Osteoarthritis of the shoulder

Shoulder pain can occur gradually and significantly reduce the patient's quality of life. To find out why the shoulder hurts, you should 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 be prescribed only by an experienced specialist.

What is?

Shoulder osteoarthritis is a long-term, constantly progressive metabolic-dystrophic disease, leading to gradual destruction of articular cartilage, protective growth of bone tissue with deformation of the joint and loss of its function.

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

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

The shoulder joint is very mobile, which is provided by the protruding head of the humerus and the relatively flat articular fossa of the shoulder blade. The joint is strengthened by the tendons of the muscles of the upper limb, above it is the coracoid-acromial ligament. Not very 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 International Classification of Diseases of the 10th Revision (ICD-10) is M19 (other types of arthrosis). Treatment of osteoarthritis of the shoulder should begin as early as possible. But even advanced stages of the disease can be successfully treated.

Causes of osteoarthritis of the shoulder

The main causes of shoulder osteoarthritis:

• consequences of acute injuries - sprains, subluxations, intra-articular fractures, bruises;
• permanent long-term microtrauma related to the profession 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 - humeroscapular periarthritis, leading to impaired blood circulation and nutrition of cartilage tissue;
• metabolic (metabolic) joint disorders - 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 joint fluid that feeds the cartilage tissue of the joint is disturbed. Cartilage gradually decreases in volume, cracks, loses its emollient properties. This leads to bone injury, its growth along the edges of the joint surfaces, deformation of the joints and reduced function. Inflammation of the synovial membrane - synovitis - periodically occurs in the joint cavity. Because of synovitis, osteoarthritis is called osteoarthritis or osteoarthritis - depending on which process predominates (inflammatory or metabolic-dystrophic). As a result of inflammation and necrosis of the bone, small pieces of tissue are released from it - sequesters or joint mice.

In danger:

• for micro-injuries - blacksmiths, miners, tennis players, weightlifters, discus throwers;
• in case of acute injuries - gymnasts, athletes, circus artists;
• persons with burdened heredity;
• persons suffering from any chronic diseases of the joints.

Symptoms of osteoarthritis of the shoulder

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

First signs

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

If such symptoms reappear, it is better to consult a doctor immediately, as any disease is easier to treat in the early stages.

Obvious symptoms

The pain increases, after exertion it does not disappear immediately. Night pains appear, as well as pains associated with the change of time. The movements in the hand become painful, accompanied by a characteristic crunch. In the morning or when you stay in a certain position for a long time, stiffness of movement occurs, to eliminate it, you need to move. The pain syndrome can be localized not only in the shoulders, but also in the arm, neck and upper back.

Periodically the joint swells, a slight reddening of the skin appears above it, the pain intensifies, it becomes permanent. Body temperature may rise slightly. This is a sign of synovitis - aseptic (no infection) 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 lymph vessels, causing a purulent inflammatory process. In this case, fever may occur, headache, the general condition may be severely impaired.

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 a number of symptoms of osteoarthritis of the shoulder, signaling that you need to seek medical help urgently. This:

• the appearance of swelling and redness of the tissues in the joints, fever;
• painful joint pain accompanied by a change in its shape;
• joint pain radiates to the arm, neck or back;
• the previous volume of movements in the arm is impossible, even lifting it itself causes severe pain.

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

What is the risk of osteoarthritis of the shoulder

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

Degrees of osteoarthritis of the shoulder joint

There are three degrees of osteoarthritis of the shoulder joint:

• Osteoarthritis of the shoulder joint 1 degree- beginning phase. All symptoms appear mild and mostly after exercise. X-rays sometimes show a slight narrowing of the joint cavity, but more often not. At this stage, it is possible to detect small abnormalities in cartilage tissue only with the help of magnetic resonance imaging (MRI).
• Osteoarthritis of the shoulder joint 2nd degree- progressive stage. The shoulder hurts constantly, the pain is aggravated by the movements of the arm, giving down (to the elbow, forearm, arm) or to the neck, back, under the shoulder blade. There are difficulties with the functioning of the limb, signs of synovitis periodically develop. On X-ray, the joint space is significantly narrowed, bone growths (osteophytes) are visible at the edges of the joint surfaces, bone tissue is compacted (osteosclerosis).
• Osteoarthritis of the shoulder joint 3rd degree- advanced stage. The 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 pain. The joint is deformed, which sometimes leads to pinching of nerves and blood vessels. On X-ray: the joint space is almost invisible, significant bone growths with joint deformity, severe sclerosis and necrosis of bone tissue, joint mice.

Possible complications

Each location and form of osteoarthritis has serious complications, so you should not delay treatment.

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

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

What to do with exacerbations

Exacerbations of the pathological process are usually associated with 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 must adhere to the following self-help algorithm:

• call a doctor at home;
• take a tablet of one of the painkillers inside;
• apply anesthetic ointment on the skin in the area of the diseased joint;
• tie an inflamed hand with a bandage - this will reduce the load;
• take a raised position - sit with a pillow under your back - this will reduce tissue swelling.

Types of shoulder osteoarthritis

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

Due to causes of illness

According to this criterion, a distinction is made between primary and secondary osteoarthritis. Primary shoulder osteoarthritis is mainly 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 determined. In this case, they are talking 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 osteoarthritis of the shoulder joint develops after injuries and previous illnesses, but even here the burden of heredity is important: in one person even a minor injury or acute arthritis can lead to osteoarthritis, while in another more significant damage ends without consequences.

According to the peculiarities of the flow

Distribute deforming arthrosis of the shoulder, characterized by rapid progression of bone deformities. A characteristic feature of this type of disease is the change in the shape of the joint and the frequent disruption of nearby blood vessels and nerves. Compression of blood vessels leads to impaired blood circulation and rapid progression of degenerative-dystrophic disorders, and compression of nerves leads to impaired sensitivity of the limb and severe pain in 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 joint structures. Metabolic-dystrophic changes occur after intra-articular fractures, dislocations, subluxations, ruptures of ligaments, tendons and simple bruises. Injuries result from a blow to the joint or a fall from the side with a bent arm. Rupture of the joint capsule with dislocation usually occurs when falling on the abducted arm.

Often, after a minor injury, a person does not notice 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 usually begins to heal in the early stages.

Osteoarthritis of the shoulder after suffering from inflammatory diseases - the symptoms and course of such pathology depend on the underlying disease. The shoulder joint is often affected in psoriatic arthritis, while osteoarthritis develops in one joint, it develops slowly but is difficult to treat. Rheumatoid arthritis affects both shoulders, osteoarthritis 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 damage to two (left and right) shoulder-scapular joints is called oligoarthrosis.

Osteoarthritis of other joints of the shoulder complex

Acromyoclavicular arthrosis - most often of 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 joint surfaces, impingement syndrome can occur - 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 progression of osteoarthritis and the deterioration of hand function.

Diagnosis

Without a proper diagnosis, it is impossible to cure 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 specialized consultations:

• 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 in the early stages;
  3. magnetic resonance imaging (MRI) - changes in soft joint 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 osteoarthritis is prescribed. If conservative therapy is ineffective, surgical treatment is prescribed.

Conservative therapy

Includes pharmacological and non-pharmacological methods.

Medical treatment

The goals of medical treatment are to eliminate pain and suppress the progression of osteoarthritis. To alleviate the patient's condition are prescribed:

1. Drugs from the groupnon-steroidal anti-inflammatory drugs (NSAIDs). The drugs are administered intramuscularly, orally or rectally; at the same time, NSAIDs are prescribed externally in the form of ointments, gels or creams.
2. Drugs from the groupmuscle relaxants- relax the muscles around the joint; the spastic state of these muscles increases the pain;
3. Pain blockadeswith local anesthetics.The drug solution is injected into the joint cavity or periarticular tissues - a rapid analgesic effect.

The course of pathogenetic (affecting the mechanisms of the disease) therapy as part of the drug treatment of osteoarthritis includes:

1. Chondroprotectors- drugs that contain 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, as well as externally in the form of ointments and creams.
2. Angioprotectors- Agents that improve blood microcirculation. Prescribe in tablets for oral administration and solutions for intravenous drip.
3. Preparations with hyaluronic acid- are introduced into the joint cavity to improve the cushioning properties and prevent the destruction of bone tissue.

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

Non-drug treatment

The basis of non-drug methods for the treatment of 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 a toxic effect on joint tissues.

Nutrition, diet

There is no special diet for the treatment of osteoarthritis of the shoulder, but proper nutrition is very important in this disease. It is recommended to include in the daily diet: sea fish, 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 (excessive amount), spicy and spicy spices.

It is advisable to give preference to cooked, stewed and stewed dishes.

Orthopedic treatment to distribute the load on the limb

To prevent injuries to the shoulder, it is recommended to periodically wear an elastic protective retainer in the form of a short sleeve that connects to the opposite arm. The device improves blood circulation, eliminates edema. But its constant wearing is not recommended, as it leads to a rapid reduction in the range of motion in the shoulder.

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

Physiotherapy

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

Physiotherapy

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

Folk remedies

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

• Decoction of viburnum branches for oral administration.Pour a glass of crushed raw materials at bedtime with 500 ml of water, bring to a boil, keep on low heat for 5 minutes, insist overnight, then strain and drink 100 ml 3 times a day. This is an anesthetic.
• An old recipe for anesthetic ointment from the herb wild rosemary.Take Vaseline or oil and dry chopped grass. In an enameled dish, fold the fat and grass to the very top in layers, close the dish with a lid, grease the cracks with dough and place in the oven (preferably in the oven) on low heat for 2 hours, remove from oven, strain through double gauze, stored in the refrigerator and rubbed into the skin over the diseased joint 2-3 times a day.

Surgical operations

If conservative therapy for shoulder osteoarthritis is ineffective, the following surgical interventions are performed:

• Arthroscopic operationsallowing the removal of various defects in the joint cavity. They are performed mainly on young people with post-traumatic osteoarthritis. Arthroscopy allows you to tighten and attach the biceps tendon to the bone (tenodesis - this will eliminate loosening of the joint), to remove bone growths - osteophytes (debridement), to restore the joint cavity with transplantation and more.
• Endoprosthesis- replacement of a destroyed, lost function is done with an artificial one.

Approach to the treatment of the disease in clinics

Clinicians have developed their own approach to the treatment of shoulder osteoarthritis. First of all, each patient is carefully examined using state-of-the-art diagnostic equipment (including MRI). He then completely relieves the pain with the help of medicinal and non-medicinal methods. At the same time, an individual complex therapy is chosen for him, including:

• the most modern medicinal and non-medicinal methods, including plasmalifting;
• traditional oriental methods for treatment 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 relieves pain and suppresses the progression of the disease. And regular preventive courses allow patients to forget about the disease and lead a normal life. Numerous patient reviews show how effective this treatment is.

Combined 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, alternating physical activity and rest;
• eat properly regularly;
• get rid of all bad habits;
• perform therapeutic exercises regularly, avoiding sudden movements;
• sleep on your back or on your healthy side at night, placing a small pillow under your sore arm;
• give up heavy physical exertion, avoid injuries, prolonged stress and colds;
• during exacerbation (development of synovitis), avoid any thermal procedures;
• follow all the recommendations of your doctor.

Prevention

It is especially important for people with impaired heredity to follow certain rules for the prevention of shoulder osteoarthritis. They should not engage in weightlifting, tennis, traumatic sports, work as hammers, blacksmiths, miners. Anyone who wants to have healthy joints should lead an active lifestyle and eat properly regularly.

Frequently asked questions about the disease

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

   The pain is painful, intensified by movement and lifting weights.

2. Why is the disease dangerous?

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

3. Which doctor treats deforming arthrosis of the shoulder?

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

4. Is there a blockade in osteoarthritis of the shoulder?

   For severe pain, yes.

5. How effective are physiotherapy methods for this disease?

   Effective as part of a comprehensive treatment.

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

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

Osteoarthritis of the shoulder should be treated for a long time, systematically and strictly under the supervision of a physician. Attempts to deal with this disease on their 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.