Shoulder arthrosis

Pain in the shoulder can appear gradually and significantly reduce the quality of life of the patient. To find out why the shoulder hurts, you need to see a doctor and undergo a complete examination. The most common cause of such pain is osteoarthritis of the shoulder.

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

What it is?

Shoulder arthrosis is a long-term, constantly progressive metabolic-dystrophic disease, leading 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 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 limb, above it is the coracoid-acromial ligament. Not too 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 shoulder arthrosis 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 arthrosis:

• consequences of acute injuries - dislocations, subluxations, intra-articular fractures, bruises;
• permanent long-term microtrauma associated with the profession or sports loads;
• 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 (exchange) articular disorders - gouty arthritis;
• hormonal disorders;
• congenital malformations (dysplasia) - for example, the articular surfaces of the joints of the shoulder.

Under the influence of any of these reasons (sometimes several at once), the composition and volume of the joint fluid that feeds the cartilaginous tissue of the joint is disturbed. The cartilage gradually decreases in volume, cracks, loses its depreciation 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 periodically occurs - synovitis. Because of synovitis, arthrosis is called osteoarthritis or osteoarthritis - depending on which process prevails (inflammatory or metabolic-dystrophic). 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 artists;
• persons with burdened heredity;
• persons suffering from any chronic diseases of the joints.

Shoulder osteoarthritis symptoms

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

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

Overt symptoms

Pain increases, after exertion does not go away immediately. Night pains appear, as well as pains associated with a change in the weather. Movements in the hand become painful, they are accompanied by a characteristic crunch. In the morning or with a long stay in a certain position, stiffness of movements appears, in order to remove it, it is necessary 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, there is a slight reddening of the skin over it, pain intensifies, it 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, 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, high fever, headache may appear, the general condition may be sharply 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 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, signaling that you need to urgently seek medical help. This:

• the appearance of edema and redness of tissues in the joint area, fever;
• aching pain in the joint, accompanied by a change in its shape;
• joint pains radiate to the arm, neck or back;
• the former volume of movements in the arm 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 danger of osteoarthritis of the shoulder

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

Degrees of arthrosis of the shoulder joint

There are three degrees of arthrosis of the shoulder joint:

• Arthrosis of the shoulder joint 1 degree- initial stage. All symptoms appear slightly and mostly after exercise. On x-rays, a slight narrowing of the joint space is sometimes visible, but more often it is not. It is possible to detect small violations in 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 pains intensify with the movements of the arm, they give down (to the elbow, forearm, hand) 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 along the edges of the articular surfaces, the bone tissue is compacted (osteosclerosis).
• Arthrosis of the shoulder joint 3 degrees- advanced stage. 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 the 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, 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 limitation of articular mobility;
• dislocations, subluxations and intra-articular fractures with minor injuries or sudden movements;
• ruptures of the tendons surrounding the joint 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 an exacerbation

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

• call a doctor at home;
• take a tablet of one of the painkillers inside;
• apply an anesthetic ointment to the skin in the area of \u200b\u200bthe diseased joint;
• tie a sore arm with a bandage-kerchief - this will reduce the load;
• take an elevated position - sit down with a pillow under your back - this will reduce tissue swelling.

Types of shoulder arthrosis

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

For reasons of disease

In accordance with this criterion, primary and secondary osteoarthritis are distinguished. Primary shoulder arthrosis 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 cannot be established. In this case, they speak of primary idiopathic arthrosis 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 injuries and previous diseases, but burdened heredity matters here too: 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 the features of the flow

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 infringement 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 along the peripheral nerves.

Origin

Post-traumatic arthrosis 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, ruptures of ligaments, tendons, and simply bruises. Injuries occur from a blow to the joint or from a fall on 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 arthrosis for a long time and seeks medical help already at the second stage of the disease. Significant injuries require long-term rehabilitation treatment, and arthrosis, as a rule, begins to be treated already in the early stages.

Shoulder arthrosis after suffering 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 arthrosis develops in one 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 then they talk about monoarthrosis. The 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 lifting weights with hands above the horizontal. Accompanied by pain when raising the arm. With the growth of osteophytes on the articular surfaces, impingement syndrome may appear - infringement 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 arthrosis and the decline in hand function.

Diagnostics

Without a correct diagnosis, it is impossible to treat 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 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 the soft articular and periarticular 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 objectives of drug treatment are to eliminate pain and suppress the progression of osteoarthritis. To alleviate the patient's condition, appoint:

1. Medicines from the groupnon-steroidal anti-inflammatory drugs (NSAIDs). Drugs are administered intramuscularly, orally or rectally; at the same time, drugs of the NSAID group are prescribed externally in the form of ointments, gels or creams.
2. Medicines from the groupmuscle relaxants- relax the muscles surrounding 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 into the periarticular tissues - a quick analgesic effect.

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

1. Chondroprotectors- drugs 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 intraarticular injections, and also externally in the form of ointments and creams.
2. Angioprotectors- Means that improve blood microcirculation. Assign in tablets for oral administration and solutions for intravenous drip.
3. Hyaluronic acid preparations- are introduced into the articular cavity to improve depreciation 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-drug methods of treatment of shoulder arthrosis 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 shoulder arthrosis, but proper nutrition is very important in this disease. It is recommended to include in the daily diet: sea fish, seafood, lean poultry meat, 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 tissues that cause swelling - salt (excessive amount), spicy and spicy seasonings.

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

Many specialists include taping in the complex treatment of shoulder arthrosis - fixing tissues with sticky elastic tapes. This gives the elimination of pain, improvement of blood circulation and joint function.

Physiotherapy

Exercise therapy - daily performance of a set of exercises - with shoulder arthrosis is the main method of rehabilitation. Gymnastics complexes are 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 the complex therapy at any stage of the disease. These are electro- and phonophoresis with the use of painkillers, laser and magnetotherapy - stimulation of regenerative processes in articular 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 before going to bed with 500 ml of water, bring to a boil, keep on low heat for 5 minutes, insist all night, then strain and drink 100 ml 3 times a day. It is an anesthetic.
• 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 fat base and grass to the very top in layers, close the dish with a lid, coat the cracks with dough and put in the oven (preferably in the oven) on a small fire for 2 hours, remove from the oven, strain through double gauze, store in the refrigerator andrub 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 articular cavity. They are carried out mainly to young people with post-traumatic arthrosis. Arthroscopy allows you to tighten and attach the biceps tendon to the bone (tenodesis - this will eliminate the looseness of the joint), remove bone growths - osteophytes (debridement), restore the articular cavity with a transplant, etc.
• Endoprosthetics- replacement of a destroyed, lost its function joint with an artificial one.

Approach to the treatment of the disease in clinics

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 is completely relieved of pain using drug and non-drug methods. At the same time, an individual complex therapy is selected for him, including:

• the most modern drugs and non-drug methods, including plasmolifting;
• traditional oriental methods of 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 a person of 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 speak of 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 right regularly;
• get rid of all bad habits;
• regularly perform therapeutic exercises, avoiding sudden movements;
• sleep on your back or on the 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 the attending physician.

Prevention

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

Frequently asked questions about the disease

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

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

2. Why is the disease dangerous?

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

3. Which doctor treats deforming arthrosis of the shoulder?

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

4. Is a blockade done for arthrosis of the shoulder?

   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 its progression 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 cope with this disease on their own 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 quality of life.