shoulder arthrosis

Shoulder pain may 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 thorough examination. The most common cause of such pain is osteoarthritis of the shoulder.

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

What is it?

Osteoarthritis of the shoulder is a long-lasting, constantly progressive metabolic-dystrophic disease that leads to the gradual destruction of articular cartilage, protective growth of bone tissue with joint deformity and loss of its function.

A wide range of arm movements is provided 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 sternum and clavicle.

The shoulder joint is very mobile, 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 limb, above which is the coracoid-acromial ligament. The unreliable 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 of the 10th revision (ICD-10) is M19 (other types of osteoarthritis). Shoulder osteoarthritis treatment should start as soon as possible. But even advanced stages of the disease can be successfully treated.

Causes of shoulder osteoarthritis

The main causes of osteoarthritis of the shoulder:

• consequences of acute injuries - dislocations, subluxations, intra-articular fractures, contusions;
• long-term permanent microtrauma associated with occupation or sports loads;
• transferred acute and chronic infectious and autoimmune processes in the shoulder joint - acute purulent arthritis, chronic rheumatoid arthritis, psoriatic and others;
• against the background of a chronic inflammatory process in the periarticular tissues - humeroscapular periarthritis, leading to impaired blood circulation and nutrition of cartilaginous tissue;
• 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 reasons (sometimes several at the same time), 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 cushioning properties. This leads to injury to the bone, its growth along the edges of joint surfaces, joint deformity, and decreased function. In the joint cavity there is periodically inflammation of the synovial membrane - synovitis. Because of synovitis, arthrosis is called osteoarthritis or osteoarthritis - depending on which process prevails (inflammatory or metabolic-dystrophic). As a result of the inflammation and necrosis of the bone, small pieces of tissue are separated from it - sequesters or joint mice.

At risk:

• for microtrauma - blacksmiths, miners, tennis players, weight lifters, discus throwers;
• for acute injuries - gymnasts, athletes, circus performers;
• people with burdened heredity;
• people suffering from any chronic joint disease.

Symptoms of Shoulder Osteoarthritis

The disease starts gradually, gradually. The rate 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 go unnoticed, especially if they occur against the background of some existing shoulder disease. These are minor, occurring periodically, especially after exercise, pain, discomfort during joint movement. Left joint pain can be confused with heart pain. They pass quickly, but they are worth paying attention to.

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

evident symptoms

The pain increases, after exertion does not disappear immediately. Nocturnal pains appear, as well as pains associated with a change in weather. Movements in the hand become painful, they are accompanied by a characteristic crisis. In the morning or when you stay in a certain position for a long time, stiffness of movements appears, to remove it, you need to move. Pain syndrome can be localized not only to the shoulder area, but also radiate to the arm, neck, and upper back.

Periodically, the joint swells, a slight redness of the skin appears over it, the pain intensifies, becomes permanent. Body temperature may rise slightly. This is a sign of synovitis - aseptic (non-infected) inflammation of the synovial membrane. If there are foci of infection in the body (decayed teeth, diseases of Organs ENT organs, etc. ), it can enter the joint through the blood and lymph vessels, causing a purulent inflammatory process. In this case, high fever, headache may appear, the general condition may be greatly disturbed.

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

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

dangerous symptoms

There are several symptoms of osteoarthritis of the shoulder joint, signaling that you need to urgently seek medical help. This one:

• the appearance of swelling and redness of the tissues in the joint area, fever;
• painful pain in the joint, accompanied by a change in its shape;
• joint pain radiates to the arm, neck, or back;
• the previous 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 shoulder osteoarthritis

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

Osteoarthritis of the shoulder joint

There are three grades of osteoarthritis of the shoulder joint:

• Arthrosis of the shoulder joint 1 degree- Initial state. All symptoms appear slightly and mostly after exercise. On x-rays, a slight narrowing of the joint space is sometimes visible, but most of the time it is not. It is possible to detect small violations in the cartilaginous tissue at this stage only with the help of magnetic resonance imaging (MRI).
• Arthrosis of the shoulder joint 2 degrees- progressive phase. The shoulder hurts constantly, the pains are aggravated by movements of the arm, they sag (in the elbow, forearm, hand) or in the neck, in the back, under the shoulder blade. There are difficulties with the functioning of the limb, signs of synovitis periodically develop. On radiography, the joint space is significantly reduced, bone growths (osteophytes) are visible along the edges of the joint surfaces, bone tissue is compacted (osteosclerosis).
• Osteoarthritis of the shoulder joint 3 degrees- Advanced state. The pain in the joint is strong, constant, with a pronounced crisis when moving the arm. Range of motion is limited, sometimes the arm is completely immobile due to pain. The joint is deformed, which sometimes leads to compression of nerves and blood vessels. On x-ray: joint space is almost invisible, significant bone growths with joint deformity, severe sclerosis and bone tissue necrosis, joint mice.

Possible complications

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

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

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

What to do with an exacerbation

Exacerbations of the pathological process are often 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 a pill of one of the pain relievers inside;
• apply an anesthetic ointment to the skin in the area of the diseased joint;
• tie a sore arm with a bandage scarf - this will reduce the burden;
• take an elevated position - sit with a pillow under your back - this will reduce tissue swelling.

Types of osteoarthritis of the shoulder

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

for reasons of illness

According to this criterion, primary and secondary osteoarthritis are distinguished. Primary osteoarthritis of the shoulder is primarily the result of age-related changes and develops after age 50. But sometimes the disease starts at a young age, but the cause of its onset cannot be established. In this case, they speak of 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 previous injuries and illnesses, but burdened heredity matters here too: in one person, even a minor injury or acute arthritis can lead to the development of osteoarthritis, while in another, more significant damage ends without consequences.

According to the flow characteristics

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 joint and frequent violation 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 limb sensitivity and severe pain along peripheral nerves.

Origin

Post-traumatic osteoarthritis of the shoulder - the symptoms and treatment of this disease have their own characteristics associated with a traumatic injury to certain joint structures. Troca-dystrophic changes occur after intra-articular fractures, dislocations, subluxations, ruptures of ligaments, tendons and simply bruises. Injuries occur from a blow to the joint or a fall to the side with an adducted 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 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 osteoarthritis, as a rule, begins to be treated in the early stages.

Shoulder arthrosis after suffering from inflammatory diseases - the symptoms and course of such a pathology depend on the underlying disease. The shoulder joint is often affected in psoriatic arthritis, while osteoarthritis develops in a 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 so they talk about monoarthrosis. Simultaneous defeat of two shoulder-scapular joints (left and right) is called oligoarthrosis.

Arthrosis of other joints of the shoulder complex

Acromioclavicular osteoarthritis - most often has a post-traumatic origin. It develops in the context of lifting weights with hands above the horizontal. Accompanied by pain when lifting the arm. With the growth of osteophytes on the joint surfaces, impingement syndrome may appear - 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 decline in hand function.

Diagnosis

Without a correct diagnosis, it is impossible to treat this disease. A complete examination is only possible 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, joint fluid - inflammatory, autoimmune and degenerative dystrophic processes are detected.
• Instrumental:
  1. radiography of the shoulder joint - changes in bone tissues are detected;
  2. computed tomography (CT) - changes in cartilage and bone tissues in the early stages;
  3. magnetic resonance imaging (MRI) - changes in joint and periarticular soft 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 goals of drug treatment are to eliminate pain and suppress the progression of osteoarthritis. To alleviate the patient's condition, name:

1. group drugsnon-steroidal anti-inflammatory drugs (NSAIDs). The 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. group drugsmuscle relaxants- relax the muscles surrounding the joint; the spastic state of these muscles increases the pain;
3. pain blockswith local anesthetics.The drug solution is injected into the joint cavity or periarticular tissues - a rapid analgesic effect.

The course of pathogenic therapy (influencing disease mechanisms) as part of the medical treatment of osteoarthritis of the shoulder includes:

1. chondroprotectors- medicines 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 also externally in the form of ointments and creams.
2. Angioprotective- Means that improve blood microcirculation. Assign tablets for oral administration and solutions for intravenous drip.
3. Hyaluronic acid preparations- are introduced into the joint cavity to improve the depreciation 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 of treating osteoarthritis of the shoulder is an active, healthy 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 treating osteoarthritis of the shoulder, but proper nutrition is very important in this disease. It is recommended to include in the daily diet: fish from the sea, seafood, lean poultry meat, dairy products, cottage cheese, cheese, cereals (oatmeal, buckwheat), vegetables, fruits.

Excluded from the diet: easily digestible carbohydrates (sweets, muffins, sweet sodas), fatty red meats, foods that irritate the tissues that cause swelling - salt (excessive amount), spicy and spicy seasonings.

It is recommended to give preference to boiled, boiled 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 retainer in the form of a short sleeve that connects to the opposite arm. The device improves blood circulation, eliminates swelling. But using it constantly is not recommended as this leads to a rapid decrease in range of motion in the shoulder.

Many specialists include the bandage in the complex treatment of osteoarthritis of the shoulder - fixing tissues with adhesive elastic tapes. This gives the elimination of pain, improves blood circulation and joint function.

Physiotherapy

Exercise therapy - performing a daily set of exercises - with shoulder osteoarthritis is the main method of rehabilitation. Gym complexes are prescribed by a doctor, mastered under the supervision of an exercise therapy instructor. Once the patient starts performing 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 analgesics, laser and magnetotherapy - stimulation of regenerative processes in joint tissues, courses of shock wave therapy (SWT) - exposure to sound, which has a pronounced chondroprotective effect.

Folk remedies

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

• Decoction of viburnum branches for oral administration.Pour a glass of crushed raw materials before going to bed 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. It's an anesthetic.
• An ancient recipe for an anesthetic ointment from the wild rosemary herb.Take Vaseline or butter and dry the chopped grass. In an enameled dish, alternately fold the fat base and the grass to the top in layers, close the dish with a lid, cover the cracks with dough and bake (preferably in the oven) on low heat for 2 hours, remove from the oven, strain with double gauze, store in the refrigerator and rub 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 operationsallowing to eliminate various defects in the joint cavity. They are performed mainly in young people with post-traumatic osteoarthritis. Arthroscopy allows you to tighten and secure the biceps tendon to the bone (tenodesis - this will eliminate joint laxity), remove bone growths - osteophytes (debridement), restore the joint cavity with a transplant, etc.
• endoprostheses- replacement of a destroyed joint, lost its function by an artificial one.

Approach to the treatment of the disease in clinics

Clinical experts have developed their own approach to treating osteoarthritis of the shoulder. First, each patient is carefully examined with the latest diagnostic equipment (including MRI). Then he is completely relieved of pain using both medicated and non-medicated methods. At the same time, an individual complex therapy is selected for him, including:

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

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

It combines proven techniques from the East and innovative methods from Western medicine.

general clinical guidelines

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

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

Prevention

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

Frequently asked questions about the disease

1. What is shoulder osteoarthritis pain?

   The pains are painful, aggravated by movement and lifting weights.

2. Why is the disease dangerous?

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

3. Which doctor treats deforming osteoarthritis of the shoulder?

   Post-traumatic - an orthopedist-traumatologist, in the context of inflammatory diseases - a rheumatologist.

4. Is a block done for osteoarthritis of the shoulder?

   For severe pain, yes.

5. How effective are physical therapy methods for this disease?

   Effective as part of complex treatment.

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

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

Shoulder arthrosis must be treated for a long time, systematically and strictly under the supervision of a doctor. Attempts to deal 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.