Osteoarthritis of the shoulder

Shoulder pain may appear gradually and significantly reduce the patient's quality of life. To find out why your shoulders hurt, you should consult your doctor and undergo a full examination. The most common cause of such pain is shoulder osteoarthritis.

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, constantly progressive metabolic-dystrophic disease that causes gradual destruction of the articular cartilage, protective growth of bone tissue with deformity of the joints and loss of its function.

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

• humeroscapular or simply humeral;
• Acromioclavicular - between the acromion process of the clavicle and scapula;
• Sternoclavicular - between the breast bone and the collar.

The shoulder joint is highly mobile, secured by the convex head of the shoulder bone and the relatively flat joint fossa of the shoulder. The joint is strengthened by the tendons of the muscles of the upper limb, above it is a coracoid-acromial ligament. Not-so-reliable reinforcement 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 10th revision International Classification of Diseases (ICD-10) is M19 (other types of arthrosis). Treatment for shoulder osteoarthritis should begin as early as possible. But even in the advanced stages of the disease it is successfully curable.

Causes of shoulder osteoarthritis

The main causes of osteoarthritis of the shoulder:

• Consequences of acute injuries - dislocations, subluxations, intra-articular fractures, bruises;
• Permanent long-term microtrauma related to occupation or sports activities;
• Transferred 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 - humeruscular periarthritis, which leads to circulatory disorders and cartilage nutrition;
• Metabolic (exchange) joint disorders - gouty arthritis;
• Hormonal disorders;
• Congenital malformations (dysplasia) - for example, the articular surfaces of the shoulder joints.

Under the influence of any of these causes (sometimes several at once) the composition and volume of joint fluid that nourishes the cartilage tissue of the joint is disrupted. Cartilage gradually decreases in volume, cracks, loses its soothing properties. This causes bone damage, its growth at the edges of the articular surfaces, deformation of the joints, and impaired function. Inflammation of the synovial membrane in the joint periodically occurs - synovitis. Arthritis due to synovitis is called osteoarthritis or osteoarthritis - depending on which process predominates (inflammatory or metabolic-dystrophic). As a result of bone inflammation and necrosis, small pieces of tissue are separated from it - sequesters or articular mice.

Under the risk:

• For microtrauma - blacksmiths, miners, tennis players, weightlifters, discus throwers;
• For severe injuries - gymnasts, athletes, circus performers;
• Persons with encumbered inheritance;
• Individuals suffering from chronic diseases of the joints.

Symptoms of shoulder osteoarthritis

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

The first signs

The initial symptoms of osteoarthritis of the shoulder joint may not be noticeable, especially if they occur against the background of some existing shoulder disease. It is insignificant, occurs periodically, mainly after exercise, pain, discomfort during joint movement. Left joint pain can be confused with heart pain. They pass quickly, but are worth paying attention to.

If similar symptoms recur, it is best to consult a doctor immediately as any disease is easier to treat at an early stage.

Obvious symptoms

The pain increases, does not disappear immediately after exercise. There are night pains as well as pains related to weather change. Hand movements become painful, they are accompanied by a characteristic cramp. In the morning or when you are in a certain posture for a long time, the strength of the movements appears, you need to move to get rid of it. The pain syndrome can be localized not only in the shoulder area but also spread to the arm, neck and back.

Periodically, the joint is swollen, there is a slight redness of the skin on it, the pain intensifies, 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 (carious teeth, ear-ear-ear-ear-ear-canine diseases, etc. ), then it can enter the joint through the blood and lymphatic vessels, causing a purulent inflammatory process. In this case may appear high fever, headache, sharply disturbed general condition.

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

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

Dangerous symptoms

There are several symptoms of osteoarthritis of the shoulder joint, indicating that you should seek medical attention immediately. this:

• Appearance of swelling and redness of tissues in the joint area, fever;
• Excruciating pain in the joint accompanied by a change in its shape;
• Joint pain extends to the arm, neck, or back;
• The former volume of movement in the arm is impossible, even just lifting it causes severe pain.

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

What is the danger of osteoarthritis of the shoulder

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

Degree of arthrosis of the shoulder joint

There are three degrees of osteoarthritis of the shoulder:

• Osteoarthritis of the shoulder joint 1 degree- Initial stage. All symptoms manifest slightly and mostly after exercise. Slight narrowing of the joint space is sometimes seen on X-ray, but more often it is not. Detection of small cartilage abnormalities at this stage is possible only with the help of magnetic resonance imaging (MRI).
• Osteoarthritis of the shoulder joint 2 degrees- Progressive stage. Shoulder pain is constant, the pain is intensified by the movement of the arm, falling (elbow, forearm, hand) or on the neck, back, under the shoulder. There are difficulties in the functioning of the limb, periodically developing signs of synovitis. At X-ray, the joint space narrows considerably, bone growths (osteophytes) appear along the edges of the joint surfaces, and bone tissue shrinks (osteosclerosis).
• Osteoarthritis of the shoulder joint 3 degrees- Advanced stage. Joint pain is strong, constant, with sharp convulsive arm movements. 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 stretch. Radiographically: joint space is almost invisible, significant bone formations with joint deformity, severe sclerosis and bone tissue necrosis, joint mice.

Possible complications

Any localization and form of osteoarthritis has serious complications, so treatment should not be delayed.

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

• Significant deformation and restriction of joint mobility;
• Dislocations, subluxations, and intra-articular fractures with minor injuries or sudden movements;
• Fractures of the tendons surrounding the joints of the muscles and ligaments - they are atrophic and easily disintegrated;
• Aseptic necrosis of the shoulder bone 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 about aggravation

Exacerbation of the pathological process is usually associated with increased stress on the limb 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 should follow the following self-help algorithm:

• Call a doctor at home;
• Take one of the analgesic tablets inside;
• Apply anesthetic ointment to the affected area of the skin;
• Attach the sore arm with a bandage - 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 different criteria, the disease is divided into separate types.

Due to the causes of the disease

This criterion distinguishes between primary and secondary osteoarthritis. Primary osteoarthritis of the shoulder is mainly the result of age-related changes and develops after 50 years. But sometimes the disease starts at a young age, but the cause of its onset is impossible to determine. In this case, they are talking about primary idiopathic arthrosis of the shoulder. An inherited predisposition plays an important role in its development: the presence of a similar disease in one of the close relatives.

Secondary arthrosis of the shoulder joint develops after injuries and previous diseases, but a loaded inheritance is important here as well: in one person a minor injury or even acute arthritis can lead to the development of osteoarthritis, while in another a more significant injury ends in failure.

According to the peculiarities of the flow

Isolated deformed arthrosis of the shoulder, which is characterized by rapid progression of bone deformities. A feature of this type of disease is a change in the shape of the joint and frequent disruption of nearby blood vessels and nerves. Compression of blood vessels leads to circulatory disorders and rapid progression of degenerative-dystrophic disorders, while nerve compression leads to decreased limb sensitivity and severe pain along peripheral nerves.

Origin

Posttraumatic arthrosis of the shoulder - The symptoms and treatment of this disease have their own characteristics associated with traumatic damage to certain joint structures. Exchange-dystrophic changes occur after intra-articular fractures, dislocations, subluxations, ligaments, tendon ruptures, and simply bruises. Injuries result from a blow to the joint or a fall to the side of the adductor arm. Dislocation of the joint capsule by dislocation usually occurs when falling on the abducted arm.

Often, after a small injury, a person does not notice the first signs of osteoarthritis for a long time and seeks medical help already in the second stage of the disease. Significant injuries require long-term rehabilitation treatment, and treatment of osteoarthritis usually begins 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 injured during psoriatic arthritis, while arthrosis develops in one joint, developing slowly but is difficult to cure. In rheumatoid arthritis, both shoulders are injured, 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 talk about monoarthritis. Simultaneous defeat of two (left and right) shoulder-scapular joints is called oligoarthrosis.

Arthrosis of other joints of the shoulder complex

Acromioclavicular arthrosis - most often has a post-traumatic origin. It develops against the background of weight lifting, with the hands above the horizontal. Accompanied by pain when raising the arm. With the increase of osteophytes on the articular surfaces, impingement syndrome may appear - disruption of the shoulder tendons and muscles during rotation between the shoulder head and scapula acromion and shoulder abduction. This accelerates the progression of osteoarthritis and impaired hand function.

Diagnosis

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

• Laboratory tests of blood and joint fluid - inflammatory, autoimmune and degenerative-dystrophic processes have been identified.
• Instrumental:
  1. Radiography of the shoulder joint - revealed changes in bone tissue;
  2. Computed tomography (CT) - changes in cartilage and bone tissue at an early stage;
  3. Magnetic resonance imaging (MRI) - changes in the soft joint and periarticular tissues;
  4. Diagnostic arthroscopy - if necessary, is performed to find out the nature of the pathological process.

Treatment of osteoarthritis of the shoulder joint

Complex conservative treatment of shoulder osteoarthritis is prescribed after the final diagnosis. If conservative therapy is ineffective, surgical treatment is prescribed.

Conservative therapy

It includes pharmacological and non-pharmacological methods.

Medical treatment

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

1. Medications from the groupNonsteroidal anti-inflammatory drugs (NSAIDs). Medications are administered intramuscularly, orally, or rectally; At the same time, drugs of the nonsteroidal anti-inflammatory group are prescribed externally in the form of ointments, gels or creams.
2. Medications from the groupMuscle relaxants- Relax the muscles surrounding the joint; Spastic condition of these muscles increases pain;
3. Pain blockadeWith local anesthetics.The drug solution is injected into the joint cavity or periarticular tissues - a rapid analgesic effect.

A course of pathogenetic (impact on disease mechanisms) therapy as part of medical treatment for shoulder osteoarthritis includes:

1. Chondroprotectors- Medications that contain biologically active substances that restore cartilage tissue. They are prescribed orally in the form of tablets and powders, intramuscular and intra-articular injections, as well as external ointments and creams.
2. Angioprotectors- Remedies that improve blood microcirculation. Prescribe tablets for oral administration and solutions for intravenous drip.
3. Hyaluronic acid preparations- Injected into the joint cavity to improve the cushioning properties and to 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-narcotic 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 contribute to circulatory disorders and have toxic effects on joint tissues.

Meals, diet

There is no specific diet to treat osteoarthritis of the shoulder, 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, foods that irritate the tissues that cause swelling - salt (excess), spicy and spicy spices.

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

Orthopedic treatment to distribute the load on the limb

To prevent shoulder injuries, it is recommended to periodically wear an elastic protective brace in the form of a short sleeve, which is connected to the opposite arm. The device improves blood circulation, eliminates swelling. But wearing it constantly is not recommended as it causes a rapid reduction in the range of motion of the support.

Many specialists include tape in the complex treatment of shoulder osteoarthritis - attaching tissues with adhesive elastic bands. It helps eliminate pain, improve blood circulation and joint function.

Physiotherapy

Exercise therapy - daily performance of a complex of exercises - with arthrosis of the shoulder is the main method of rehabilitation. Gymnastics complexes are prescribed by a doctor, mastered under the supervision of an exercise therapy instructor. Once the patient begins to perform the entire set of exercises correctly, this can be done at home.

Physiotherapy

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

Folk remedies

Folk remedies will bring great benefits only with a doctor's prescription. Here are some of them:

• Decoction of viburnum branches for oral administration.One cup of crushed raw material pour 500 ml of water before bedtime, bring to a boil, simmer on low heat for 5 minutes, leave overnight, then strain and drink 100 ml 3 times a day. This is an anesthetic.
• An old recipe for anesthetic ointment from wild rosemary herb.Take Vaseline or butter and dry the chopped grass. In a glazed dish, alternately lay the fat base and grass in layers on top, cover the dish with a lid, cover the cracks with dough and bake in the oven (preferably in the oven) on low heat for 2 hours. Remove from the oven, drizzle with double gauze, store in the refrigerator and massage into diseased skin 2-3 times a day.

Surgical operations

Due to the ineffectiveness of conservative therapy of shoulder arthrosis, the following surgical interventions are performed:

• Arthroscopic surgeriesAllows to eliminate various defects in the joint cavity. They are performed mainly on young people with post-traumatic arthrosis. Arthroscopy allows you to stretch and attach to the biceps tendon (tendonitis - this eliminates joint vigilance), remove bone growths - osteophytes (debridement), restore joint cavity transplantation, and more. Sh.
• Endoprosthesis- Replacement of a damaged, lost joint with an artificial one.

Approach to disease treatment in clinics

Clinical specialists have developed their own approach to the treatment of shoulder osteoarthritis. First of all, each patient is carefully examined using the most modern diagnostic equipment (including MRI). He is then completely relieved of pain by narcotic and non-narcotic methods. At the same time, individual complex therapy will be selected for him, including:

• State-of-the-art medications and non-narcotic methods, including plasmolifting;
• Traditional oriental methods of treatment and restoration of joint and body function; These are acupuncture, moxibustion, auriculotherapy, taping and so on. Sh.

This approach quickly relieves a person of pain and inhibits disease progression. And regular prophylactic courses allow patients to forget about the disease and live a normal life. Numerous patient reviews talk about how effective this treatment is.

Combined with the proven techniques of the East and the innovative methods of Western medicine.

General clinical guidelines

Recommended for people with osteoarthritis of the shoulder:

• Lead a healthy, active lifestyle, alternating between physical activity and relaxation;
• Eat right regularly;
• Get rid of all bad habits;
• Perform therapeutic exercises regularly, avoid sudden movements;
• Sleep at night on your back or healthy side, place a small pillow under your sore arm;
• Avoid strenuous physical activity, avoid injuries, prolonged stress and colds;
• In case of exacerbation (development of synovitis), avoid any thermal procedures;
• Follow all the recommendations of the attending physician.

Prevention

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

Frequently asked questions about the disease

1. What is the pain during shoulder osteoarthritis?

   The pains ache, intensifying with movement and weight lifting.

2. Why is the disease dangerous?

   Formation of persistent pain syndrome and loss of limb function.

3. Which doctor treats deformed arthrosis of the shoulder?

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

4. Is blockade done during 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 arthrosis of the shoulder?

   No, but the doctor can slow down her progress and save the patient from pain.

Osteoarthritis of the shoulder should be treated for a long time, systematically and under strict medical supervision. Attempts to deal with this disease independently are fraught with complications and disability. 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.