The shoulder joint is one of the most sensitive parts of the human skeleton. This is due to the rather complex structure of the articulation with a weak fixation with the scapula. The shoulder receives a large amount of stress every day while performing household or professional duties. If an injury occurs, metabolic processes are disrupted, tissues wear out due to age - dystrophic changes begin in the cartilage tissue. This pathology is called arthrosis of the shoulder joint.
Depending on the manifestations of the glenohumeral joint and the degree of damage, four degrees of pathology are diagnosed. There is also a difference between acute and chronic shoulder arthrosis. If the treatment is not carried out in time or with bad intentions, 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 grade 1 shoulder arthrosis can be completely treated. But this does not mean that you cannot refuse pathology of the 2nd and higher degree and do nothing. Comprehensive and adequate treatment of arthrosis of the shoulder joint with the help of drugs or surgical intervention 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 a 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 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 muscles, connective and bone tissues. It first manifests itself as pain - small, painful at first. Then they become more intense and never disappear in the advanced stages, which significantly reduces a person's performance 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 in atherosclerosis and other chronic diseases related to blood vessels.
- Chronic pathologies of an autoimmune nature, for example, rheumatoid arthritis, systemic lupus erythematosus.
- Endocrine system dysfunction (diabetes mellitus).
- Congenital anomalies of the shoulder joint, birth injuries in infants and other injuries that cause pathological deformation and dysfunction of the limb.
- Acquired pathologies of articular structures after an injury or accident, unsuccessful operations, including arthritis, synovitis, osteoporosis, etc.
In addition, there are provoking factors, under the influence of which the risk of developing shoulder arthrosis increases several times. These include:
- professional activity during which the shoulder joint receives heavy loads day after day for many years - shoulder arthrosis is quite rightly called the disease of plasterers, painters and porters;
- 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 combined with the previous factor; with obesity, a person cannot move actively, the joints receive additional stress due to extra pounds;
- hereditary tendency;
- old age - about 80% of people over the age of 70 show signs of osteoarthritis.
Often, during the examination and interview of a patient, the doctor identifies a combination of several diseases and provoking factors. A typical patient diagnosed with arthrosis 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, the right shoulder lesions are more frequent than the left. This is due to the fact that most people, with the exception of natural left-handers, actively use their right hand at work and at home.
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 associates it with 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, the pain becomes constant, strong, bothers you at rest and at night. In addition to this symptom, the following symptoms will indicate dystrophic changes in the shoulder joint:
- swelling and deformation of the joint noticeable with the naked eye;
- redness of the skin over the joint, local increase in temperature;
- a characteristic crisis in the joint. Crackling sounds when the hand moves sharply are explained by the accumulation of salts in the cartilage cracks and between the joint elements. At first, wheezing occurs only with sudden movements, is quiet and barely audible. In advanced forms of the disease, the shoulder is torn with every movement, the sound is heard by others;
- limitation of mobility of extremities. While examining the patient, the doctor will ask him to comb his hair. This test is sufficient for the diagnosis of osteoarthritis of the shoulder joint: the patient will experience sharp pains, rotate the shoulder, it will be difficult for him to move the shoulder back, the doctor will hear cracking and clicking in the joint.
DOA of the shoulder must be treated, otherwise, over time, the patient will lose full mobility and performance of the upper limb. If the process of destruction of cartilage and surrounding tissues has already started, it will not stop by itself. Here, proper nutrition, folk remedies, healthy lifestyle and sports are not enough. Complex treatment using various effective drugs and physical procedures will be required to overcome the problem and prevent disability.
Degrees
There are several stages of DOA of the shoulder joint, each of which 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 the cartilage tissue are still small. The main symptoms of 1st degree DOA are weakness of joints and limbs and periodic nagging pains. Pain occurs after physical exertion, during prolonged monotonous, repetitive hand movements. 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 drugs and physical procedures - a light warm-up is enough. If you take an X-ray at this stage, the thinning and deformation of the cartilage will be noticeable, but the image will not show significant changes in the joint structures.
- 2nd degree.The pathological process continues and manifests itself more actively. A person is already used to the fact that his shoulder will hurt after work, he "expects" pain, analgesics and ointments for joint pain, pharmacy or homemade. X-ray diagnostics will show noticeable changes in the joint: thinning and deformation of the cartilage, inflammation of the articular membrane. From time to time, the joint turns red and swells, and when moving, creaking, creaking and clicking sounds are heard.
- 3rd degree.The shoulder joint constantly hurts and tightens, and to reduce discomfort, a person tries not to touch it and not to move around at all. Deformation is visually noticeable; the size and shape of the affected shoulder differs from the healthy one; it often turns red and swells, which is accompanied by increased pain. It is impossible to eliminate 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 limb. In this case, it is no longer necessary to prescribe drugs and physiotherapy, only endoprosthetic surgery will help restore the functionality of the hand at least partially. But this is not always successful.
In the note:In medical practice, it is extremely rare to encounter shoulder arthrosis of the 3rd degree. Typically, the patient seeks medical help and begins treatment earlier. If the patient cannot see a doctor for some reason, or if the person lives in unfavorable social conditions where there are no qualified doctors, serious cartilage destruction can occur against the background of extensive trauma.
How is arthrosis diagnosed and treated?
A good doctor will be able to make a preliminary diagnosis after a conversation with the patient and his external examination. There is a greater need for instrumental diagnostic methods to exclude or identify other pathologies and complications. The following diagnostic measures are performed to determine exactly how much the joint is affected and whether inflammation has occurred:
- radiography;
- CT scan;
- magnetic resonance imaging;
- in some cases, to get a complete picture of the state of the ultrasound joint;
- clinical urine and blood tests - leukocyte count and erythrocyte sedimentation rate will be evaluated. If they are too high, an inflammatory process develops in the body.
The best way to treat pathology is determined by the doctor individually, taking into account the age, profession and general condition of the patient.
Traditional treatment involves the use of the following methods and tools:
- A course of therapy with non-steroidal anti-inflammatory drugs. To eliminate the main symptoms of inflammation - pain, swelling, redness, increase in body temperature, drugs are prescribed in the form of tablets or powders for oral administration or in the form of ointments for external use.
- 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 for extreme cases when the pain is unbearable.
- A course of taking chondroprotectors - drugs that promote the regeneration of cartilage tissue and prevent further destruction. They also partially eliminate pain and swelling, deformation of the shoulder joint. Such drugs do not have an immediate effect, they should be taken for at least 3-4 months.
- A course of muscle relaxants - tablets or injections that relieve 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.
Special therapeutic nutrition is also prescribed to increase the effectiveness of treatment, speed recovery and prevent new lesions. The patient's diet includes foods rich in vitamins B, A, C, E - fresh fruits and vegetables, any type of cabbage, 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 cattle hooves and tails, flavored meat and various jellies. It is useful to take gelatin in its pure form, previously soaked in hot water.
The next important point in the complex treatment of osteoarthritis of the shoulder is physiotherapy. They start only when the inflammatory process stops. Depending on the degree 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 treatment;
- different types of massages;
- 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 drugs taken and their dosage, which is especially valuable if the pathology is observed in a teenager, an elderly person or a nurse.
Helpful tip:It is possible to treat grade 1-2 lesions of the shoulder joint at home with the additional use of folk remedies. The main thing is that the patient does not forget to take medicines on time and does not skip physical procedures - the effect will be noticeable and permanent only if all the doctor's prescriptions are followed regularly and honestly.
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 replaced with a prosthesis. Such an intervention is not unusual, but 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 feel that your shoulder regularly starts to hurt, pull, numb, or hear a creaking sound when you move, do not delay going to the doctor, get a timely examination and start treatment if necessary.
Osteoarthritis of the shoulder joint is a fairly common pathology of the musculoskeletal system, which occurs mainly in people over 50 years of age. The pathology develops gradually, slowly, 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 development of the disease can be stopped with the help of comprehensive treatment: drugs, vitamin supplements, diet therapy and physical therapy. Advanced osteoarthritis can only be treated surgically.