Arthrosis of the shoulder joint is a degenerative-dystrophic disease in which thinning and destruction of cartilage tissue occurs. In addition, pathological changes in the soft tissues are observed and bone growths are formed. A disease can occur as a result of certain circumstances, in particular, such as trauma. And sometimes for no apparent reason.
The likelihood of developing arthrosis of the shoulder joint increases significantly with age. A violation manifests itself in the form of a crunch in the affected area. At later stages, a decrease in range of motion occurs. The disease can occur in the chronic stage, gradually progressing.
The diagnosis is made on the basis of the available symptoms and x-ray examination. The treatment is mostly conservative, and in case of joint destruction, endoprosthetics are indicated.
Causes of occurrence
Osteoarthritis of the shoulder joint according to ICD 10 has the code M19.91, this pathology occurs as a result of the prolonged course of the inflammatory process. Without competent timely treatment, the disease progresses more and more every year, which negatively affects the quality of life of a sick person. Inflammation provokes swelling of the cartilaginous tissue, squeezing of the membranes of the joint, as well as lymph and blood vessels.
There is no specific reason for the occurrence of arthrosis of the shoulder joint, there are only a few factors that influence the development of this disease, namely:
- infectious and viral lesions;
- genetic predisposition;
- various injuries;
- overweight;
- load on the shoulder girdle;
- taking certain medications;
- endocrine diseases;
- vascular disorders;
- elderly age.
In addition, there may be certain non-specific causes of joint inflammation, which are established only by the doctor on the basis of the examination.
Developmental stages
There are 3 degrees of arthrosis of the shoulder joint, each of which is characterized by certain symptoms and a particular course. At the first stage, gross changes are absent. The composition of the synovial fluid is changed, and the nutrition of the cartilage tissue is disturbed. With arthrosis of the shoulder joint of the 1st degree, the cartilage does not tolerate the load, so painful sensations in the joint periodically arise.
In the second stage, the cartilage tissue begins to thin, its structure changes, and the surface loses its smoothness. As a result of this, cysts form . Bone tissue is not strongly deformed, however, bone growths form along the edges of the joint. The pain becomes permanent.
In the third stage, there is a thinning and violation of the cartilage tissue with extensive areas of destruction. The joint surface is not deformed. In addition, restriction of range of motion, weakness of ligaments and atrophy of adjacent muscles are determined.
The main symptoms
Arthrosis of the shoulder joint progresses quite slowly, which greatly complicates the diagnosis at the initial stages of the disease. Periodically arising pain is perceived by the patient as a result of fatigue and excessive physical exertion. The first painful sensations occur when the arm is moved back or to the side. It may also cause discomfort when touching the shoulder blade or collarbone. In addition, there may be symptoms of shoulder arthrosis, such as:
- redness and swelling;
- sharp pain and restriction of movement;
- temperature rise;
- numbness and weakening of muscle tone;
- visual changes in the shoulder joint.
The intensity of the symptoms can be different and it depends on the stage of the course of the disease. Unpleasant sensations can be periodic or permanent. The intensity of pain is affected by many different factors, in particular, such as the level of physical exertion, trauma, hypothermia, increased muscle tone and many others. With the formation of osteophytes inside the joint, a crackling and snapping is observed with each movement of the hand.
Diagnostics
To determine the course of deforming arthrosis of the shoulder joint, a thorough examination of the patient is necessary. The diagnosis is made on the basis of available clinical and radiological signs. On radiography, it is possible to determine the presence of dystrophic changes and bone growths. At later stages, an x-ray shows a narrowing of the joint space, as well as a change and deformation of the structure of the adjacent bone. The joint gap can become wedge-shaped, and changes and cysts are determined in the bone tissue.
In doubtful cases, especially at the initial stage of the course of the disease, the patient can be sent for tomography to obtain additional data on the condition of the cartilage, bone and soft tissues. If there is a suspicion of a secondary arthrosis, consultation of an endocrinologist and surgeon may be additionally prescribed.
Differential diagnosis is carried out with psoriatic, reactive, gouty, rheumatoid arthritis. In the blood tests, in this case, all the signs of inflammation are determined, and on the X-ray, the changes are not very pronounced, there are no bone growths, and there are no signs of deformation of the articular surfaces.
With psoriatic arthritis, along with articular manifestations, rashes on the skin are often found. In the case of pyrophosphate arthropathy and gouty arthritis, corresponding changes are detected in the biochemical analysis of blood, in particular, an increase in the level of uric acid.
Treatment features
How to treat arthrosis of the shoulder joint, only a doctor can say after an examination. Therapy should be started as early as possible, since with the development of the disease a lack of elements important for cartilage tissue may occur. There are several main methods of treatment, among which it is necessary to highlight, such as:
- drug therapy;
- ethnoscience;
- massage and exercise therapy;
- surgical intervention.
It is necessary to take chondroprotectors based on chondroitin. In addition, it is regularly necessary to consume collagen-containing foods. Basically, the treatment of arthrosis of the shoulder joint begins when severe pain appears, and the primary task is to eliminate pain. The range of analgesic techniques is wide enough.
The doctor prescribes anti-inflammatory drugs in the form of injections, gels, ointments based on diclofenac, ketaprofen, indomethacin. Shock wave and laser therapy is also indicated. Manual therapy and massage will help eliminate painful sensations and normalize well-being.
If conservative treatment for a long time does not bring a positive result, surgical intervention is prescribed. In particular, the replacement of a diseased joint with an artificial one is carried out. However, this is the most extreme measure, which is rarely used. The functional importance of the shoulder joint is very high, but much less than that of the knee and hip.
The main way to maintain the health of the shoulder joint is physiotherapy. To eliminate the main symptoms, the treatment of arthrosis of the shoulder joint is carried out with the help of special exercises, however, they must be dosed and extra loads should not be allowed.
Drug therapy
Treatment of arthrosis of the shoulder joint is carried out with the help of medications. Anti-inflammatory drugs are prescribed to eliminate the pain. Their intake should not be constant, since the abuse of drugs can lead to completely different disturbances in the functioning of the body. Anti-inflammatory drugs can be prescribed in tablet form or as ointments that are applied topically. Among them, one can distinguish Ortofen, Diclofenac, and Indomethacin.
Special drugs, such as Trental and Pentoxifylline, will help normalize blood microcirculation in the affected area and restore cartilage nutrition. They are used for intravenous administration. It is important to take vitamin and mineral complexes in addition. Replenishment of calcium deficiency is especially recommended.
The basis of treatment is chondroprotectors. It can be Chondroxide, Chondroitin Complex, Structum, Rumalon. They are used in tablet form or as injections that are injected into the joint cavity. The composition of these drugs includes one or two substances that contribute to the restoration of cartilage. Their reception should be long, but intermittently. The course of therapy should be determined by the attending doctor.
Physiotherapeutic treatment
One drug treatment is often not enough for treatment. Only a set of procedures will help solve the problem and normalize the well-being of the patient. However, it is worth remembering that physiotherapeutic procedures, massage and therapeutic exercises can be carried out only after stopping the acute period.
Among the main physiotherapeutic methods, it is necessary to distinguish:
- paraffin;
- ultrasound;
- mud therapy;
- acupuncture;
- laser therapy;
- therapeutic baths;
- magnetotherapy.
During the period of remission, the patient is sent to a spa treatment. After completing the full course of therapy, the patient must undergo a comprehensive examination to assess the quality of treatment and the condition of the shoulder joint. This is especially required in the case of hormonal pathologies.
Folk techniques
Treatment of arthrosis of the shoulder joint at home can be carried out using folk remedies. Animal and plant components are also used as prophylaxis after the main therapy, however, it is still desirable to combine them with medications.
Traditional medicine recipes are more based on self-made ointments, which are applied as compresses to the affected area, rubbed and wrapped to enhance the therapeutic effect. The most popular of them are:
- propolis and melted pork fat;
- freshly picked or heated in a water bath honey;
- hops, clover and St. John's wort with petroleum jelly;
- Ledum, hellebore and melted fat.
A bath prepared on the basis of mint or mustard can bring a positive effect. Treatment of arthrosis of the shoulder joint at home should begin at the initial stages of the course of the disease, as soon as painful sensations arose. At this time, the cartilage tissue has not yet begun to deform and scars do not form.
Massage and exercise
Massage and gymnastics with arthrosis of the shoulder joint can be performed only during the period of remission. You can do this yourself at home. The only condition is that classes should be done regularly. Exercises are performed while standing or sitting. Gradually, the load needs to be increased. Very good help to cope with the disease classes in the pool.
As exercises, you need to wiggle your arms, shoulders, and with light movements to take the elbows away from the body. It is not recommended to perform gymnastics in the presence of high temperature and other diseases in which absolutely any loads are prohibited. It should be remembered that therapeutic exercises will give the greatest effect only in combination with massage.
Surgical intervention
If conservative methods for a long time do not bring any result, then the doctor may prescribe an operation. In addition, surgery is performed at a late stage of arthrosis. During surgery, the destroyed joint is replaced with an artificial prosthesis.
Having noticed the slightest signs of the course of the disease, you need to urgently consult a doctor. If this is not done, then the joint will begin to collapse even more and the cartilage will turn into a scar over time, and the pain will become much more intense.
When treating arthrosis, you should not count on a quick result. It is worth noting that the pain goes away very slowly, and for the full restoration of motor functions it may take more than one month.
Power Features
When conducting a therapeutic course, it is very important to follow a balanced diet. In a daily diet, foods such as:
- poultry meat;
- seafood;
- dried fruits;
- fresh vegetables, herbs and fruits;
- a fish.
All these products contain a lot of natural collagen, which is the main building material for cartilage. In addition, a plentiful drink is required, it is advisable to use diuretic fees. It is worth excluding salty and spicy dishes, as well as products that increase the level of acidity in the body, from the usual diet.
The prognosis of arthrosis
It is necessary to carry out not only complex treatment, but also prevention, in order to prevent the development of arthrosis, which can provoke complete destruction of the joints. It is worth remembering proper nutrition, since fatty, spicy and salty foods, as well as products with preservatives, are not only undesirable for consumption, but also have a detrimental effect on the joints.
Preference should be given to plant foods, lean foods, sour-milk dishes and products with a gelling substance. Alcohol and tobacco must be excluded. With timely and proper treatment, the prognosis for restoration of bone and cartilage tissue will be positive. Otherwise, the patient expects surgery.
Arthrosis of the shoulder joint develops as a result of degenerative changes in the cartilage and adjacent bone tissue. The disease progresses quickly enough and over time can lead to a complete loss of hand function, therefore, urgent medical intervention is required.