The shoulder joint is one of the most vulnerable in the human skeleton. This is due to a rather complex articulation structure with a weak fixation with the scapula. The shoulder is exposed to great stress every day when performing household or professional duties. If an injury occurs, metabolic processes are disturbed, tissues wear out due to age - dystrophic changes in the cartilage tissue begin. This pathology is called osteoarthritis of the shoulder joint.
Depending on the manifestations and degree of damage to the glenohumeral joint, four degrees of pathology are diagnosed. There is also a difference between acute and chronic arthrosis of the shoulder. If the treatment is not carried out on time or in an insufficiently deliberate manner, the joint continues to deform and collapse, which ultimately results in a significant limitation of the functions of the upper limb and loss of mobility.
Today, only shoulder arthrosis of the first degree can be completely cured. But this does not mean that you can give up and do nothing with pathology of the 2nd and higher degrees. Comprehensive and adequate treatment of arthrosis of the shoulder joint with the help of drugs or surgery helps to slow down the destruction of the joint, at least partially preserve the mobility of the arm and shoulder, and prevent disability.
Symptoms and causes
Deforming arthrosis of the shoulder joint does not develop in one day. At first, the changes are small. Cartilage gradually loses its elasticity under the influence of various factors - these can be age-related changes or disruption of metabolic processes in the tissues. Microcracks appear on its surface where calcium salts accumulate. Then it becomes thin, brittle and begins to collapse.
Often this process is accompanied by inflammation, which spreads to the surrounding muscle, connective and bone tissue. It manifests primarily as pain - at first minor, painful. Then they become more intense and in an advanced stage they never disappear, which significantly reduces a person's performance and quality of life.
The main reasons for developing DOA of the shoulder joint are as follows:
- Disturbance of blood circulation in the cartilage tissue of the shoulder in atherosclerosis and other chronic diseases related to blood vessels.
- Chronic pathologies of an autoimmune nature, for example, rheumatoid arthritis, systemic lupus erythematosus.
- Dysfunction of the endocrine system (diabetes mellitus).
- Congenital abnormalities of the shoulder joint, birth injuries in infants and other injuries that lead to pathological deformation and dysfunction of the extremities.
- Acquired pathologies of joint structures after injury or accident, unsuccessful operations, including inflammation caused by arthritis, synovitis, osteoporosis, etc.
In addition, there are provoking factors, under the influence of which the risk of developing shoulder arthrosis increases several times. This includes:
- professional activity in which the shoulder joint receives heavy loads day after day for many years - arthrosis of the shoulder is quite rightly called the disease of plasterers, painters and loaders;
- sedentary lifestyle, lack of physical activity - with insufficient exercise, blood circulation slows down, joint tissues do not receive the necessary amount of nutrients and begin to atrophy;
- overweight - often in combination with the previous factor; with obesity, a person is not able to move actively, while the joints receive additional stress due to extra weight;
- hereditary predisposition;
- age - about 80% of people over the age of 70 show symptoms of osteoarthritis.
Most often, during the examination and interview of the patient, the doctor identifies a combination of several diseases and provoking factors. A typical patient with a diagnosis of osteoarthritis of the shoulder joint is a man or woman over 50 years of age, engaged in heavy physical work, overweight and other chronic pathologies (diabetes mellitus, arterial hypertension, varicose veins, knee arthritis, etc. ). In this case, lesions of the right shoulder are more common than the left. This is due to the fact that most people actively use their right hand at work and at home, with the exception of natural left-handers.
How to recognize the disease
Symptoms of arthrosis of the shoulder joint may not appear for a long time. If the shoulder starts to hurt from time to time, the person attributes it to fatigue, takes painkillers, uses ointment with a warming effect and calms down. But sooner or later there comes a time when tablets and ointments no longer help, the pain becomes constant, intense and bothersome at rest and at night. In addition to this symptom, the following signs will indicate dystrophic changes in the shoulder joint:
- swelling and deformation of the joint, visible to the naked eye;
- redness of the skin over the joint, local increase in temperature;
- characteristic creaking in the wrist. Creaking sounds when the hand moves suddenly are explained by the accumulation of salt in the cracks of the cartilage and between the joint elements. At first, the creaking occurs only with sudden movements, it is quiet and barely audible. In advanced forms of the disease, the shoulder creaks with every movement, the sound is heard by others;
- limitation of limb mobility. When examining the patient, the doctor will ask him to comb his hair. This test is enough to diagnose osteoarthritis of the shoulder joint: the patient will feel a sharp pain, make a rotational movement with the shoulder, it will be difficult to move the shoulder back, the doctor will hear a crack and a click in the joint.
Shoulder DOA must be treated, otherwise over time the patient will lose full upper extremity mobility and performance. If the process of destruction of cartilage and surrounding tissues has already started, it will not stop by itself. Proper nutrition, folk remedies, a healthy lifestyle and exercise are not enough here. Solving the problem and preventing disability will require complex treatment with drugs of different effects and physical procedures.
Degrees
There are several stages of DOA of the shoulder joint, each of them manifests itself differently and requires a different approach to treatment.
- 1st degree.At this stage, the disease is just beginning to develop, the changes in cartilage tissue are still small. The main symptoms of DOA grade 1 are joint and limb weakness and periodic pain. Pain occurs after physical exertion, with monotonous, repeated movements of the hand for a long time. After a night's sleep or a long rest, a person feels stiffness in the shoulder joint, but as it develops, the stiffness still passes without medication and physical interventions - a gentle warm-up is enough. If you take an X-ray at this stage, the image will not show significant changes in the joint structures, although thinning and deformation of the cartilage can be observed.
- 2nd degree.The pathological process continues and manifests itself more actively. A person already gets used to the fact that his shoulder will hurt after work, he "waits" for the pain, he has ready analgesics and ointments for joint pain, pharmaceutical or homemade. X-ray diagnostics will show noticeable changes in the joint: thinning and deformation of the cartilage, inflammation of the joint membrane. From time to time, the joint becomes red and swollen, there is a creaking, creaking and clicking sound when moving.
- 3rd degree.The shoulder joint constantly hurts and creaks, in order to reduce the discomfort, the person tries not to touch it and does not move the limb at all. The deformity is visible visually, the affected shoulder differs in size and shape from the healthy one, it often turns red and swells, which is accompanied by increased pain. It is not possible to remove them with painkillers.
If nothing is done in the third stage of the disease, the fourth stage will occur - complete immobility of the shoulder joint and extremities. In this case, it is already meaningless to prescribe drugs and physiotherapy, only endoprosthetic surgery will help to at least partially restore the functionality of the hand. But even this is not always successful.
note:In medical practice, it is extremely rare to encounter shoulder arthrosis of the 3rd degree. Usually, the patient seeks medical help earlier and begins treatment. Severe destruction of cartilage can occur against the background of extensive trauma, if the patient could not see a doctor for some reason, or if the person lives in unfavorable social conditions where qualified doctors are not available.
How is arthrosis diagnosed and treated?
A good doctor will be able to make a preliminary diagnosis after talking with the patient and his external examination. Instrumental diagnostic methods are more necessary to exclude other pathologies and complications or to identify them. In order to accurately determine how badly the joint is affected and whether inflammation occurs, the following diagnostic measures are performed:
- radiography;
- CT scanner;
- M. R. I;
- in some cases, ultrasound to obtain a complete picture of the state of the joint;
- clinical tests of urine and blood - the number of leukocytes and the sedimentation rate of erythrocytes will be assessed. If they are too high, an inflammatory process develops in the body.
The best way to treat the pathology is determined by the doctor on an individual basis, taking into account the patient's age, occupation and general condition.
Traditional treatment includes the use of the following methods and means:
- Course of therapy with non-steroidal anti-inflammatory drugs. Medicines are prescribed in the form of tablets or powder for oral administration or in the form of ointment for external use to eliminate the main symptoms of inflammation - pain, swelling, redness, increased body temperature.
- Anesthetics for severe pain in the form of tablets or injections. These drugs cannot be taken continuously, they do not remove the cause of the disease and are intended only in extreme cases when the pain is unbearable.
- The course of taking chondroprotectors - drugs that stimulate the renewal of cartilage tissue and prevent further destruction. They partially alleviate pain and swelling, as well as deformations of the shoulder joint. Such drugs do not work immediately, it is necessary to take them for at least 3-4 months.
- A course of muscle relaxants - tablets or injections that relax muscle spasms. These are optional drugs in the complex treatment of osteoarthritis, they are not always prescribed.
- Course of taking vitamin-mineral complexes and dietary supplements with collagen and hyaluronic acid.
A special therapeutic diet is also prescribed to increase the effectiveness of treatment, quick recovery and prevention of new lesions. The patients' diet includes food rich in vitamins B, A, C, E - fresh fruits and vegetables, cabbage of any variety, cereals, legumes. Polyunsaturated fatty acids can be obtained from marine fish and seafood. A gelatin diet is practiced, because gelatin helps to restore the elasticity of the cartilage tissue. The menu includes jelly made from beef hooves and tails, aspic and various jellies. It is useful to take gelatin in its pure form, previously soaked in warm water.
Physiotherapy is the next important point in the complex treatment of shoulder osteoarthritis. They start only when the inflammatory process is stopped. Depending on the degree of the disease, its dynamics and the effectiveness of drug therapy, the doctor chooses a combination of the following physical procedures:
- cryotherapy;
- acupuncture;
- electrophoresis;
- laser therapy;
- magnetic therapy;
- mud therapy;
- various types of massage;
- physiotherapy.
Physiotherapy procedures are aimed at activating metabolic processes in joint tissues, normalizing blood circulation and restoring limb mobility. With their help, it is possible to reduce the number of medications taken and their dosage, which is especially valuable if the pathology is observed in teenagers, the elderly or nursing mothers.
Helpful Hint:It is possible to treat lesions of the shoulder joint 1-2 degrees at home, with the additional use of folk remedies. The main thing is that the patient does not forget to take medication on time and does not skip physical procedures - the effect will be noticeable and lasting only if they regularly and conscientiously follow all the doctor's prescriptions.
If conservative treatment is ineffective, the doctor is forced to offer the patient surgery. The remains of the destroyed joint will be removed, and a prosthesis will be installed in its place. This type of intervention is not uncommon, but it requires highly qualified doctors, precision and attention at every stage. In addition, prostheses do not always take root well, and the recovery period after surgery lasts at least six months. Therefore, if you notice that your shoulder starts to hurt regularly, pulls, goes numb or you hear a creaking sound when you move, do not delay the visit to the doctor, get yourself examined in time and, if necessary, start treatment.
Osteoarthritis of the shoulder joint is a fairly common pathology of the musculoskeletal system, which occurs mainly in people over 50 years old. The pathology develops gradually, little by little, under the influence of unfavorable factors, joint structures begin to collapse, which is manifested by pain, swelling and stiffness of the joint. In the early stages, the progression of the disease can be stopped with the help of comprehensive treatment: drugs, vitamin supplements, diet and physical therapy. Advanced osteoarthritis can only be treated surgically.