osteoarthritis of the shoulder

Pain in the shoulder can appear gradually and significantly affect the patient's quality of life. To find out why the shoulder hurts, you need to see a doctor and undergo a full examination. The most common cause of such pain is osteoarthritis of the shoulder.

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

What is it?

Shoulder osteoarthritis is a long-term, steadily progressive metabolic dystrophic disease that leads to gradual destruction of articular cartilage, protective growth of bone tissue with joint deformity and loss of function.

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

• humeroscapular or simply humeral;
• Acromioclavicular - between the clavicle and the acromial process of the scapula;
• Sternoclavicular - between the breastbone and collarbone.

The shoulder joint is very mobile, which is given by the convex head of the humerus and the relatively shallow joint fossa of the scapula. The joint is strengthened by the tendons of the muscles of the upper limb, above it is the coracoid-acromial ligament. Not too reliable reinforcement allows the joint to move in different directions, but at the same time increases the risk of injury.

The code for osteoarthritis of the shoulder according to the International Classification of Diseases 10th Revision (ICD-10) is M19 (Other Types of Osteoarthritis). Shoulder osteoarthritis should be treated as early as possible. However, advanced stages of the disease can also be treated successfully.

Causes of osteoarthritis of the shoulder

The main causes of shoulder arthrosis:

• Consequences of acute injuries - dislocations, subluxations, intra-articular fractures, bruises;
• permanent long-term microtrauma related to work or sporting loads;
• transmitted acute and chronic infectious-inflammatory and autoimmune processes 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 impaired blood circulation and nutrition of cartilaginous tissues;
• Metabolic (exchange) joint diseases - gouty arthritis;
• hormonal disorders;
• congenital malformations (dysplasia) - for example, the articular surfaces of the shoulder joints.

Under the influence of one of these reasons (sometimes several at once), the composition and volume of the synovial fluid that feeds the cartilaginous tissue of the joint is disturbed. The cartilage gradually decreases in volume, tears, loses its cushioning properties. This leads to injury to the bone, its growth at the edges of the articular surfaces, joint deformity and reduced function. In the joint cavity, there is periodic inflammation of the synovial membrane - synovitis. Because of the synovitis, the arthrosis is called arthrosis or arthrosis - depending on which process predominates (inflammatory or metabolic-dystrophic). As a result of inflammation and necrosis of the bone, small pieces of tissue are separated from it - sequestra or joint mice.

In danger:

• for microtrauma - blacksmiths, miners, tennis players, weightlifters, discus throwers;
• in acute injuries - gymnasts, athletes, circus performers;
• inherited people;
• People suffering from chronic diseases of the joints.

Symptoms of shoulder osteoarthritis

The disease begins gradually, gradually. The speed of their progression depends on the cause, the general condition of the patient and his heredity.

First signs

The first symptoms of arthrosis of the shoulder joint may not be noticed, especially if they appear against the background of an existing shoulder disease. These are minor and occur regularly, mainly after physical exertion, pain, discomfort during movement of the joint. Pain in the left joint can be mistaken for heart pain. They pass quickly, but it is worth paying attention to them.

If such symptoms appear again, it is better to immediately consult a doctor, since any disease is easier to treat in the initial stages.

Obvious Symptoms

The pain increases, after exertion it does not go away immediately. Night pain occurs, as well as pain associated with a change in the weather. Movements in the hand become painful, they are accompanied by a characteristic crunch. Stiffness of movement occurs in the morning or when you stay in a certain position for a long time. To eliminate them you have to move. The pain syndrome can be localized not only in the shoulder area, but also radiate to the arm, neck and upper back.

Periodically, the joint swells, a slight reddening of the skin appears over it, the pain intensifies, it becomes permanent. Body temperature may rise slightly. This is a sign of synovitis - aseptic (without infection) inflammation of the synovial membrane. If there are foci of infection in the body (decay teeth, diseases of the ENT organs, etc. ), it can get into the joint through the blood and lymphatic vessels and cause a purulent inflammatory process. In this case, high fever, headaches may appear, the general condition may be severely disturbed.

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

But even such patients can be helped, you just have to go to the clinic.

Dangerous Symptoms

There are a number of symptoms of osteoarthritis of the shoulder joint that indicate that you need urgent medical help. The:

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

These symptoms indicate that your body needs help. There can only be one doctor.

What is the danger of osteoarthritis of the shoulder?

Without medical care, brachial arthrosis is dangerous with steady progression with the development of a permanent pain syndrome, reduced function of the limbs and various, sometimes life-threatening, complications.

Degrees of arthrosis of the shoulder joint

There are three degrees of osteoarthritis of the shoulder joint:

• Osteoarthritis of the shoulder joint 1 degree- First phase. All symptoms are mild and usually appear after exercise. X-rays sometimes show a slight narrowing of the joint space, but more often not. Small injuries in the cartilage tissue can only be detected at this stage with the help of magnetic resonance imaging (MRI).
• Osteoarthritis of the shoulder joint 2 degrees- progressive stage. The shoulder constantly hurts, the pain is aggravated by the movements of the arm, it gives down (to the elbow, forearm, to the hand) or to the neck, back, under the shoulder blade. There are difficulties with the functioning of the limb, signs of synovitis periodically develop. In the x-ray, the joint space is clearly narrowed, bone growths (osteophytes) are visible on the edges of the articular surfaces, and the bone tissue is thickened (osteosclerosis).
• Osteoarthritis of the shoulder joint 3 degrees- advanced. Pain in the joint is strong, constant, with a pronounced crunch when moving the arm. The range of motion is limited, sometimes the arm is completely immobile due to the pain. The joint becomes deformed, sometimes leading to pinching of nerves and blood vessels. On the X-ray: the joint space is almost invisible, noticeable bone growths with joint deformity, severe sclerosis and necrosis of bone tissue, joint mice.

Possible complications

Each localization and form of arthrosis has serious complications, so you should not delay treatment.

If you do not treat the disease or treat it yourself with folk remedies, there is a risk of complications such as:

• significant deformity and limitation of joint mobility;
• Dislocations, subluxations and intra-articular fractures with minor injuries or sudden movements;
• tears of the tendons surrounding the joint of muscles and ligaments - they atrophy and tear easily;
• aseptic necrosis of the humeral head with complete destruction of the joint and loss of function;
• purulent-septic complications when infection enters the articular cavity from other foci.

What to do with an exacerbation

As a rule, exacerbations of the pathological process are associated with an increased load on the limb or with the development of inflammation - synovitis. In this case, the joint hurts more, there is a slight swelling, body temperature rises. In such cases, you should stick to the following self-help algorithm:

• call a doctor at home;
• take a tablet of any of the painkillers inside;
• apply an anesthetic ointment to the skin in the area of \u200b\u200bthe diseased joint;
• tie a sore arm with a bandage - this will reduce the load;
• Take an elevated position - sit under your back with a pillow - this will reduce swelling of the tissues.

Types of shoulder osteoarthritis

According to various criteria, the disease is divided into several types.

For reasons of illness

According to this criterion, a distinction is made between primary and secondary arthrosis. Primary shoulder arthrosis is mainly the result of age-related changes and develops after the age of 50. But sometimes the disease begins at a young age, but the cause of its onset cannot be established. In this case one speaks of a primary idiopathic arthrosis 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 here too there is a hereditary factor: for one person, even a minor injury or acute arthrosis can lead to the development of arthrosis, for another, greater damage ends without consequences.

According to the characteristics of the current

Allocate deforming arthrosis of the shoulder, characterized by rapid progression of bone deformities. A feature of this type of disease is a change in the shape of the joints and frequent injury to nearby blood vessels and nerves. Compression of blood vessels leads to impaired blood circulation and rapid progression of degenerative-dystrophic diseases, and compression of nerves leads to impaired sensitivity of the limbs and severe pain along the peripheral nerves.

origin

Post-traumatic arthrosis of the shoulder - the symptoms and treatment of this disease have their own characteristics associated with a traumatic lesion of certain joint structures. Exchange dystrophic changes occur after intra-articular fractures, dislocations, subluxations, tears of ligaments, tendons and simple bruises. Injuries result from a blow to the ankle or from falling onto your side with your arm adducted. A fall on the abducted arm usually results in a rupture of the joint capsule with dislocation.

After a minor injury, the first signs of arthrosis are often not noticed for a long time and seek medical help as early as the second stage of the disease. Significant injuries require long-term rehabilitation treatment, and treatment for osteoarthritis usually begins at an early stage.

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

distribution

Only one left or right joint can be affected and then one speaks of monoarthrosis. Damage to two (left and right) shoulder-shoulder joints at the same time is referred to as oligoarthrosis.

Arthrosis of other joints of the shoulder complex

Acromioclavicular arthrosis - most often has a post-traumatic origin. It develops against the background of lifting weights with hands above the horizontal. Accompanied by pain when raising the arm. With the growth of osteophytes on the articular surfaces, impingement syndrome can occur - injury to the tendons and muscles of the shoulder between the humeral head and the acromion during rotation and abduction of the shoulder. This accelerates the progression of osteoarthritis and the decline in hand function.

diagnosis

Without a correct diagnosis, it is impossible to treat this disease. A full examination is possible only in the clinic. At the initial consultation, the doctor asks the patient, examines him, prescribes additional research methods and specialist consultations:

• Laboratory tests of blood, synovial fluid - inflammatory, autoimmune and degenerative-dystrophic processes are detected.
• Instrumental:
  1. radiography of the shoulder joint - changes in bone tissue are detected;
  2. Computed tomography (CT) - changes in cartilage and bone tissue in the early stages;
  3. Magnetic resonance imaging (MRI) - changes in soft articular and periarticular tissues;
  4. diagnostic arthroscopy - performed if necessary, to clarify the nature of the pathological process.

Treatment of osteoarthritis of the shoulder joint

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

Conservative therapy

It includes pharmacological and non-pharmacological methods.

Medical treatment

The aim of drug treatment is to eliminate pain and suppress the progression of osteoarthritis. To alleviate the patient's condition appoint:

1. drugs from the groupnonsteroidal anti-inflammatory drugs (NSAIDs). Drugs are administered intramuscularly, orally or rectally; At the same time, drugs from the NSAID group are prescribed externally in the form of ointments, gels or creams.
2. drugs from the groupmuscle relaxants- relax the muscles surrounding the joint; the spastic condition of these muscles increases the pain;
3. pain blockswith local anesthesia.The drug solution is injected into the joint cavity or into the periarticular tissue - a rapid analgesic effect.

The course of pathogenetic (influencing the mechanisms of the disease) therapy as part of the drug treatment of shoulder arthrosis includes:

1. chondroprotectors- Drugs that have in their composition biologically active substances that restore cartilage tissue. They are prescribed orally in the form of tablets and powders, in the form of intramuscular and intra-articular injections, and externally in the form of ointments and creams.
2. angioprotectors- Means that improve blood microcirculation. Assign tablets for oral administration and solutions for intravenous infusion.
3. hyaluronic acid preparations- are inserted into the joint cavity to improve wear properties and prevent bone tissue destruction.

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

Non-drug treatment

The basis of non-drug treatments for shoulder arthrosis is a healthy, active lifestyle and proper nutrition. It is very important to get rid of such bad habits as smoking and alcohol abuse - they contribute to impaired blood circulation and have a toxic effect on joint tissues.

nutrition, diet

There is no specific diet to treat shoulder osteoarthritis, but proper nutrition is very important with this condition. It is recommended to include in the daily diet: sea fish, seafood, lean poultry meat, dairy products, cottage cheese, cheese, cereals (oatmeal, buckwheat), vegetables, fruits.

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

It is recommended to give preference to boiled, stewed and stewed dishes.

Orthopedic treatment to distribute the load on the limb

To prevent shoulder injuries, it is recommended to regularly wear an elastic protective retainer in the form of a short sleeve connected to the opposite arm. The device improves blood circulation, eliminates swelling. However, wearing it all the time is not recommended, as it leads to a rapid decrease in the range of motion in the shoulder.

Many specialists include taping in the complex treatment of shoulder arthrosis - fixing tissues with sticky elastic bands. This eliminates pain, improves blood circulation and joint function.

physical therapy

Exercise therapy - daily performance of a set of exercises - for shoulder arthrosis is the main method of rehabilitation. Gymnastic complexes are prescribed by a doctor and are mastered under the supervision of a teacher of physical therapy. After the patient has started to perform the entire set of exercises correctly, it can be done at home.

physical therapy

Physiotherapy is included in complex therapy at any stage of the disease. These are electro- and phonophoresis with painkillers, laser and magnetotherapy - stimulation of regenerative processes in joint tissues, shock wave therapy (SWT) - sound exposure, which has a pronounced chondroprotective effect.

home remedies

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

• Decoction of viburnum branches for oral administration.Before bedtime, pour a glass of crushed raw materials with 500 ml of water, bring to a boil, keep on low heat for 5 minutes, insist all night, then strain and drink 100 ml three times a day. It isan anesthetic.
• An old recipe for a numbing ointment made from the herb wild rosemary.Take petroleum jelly or butter and dry chopped grass. In an enameled form, alternately fold the fat bottom and grass up in layers, close the form with a lid, smear the cracks with dough and put in the oven (preferably in the oven) on a small fire for 2 hours, out of the oventake, strain through double gauze, store in the fridge and massage into the skin over the diseased joint 2-3 times a day.

surgical operations

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

• Arthroscopic surgeriesallows to eliminate various defects in the articular cavity. They are mainly performed on young people with post-traumatic osteoarthritis. Arthroscopy allows you to tighten the biceps tendon and attach it to the bone (tenodesis - this eliminates loosening of the joint), remove bone growths - osteophytes (debridement), restore the joint cavity with a transplant, etc.
• endoprosthetics- Replacement of a destroyed, non-functioning joint with an artificial one.

Approach to the treatment of the disease in clinics

Clinical specialists have developed their own approach to treating shoulder osteoarthritis. First, each patient is carefully examined using the latest diagnostic equipment (including MRI). Then, using drug and non-drug methods, he becomes completely painless. At the same time, individual complex therapy is selected for him, which includes:

• state-of-the-art drug and non-drug methods, including plasmolifting;
• traditional oriental methods of treatment and restoration of the function of the joints and the whole organism; These are acupuncture, moxibustion, auriculotherapy, taping, etc.

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

Combines proven techniques of the East and innovative methods of Western medicine.

General Clinical Guidelines

For people suffering from osteoarthritis of the shoulder it is recommended:

• Lead a healthy mobile lifestyle, alternate physical activity and rest.
• eat right regularly;
• get rid of all bad habits;
• regularly perform therapeutic exercises, avoiding sudden movements;
• At night, sleep on your back or on your healthy side and place a small pillow under your aching arm.
• refrain from heavy physical exertion, avoid injuries, prolonged stress and colds;
• During exacerbation (development of synovitis), avoid thermal procedures.
• Follow all recommendations of the attending physician.

prevention

It is particularly important for people with a difficult heredity to follow certain rules to prevent shoulder arthrosis. You should not engage in weightlifting, tennis, traumatic sports, hammering, blacksmithing, or miners. If you want to have healthy joints, you should lead an active lifestyle and eat properly on a regular basis.

Frequently asked questions about the disease

1. What is the pain of osteoarthritis of the shoulder?

   The pain is painful and is made worse by exercise and lifting weights.

2. Why is the disease dangerous?

   The formation of a permanent pain syndrome and loss of limb function.

3. Which doctor treats deforming arthrosis of the shoulder?

   Post-traumatic - an orthopedist-traumatologist, against the background of inflammatory diseases - a rheumatologist.

4. Is a blockage made for osteoarthritis of the shoulder?

   If the pain is severe, yes.

5. How effective are physiotherapeutic methods in this disease?

   Effective as part of a complex treatment.

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

   No, but the doctor can suppress its progression and save the patient from pain.

Shoulder arthrosis should be treated for a long time, systematically and strictly under medical supervision. Attempts to cope with this disease on your own are fraught with complications and disabilities. But a qualified specialist can stop the process at any stage of the disease, save the patient from pain and significantly improve his quality of life.