Shoulder arthritis

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

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

What is this?

Shoulder arthrosis is an ever-progressive long-term metabolic-dystrophic disease, leading to gradual destruction of articular cartilage, protective growth of bone tissue with joint deformity and loss of its function.

Various arm movements are provided by the synchronous interaction of complex shoulder joints:

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

The shoulder joint is highly mobile, provided by the convex head of the humerus and a relatively flat articular fossa on the scapula. The joint is strengthened by the muscular tendons of the upper limb, above which is the coracoid-acromial ligament. Not -so -reliable strengthening allows the joint to move in different directions, but at the same time increases the risk of injury.

The code for shoulder arthrosis according to the International Classification of Diseases for the 10th revision (ICD-10) is M19 (other types of arthrosis). Treatment of shoulder arthrosis should begin as early as possible. But even advanced stages of the disease can be treated successfully.

Causes of shoulder osteoarthritis

The main causes of shoulder arthrosis:

• as a result of acute injuries - dislocations, subluxations, intra -articular fractures, bruises;
• permanent long -term microtrauma associated with a profession or sports load;
• transfer of acute and chronic inflammatory and autoimmune processes in the shoulder joint - acute purulent arthritis, chronic rheumatoid, psoriatic and other arthritis;
• against the background of chronic inflammatory processes in periarticular tissues - humeroscapular periarthritis, which leads to impaired blood circulation and nutrition of cartilage tissue;
• metabolic disorders (exchange) of the articular - gouty arthritis;
• hormonal disorders;
• congenital defects (dysplasia) - for example, the articular surface of the shoulder joint.

Under the influence of any of these causes (sometimes several at once), the composition and amount of joint fluid that feeds the cartilage tissue of the joint is disturbed. Cartilage gradually decreases in volume, cracks, loses its cushioning properties. This leads to injury to the bone, its growth along the edges of the articular surface, joint deformities and decreased function. In the joint cavity, inflammation of the synovial membrane periodically occurs - synovitis. Because of synovitis, arthrosis is called osteoarthritis or osteoarthritis - depending on the process taking place (inflammatory or metabolic -dystrophic). As a result of inflammation and necrosis of the bone, small pieces of tissue are separated from it - sequester or articular rats.

At risk:

• for microtrauma - blacksmiths, miners, tennis players, weightlifters, discus throwers;
• for acute injuries - gymnasts, athletes, circus artists;
• people with burdened offspring;
• people with any chronic disease of the joints.

Symptoms of shoulder osteoarthritis

The disease begins gradually, gradually. The rate of its development depends on the cause, the general condition of the patient and his offspring.

The first signs

Early symptoms of shoulder joint arthrosis may not be observed, especially if it occurs against the background of some pre -existing shoulder disease. These are small, occur periodically, especially after exercise, pain, discomfort during joint movements. Pain in the left joint can be confused with heart pain. They pass quickly, but it’s worth paying attention to them.

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

Obvious symptoms

The pain increases, after doing the exercise does not disappear immediately. Night pain appears, as well as pain associated with weather changes. Movements in the hands become painful, they are accompanied by characteristic dryness. In the morning or when you are in a certain position for a long time, stiffness of movement appears, to remove it, you need to move. The pain syndrome can be localized not only in the shoulder area, but also radiate to the arms, neck and upper back.

Periodically, the joints swell, a slight redness of the skin appears on it, the pain intensifies, it becomes permanent. Body temperature may rise slightly. This is a sign of synovitis - aseptic inflammation (without infection) of the synovial membrane. If there is a focus of infection in the body (dental caries, ENT organ disease, etc. ), then it can enter the joints through the blood and lymph vessels, causing a purulent inflammatory process. In this case, high fever, headache may appear, the general condition may be abruptly disturbed.

The combination of degenerative-dystrophic processes and inflammation in the joints gradually leads to permanent loss of limb function and persistent pain.

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

Dangerous symptoms

There are several symptoms of osteoarthritis of the shoulder joint, indicating you need to seek medical help immediately. this:

• appearance of edema and redness of tissues in the joint area, fever;
• aching pain in the joints, accompanied by changes in its shape;
• joint pain radiating to the arms, neck or back;
• the amount of former movement in the arm is impossible, even if just raising it causes severe pain.

These symptoms indicate that your body needs help. Only a doctor can give it.

What are the dangers of osteoarthritis in the shoulder

In the absence of medical treatment, brachial arthrosis is dangerous with a stable progression with the development of permanent pain syndrome, decreased limb function, and various, sometimes life -threatening complications.

Stages of arthrosis of the shoulder joint

There are three degrees of arthrosis of the shoulder joint:

• Arthrosis of the shoulder joint 1 degree- early stage. All symptoms appear slightly and mostly after exercise. On x-rays, a slight narrowing of the joint space is sometimes visible, but more often not. It is possible to detect small violations in cartilage tissue at this stage only with the help of magnetic resonance imaging (MRI).
• Arthrosis of the shoulder joint 2 degrees- progressive level. Shoulders are always sore, the pain is exacerbated by the movement of the arms, they give up (to the elbows, forearms, hands) or to the neck, back, under the shoulder blades. There are difficulties with limb function, signs of synovitis periodically develop. On X-rays, the joint space becomes significantly narrower, bone growths (osteophytes) appear along the edges of the articular surface, bone tissue is compacted (osteosclerosis).
• Arthrosis of the shoulder joint 3 degrees- advanced rankings. The pain in the joints is strong, persistent, with marked dryness when moving the arms. The range of motion is limited, sometimes the arm cannot move fully due to pain. The joint is deformed, which sometimes leads to pinching of nerves and blood vessels. On x-ray: almost invisible joint space, significant bone growth with joint deformity, severe sclerosis and necrosis of bone tissue, articular rats.

Possible Complications

Any 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, then the risk of complications such as:

• significant deformities and limitations of articular mobility;
• dislocation, subluxation and intra-articular fractures with minor injury or sudden movement;
• ruptured tendons that surround muscle joints and ligaments - they atrophy and tear easily;
• aseptic necrosis of the head of the humerus with complete destruction of the articulation and loss of its function;
• purulent-septic complications when infection enters the joint cavity from another focus.

What to do with aggravation

The severity of the pathological process is usually associated with increased pressure on the limbs or with the development of inflammation - synovitis. In this case, the joints are more sore, there is a slight swelling, the body temperature rises. In such cases, you should adhere to the following self -help algorithms:

• call a doctor at home;
• take a tablet of one of the painkillers in it;
• apply anesthetic ointment to the skin in the area of the diseased joint;
• tie the sore arm with a bandage - this will reduce the load;
• take a high position - sit with a pillow under your back - this will reduce tissue swelling.

Types of shoulder arthrosis

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

Due to illness

Consistent with these criteria, primary and secondary osteoarthritis were distinguished. Primary shoulder arthrosis is primarily the result of age -related changes and develops after 50 years. But sometimes the disease begins at a young age, but the cause of its onset can not be established. In this case, they are talking about primary idiopathic arthrosis of the shoulder. An important role in its development is played by hereditary predisposition: the presence of the same disease in one of the closest relatives.

Secondary arthrosis of the shoulder joint develops after previous injuries and illnesses, but a burdensome heredity is also important here: in one person, even a minor injury or acute arthritis can lead to the development of arthrosis, while in another, more significant damage ends without consequence.

According to the flow characteristics

Provision of deformed arthrosis of the shoulder, characterized by the rapid development of bone deformities. Characteristic of this type of disease are changes in the shape of the joints and frequent violations of nearby blood vessels and nerves. Blood vessel compression leads to impaired blood circulation and rapid development of degenerative-dystrophic disorders, and nerve compression leads to impaired limb sensitivity and severe pain along peripheral nerves.

origin

Post -traumatic shoulder arthrosis - symptoms and treatment of this disease have their own characteristics associated with traumatic lesions of certain articular structures. Exchange-dystrophic changes occur after intra-articular fractures, dislocations, subluxations, rupture of ligaments, tendons, and only bruising. Injuries occur from a blow to a joint or from a fall on the side with an extended arm. Rupture of the joint capsule with dislocation usually occurs during a fall on the abducted arm.

Often, after a minor injury, a person does not notice the first signs of arthrosis for a long time and seeks medical help already in the second stage of the disease. Significant injuries require long -term rehabilitative treatment, and arthrosis, as a rule, begins to be treated already at an early stage.

Arthrosis of the shoulder after experiencing an inflammatory disease - the symptoms and course of such pathology depend on the underlying disease. The shoulder joint is often affected in psoriatic arthritis, while arthrosis 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 they talk about monoarthrosis. The simultaneous defeat of two shoulder-scapular joints (left and right) is called oligoarthrosis.

Arthrosis of another complex joint of the shoulder

Acromioclavicular arthrosis - most often has a post -traumatic origin. It develops against the background of lifting weights with the hands on the horizontal. Accompanied by pain when lifting the arm. With the growth of osteophytes on the articular surface, impingement syndrome may appear - a violation of the tendons and muscles of the shoulder between the head of the humerus and the acromion of the scapula during rotation and abduction of the shoulder. This accelerates the development of arthrosis and a decrease in hand function.

Diagnostics

Without proper diagnosis, it is impossible to treat the disease. A full examination can only be done at the clinic. At the initial consultation, the doctor asks the patient, examines him, prescribes additional research methods and expert consultation:

• Laboratory tests of blood, joint 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 at an early stage;
  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, 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 objective of drug treatment is to eliminate pain and inhibit the development of osteoarthritis. To alleviate the patient's condition, appoint:

1. Drugs from the groupnonsteroidal anti-inflammatory drugs (NSAIDs). The drug is 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. Drugs from the groupmuscle relaxants- relax the muscles around the joints; this spastic state of the muscle increases the pain;
3. Pain restrictionwith a local anesthetic.The drug solution is injected into the joint cavity or into the periarticular tissue - a rapid analgesic effect.

Courses of pathogenetic therapy (affecting the mechanism of the disease) as part of the medical treatment of shoulder arthrosis include:

1. Chondroprotectors- drugs that have in the composition of biologically active substances that restore cartilage tissue. They are prescribed orally in the form of tablets and powders, in the form of intramuscular and intraarticular injections, and also externally in the form of ointments and creams.
2. Angioprotectors- Means that increase blood microcirculation. Give in tablets for oral administration and solution for intravenous drip.
3. Hyaluronic acid preparations- inserted into the articular cavity to improve the depreciation properties and prevent the destruction of bone tissue.

Vitamin-mineral complex to enhance metabolic processes in articular and periarticular tissues.

Non -drug treatment

The basis of non -drug methods of treatment of shoulder arthrosis 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 contribute to circulatory disorders and have toxic effects on joint tissue.

Nutrition, diet

There is no special diet for the treatment of shoulder arthrosis, but proper nutrition is very important in this disease. It is recommended to include in the daily diet: sea fish, seafood, lean chicken, 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 the tissues that cause swelling - salt (excessive amount), spicy and spicy seasonings.

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

Orthopedic treatment to distribute the load on the limbs

To avoid shoulder injuries, it is recommended to wear elastic protective restraints periodically in the form of short sleeves connected to the opposite arm. The device improves blood circulation, eliminates swelling. But wearing it continuously is not recommended, as this leads to a rapid decrease in the range of motion in the shoulders.

Many specialists include recording in the complex treatment of shoulder arthrosis - correcting the tissue with sticky elastic tape. This provides pain relief, improved blood circulation and joint function.

Physiotherapy

Exercise therapy - the daily performance of a set of exercises - with shoulder arthrosis is the main method of recovery. The gymnastics complex is prescribed by a doctor, supervised under the supervision of an exercise therapy instructor. After the patient starts doing the whole set of exercises properly, it can be done at home.

Physiotherapy

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

Restoration of the people

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

• Decoction of viburnum branches for oral administration.Pour a glass of crushed raw material before bedtime with 500 ml of water, bring to a boil, let simmer for 5 minutes, insist overnight, then strain and drink 100 ml 3 times a day. It is an anesthetic.
• An old recipe for anesthetic ointment from the herb wild rosemary.Take vaseline or butter and dried chopped grass. In an enamel dish, fold the fat and grass base alternately to the top of the layer, cover the dish with a lid, coat the cracks with dough and put in the oven (preferably in the oven) on low heat for 2 hours, remove from the oven, strain through double gauze, store in the refrigerator and rub into the skin on diseased joints 2-3 times a day.

Surgical operation

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

• Arthroscopic surgeryallows to eliminate various defects in the articular cavity. They are performed primarily on young people with post -traumatic arthrosis. Arthroscopy allows you to tighten and attach the biceps tendon to the bone (tenodesis - this will eliminate joint relaxation), remove bone growth - osteophytes (debridement), restore the articular cavity by transplantation, etc.
• Endoprosthetics- replacement of destroyed joints, lost their function with artificial ones.

Disease treatment approaches in the clinic

Clinicians have developed their own approaches to the treatment of shoulder arthrosis. First of all, each patient is carefully examined using the most modern diagnostic equipment (including MRI). Then he really relieved the pain using drug methods instead of drugs. At the same time, individual complex therapies are selected for him, including:

• most modern drug and non -drug methods, including plasmolifting;
• traditional oriental methods of treatment and restoration of joint function and the whole organism as a whole; these are acupuncture, moxibution, auriculotherapy, recording, etc.

This approach quickly relieves a person of pain and suppresses disease progression. And a regular course of prevention allows patients to forget about the disease and lead a normal life. Many patient reviews speak of the effectiveness of this treatment.

A combination of Eastern proven techniques and innovative methods of Western medicine.

General clinical guidelines

For those with shoulder osteoarthritis, it is recommended:

• leading a healthy, mobile lifestyle, intermittent physical activity and rest;
• eat properly regularly;
• get rid of all bad habits;
• regularly perform therapeutic exercises, avoid sudden movements;
• sleep on your back or on a healthy side at night, place a small pillow under your aching arm;
• stop doing strenuous physical exercise, avoid injuries, prolonged stress and colds;
• during exacerbations (development of synovitis), avoid any thermal procedures;
• follow all the recommendations of the treating physician.

prevention

It is especially important for people with severe heredity to follow certain rules for the prevention of shoulder arthrosis. They should not be involved in weightlifting, tennis, traumatic sports, working as hammers, blacksmiths, miners. Everyone who wants to have healthy joints should lead an active lifestyle and eat right regularly.

Frequently asked questions about this disease

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

   The pain is aching, aggravated by movement and lifting weights.

2. Why is the disease dangerous?

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

3. Which doctor treats deformed shoulder arthrosis?

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

4. Are restrictions performed for shoulder arthrosis?

   For severe pain, yes.

5. How effective are physiotherapy methods for this disease?

   Effective as part of a complex treatment.

6. Is it possible to completely cure deformed shoulder arthrosis?

   No, but doctors can block its development and save patients from pain.

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