Osteoarthritis of the shoulder is a lifelong degenerative-dystrophic disease in which the articular cartilage is affected primarily and then the head of the bones that make up the shoulder joint. By causing severe pain and impaired joint mobility, osteoarthritis can lead to disability and significant difficulty in self-care in the family. It is also brimming with transitions of degeneration to the spine, especially the cervical spine.
In spite ofsymptoms of arthropathy of the shoulder jointUsually occurs in people over 45 years of age, the disease can also develop in very young patients - due to trauma, infection, heavy lifting, improper load distribution, postural disorders. Leave withoutTreating the symptoms of dry shoulder diseaseno - after a few years or decades this can lead to bone fusion and complete blockage of the shoulder. This condition is especially painful because the pathology usually affects the main hand (right - in right-handed people, left - in left-handed people).
Shoulder arthritis symptoms
Symptoms and treatment of shoulder osteoarthritiswill vary depending on the stage of the disease. There are 3 stages where the following symptoms are specific:
- State 1.Pain from shoulder osteoarthritisIn the early stages, it is localized directly in the joint, but it can also radiate to the shoulder blades. The nature of the pain, mainly aching or dull, tends to increase with exertion or during the workday. Sharp pains and pain at rest are absent. Radiographic examination may reveal a slight decrease in the joint cavity and rare osteomas (bone tumors in the form of spines, tubers, hooks, "peaks"). At this stage, the disease responds most to treatment and is considered to be conditionally reversible.
- Stage 2. Pain syndrome increases and persists at rest, disturbing the patient at night. Appears drycrackling sound in the shoulderand difficult to move (as if sand had been poured into the joint). Typical of grade 2 shoulder disease is severe edema, elevated soft tissue temperature, and other inflammatory symptoms that limit the patient's daily activities. The process of gradual muscle atrophy begins, which is manifested by the "drying out" of muscle tissue. Some patients also report spasticity and an inability to perform certain range of motions (usually at the pole position of the hip bone).
- 3rd Stage. Bindingshoulder joint painStage 3 interferes with work performance and healthy sleep. There is a marked limitation of mobility in the joints, stiffness of the arms and back. The telltale sign of this stage is the deformity of the shoulder joint, which can be noticed even with the naked eye.
Pain
Patients are most likely to notice paina symptom of dry joint disease of the shoulder joint. . . Its cause is the appearance of abrasions and abrasions on the surface of the synovial cartilage. They roughen the joint surfaces, create friction and prevent healthy sliding of the joint elements. Then, bone-forming substances, which damage the tissues around the joints, contribute to the enhancement of pain syndrome. The pain usually occurs at the end of the workday or after a heavy load (for example, working out at the gym). At firstshoulder joint painretreats after resting, which is why she is mistaken for overworked or overworked. Soon, however, the patient noticed a sharp and progressive decrease in stamina.
Then there is noshoulder osteoarthritis treatment, the pain ranges from dull to acute, localized in the clavicle-fish scale triangle. Sharp pain on exertion can be almost unbearable. After that, severe aches and pains bother the patient even at night. That's the featureshoulder joint painaggravated when trying to bring the arm up or behind the back. Often moving the hand to this position is accompanied by clicking, crunching, crunching sounds.
Shoulder
Shoulder smack -this isa symptom of dry joint disease of the shoulder joint, which increases with wear of the joint surface. It is important to know that shoulder crunches are considered a physiological norm and that resonant clicks can often be heard even in healthy individuals. These harmless clicks are usually caused by air bubbles that burst in the joint fluid when it is compressed.
It can only be said that the condition of shoulder osteoarthritis is caused by the sound when it is accompanied by pain and limited movement. In addition, anxiety is caused by a dull "heavy" cry (as if bones are rubbing, "gluing" together).
Decreased shoulder mobility
The range of voluntary movements is reduced due to the narrowing of joint space. The lumen of the joint cavity may be reduced by thinning of cartilage and proliferation of osteoblasts. Edema can also cause partial obstruction of the shoulder. In the later stages of the disease, spasticity (persistent limitation of mobility) and even ankylosing spondylitis (complete fusion of the bones) occurs.
Movement disorder is a symptom of shoulder osteoarthritis that is often accompanied by pulling, pain, or throbbing when trying to tie an apron, hang clothes, turn a steering wheel, or perform other household activities. In the morning, the patient is concerned about stiffness, which first passes after normal morning activities, then-can last all day. Usually, stiffness is accompanied by cyclical muscle spasms caused by constant stress.
Shoulder deformity
The deformity of the shoulder becomes noticeable already in the 3rd stage of arthropathy, when the only possible treatment option is surgery. When articular cartilage is depleted, compensatory mechanisms are activated: bone tissue grows in place of cartilage tissue to maintain the stability of the musculoskeletal system. Due to the proliferation of bone-forming cells and changes in the structure of cartilage, bone tissue begins to deform, this bone tissue also wears away.
The outer contours of the joints also change due to edema, which occurs due to overproduction of synovial fluid and metabolic disturbances at the heart of the inflammation.
The deformity of the shoulder shows that the cartilage has been completely destroyed and the degeneration has moved to the ends of the bones. A natural result of this, in addition to deformation and violation of the (coincidence) congruence of the articular surfaces, is shortening of the ligaments and muscular dystrophy.
Shoulder joint treatment
Shoulder joint treatmentare selected individually for each patient, taking into account the extent of the disease, individual features of its course, further prognosis and concomitant diseases. If the process is secondary to a pre-existing disease (gout, diabetes, rheumatoid arthritis), thenshoulder osteoarthritis treatmentperformed with the participation of specialized specialists.
At stage 1, shoulder arthropathy can be completely terminated with the help of competent treatment and strict adherence to clinical recommendations. At stage 2, its development can be significantly slowed down with the help of complex therapy (physical therapy, pharmacotherapy, exercise therapy, a healthy lifestyle). In stage 3, with major destruction of the joint architecture, only surgery can help the majority of patients.
Shoulder Osteoarthritis Surgery
In the final stages of osteoarthritis, irreversible changes in bone tissue occur, therefore, in order to eliminate pain and restore mobility, doctors recommend the installation of organs. In this case, the diseased joint is replaced with a titanium or other implantable device.
Usually, surgery is used only with advanced, untreated joint disease. However, with an unfavorable course of the disease and the ineffectiveness of conservative therapy, surgical solution may become the only solution even with adequate treatment. Such activities are carried out even at a young and middle age.
After placing the implant, the patient's condition improves significantly, but it is necessary to adhere to the orthopedic regimen. Despite their "durability, " an implant is not a 100% replacement for a healthy joint.
If the extent of osteoarthritis allows for minimally invasive intervention, the patient may be indicated:
- Arthroscopy (withdrawal of inflammatory exudate after taking the drug);
- arthroscopy ("cleansing" the joint from bone-forming substances and dead tissue fragments through a small incision).
Physiotherapy treatment of shoulder osteoarthritis
Physical therapy techniques reduce the symptoms of shoulder osteoarthritis and the patient's physical condition, slowing the progression of the disease. Certain types of physiotherapeutic effects contribute to the destruction of bone-forming cells, improve the flow of drugs directly into the affected area, stimulate blood circulation, and help maintain muscle tissue volume. They also have an indirect effect on the rate of cartilage tissue regeneration, eliminating edema and inflammation.
The most effective treatments for treating symptoms of shoulder joint disease include:
- acupuncture therapy;
- laser therapy;
- shock wave therapy;
- electrical stimulation;
- electrophoresis and drug electrophoresis;
- massage and manual therapy;
- Exercise therapy;
- tonic bath therapy (especially turpentine baths, sodium chloride);
- cryotherapy method;
- ozone therapy;
- therapeutic mechanics.
Exercise therapy for shoulder osteoarthritis
Gymnastics forshoulder osteoarthritis treatmentmainly consists of static exercises (when you need to linger in a certain position). Such exercises strengthen muscles and ligaments and allow you to transfer loads from the diseased joint (active movements in the joint can only injure it). Exercise therapy is used forshoulder osteoarthritis treatmentonly in a state of remission, i. e. no symptoms of inflammation. With painful sensations, the gymnastics is stopped.
The best can be considered gentle exercises for the shoulder complex, performed in a standing or sitting position. They should be taken daily, preferably-2-3 sessions a day for effective joint pain relief. The correct set of exercises should be selected by an exercise therapist or a rehabilitation physician.-taking into account the age, structure, anatomical features and condition of the patient.
Medical treatment of shoulder joint disease
Drug treatment of shoulder osteoarthritishas the following goals:
- eliminate pain and inflammatory symptoms;
- improves metabolism in cartilage, bones and soft tissues;
- cartilage tissue recovery.
Anti-inflammatory drugs
Anti-inflammatory drugs (non-steroidal and glucocorticoids) effectively suppress inflammation in stages 1 and 2 of the disease, however, they only provide temporary symptomatic relief. This class of drugs does not cause structural improvement of cartilage tissue and does not inhibit disease progression. Thus, without basic therapy, NSAIDs and GCs will eventually stop working.
Anti-inflammatory drugs forshoulder osteoarthritis treatmentavailable in the form of tablets, capsules, ointments and creams, as well as injections and rectal suppositories. NSAIDs for external use can be used continuously; in other forms of issuance, as a rule, they cannot be used forshoulder osteoarthritis treatmentmedicine for more than 12 days.
Chondroprotectors
Preparations based on cartilage components-This is the only class of drugs capable of initiating the comparison process in the cartilage layer. In combination with other treatments for osteoarthritis of the shoulder, chondroprotectors have the ability to eliminate cartilage-eroding lesions in the early stages of the disease, as well as slow down the progression of the disease in later stages. In addition, chondroprotectors can be used to prevent joint disease if a person is at risk for the disease (for example, weightlifting or doing work that involves heavy physical labor).
How do they work? First of all, chondroprotectors improve the quality of synovial fluid (which lubricates joints) and make it more viscous. In joint disease, synovial fluid is usually produced in large volumes, but has a poor composition and low viscosity. As a result, it cannot properly nourish the cartilage and causes slippage of the joint surface.
Chondroprotectors enrich the composition of joint lubricants, which leads to the formation of more resistant chondrocytes, and also accelerates cartilage regeneration. They should be taken every 2 to 6 months a year.-but they have long lasting effects. Chondroprotectors are easy to use and have helped many patients. Unlike other products forDrug treatment of shoulder osteoarthritisno side effects.
Antispasmodics and vitamins
Due to the degenerative process, the load anatomically assumed by articular cartilage is redistributed to skeletal structures and the musculoskeletal apparatus. This leads to constant spasm, which is not only painful for the patient, but also leads to muscle breakdown, chronic fatigue and reduced mobility of the shoulder and neck area.
To reduce spasms that occur during disease progression, antispasmodics, muscle relaxants and B vitamins are used (which also reduce inflammation).
Microcirculation stimulants
DRAWshoulder osteoarthritis treatmentRegulators of blood microcirculation perform two functions: they indirectly improve the regeneration of cartilage tissue and slow down its destruction, and also have a moderate anti-edematous effect. This class of drugs promotes the rapid elimination of decay products formed during the death of chondrocytes (meaning the body produces less enzymes that can harm healthy cells). Therefore, they are especially effective when used in conjunction with enzyme blockers.
Is different
In recent years, forshoulder osteoarthritis treatmentalso use genetically modified drugs (eg, purified patient plasma). Plasmolifting is most commonly used, in which plasma is injected locally into the focus of the degranulation process. This procedure stimulates blood circulation and regeneration of chondrocytes.
Prevention of shoulder osteoarthritis
Prevention of shoulder osteoarthritis includes the following simple rules:
- maintain daily physical activity;
- posture tracking;
- practice a healthy chiropractic regimen when performing household and professional chores, as well as during sleep;
- equip the workplace in such a way that the load on the shoulder joint is minimized;
- refuse bad habits;
- food variety and refusal of junk food;
- lose weight if overweight;
- Avoid overload and when playing sports-adhere to a mode of saving;
- Visit your chiropractor or rheumatologist every year for a checkup.
Doctors said that an unbalanced diet and lack of nutrients play a huge role in the formation of shoulder osteoarthritis. Therefore, they recommend minimizing the intake of fatty, salty, sweet and spicy foods, giving up canned, semi-finished products and other processed foods. Fatty meat, pork cartilage (ear, leg), fatty fish from the North Sea, nuts, fresh vegetables, cereals, lean meat, dairy products, eggs will help meet the body's needs andFirst of all, the joints. Such a diet allows you to reducesymptoms of arthropathy of the shoulder jointeven when the pathological process has already begun.
Be healthy!