Shoulder arthrosis

Pain in the shoulder can 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 full examination. The most common cause of such pain is shoulder osteoarthritis.

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

What's that?

Shoulder arthrosis is a long-term, persistently progressive metabolic dystrophic disease, which leads to the gradual destruction of the articular cartilage, the protective growth of bone tissue with joint deformity and loss of its function.

The full range of motion of the arm is provided by the synchronous interaction of the joint of the shoulder complex:

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

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 the tendons of the muscles of the upper extremity, above which is the coracoid-acromial ligament. Not very reliable reinforcement allows the joints 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 of the 10th revision (ICD-10) is M19 (other types of arthrosis). Treatment of shoulder arthrosis should be started as early as possible. But even the advanced stages of the disease can be successfully treated.

Causes of shoulder osteoarthritis

The main causes of shoulder arthrosis:

• consequences of acute injury - dislocation, subluxation, intra-articular fracture, bruising;
• long-term permanent microtrauma associated with a profession or sporting load;
• transfer of acute and chronic infectious inflammatory and autoimmune processes of the shoulder joint - acute purulent arthritis, chronic rheumatoid, psoriatic and other arthritis;
• against the background of a chronic inflammatory process in the periarticular tissue - humeroscapular periarthritis, which leads to impaired blood circulation and nutrition of cartilage tissue;
• disorders of articular (exchange) metabolism - gouty arthritis;
• hormonal disorders;
• congenital malformation (dysplasia) - for example, the articular surface of the shoulder joint.

Under the influence of any of these reasons (sometimes several at once), the composition and volume of the joint fluid that feeds the cartilage tissue of the joint is disturbed. Cartilage gradually decreases in volume, cracks, loses its bearing properties. This leads to injury to the bone, its growth along the edges of the articular surfaces, joint deformity and decreased function. In the joint cavity, inflammation of the synovial membrane occurs periodically - synovitis. Due to synovitis, arthrosis is called osteoarthritis or osteoarthritis - depending on which process is occurring (inflammatory or metabolic dystrophy). 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;
• people with burdened ancestry;
• people who suffer from chronic diseases of the joints.

Symptoms of shoulder osteoarthritis

The disease begins gradually, gradually. The degree of development depends on the cause, the general condition of the patient and hereditary factors.

First signs

Early symptoms of arthrosis of the shoulder joint may go unnoticed, especially if it occurs against the background of several existing shoulder diseases. It is minor, occurs periodically, especially after exercise, pain, discomfort during joint movement. Pain in the left joint can be confused with heart pain. They pass quickly, but are worth noting.

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

Obvious symptoms

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

Periodically, the joint swells, a slight redness of the skin appears on it, the pain increases, becomes permanent. Body temperature may rise slightly. This is a sign of synovitis - aseptic inflammation (without infection) 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, causing a purulent inflammatory process. In this case, a high fever, a headache may appear, the general condition may be seriously disturbed.

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

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

Dangerous symptoms

There are a number of symptoms of osteoarthritis of the shoulder joint, indicating that you need to seek medical attention immediately. This:

• the appearance of edema and redness of the tissues in the joint area, fever;
• pain pain in the joints, accompanied by a change in their shape;
• joint pain radiating to the arms, neck or back;
• the previous volume of movement in the arm was impossible, even just lifting it caused severe pain.

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

What are the dangers of shoulder osteoarthritis?

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

Degree 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 a little and mostly after exercise. On X-rays, a slight narrowing of the joint space is sometimes seen, but more often it is not. It is possible to detect small violations of the cartilage tissue at this stage only with the help of magnetic resonance imaging (MRI).
• Arthrosis of the shoulder joint 2 degrees- progressive stage. The shoulder hurts constantly, the pain is aggravated by the movement of the arm, they give up (to the elbow, forearm, hand) or to the neck, back, under the shoulder blades. There are difficulties with the functioning of the limbs, signs of synovitis develop periodically. On X-ray, the joint space is significantly narrowed, bone growths (osteophytes) are visible along the edges of the articular surfaces, bone tissue is compacted (osteosclerosis).
• Arthrosis of the shoulder joint 3 degrees- advanced stage. Pain in the joint is strong, constant, with a crackling sound when moving the arm. Range of motion is limited, sometimes the arm is completely immobile due to the pain. Joints are deformed, which sometimes causes pinched nerves and blood vessels. On x-ray: barely visible joint space, significant bone growth with joint deformity, severe sclerosis and necrosis of bone tissue, articular mice.

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 developing complications such as:

• significant deformity and limited articular mobility;
• intra-articular dislocations, subluxations and fractures with minor injury or sudden movement;
• rupture of the tendons surrounding the joints of muscles and ligaments - they atrophy and tear easily;
• aseptic necrosis of the humeral head with complete destruction of the articulation and loss of its function;
• purulent-septic complications when infection enters the joint cavity from other foci.

What to do with exacerbations?

Exacerbation 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 hurt more, there is less swelling, the body temperature rises. In such cases, you must adhere to the following self-help algorithm:

• call the doctor at home;
• take a tablet of one of the painkillers in it;
• apply anesthetic ointment to the skin in the area of \u200b\u200bthe painful joint;
• tie the sore arm with a handkerchief - this will reduce the load;
• take an elevated 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 several separate types.

Due to illness

According to these criteria, primary and secondary osteoarthritis are 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 cannot be determined. In this case, they are talking about primary idiopathic arthrosis of the shoulder. An important role in its development is played by a hereditary predisposition: the presence of a similar disease in one of the close relatives.

Secondary arthrosis of the shoulder joint develops after previous injuries and illnesses, but hereditary factors are 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 consequences. .

According to flow features

Allocate deforming arthrosis of the shoulder, 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 violations of nearby blood vessels and nerves. Compression of blood vessels leads to impaired blood circulation and the rapid development of degenerative-dystrophic disorders, 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 - symptoms and treatment of this disease has its own characteristics associated with traumatic lesions of certain articular structures. Exchange dystrophic changes occur after intra-articular fractures, dislocations, subluxations, ruptures of ligaments, tendons, and contusions only. The injury occurs from a blow to the joint or from falling to the side with the adducted arm. Joint capsule rupture 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 in the second stage of the disease. Significant injuries require long-term rehabilitation treatment, and arthrosis, as a rule, is already treated at an early stage.

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

Distribution

Only one joint left or right can be affected and then they talk about monoarthrosis. Simultaneous defeat of the two shoulder-scapula joints (left and right) is called oligoarthrosis.

Arthrosis of other joints of the shoulder complex

Acromioclavicular arthrosis - most often has a post-traumatic origin. It develops against a background of lifting weights with hands above horizontal. Accompanied by pain when lifting the arm. With the growth of osteophytes on the articular surface, an 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.

Diagnostic

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

• Laboratory tests of blood, joint fluid - inflammatory, autoimmune and degenerative-dystrophic processes are detected.
• Instrumental:
  1. radiograph 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 the soft articular and periarticular tissues;
  4. diagnostic arthroscopy - is 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

This includes pharmacological and non-pharmacological methods.

Medical treatment

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

1. Drugs from the groupnon-steroidal 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 relaxant- relax the muscles around the joints; spasm of these muscles increases pain;
3. Pain blockwith local anesthetic.The drug solution is injected into the joint cavity or into the periarticular tissue - the analgesic effect is rapid.

Pathogenetic therapy courses (affecting disease mechanisms) as part of the medical treatment of shoulder arthrosis include:

1. chondroprotector- drugs that have a composition of biologically active substances that restore cartilage tissue. They are prescribed orally in the form of tablets and powder, in the form of intramuscular and intra-articular injections, and also externally in the form of ointments and creams.
2. Angioprotector- Means that improve blood microcirculation. Assign tablets for oral administration and solutions for infusion.
3. Hyaluronic acid preparation- inserted into the articular cavity to increase shrinkage properties and prevent bone tissue breakdown.

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

Treatment without drugs

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 such bad habits as smoking and alcohol abuse - they contribute to circulatory disorders and have a toxic effect on joint tissues.

Nutrition, diet

There is no specific 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: seafood, seafood, lean poultry, 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, tissue irritating foods that cause swelling - salt (excessive amounts), spicy and spicy seasonings.

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

Orthopedic treatment to distribute the load on the limbs

To prevent shoulder injuries, it is recommended to periodically wear an elastic protective restraint in the form of a short sleeve connected to the opposite arm. This device improves blood circulation, eliminates swelling. But wearing them constantly is not recommended, as this leads to a rapid decrease in the range of motion in the shoulders.

Many specialists include plaster in the complex treatment of shoulder arthrosis - fixing the tissue with a sticky elastic band. It provides pain relief, increased blood circulation and joint function.

Physiotherapy

Exercise therapy - daily performance of a set of exercises - with arthrosis of the shoulder is the main method of rehabilitation. The gymnastic complex is prescribed by a doctor, mastered under the supervision of an exercise therapy instructor. After the patient begins to perform the entire set of exercises correctly, 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, courses of shock wave therapy (SWT) - exposure to sound, which has a pronounced chondroprotective effect.

Traditional medicine

Traditional medicine will be very useful only if it is prescribed by a doctor. Here are some of them:

• Decoction of viburnum branches for oral administration.Pour a glass of crushed raw material before going to bed with 500 ml of water, bring to a boil, over low heat for 5 minutes, insist all night, then strain and drink 100 ml 3 times a day. This is dope.
• An old recipe for an anesthetic ointment from the herb wild rosemary.Take vaseline or butter and dry chopped grass. In an enameled dish, alternately fold the grease and grass mats onto the topmost layer, cover the plate with a lid, coat the cracks with dough and put in the oven (preferably in the oven) over low heat for 2 hours, remove from the oven, strain. through double gauze, store in the refrigerator and rub into the skin over the sore joint 2-3 times a day.

Surgery

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

• Arthroscopic surgeryallows to eliminate various defects in the articular cavity. They are performed mainly for young people with post-traumatic arthrosis. Arthroscopy allows you to tighten and attach the biceps tendon to the bone (tenodesis - this will remove joint looseness), remove bone growths - osteophytes (debridement), restore the articular cavity by transplantation, etc.
• Endoprosthetics- replacement of damaged and lost joints with artificial joints.

Approach to disease treatment in the clinic

Clinical specialists have developed their own approach to the treatment of shoulder arthrosis. First of all, each patient is carefully examined using the most modern diagnostic equipment (including MRI). Then he was completely pain free using both medicinal and non-medicinal methods. At the same time, individual complex therapy is selected for him, including:

• the most modern drugs and non-drug methods, including plasmolifting;
• methods of traditional oriental medicine and restoration of the function of the joints and the whole organism as a whole; these are acupuncture, moxibustion, auriculotherapy, taping, etc.

This approach quickly reduces a person's pain and suppresses the progression of the disease. And regular preventive courses allow the patient to forget about his illness and lead a normal life. Many patient reviews talk about how effective this treatment is.

Combination of proven techniques from the East and innovative methods of Western medicine.

General clinical guidelines

For people suffering from shoulder osteoarthritis, it is recommended:

• lead a healthy lifestyle and move, alternating physical activity and rest;
• eat properly on a regular basis;
• get rid of all bad habits;
• regularly perform therapeutic exercises, avoiding sudden movements;
• sleep on your back or on the healthy side at night, put a small pillow under your sore arm;
• stop strenuous physical activity, avoid injuries, stress and prolonged colds;
• during exacerbations (development of synovitis), avoid any thermal procedures;
• follow all the recommendations of the attending physician.

Prevention

It is very 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, work as hammers, blacksmiths, miners. Everyone who wants to have healthy joints should lead an active lifestyle and regularly eat right.

Frequently asked questions about illness

1. What is the pain of shoulder osteoarthritis?

   The pain is aching, made worse by movement and lifting weights.

2. Why is this disease dangerous?

   Formation of permanent pain syndrome and loss of limb function.

3. Which doctor treats deforming arthrosis of the shoulder?

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

4. Is blockade used for shoulder arthrosis?

   For terminally ill, yes.

5. How effective are physiotherapy methods for this disease?

   Effective as part of a complex treatment.

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

   No, but doctors can suppress its development and save the patient from pain.

Shoulder arthrosis should be treated for a long time, systematically and strictly under the supervision of a doctor. Attempts to overcome this disease alone 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 the quality of his life.