One of the most anatomically complex parts of the human body is the shoulder joint. It is he who is responsible for performing most of the functions of the upper limbs, including for complex movements above the head. However, over time, the rotational cuff of the shoulder wears out, and also as a result of injuries and various diseases, it begins to work less stable and is much worse responsible for its purpose.
As a rule, problems with the shoulder joint most often occur in middle-aged people, but no one is safe from getting injured, therefore many young people also come to the hospital for medical care, especially those who lead an active lifestyle and play sports.
A bit of anatomy
The structure of the shoulder is quite complex, but at the same time very elegant. It is formed by three components - the humerus, collarbone and scapula. The latter is formed by the head and acromioma, which is a kind of semblance of a joint roof. An axillary muscle also plays an important role , the functions of which are to perform the rotation of the upper extremities together with the rotator cuff. It consists of their four tendons. They just allow you to rotate your hands in any direction.
The scapular part is also part of the scapula, along which strong bonds connecting the bones pass. The cuff consists of four types of muscles responsible for turning the shoulder outward or inward, and also raise the arm up. A special bursa is responsible for reducing the friction of bone formations. It acts as a kind of lubricant that extends the life of the entire joint.
Nevertheless, in the process of human life, the joint gradually wears out. This happens especially quickly among professional athletes and people whose labor activity is associated with great physical exertion. As a result of this, they begin to show pain in the shoulder. The reasons for this will be discussed later. But regardless of them, it is recommended to go to the hospital, since it becomes very difficult for a person to perform even basic tasks, which greatly complicates everyday life.
Causes of shoulder damage
Impaired functioning can occur as a whole joint, and its individual parts. At an increased risk group are people whose activities are associated with a large burden on the shoulder, for example, painters, athletes, movers, builders, carpenters, etc.
In this case, injuries are very dependent on the following factors:
- The age of a person. As you grow older, the likelihood of damage increases for a variety of reasons.
- Occupation in certain sports that are associated with a load on the upper limbs.
- Features of certain types of professions.
- Genetic characteristics of each person.
In addition, the rotator cuff of the shoulder can be damaged as a result of household injuries, traffic accidents, falling during icy conditions, as well as for many other reasons beyond the control of a person.
Symptomatology
The main clinical manifestation of the injury is severe shoulder pain. The reasons for this have already been considered earlier, and now it's time to talk about what symptoms a person can independently determine that he has problems with the shoulder joint.
It is worth noting that the pain syndrome makes itself felt not only during physical exertion, but also during a turn of the arm. Moreover, the shoulder constantly aches and does not give rest for a minute. Especially neuralgia worsens at night, as a result of which a person may even wake up. At first, the pain rolls periodically, disappearing after a certain time. However, in the absence of proper treatment, it acquires a continuous character, and any movements of the hands are given with very great effort or become completely impossible.
Among the main clinical manifestations is also a weakness in the joint. If your shoulder begins to hurt badly, then raise your arms up. If all else fails, then this is evidence of any problems with the joint. Gradually, weakness will increase, and the functionality of the limbs will decrease. In addition, rotational movements may be accompanied by a crunch or creak.
Basic diagnostic methods
Based on the symptomatology alone, it is not possible to independently determine the shoulder-shoulder periarthritis (ICD-10 assigned code M75.0) or any other problem is impossible. An accurate diagnosis can only be made by a specialist after a thorough examination of the patient, as well as with the results of all the necessary tests on hand.
To determine the nature and severity of the injury, the doctor prescribes the following types of laboratory tests:
- X-ray of the shoulder joint ;
- Ultrasound
- MRI
- CT scan.
The latter method is one of the most modern and effective, because it allows you to diagnose any disease with absolute accuracy and get a detailed clinical picture of the patient’s health status.
Most common problems
One of the most commonly diagnosed diseases of the shoulder joint is the shoulder-shoulder periarthritis (ICD-10 disease code is M75.0). According to medical statistics, about 10 percent of all Russians suffer from this disease. It is important to understand here that if you do not start treatment of the inflammatory process in time, then a person may eventually become disabled. At the same time, both women and men equally suffer from this pathology, regardless of age category.
The main reasons for the development of inflammatory and degenerative changes in the periarticular soft tissues are:
- impaired peripheral circulation ;
- deficiency of vitamins and minerals;
- complications after surgery on the vessels;
- too much physical activity;
- joint injuries;
- hypothermia;
- impaired functioning and various pathologies of internal organs;
- malfunction of the endocrine glands;
- sedentary lifestyle;
- sedentary work;
- spinal problems and disc protrusion;
- myocardial infarction;
- chronic exhaustion of the body;
- decrease in basal rate of metabolic processes;
- wear of articular surfaces.
The clinical manifestations of the disease are pronounced and only increase as it progresses. In the later stages, the pain in the shoulder becomes simply unbearable and can be transmitted to other parts of the skeleton, as well as the functionality of the arm drops to almost zero. In addition, very often in patients there is an increase in basal body temperature.
If the rotational cuff of the shoulder is inflamed, then the treatment should be comprehensive. Doctors prescribe patients a course of taking medications, as well as many other procedures. If after a certain period of time no improvements are observed, then they resort to surgery.
The main methods of therapy
As already mentioned at the beginning of the article, the structure of the shoulder is very complex, therefore, in case of injury or the development of any pathologies, a very long treatment is required, which is selected for each patient individually depending on the nature of the disease. Most often, therapy is carried out on an outpatient basis, but in some cases the patient may be allowed to go home.
With not very complex injuries, you can try to cope with them yourself. To do this, it is necessary to minimize physical activity on the shoulder and arm, as well as put cold compresses on the joint, the duration of which is an average of 20 minutes at two-hour intervals. On the third day, you can start using a heating pad. If the tendons of the shoulder muscles were torn, then an operation is required. In addition, you need to take a number of drugs, which can only be selected by a specialist.
Physiotherapy
To achieve maximum efficiency, together with taking medications, the patient must perform a set of special physiotherapeutic procedures. They will not only accelerate the healing process, but also ease pain and improve blood circulation of the damaged joint.
The rotational cuff of the shoulder will return to normal much faster if the patient undergoes the following:
- electrophoresis;
- UHF therapy;
- cold treatment;
- taking mineral baths;
- greasing with healing mud;
- laser therapy;
- UZT.
All of the above modern treatment methods are very effective if the head of the humerus has worn off, the inflammatory process of the soft tissues has gone or there was a fracture.
Massotherapy
One of the effective methods of physiotherapy, which has been successfully used to treat many diseases for many years now, is massage.
It contributes to the following:
- Normalization of peripheral circulation and microcirculation.
- Elimination of pain.
- Slowing the development of the disease.
- Minimizing the risk of complications.
- Restore joint functionality.
As medical practice shows, already after several courses of therapeutic massage in patients with arm movements, they become less problematic and painful. In the first sessions, those areas of the shoulder that hurt the most, have minimal impact, and then gradually increase the load.
Physiotherapy
If the rotational cuff of the shoulder was damaged as a result of the injury, then doctors recommend that their patients perform a set of special physical exercises. Which doctor should be used is decided by the attending physician depending on the etiology and stage of the disease, however, most of the exercises will require small dumbbells and a rubber expander, so you can buy them in advance.
The following exercise therapy procedures will help strengthen the joint and accelerate the recovery process after surgery:
- Stand in the doorway, bend the damaged limb and try to touch the wall with your palm. If you succeed, then complicate the task a little. Press an object with your elbow to the body and repeat the exercise again.
- Lie on a healthy side and raise your hands several times so that the elbow touches the body. Next, do the same with dumbbells, gradually increasing its weight.
- Develop the shoulder joint with an expander. If your right arm is damaged, one end must be clamped with the left foot and vice versa. Do several of these approaches every day.
It is worth noting that it is not recommended to perform any physiotherapeutic exercises without first consulting with the attending physician, since this way you can only aggravate the situation and lead to the development of various complications.
Surgery
If the rotator cuff of the shoulder was very badly damaged, for example, it ruptured, or drug therapy does not bring absolutely any results, then in this case, surgery is one of the mandatory procedures that play a key role. But all success depends on when it was completed. It is best that the surgery be carried out immediately after damage to the joint, so you should not postpone a visit to the doctor if you are injured. Until the inflammatory process has begun, for the elimination of which it may take from several months to one year, the probability of complete restoration of soft tissues is high. At the same time, throughout the entire period of rehabilitation, the patient should engage in therapeutic exercises and regularly go for massage.
Preventive actions
If you are at an increased risk of injury or the development of various diseases associated with the shoulder joint, you need to make every effort to avoid problems with the rotator cuff. If there are injuries in the past, it is recommended to carry out exercises every day aimed at strengthening the muscular apparatus of the shoulder. As practice shows, most people completely forget about it, paying more attention to the chest and biceps. If you have recently undergone surgery, then you need to visit a qualified specialist who will examine you and select the optimal course of physiotherapy. This will reduce the rehabilitation time to 3-6 months, after which you will be able to return full functionality to your shoulder and begin your usual lifestyle without any restrictions.
It is worth noting that it is not recommended to postpone physical therapy classes for a long time. The sooner they are started, the better for you and your shoulder, because otherwise torn soft tissues and damaged bone formations may not grow together correctly, and you will have to suffer with a shoulder joint for the rest of your life. Always take care of your health!