The shoulder joint is one of the most vulnerable in the human skeleton. This is due to the rather complex structure of the joint with weak fixation with the scapula. The shoulder takes a lot of stress every day when performing household or professional tasks. If an injury occurs, metabolic processes are interrupted, tissues wear out due to age - dystrophic changes in 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 shoulder arthrosis. If the treatment is not carried out on time or in bad faith, the joint continues to deform and collapse, which eventually results in significant limitation of upper limb functions and loss of mobility.
Today, only grade 1 shoulder arthrosis can be completely cured. But this does not mean that you can give up and do nothing with pathology of the 2nd degree and higher. 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 in preserving the mobility of the arm and shoulder and preventing disability.
Symptoms and causes
The 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 the tissue. Microcracks appear on its surface, in which calcium salts accumulate. Then it becomes thin, brittle and begins to collapse.
Often this process is accompanied by inflammation, which also spreads to the surrounding muscles, connective and bone tissues. This is mainly manifested as pain - at first small, aching. Then they become more intense and in advanced stages they never disappear, which significantly reduces a person's performance and quality of life.
The main reasons why DOA of the shoulder joint develops are as follows:
- Impaired blood circulation in shoulder cartilage tissue 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 anomalies of the shoulder joint, birth injuries in infants and other injuries leading to pathological deformity and limb dysfunction.
- Acquired pathologies of articular structures after injury or accident, unsuccessful surgery, including inflammation due to 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 - shoulder arthrosis is rightly called a 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 combined with the previous factor; with obesity, a person is not able to move actively, while the joints receive additional stress due to extra pounds;
- hereditary predisposition;
- old age - approximately 80% of people over 70 show symptoms of osteoarthritis.
Most often, when examining and interviewing a patient, the doctor identifies 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 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 from time to time the shoulder begins to hurt, 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 moment when pills and ointments no longer help, the pain becomes constant, intense and bothers you 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 crackling in joints. Crackling sounds when the hand moves strongly is explained by the accumulation of salts in the cracks of the cartilage and between the elements of the joints. At first, the twitching occurs only with sudden movements; it is quiet and barely audible. In advanced forms of the disease, the shoulder cracks with every movement, the sound is heard by others;
- limitation of limb mobility. When examining a patient, the doctor will ask him to comb his hair. This test is sufficient to diagnose osteoarthritis of the shoulder joint: the patient will experience sharp pains, perform a rotational movement with the shoulder, it will be difficult to move the shoulder back, the doctor will hear crackling and clicking in the joint.
DOA of the shoulder must be treated, otherwise over time the patient will lose full mobility of the upper limb and performance. If the process of destruction of cartilage and surrounding tissues has already begun, it will not stop on its own. Proper nutrition, folk remedies, a healthy lifestyle and exercise are not enough here. To cope with the problem and prevent disability, complex treatment using medications with different effects and physical procedures will be required.
Diplomas
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 has just begun to develop, the changes in the cartilage tissue are still small. The main symptoms of DOA grade 1 are joint and limb weakness and periodic nagging pain. The pain appears after physical exertion, during monotonous, repetitive movements of the hands for a long time. After a night's sleep or a long period of rest, a person feels stiffness in the shoulder joint, but as it develops, the stiffness still goes away without medications and 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 joint structures, although thinning and deformation of the cartilage may be observed.
- 2nd degree. The pathological process continues and manifests itself more actively. A person already gets used to the fact that after work his shoulders will hurt, he "expects" pain, he has analgesics and ointments for joint pain, pharmacy or home, ready. X-ray diagnostics will show obvious changes in the joints: thinning and deformation of the cartilage, inflammation of the articular membrane. Occasionally, the nodule becomes red and swollen; creaking, creaking and clicking can be heard when moving.
- 3rd degree.The shoulder joint hurts and crunches constantly, to reduce the discomfort, the person tries not to touch it and not to move the limb at all. Deformation is noticed visually, the affected shoulder changes in size and shape from the healthy one, it often becomes red and swollen, which is accompanied by increased pain. It is not possible to remove them with sedatives.
If nothing is done in the third stage of the disease, the fourth stage will occur - complete immobility of the shoulder joint and limbs. In this case, it is already useless to prescribe medicines and physiotherapy; only endoprosthetic surgery will help to at least partially restore the functionality of the hand. But even this is not always successful.
On a note:In medical practice, it is extremely rare to encounter grade 3 shoulder arthrosis. Typically, the patient seeks medical help earlier and begins treatment. Severe cartilage destruction can occur against the background of extensive trauma, if for some reason the patient cannot visit a doctor, 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 a conversation with the patient and his external examination. Instrumental diagnostic methods are needed more to exclude pathologies and other complications or to identify them. To accurately determine how severely the joint is affected and if 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 condition of the joint;
- clinical analyzes of urine and blood - the number of leukocytes and the rate of sedimentation of erythrocytes 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 on an individual basis, taking into account the age, profession and general condition of the patient.
Traditional treatment includes the use of the following methods and tools:
- A course of therapy with non-steroidal anti-inflammatory drugs. Medicines are prescribed in the form of tablets or powders for oral administration or in the form of ointments 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 medications 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 restoration of cartilage tissue and prevent further destruction. They also partially relieve pain and swelling and deformity of the shoulder joint. Such medications do not work immediately, they must 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.
To increase the effectiveness of treatment, quick recovery and prevention of new lesions, special therapeutic food 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. Unsaturated fatty acids can be obtained from sea fish and seafood. A gelatin diet is practiced, as gelatin helps to restore the elasticity of cartilage tissue. The menu includes jellied meat made from calf 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 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 therapy;
- massages of various types;
- 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 nursing woman.
Useful tips:It is possible to treat lesions of the 1st-2nd degree 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 medications at the right time and does not skip physical procedures - the effect will be visible and 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 surgery. The remains of the destroyed joint will be removed and a prosthesis will be placed in its place. Such an intervention is not unusual, but requires 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, becomes numb or hear a cracking noise when you move, do not postpone the visit to the doctor, get checked in time and, if necessary, start treatment.
Shoulder joint arthrosis 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 adverse 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: medications, vitamin supplements, diet therapy and physical therapy. Advanced osteoarthritis can only be treated surgically.