Shoulder osteoarthritis

Shoulder pain can appear gradually and significantly reduce the patient's quality of life. To find out why the shoulder hurts, you need to consult a doctor and undergo a comprehensive examination. The most common cause of this pain is osteoarthritis of the shoulder.

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

Things?

Osteoarthritis of the shoulder is a long-term and constantly progressive metabolic-dystrophic disease, which leads to the gradual destruction of joint cartilage, the protective growth of bone tissue with joint deformity 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 breastbone and the collarbone.

The shoulder joint is very mobile, which is supplied by the convex head of the humerus and the relatively flat joint 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 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 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, bruises;
• long-term permanent microtrauma associated with profession or sports loads;
• transferred acute and chronic infectious-inflammatory and autoimmune processes in the shoulder joint - acute purulent arthritis, chronic rheumatoid, psoriasis 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 joint 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 supplying 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 the joint surfaces, joint deformity and impaired function. In the joint cavity, inflammation of the synovial membrane occurs periodically - synovitis. Due to synovitis, osteoarthritis is called osteoarthritis or osteoarthritis - depending on which process prevails (inflammatory or metabolic-dystrophic). Due to inflammation and necrosis of the bone, small pieces of tissue are separated from it - joint sequestrators or mice.

At risk:

• for microtraumas: blacksmiths, miners, tennis players, weightlifters, disc throwers;
• for acute injuries - gymnasts, athletes, circus performers;
• people with burdened inheritance;
• people suffering from chronic joint diseases.

Shoulder Osteoarthritis Symptoms

The disease begins gradually, gradually. The speed 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 not be noticed, especially if they occur against the background of some existing shoulder diseases. These are minor, occurring periodically, mainly after exercise, pain, discomfort when moving the joint. Left joint pain can be confused with heart pain. They pass quickly, but it is worth paying attention to them.

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

Obvious symptoms

The pain increases, after exertion it does not disappear immediately. Night aches and pains associated with a change in the weather appear. Hand movements become painful, they are accompanied by a characteristic crunch. 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 in the shoulder area, but also radiate to the arm, neck and upper back.

Periodically, the joint swells, a slight reddening of the skin appears on it, the pain intensifies, 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 (decayed teeth, diseases of the ENT organs, etc. ), 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 can be strongly 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 these patients can also be helped, you just need to go to the clinic.

Dangerous symptoms

There are a number of symptoms of osteoarthritis of the shoulder joint, which signal that it is necessary to seek urgent medical help. This:

• the appearance of edema and redness of the tissues in the joint area, fever;
• aching pain in the joint, accompanied by a change in its shape;
• joint pain radiates to the arm, neck or back;
• the previous volume of arm movements 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 arthrosis of the shoulder

In the absence of medical treatment, brachial osteoarthritis is dangerous with constant progression with the development of a permanent pain syndrome, impaired 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 state. All symptoms appear mildly and mainly after exercise. A slight narrowing of the joint space is sometimes seen on x-rays, 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).
• Osteoarthritis of the shoulder joint 2 degrees- progressive stage. The shoulder constantly hurts, the pains are aggravated by movements of the arm, lower (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 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 stage. The 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 motionless due to pain. The joint is deformed, which sometimes leads to pinching of the nerves and blood vessels. On radiography: joint space is almost invisible, significant bone growths with joint deformity, severe sclerosis and necrosis of bone tissue, joint mice.

Possible complications

Any localization 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, then the risk of developing such complications as:

• significant deformity and limitation of joint mobility;
• intra-articular dislocations, subluxations and fractures with minor injuries or sudden movements;
• ruptures of the tendons surrounding the joint of muscles and ligaments: they atrophy and tear easily;
• aseptic necrosis of the humerus 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 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 anesthetic ointment to the skin in the area of the diseased joint;
• tie a sore arm with a bandage handkerchief - this will reduce the load;
• take an elevated position - sit with a pillow under your back - this will reduce swelling of the tissues.

Types of shoulder osteoarthritis

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

For reasons of illness

Based on this criterion, primary and secondary osteoarthritis is distinguished. Primary shoulder osteoarthritis is primarily the result of age-related changes and develops after 50 years. But sometimes the disease begins at a young age, but it is not possible to establish the cause of its occurrence. In this case we 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 diseases, but burdened heredity also matters here: in a person, even a minor injury or acute arthritis can lead to the development of osteoarthritis, while in a the other the most significant damage ends without consequences.

According to the characteristics of the flow

Assign deforming osteoarthritis of the shoulder, characterized by a rapid progression of bone deformities. A feature of this type of disease is a change in the shape of the joint and a 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 the nerves leads to reduced sensitivity of the limb and severe pain along the 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 of certain joint structures. Dystrophic changes of exchange 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. Dislocated joint capsule rupture 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 assistance already in the second stage of the disease. Significant injuries require long-term rehabilitation treatment, and osteoarthritis, as a rule, begins to be treated already in the early stages.

Osteoarthritis of the shoulder after suffering from inflammatory diseases: the symptoms and course of this 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, osteoarthritis develops in waves with frequent alternation of metabolic-dystrophic and inflammatory processes.

Distribution

Only a left or right joint can be affected and then one speaks of monoarthrosis. Simultaneous defeat of two 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 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: 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.

Diagnostics

Without a correct diagnosis, it is impossible to cure 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 are detected: inflammatory, autoimmune and degenerative-dystrophic processes.
• Instrumental:
  1. x-ray 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 arthrosis of the shoulder joint

After establishing the final diagnosis, a complex conservative treatment of arthrosis of the shoulder 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, appoint:

1. Medicines of the groupnon-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. Medicines of the groupmuscle relaxants- relax the muscles surrounding the joint; the spastic state of these muscles increases pain;
3. Pain blockswith local anesthetics.The drug solution is injected into the joint cavity or periarticular tissues - a quick analgesic effect.

The course of pathogenetic therapy (affecting the mechanisms of the disease) as part of the medical treatment of osteoarthritis of the shoulder 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 intravenous drip solutions.
3. Preparations of hyaluronic acid- 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 the joint and periarticular tissues.

Non-drug treatment

The basis of non-drug methods for the treatment of arthrosis of the shoulder is a healthy and 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 osteoarthritis of the shoulder, 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 meats, irritating foods of the tissues that cause swelling - salt (excessive amount), hot 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 it is not recommended to wear it constantly, as this leads to a rapid decrease in the range of motion of the shoulder.

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

Physiotherapy

Physical therapy - the daily performance of a series of exercises - with osteoarthritis of the shoulder is the main method of rehabilitation. Gymnastics complexes are prescribed by a doctor, mastered under the supervision of a physical therapy instructor. After the patient has begun to perform 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. This is electro and phonophoresis with the use of painkillers, lasers and magnetotherapy - stimulation of regenerative processes in the joint tissues, courses of shock wave therapy (SWT) - exposure to sound, 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 chopped raw material before bedtime 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 ancient recipe for an anesthetic ointment from wild rosemary herb.Take petroleum jelly or butter and chopped dry herb. In an enameled pan, alternately fold the fat base and the herb up to the top in layers, close the pan with a lid, cover the cracks with the dough and put in the oven (preferably in the oven) over low heat for 2 hours, remove from the oven, strain through double gauze, refrigerate and rub into the skin over the diseased joint 2-3 times a day.

Surgical operations

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

• Arthroscopic operationsallowing to eliminate various defects in the joint cavity. They are mainly performed on young people with post-traumatic arthrosis. Arthroscopy allows you to tighten and attach the biceps tendon to the bone (tenodesis - this will eliminate loosening of the joint), remove bone growths - osteophytes (debridement), restore the joint cavity with a transplant, etc.
• Endoprosthesis- replacement of a destroyed joint, which has lost its function, with an artificial one.

Approach to the treatment of the disease in the clinic

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

• the most modern drugs and non-pharmacological 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 with shoulder osteoarthritis, we recommend:

• lead a healthy and mobile lifestyle, alternating physical activity and rest;
• eat well regularly;
• get rid of all bad habits;
• regularly perform therapeutic exercises, avoiding sudden movements;
• sleeping on your back or sound side at night, placing a small pillow under your sore arm;
• give up intense 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 that people with aggravated heredity follow certain rules for the prevention of osteoarthritis of the shoulder. They should not engage in weight lifting, tennis, traumatic sports, work as hammers, blacksmiths, miners. Anyone who wants to have healthy joints should lead an active lifestyle and eat properly regularly.

Frequently asked questions about the disease

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

   The pains are aching, made worse by movement and weight lifting.

2. Why is the disease dangerous?

   The 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, against the background of inflammatory diseases - a rheumatologist.

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

   For intense pain, yes.

5. How effective are physiotherapy methods for this disease?

   Effective as part of a 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 osteoarthritis must 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 her quality of life.