Shoulder arthrosis

Shoulder pain may appear gradually and significantly reduce the patient's quality of life. To find out why your shoulder hurts, you need to see a doctor and undergo a thorough examination. The most common cause of such pain is osteoarthritis of the shoulder.

The disease requires long-term adequate treatment, which can be prescribed only by an experienced specialist.

What is this?

Osteoarthritis of the shoulder is a long-term, constantly progressive metabolic-dystrophic disease, leading to the gradual destruction of joint cartilage, protective growth of bone tissue and loss of function with joint deformity.

A wide range of arm movements is provided by synchronous interaction of the joints of the shoulder complex:

• humeroscapular or simply humeral;
• acromioclavicular - between the acromial process of the clavicle and the scapula;
• sternoclavicular - between the sternum and the clavicle.

The shoulder joint is very mobile, which is provided by the convex head of the humerus and the relatively flat articular fossa of the scapula. The joint is strengthened by tendons of the muscles of the upper extremity, there is a coracoid-acromial ligament above. Unreliable reinforcement allows the joint to move in different directions, while increasing the risk of injury.

According to the International Classification of Diseases (ICD-10) of the 10th revision, the code for shoulder arthrosis is M19 (other types of osteoarthritis). Treatment of shoulder osteoarthritis should begin as early as possible. However, advanced stages of the disease can also be successfully treated.

Causes of shoulder osteoarthritis

The main causes of shoulder osteoarthritis:

• Consequences of acute injuries - dislocations, subluxations, intraarticular fractures, bruises;
• permanent long-term microtraumas associated with occupational or sports loads;
• Acute and chronic infectious-inflammatory and autoimmune processes transmitted in the shoulder joint - acute purulent arthritis, chronic rheumatoid, psoriatic and other arthritis;
• against the background of a chronic inflammatory process in the periarticular tissues - humeroscapular periarthritis, which leads to disruption of blood circulation and nutrition of cartilage tissue;
• metabolic (metabolic) articular disorders - gout arthritis;
• hormonal disorders;
• congenital malformations (dysplasia) - for example, the articular surfaces of the shoulder joints.

For any of these reasons, under the influence of any (sometimes several), the composition and volume of the articular fluid that nourishes the cartilage tissue of the joint is disrupted. Cartilage gradually shrinks in size, cracks, and loses its buffering properties. This causes bone damage, enlargement of articular surfaces along the edges, deformation of joints and decreased function. In the joint space, inflammation of the synovial membrane occurs periodically - synovitis. Osteoarthritis due to synovitis is called osteoarthritis or osteoarthritis - depending on which process is predominant (inflammatory or metabolic-dystrophic). As a result of inflammation and necrosis of the bone, small pieces of tissue are separated from it - sequesters or articular mice.

At risk:

• for microtrauma - blacksmiths, miners, tennis players, weightlifters, discus throwers;
• for acute injuries - gymnasts, athletes, circus performers;
• persons carrying the burden of heredity;
• people suffering from any chronic diseases of the joints.

Symptoms of shoulder osteoarthritis

The disease begins gradually, gradually. Its rate of progression depends on the cause, the patient's general condition, and heredity.

The first signs

The initial symptoms of osteoarthritis of the shoulder joint are indistinguishable, especially if they occur against the background of some existing shoulder diseases. These are small, occur occasionally, mainly after exercise, pain during joint movement. Pain in the left joint can be confused with heart pain. They pass quickly, but they are worth paying attention to.

If such symptoms recur, it is better to consult a doctor immediately, because any disease is easier to treat at an early stage.

Overt symptoms

The pain increases, does not pass immediately after the force. Night pains, as well as pains associated with weather changes are visible. Hand movements are painful, they are accompanied by a characteristic crisis. In the morning or when you stay in a certain position for a long time, the stiffness of the movements is visible, it is necessary to move to eliminate it. Pain syndrome can spread not only to the shoulder area, but also to the arms, neck and upper back.

Periodically, the joint swells, light redness of the skin appears on it, the pain intensifies and becomes permanent. Body temperature may rise slightly. This is a sign of synovitis - aseptic (non-infectious) inflammation of the synovial membrane. If there are foci of infection in the body (carious teeth, diseases of the ENT organs, etc. ), then it can enter the joint through the blood and lymphatic vessels and cause a purulent inflammatory process. In this case, high fever, headache may appear, the general condition may deteriorate sharply.

The combination of degenerative-dystrophic and inflammatory processes in the joint gradually leads to permanent loss of limb function and constant pain.

But it is possible to help such patients, you just need to go to the clinic.

Dangerous symptoms

There are a number of symptoms of osteoarthritis of the shoulder joint, which indicates the need to seek emergency medical attention. This is:

• appearance of edema and redness of tissues in the joint area, fever;
• aching pain in the joint accompanied by a change in shape;
• joint pain spreads to the arm, neck or back;
• the previous volume of movements in the arm is impossible, even lifting it causes severe pain.

These symptoms indicate that your body needs help. Only a doctor can provide this.

What is the danger of shoulder arthrosis?

In the absence of medical care, brachial osteoarthritis is dangerous with persistent progression with the development of persistent pain syndrome, decreased limb function, and the development of various, sometimes life-threatening complications.

Degrees of arthrosis of the shoulder joint

There are three degrees of arthrosis of the shoulder joint:

• Osteoarthritis of the shoulder joint 1 degree- initial stage. All symptoms appear for a while and mostly after exercise. X-rays sometimes show a slight narrowing of the joint space, but more often this is not the case. At this stage, it is possible to detect small abnormalities in the cartilage tissue only with the help of magnetic resonance imaging (MRI).
• Osteoarthritis of the shoulder joint 2 degrees- progressive stage. The shoulder is constantly aching, the pain is intensified by the movements of the arm, lowered (elbow, wrist, hands) or in the neck, back, under the shoulder blade. There are difficulties in the functioning of the limb, the symptoms of synovitis develop from time to time. On X-ray, the joint space is significantly narrowed, bone growths (osteophytes) are visible along the edges of the joint surfaces, and bone tissue is compressed (osteosclerosis).
• Osteoarthritis of the shoulder joint 3 degrees- advanced stage. Joint pain is strong, stable, with an open crisis when moving the arm. The range of motion is limited, sometimes the arm is completely immobile due to pain. The joint is deformed, which sometimes causes the nerves and blood vessels to constrict. On X-ray: the joint cavity is almost invisible, significant bone growths with joint deformation, severe sclerosis and necrosis of bone tissue, articular mice.

Possible complications

Any localization and form of osteoarthritis has serious complications, so you should not delay treatment.

If you do not treat the disease or do not treat yourself with folk remedies, then there is a risk of developing complications, for example:

• significant deformation and limitation of articular mobility;
• dislocations, subluxations, and intraarticular fractures with minor injuries or sudden movements;
• rupture of tendons surrounding the joints of muscles and ligaments - they are atrophied and easily torn;
• aseptic necrosis of the head of the humerus with complete disruption of articulation and loss of function;
• purulent-septic complications when the infection enters the joint cavity from other foci.

What to do with aggravation

Exacerbation of the pathological process is usually associated with increased stress on the joint or the development of inflammation - synovitis. In this case, the joint hurts more, there is a slight swelling, the body temperature rises. In such cases, you must follow the following self-help algorithm:

• call a doctor at home;
• take a tablet of one of the painkillers inside;
• apply an anesthetic ointment to the skin in the affected joint area;
• Cover the injured arm with a bandage towel - it will reduce the load;
• take an elevated position - sit with a pillow under your back - this will reduce tissue swelling.

Types of shoulder arthrosis

The disease is divided into different types according to different criteria.

Due to illness

According to this criterion, primary and secondary osteoarthritis are distinguished. Primary shoulder osteoarthritis is mainly the result of age-related changes and develops after 50 years. However, sometimes the disease begins at a young age, but the cause of its onset can not be determined. In this case, they talk about primary idiopathic osteoarthritis of the shoulder. An important role in its development is played by hereditary predisposition: the presence of a similar disease in one of the close relatives.

Secondary arthrosis of the shoulder joint develops after injuries and previous illnesses, but the inherited burden is also important here: in one person, even a minor injury or acute arthritis can lead to the development of osteoarthritis, while in others, more serious injuries end in failure.

According to the characteristics of the flow

Distinguish shoulder arthrosis characterized by the rapid development of bone deformities. A feature of this type of disease is a change in the shape of the joints and frequent disruption of nearby blood vessels and nerves. Vascular constriction leads to circulatory disorders and the rapid progression of degenerative-dystrophic disorders, while nerve constriction leads to impaired joint sensitivity and severe pain along peripheral nerves.

Origin

Post-traumatic osteoarthritis of the shoulder - the symptoms and treatment of this disease have their own characteristics associated with traumatic damage to certain articular structures. Metabolic-dystrophic changes occur after intra-articular fractures, dislocations, subluxations, rupture of ligaments, tendons, and simply bruises. Injuries occur as a result of a blow to the joint or a fall to the side with an adducted arm. Rupture of the capsule with dislocation usually occurs when it falls on the abducted arm.

Often, after a minor injury, a person does not feel the first signs of osteoarthritis for a long time and seeks medical help in the second stage of the disease. Significant injuries require long-term rehabilitation treatment, and osteoarthritis, as a rule, begins to be treated in the early stages.

Osteoarthritis of the shoulder after inflammatory diseases - the symptoms and course of such pathology depend on the underlying disease. The shoulder joint is often affected by psoriatic arthritis, while osteoarthritis develops in one joint, progressing slowly but difficult to treat. With rheumatoid arthritis, both shoulders are affected, and osteoarthritis develops in waves with frequent changes in metabolic-dystrophic and inflammatory processes.

Distribution

Only one left or right joint can be affected and then talk about monoarthritis. Simultaneous failure of two (left and right) shoulder-scapular joints is called oligoarthritis.

Osteoarthritis of other joints of the shoulder complex

Acromioclavicular arthrosis is often of post-traumatic origin. It develops against the background of lifting weights with his hands above the horizontal. Accompanied by pain when raising the arm. Compression syndrome can be seen with the growth of osteophytes on the articular surfaces - a violation of the shoulder tendons and muscles between the head of the humerus and the acromion of the backbone during rotation and abduction of the shoulder. This accelerates the progression of osteoarthritis and the reduction of hand function.

Diagnostics

It is impossible to treat this disease without a proper diagnosis. A full examination is only possible at the clinic. At the initial consultation, the doctor asks the patient, examines him, prescribes additional research methods and expert advice:

• Laboratory tests of blood, joint fluid - inflammatory, autoimmune and degenerative-dystrophic processes are detected.
• Instrumental:
  1. X-ray of the shoulder joint - changes in bone tissue are detected;
  2. computed tomography (CT) - early changes in cartilage and bone tissue;
  3. magnetic resonance imaging (MRI) - changes in the soft articular and periarticular tissues;
  4. Diagnostic arthroscopy - is performed when necessary to clarify the nature of the pathological process.

Treatment of osteoarthritis of the shoulder joint

After the final diagnosis, a complex conservative treatment of shoulder arthrosis is prescribed. If conservative therapy is ineffective, surgery is prescribed.

Conservative therapy

This includes pharmacological and non-pharmacological methods.

Treatment

The goals of drug treatment are to relieve pain and prevent the development of osteoarthritis. To alleviate the patient's condition, appoint:

1. Medications from the groupnon-steroidal anti-inflammatory drugs (NSAIDs). The drugs are administered intramuscularly, orally or rectally; At the same time, drugs of the NSAID group are prescribed externally in the form of ointments, gels or creams.
2. Medications from the groupmuscle relaxants- relax the muscles surrounding the joint; the spastic condition of these muscles increases the pain;
3. Pain blockadeswith local anesthesia.The drug solution is injected into the joint cavity or periarticular tissues - quickly has an analgesic effect.

As part of the medical treatment of shoulder osteoarthritis, the course of pathogenetic (affecting the mechanisms of the disease) includes:

1. Chondroprotectors- Drugs containing biologically active substances that restore cartilage tissue. They are prescribed in the form of tablets and powders, in the form of intramuscular and intraarticular injections, as well as externally in the form of ointments and creams.
2. Angioprotectors- Means that improve blood microcirculation. Assign in tablets for oral administration and solutions for intravenous drip.
3. Hyaluronic acid preparations- is inserted into the articular cavity to improve the amortization properties and prevent the destruction of bone tissue.

Vitamin-mineral complexes to improve metabolic processes in articular and periarticular tissues.

Non-drug treatment

The basis of non-drug methods of treatment of shoulder osteoarthritis is a healthy active lifestyle and proper nutrition. It is very important to get rid of bad habits such as smoking and alcohol abuse - they help to disrupt blood circulation and have a toxic effect on joint tissues.

Nutrition, diet

There is no specific diet for the treatment of shoulder osteoarthritis, but proper nutrition is very important in this disease. It is recommended to include in the daily diet: seafood, seafood, lean poultry, dairy products, cottage cheese, cheese, cereals (oatmeal, buckwheat), vegetables, fruits.

Excluded from the diet: easily digestible carbohydrates (sweets, cakes, sweet carbonated drinks), fatty red meat, foods that irritate the tissues that cause swelling - salt (in excessive amounts), spicy and spicy spices.

It is recommended to prefer boiled, baked and steamed food.

Orthopedic treatment to distribute the load on the face

To prevent shoulder injuries, it is recommended to wear an elastic protective brace in the form of a short sleeve that periodically connects to the opposite arm. The device improves blood circulation, eliminates swelling. However, it is not recommended to wear it all the time, as it causes a rapid decrease in the range of motion in the shoulder.

Many specialists involve bandaging in the complex treatment of shoulder arthrosis - the fastening of tissues with adhesive elastic bands. It relieves pain, improves blood circulation and joint function.

Physiotherapy

Exercise therapy - the daily performance of a number of exercises - is the main method of rehabilitation with shoulder arthrosis. Gymnastics complexes are prescribed by a doctor and mastered under the supervision of an exercise therapy instructor. This can be done at home once the patient has started doing all the exercises correctly.

Physiotherapy

At any stage of the disease, physiotherapy is a complex therapy. These include electro- and phonophoresis with the use of painkillers, laser and magnetotherapy - stimulation of regenerative processes in joint tissues, courses of shock wave therapy (SWT) - exposure to sound with an obvious chondroprotective effect.

Folk remedies

Folk remedies will be of great benefit only if prescribed by a doctor. Here are some of them:

• Decoction of viburnum stalks for oral administration.Before going to bed, pour a glass of crushed raw material with 500 ml of water, bring to a boil, keep on low heat for 5 minutes, insist all night, then strain and strain for 100 ml 3 times a day. This is an anesthetic.
• An old recipe for anesthetic ointment from the wild rosemary plant.Take Vaseline or butter and dry chopped herbs. In an enamel bowl, fold the oil base and grass in turn, cover with a lid, cover the cracks with dough and put in the oven (preferably in the oven) on low heat for 2 hours, remove from the oven, double-wrap, refrigerate and leave for 2 days. Rub the skin on the affected joint -3 times.

Surgical operations

With the ineffectiveness of conservative therapy for shoulder arthrosis, the following surgical interventions are performed:

• Arthroscopic operationsallows you to eliminate various defects in the articular cavity. They are mainly given to young people with post-traumatic osteoarthritis. Arthroscopy allows you to attach and close the biceps tendon to the bone (tenodesis - this will remove the joint cavity), remove bone growths - osteophytes (debridment), restore the joint cavity with a transplant, etc.
• Endoprostheses- artificial replacement of broken, lost function.

Approach to the treatment of the disease in clinics

Clinicians have developed their own approaches to the treatment of shoulder osteoarthritis. First of all, each patient is carefully examined using the latest diagnostic equipment (including MRI). Then he completely gets rid of the pain using medicinal and non-medicinal methods. At the same time, individual complex therapy is selected for him, including:

• plasmolifting, including the most modern drugs and non-drug methods;
• traditional oriental methods of treatment and rehabilitation of joints and the function of the whole organism as a whole; These include acupuncture, moxibustion, auriculotherapy, banding, etc.

This approach quickly relieves pain and suppresses the course of the disease. And regular preventive courses allow patients to forget about the disease and lead a normal life. Numerous patient reviews speak about how effective this treatment is.

Proven techniques of the East and innovative methods of Western medicine.

General clinical indications

Recommended for people suffering from shoulder osteoarthritis:

• lead a healthy, mobile lifestyle, alternate physical activity and rest;
• eat right on a regular basis;
• to get rid of all bad habits;
• do regular therapeutic exercises to avoid sudden movements;
• lie on your back or healthy side at night with a small pillow under your aching arm;
• refrain from heavy physical force, avoid injuries, long-term stresses and colds;
• during exacerbation (development of synovitis), avoid any heating procedure;
• Follow all the recommendations of the attending physician.

Prevention

It is especially important for people with aggravated heredity to follow certain rules to prevent shoulder osteoarthritis. They should not be involved in weightlifting, tennis, traumatic sports, hammer, blacksmith, miner should not work. Everyone who wants to have healthy joints should lead an active lifestyle and eat properly on a regular basis.

Frequently asked questions about the disease

1. What is the pain of shoulder osteoarthritis?

   The aches and pains are exacerbated by movement and lifting weights.

2. Why is the disease dangerous?

   Formation of chronic pain syndrome and loss of function of the extremities.

3. Which doctor treats osteoarthritis of the shoulder?

   Post-traumatic - orthopedic-traumatologist, against the background of inflammatory diseases - rheumatologist.

4. Is it blocked for shoulder arthrosis?

   For severe pain, yes.

5. How effective are physiotherapy methods for this disease?

   It is effective as part of a complex treatment.

6. Is it possible to completely cure osteoarthritis of the shoulder?

   No, but the doctor can strangle him and save the patient from pain.

Osteoarthritis of the shoulder should be treated for a long time, systematically and seriously under the supervision of a physician. Attempts to cope with this disease on their own are fraught with complications and disability. However, a qualified specialist can stop the process at any stage of the disease, save the patient from pain and significantly improve the quality of life.