The shoulder joint is one of the most vulnerable parts of the human skeleton. This is due to the rather complex structure of the articulation, weak fixation with the scapula. Shoulders experience a lot of stress every day when performing household or professional duties. If damage occurs, metabolic processes are disturbed, tissues wear out due to age - dystrophic changes of cartilage tissue begin. This pathology is called osteoarthritis of the shoulder joint.
Depending on the degree of glenohumeral joint manifestations and damage, four degrees of pathology are diagnosed. There is also a difference between acute and chronic arthrosis of the shoulder. If treatment is not carried out on time or improperly, the joint continues to deform and collapse, which ultimately leads to a significant limitation of the functions of the upper limb and loss of mobility.
Today, only degree 1 shoulder arthrosis can be completely cured. But this does not mean that you can give up and do nothing with pathology of 2 and higher degrees. Comprehensive and adequate treatment of arthrosis of the shoulder joint with drugs or surgical assistance helps to slow down the destruction of the joint, at least partially preserves the mobility of the arm and shoulder and prevents disability.
Symptoms and causes
Deformed arthrosis of the shoulder joint does not develop in one day. At first, the changes are insignificant. Cartilage gradually loses its elasticity under the influence of various factors - it can be age-related changes or disruption of metabolic processes in tissues. Microcracks appear on its surface, in which calcium salts accumulate. Then it becomes thin, fragile and begins to collapse.
Often this process is accompanied by inflammation, which also spreads to the surrounding muscle, connective and bone tissues. It manifests itself mainly in the form of pain - at first it is insignificant, it hurts. Then they become more intense and never disappear in the advanced stages, which significantly reduces a person's work capacity and quality of life.
The main reasons for the development of DOA of the shoulder joint are as follows:
- Disruption of blood circulation in shoulder cartilage tissues during 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).
- Congenital anomalies of the shoulder joint, birth injuries in newborns and other injuries that cause pathological deformation and dysfunction of the limb.
- Acquired pathologies of joint structures after an injury or accident, unsuccessful surgical intervention, including inflammation of arthritis, synovitis, osteoporosis, etc. Sh.
In addition, there are provoking factors under the influence of which the risk of developing shoulder arthrosis increases several times. They include:
- professional activity during which the shoulder joint receives a heavy load every day for many years - arthrosis of the shoulder is 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 required amount of nutrients and begin to atrophy;
- Excess weight - often combined with the previous factor; With obesity, a person cannot move actively, and the joints receive additional stress due to extra kilograms;
- hereditary predisposition;
- Old age - About 80% of people over the age of 70 have symptoms of osteoarthritis.
Most often, during the examination and interview of the patient, the doctor determines a combination of several diseases and provoking factors. A typical patient diagnosed with osteoarthritis of the shoulder joint is a man or woman over 50 years old, engaged in heavy physical work, overweight and other chronic pathologies (diabetes, arterial hypertension, varicose veins, knee arthritis, etc. ). In this case, injuries to 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, except for 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, a person attributes it to fatigue, takes painkillers, uses an ointment with a warming effect and calms down. But sooner or later there comes a time when pills and ointments no longer help you, the pain becomes constant, intense and bothers you at rest and at night. In addition to this symptom, the following signs indicate dystrophic changes in the shoulder joint:
- Swelling and deformation of the joint, visible to the naked eye;
- Redness of the skin on the joint, local increase in temperature;
- A characteristic cramp in the joint. Making sounds during sharp movements of the hand is explained by the accumulation of salts in the cracks of the cartilage and between the elements of the joint. At first, the seizure occurs only with sudden movements, it is quiet and barely audible. In advanced forms of the disease, the shoulder twitches at every movement, the sound is heard by others;
- Limitation of limb mobility. While examining the patient, the doctor asks him to comb his hair. This test is sufficient to diagnose osteoarthritis of the shoulder joint: the patient will experience 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.
DOA of the shoulder must be treated or the patient will lose full mobility and performance of the upper extremity over time. If the process of destruction of cartilage and surrounding tissues has already started, it will not stop by itself. Proper nutrition, folk remedies, healthy lifestyle and exercise are not enough here. To solve the problem and prevent disability, it will be necessary to have a complex treatment using drugs with different effects and physical procedures.
degrees
There are several stages of DOA of the shoulder joint, each of which presents differently and requires a different treatment approach.
- 1 degree.At this stage, the disease is just beginning to develop, the changes in the cartilage tissue are still insignificant. The main symptoms of DOA grade 1 are joint and limb weakness and intermittent nagging pain. The pain appears after physical exertion, during monotonous, repetitive movements of the hand for a long time. After a night's sleep or a long rest, a person feels the stiffness of the shoulder joint, but as it develops, the stiffness disappears without medication or physical procedures - a light warm-up is enough. If you take an X-ray at this stage, the image will not show significant changes in the structures of the joint, although thinning and deformation of the cartilage may be noticeable.
- 2nd degree.The pathological process is more active and manifested. A person is already used to the fact that his shoulders hurt after work, he "expects" the pain, he has painkillers and ointments for joint pain, pharmacy or homemade, ready. X-ray diagnostics shows 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. ; when moving, there is a crunch, a fight and a click.
- 3rd degree.The shoulder joint hurts and constantly convulses, to reduce the discomfort, a person tries not to touch it and not to move the limb at all. Deformation is noticeable visually, the size and shape of the damaged shoulder differs from the healthy one, it often becomes red and swollen, which is accompanied by increased pain. They cannot be removed 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 limb. In this case, it is pointless to prescribe medicines and physiotherapy, only endoprosthetics can help restore the hand's functionality at least partially. But it is not always successful.
On note:In medical practice, shoulder arthrosis of the 3rd degree is very rare. As a rule, the patient seeks medical help early and starts treatment. Severe destruction of cartilage can occur in the background of extensive trauma, if the patient could not consult a doctor for some reason, or if a 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 after examining him externally. Instrumental diagnostic methods are more needed to exclude or identify other pathologies and complications. To determine exactly how severely the joint is affected and whether inflammation occurs, the following diagnostic measures are performed:
- radiography;
- CT scan;
- magnetic resonance imaging;
- In some cases, ultrasound to get a complete picture of the state of the joint;
- Clinical urine and blood tests - the number of leukocytes and the erythrocyte sedimentation rate will be evaluated. If they are too high, an inflammatory process develops in the body.
The best way to treat the pathology is determined by the doctor individually, taking into account the patient's age, profession and general condition.
Traditional treatment includes the use of the following methods and means:
- A course of therapy with non-steroidal anti-inflammatory drugs. Medicines are prescribed in the form of tablets or powders for oral administration or for external use in the form of ointments 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 eliminate the cause of the disease and are intended only in extreme cases when the pain is unbearable.
- A course of taking chondroprotectors - drugs that help restore cartilage tissue and prevent further destruction. They also partially relieve pain and swelling and deformity of the shoulder joint. Such medicines do not work immediately, they need to be taken 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.
- A course of taking vitamin-mineral complexes and dietary supplements with collagen and hyaluronic acid.
In order to increase the effectiveness of treatment, quick recovery and prevention of new injuries, special therapeutic nutrition is also prescribed. The patient's diet includes foods 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. Gelatin diet is used because gelatin helps to restore the elasticity of cartilage tissue. The menu includes jellied meat 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 stops. Depending on the quality of the disease, its dynamics and the effectiveness of drug treatment, the doctor chooses a combination of the following physical procedures:
- cryotherapy;
- acupuncture;
- electrophoresis;
- laser therapy;
- magnetic therapy;
- mud therapy;
- different types of massage;
- Physiotherapy.
Physiotherapy procedures aim to activate metabolic processes in joint tissues, normalize blood circulation and restore 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 a teenager, the elderly or a nursing woman.
Useful tip:It is possible to treat 1-2 degrees of damage to the shoulder joint at home with the additional use of folk remedies. The main thing is that the patient does not forget to take medications on time and does not skip physical procedures - the effect will be noticeable and long-lasting only if all the doctor's prescriptions are followed regularly and conscientiously.
If conservative treatment is ineffective, the doctor is forced to offer the patient an operation. The remains of the destroyed joint will be removed and a prosthesis will be inserted in its place. Such an intervention is not rare, but requires highly qualified doctors, accuracy and attention at all stages. 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 regularly hurts, pulls, becomes numb, or you hear a creaking sound when you move, do not delay a visit to the doctor, undergo a timely examination and, if necessary, start treatment.
Osteoarthritis of the shoulder joint is a fairly common pathology of the musculoskeletal system, which mainly occurs in people over 50 years of age. The pathology develops gradually, slowly, under the influence of unfavorable factors, the joint structures begin to collapse, which is manifested by joint pain, swelling and stiffness. In the early stages, the progression of the disease can be stopped with the help of comprehensive treatment: medicines, vitamin supplements, diet therapy and physical therapy. Advanced osteoarthritis can only be treated surgically.