Osteoarthritis of the shoulders

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

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

What is it?

Osteoarthritis of the shoulder is a long-term, continuously progressive metabolic-dystrophic disease, leading to the gradual destruction of articular cartilage, the protective growth of bone tissue with deformity of the joints, and the 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 clavicle and the acromial process of the scapula;
• sternoclavicular - between the sternum and clavicle.

The shoulder joint is highly mobile, which is provided by the convex head of the humerus and the relatively flat articular fossa of the scapula. The ligament 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 osteoarthritis according to the International Classification of Diseases of the 10th revision (ICD-10) is M19 (other types of osteoarthritis). Treatment of shoulder osteoarthritis should begin as soon as possible. But even the 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 - dislocations, subluxations, intra-articular fractures, bruising;
• permanent long-term microtrauma related to occupation or sports loads;
• acute and chronic infectious-inflammatory and autoimmune processes transferred to 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, which leads to impaired blood circulation and nutrition of cartilage 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 nourishes the cartilage tissue of the joint is disturbed. Cartilage gradually decreases in volume, cracks, loses its protective properties. This leads to bone damage, its growth along the edges of articular surfaces, deformity of the joints and decreased function. In the joint cavity, inflammation of the synovial membrane occurs periodically - synovitis. Due to synovitis, osteoarthritis is called osteoarthritis or osteoarthritis - depending on the process that prevails (inflammatory or metabolic-dystrophic). As a result of inflammation and necrosis of bone, small pieces of tissue separate from it - sequestering or articular mice.

In danger:

• for microtraumas - blacksmiths, miners, tennis players, weightlifters, discus throwers;
• for acute injuries - gymnasts, athletes, circus performers;
• persons with aggravated inheritance;
• persons suffering from any chronic joint disease.

Symptoms of osteoarthritis of the shoulders

The disease begins gradually, gradually. The degree 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 noticed, especially if they occur against the background of some existing shoulder diseases. These are small, occurring periodically, mainly after exercise, pain, discomfort during joint movement. Pain in the left joint can be confused with heart pain. They pass quickly, but it's 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.

Visible symptoms

The pain increases, after exercise it does not go away immediately. Night pains appear, as well as pains associated with changing weather. Hand movements become painful, accompanied by a characteristic crack. In the morning or when you stay in a certain position for a long time, stiffness of movements appears, to remove it you have to move. The pain syndrome can be localized not only in the shoulder area, but also radiate to the arm, neck and upper back.

Periodically, the joint swells, 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 (no infection) inflammation of the synovial membrane. If there are foci of infection in the body (caries teeth, diseases of the ENT organs, 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 occur, the general condition may be significantly disturbed.

The combination of degenerative-dystrophic and inflammatory processes in the joints gradually leads to a permanent loss of limb function and persistent 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 joint, which signal that you need to seek medical help urgently. This:

• the appearance of edema and redness of tissues in the joint area, fever;
• painful pain in the joints, accompanied by a change in its shape;
• joint pain radiating to arm, neck or spine;
• the previous volume of arm movements is impossible, even just raising it 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 arthrosis is dangerous with sustained progression with the development of a permanent pain syndrome, decreased 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- initial phase. All symptoms appear slightly and mainly after exercise. On X-rays, a slight narrowing of the joint space is sometimes noticeable, but more often it is not. It is possible to detect small abnormalities in cartilage tissue at this stage only with the help of magnetic resonance imaging (MRI).
• Osteoarthritis of the shoulder joint 2 degrees- progressive phase. The shoulder hurts constantly, the pain is aggravated by the movements of the arm, they go down (in the elbow, forearm, hand) or in the neck, back, under the shoulder blade. There are difficulties in the functioning of the limbs, the signs of synovitis develop periodically. On X-ray, the joint space narrows significantly, bone growths (osteophytes) are visible along the edges of the articular surfaces, the bone tissue is compressed (osteosclerosis).
• Osteoarthritis of the shoulder joint 3 degrees- advanced phase. The pain in the wrist is strong, constant, with a pronounced crackling during arm movement. The range of motion is limited, sometimes the arm is completely immobile due to pain. This joint is deformed, which sometimes leads to constriction of nerves and blood vessels. On x-ray: joint space is almost invisible, significant bone growth with joint deformity, severe sclerosis and necrosis of bone tissue, articular mice.

Possible complications

Every localization 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 restriction of joint mobility;
• dislocations, subluxations, and intra-articular fractures with minor injuries or sudden movements;
• rupture of tendons surrounding the joint of muscles and ligaments - they atrophy and tear easily;
• aseptic necrosis of the head of the humerus 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 a deterioration

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

• call a doctor at home;
• take one tablet of one of the sedatives inside;
• apply an anesthetic ointment to the skin in the diseased wrist area;
• tie an injured arm with a bandage 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 osteoarthritis

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

Due to illness

According to this criterion, primary and secondary osteoarthritis are distinguished. 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 occurrence can not be determined. In this case, they are talking about idiopathic primary 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 arthrosis of the shoulder joint develops after previous injuries and diseases, but even here the severe inheritance is important: in one person, even a minor injury or acute arthritis can lead to the development of osteoarthritis, while in another more serious injurysignificant ends without consequences.

According to flow characteristics

Allocate deforming osteoarthritis of the shoulder, characterized by the rapid progression of bone deformities. A feature of this type of disease is the change in the shape of the joint and the frequent damage to nearby blood vessels and nerves. Compression of blood vessels leads to impaired blood circulation and rapid progression of degenerative-dystrophic disorders, and nerve compression 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 lesion of certain articular structures. Exchange-dystrophic changes occur after intra-articular fractures, dislocations, subluxations, ligament ruptures, tendons, and simply bruising. Injuries occur from a blow to the wrist or from a fall to the side with an adequate arm. Dislocation of the dislocated ankle capsule usually occurs during a fall in 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 rehabilitative treatment, and osteoarthritis, as a rule, begins to be treated already in the early stages.

Osteoarthritis of the shoulders 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 it is difficult to treat. With rheumatoid arthritis, both shoulders are affected, arthrosis develops in waves with frequent alternation of metabolic-dystrophic and inflammatory processes.

distributed

Only one left or right joint can be affected and then talk about monoarthritis. Simultaneous loss of two shoulder-scapular joints (left and right) is called oligoarthrosis.

Osteoarthritis of other joints of the shoulder complex

Acromioclavicular arthrosis - most often has a post-traumatic origin. It takes place against the background of lifting weights with the hands above the horizontal. Accompanied by pain when raising the arm. As osteophytes grow on the articular surfaces, shock syndrome - damage to the tendons and muscles of the shoulder between the humerus head and the scapular acromion during rotation and abduction of the shoulder - can occur. This accelerates the progression of osteoarthritis and decreased hand function.

Diagnosing

Without an accurate diagnosis, it is impossible to treat this disease. A full examination is only possible in the clinic. At the initial consultation, the doctor asks the patient, examines him, describes additional research methods and specialist consultations:

• Laboratory tests of blood, joint fluids - 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 articular and periarticular soft tissues;
  4. diagnostic arthroscopy - is performed if necessary to clarify the nature of the pathological process.

Treatment of osteoarthritis of the shoulder joints

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

It includes pharmacological and non-pharmacological methods.

Medical treatment

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

1. Medicines from the groupNon-steroidal anti-inflammatory drugs (NSAIDs). Medications are administered intramuscularly, orally or rectally; at the same time, NSAID group drugs are prescribed externally in the form of ointments, gels or creams.
2. Medicines from the groupmuscle relaxants- relax the muscles surrounding the wrist; spastic condition of these muscles increases pain;
3. Blockade of painwith local anesthesia. The drug solution is injected into the joint cavity or periarticular tissue - a rapid analgesic effect.

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

1. Chondroprotectors- drugs that contain 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, as well as externally in the form of ointments and creams.
2. Angioprotectors- Tools that improve blood microcirculation. Prescribe tablets for oral administration and solutions for intravenous drip.
3. Hyaluronic acid preparations- inserted into the articular cavity to improve the cushioning properties and 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-medicated methods of treating osteoarthritis of the shoulder is a healthy active lifestyle and proper nutrition. It is very important to get rid of bad habits like 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 treating osteoarthritis of the shoulders, but proper nutrition is very important in this disease. It is recommended to include in the daily diet: seafood, 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 (excess), spicy and spicy spices.

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

Orthopedic treatment for the distribution of load on the limbs

To prevent shoulder injuries, it is recommended that you periodically wear a protective elastic brace in the form of a short sleeve that connects to the opposite arm. The device improves blood circulation, eliminates swelling. But holding it constantly is not recommended, as this leads to a rapid decrease in range of motion in the shoulder.

Many specialists include tape in the complex treatment of shoulder osteoarthritis - fixing tissue with adhesive elastic bands. This provides elimination of pain, improved blood circulation and joint function.

Physiotherapy

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

Physiotherapy

Physiotherapy is involved in complex therapy at every stage of the disease. These are electro- and phonophoresis with the use of sedatives, laser and magnetotherapy - stimulation of regenerative processes in joint tissues, and shock wave therapy (SWT) - exposure to sound, which has a pronounced chondroprotective effect.

Folk remedies

Folk remedies will have 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 material before bed with 500 ml of water, let it simmer, keep on low heat for 5 minutes, insist overnight, then drain and drink 100 ml 3 times a day. It is an anesthetic.
• An old recipe for an anesthetic ointment from the wild rosemary plant.Take Vaseline or butter and dry the chopped grass. In an enameled container, alternately fold the fat base and grass to the top in layers, close the container with a lid, grease the cracks with dough and place in the oven (preferably in the oven) on a low heat for 2 hours. remove from the oven, drain with double gauze, store in the refrigerator and rub into the skin over the diseased wrist 2-3 times a day.

Surgical operations

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

• Arthroscopic surgeryallowing the elimination of various defects in the articular cavity. They are performed mainly in young people with post-traumatic osteoarthritis. Arthroscopy allows you to tighten and connect the biceps tendon to the bone (tenodesis - this will eliminate the looseness of the joint), remove bone growths - osteophytes (debridement), restore the joint cavity with a transplant, etc.
• Endoprosthetics- replacement of a destroyed, lost functional joint with an artificial one.

Disease treatment approach in clinics

Clinical specialists have developed their own approach to treating shoulder osteoarthritis. First of all, every patient is carefully examined using the most modern diagnostic equipment (including MRI). He is then completely relieved of the pain using medicated and non-drug methods. At the same time, to choose a complex individual therapy, including:

• most modern drugs 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, moxibustion, auriculotherapy, taping, etc.

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

Combining proven Eastern techniques 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 regularly properly;
• give up all bad habits;
• perform therapeutic exercises regularly, avoiding sudden movements;
• sleep on your back or on the healthy side at night, placing a small pillow under your injured arm;
• give up strenuous physical exertion, avoid injuries, prolonged stress, and colds;
• during irritation (development of synovitis), avoid any thermal procedures;
• follow all recommendations of the attending physician.

prevention

It is especially important that people with severe heredity follow some rules to prevent shoulder osteoarthritis. They do not have to deal with weightlifting, tennis, traumatic sports, work as a hammer, blacksmith, miners. All those who want to have healthy joints should lead an active lifestyle and eat regularly properly.

Frequently asked questions about the disease

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

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

2. Why is the disease dangerous?

   Formation of a permanent pain syndrome and loss of limb function.

3. Which doctor treats deforming osteoarthritis of the shoulder?

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

4. Is there a blockage for shoulder osteoarthritis?

   For severe pain, yes.

5. How effective are physiotherapy methods for this disease?

   Effective as part of complex treatment.

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

   No, but the doctor can suppress his progress 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 doctor. Attempts to cope 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.