are used as electrocardiography, radiography, magnetic resonance imaging, electroneuromyography, osteodensitometry and others.
Treatment of thoracalgia with shock wave therapy
Shock wave therapy (SWT), despite the use of the method and in cardiovascular pathology (ischemic heart disease), is used mainly in the treatment of vertebrogenic thoracalgias. This term means that chest pain occurs due to damage to the spine and adjacent structures (muscles and ligaments).
Degenerative diseases of the spine (spondyloarthrosis, disc herniation, etc.) do not pose a direct threat to life. However, they are characterized by a long-term chronic course, sometimes with severe pains that worsen the quality of life of patients. Compression of the thoracic nerve roots by disc herniation, osteophytes, calcifications and other dense formations leads to a sharp restriction of the mobility of the trunk, disruption of the organs of the thoracic and abdominal cavities (especially the heart and lungs). The typical patient with vertebral thoracalgia can take pain relievers and anti-inflammatory drugs for years, which reduce pain, but do not eliminate its cause and have a number of side effects. That is why the role of physiotherapeutic methods in the treatment of vertebrogenic thoracalgias (in particular SWT) is difficult to overestimate.
Shockwave therapy can very effectively eliminate the causes of pain in the thoracic spine and chest. Radial shock waves have a depth of penetration into tissues of up to 5-7 cm, which in most cases is sufficient to affect the focus of the pathological process. The analgesic, muscle relaxant and anti-inflammatory effect of shock wave therapy leads to a significant reduction in pain after the first sessions.
Also, shock waves destroy the deposits of calcium salts, foci of fibrous and bone tissue along the spine with further gradual resorption of their fragments. Improvement of local blood circulation leads to an improvement in the trophism of the intervertebral muscles, joints and ligaments, and stops the progression of the degenerative process. The course of treatment includes 5-7 procedures with an interval between sessions up to 7 days.
In addition to the SWT itself, the V-Actor technology is used during the procedures in the Awatage medical center - biomechanical muscle stimulation, which leads to an additional improvement in blood and lymph flow in the affected areas, and muscle tension is instantly relieved. The duration of the session is 15-20 minutes.
The procedures are completely safe and well tolerated by patients. Shock wave therapy can be combined with any medication and non-medication treatment. The effectiveness of the treatment of thoracalgia with shock wave therapy using the Belgian Gymna equipment at the Awatage medical center is 98%.