Deforming osteoarthrosis (DOA) of the shoulder joint is a chronic degenerative disease of cartilage, which manifests itself in pain and a feeling of stiffness during movement. It is important that the doctor at the stage of diagnosis establish the true causes of pain and discomfort, because the therapy of this pathology has its own characteristics.
We will understand what pain in the shoulder means when raising a hand up.
Causes of the disease
The causes of osteoarthritis are the natural wear of the joint, which under the influence of various factors occurs until old age. The shoulder joint is a complex structure. Representatives of a number of professions (for example, builders, workers, athletes, etc.) load their hands daily, which may sooner or later affect their health. Another reason that can lead to arthrosis is injury.
DOA of the shoulder joint is common and occurs in approximately 7% of the population. The most common areas of the disease that can result in disability for a person are the knee, ankle and hip joint.
Symptoms of the disease
The first symptom that draws the patient’s attention in the presence of this ailment is pain in the shoulder when the arm is raised up. It occurs after prolonged stress at work, at home or in the gym. The next day, uncomfortable sensations may recede, but in the future appear more often.
In the event that you do not go to the doctor in time and do not begin treatment, then stiffness will join pain discomfort over time: the amplitude of the joint movements will decrease so much that it will be impossible to move your arms back or stretch them up. In this case, a person will hear a crunch with clicks in his shoulder.
Disease severity
The severity of DOA of the shoulder joint does not always correspond to the severity of symptoms, since pain sensitivity in patients is different, and pathological processes can develop faster or, conversely, slower, depending on various concomitant circumstances. Therefore, doctors without fail clarify the diagnosis using instrumental diagnostic techniques, for example, by means of radiography, magnetic resonance imaging and computed tomography.
1st degree
With DOA of the 1st degree of the shoulder joint, the doctor sees in the pictures a small narrowing of the joint gap along with single osteophytes. As a rule, at an early stage, patients complain only of a short pain after exercise and limitation of mobility. With proper treatment, arthrosis of the first degree can not only be stopped, but the pathology can also be reversed, returning the joints to their healthy state.
Next, consider deforming arthrosis of the 2nd degree.
2nd degree
In the event that the disease progresses due to inactivity of the patient or due to an incorrect diagnosis, the joint cavity is narrowed to a minimum, and then the second degree of this pathology is already being discussed. At the same time, parts of dead cartilage can fall into the gap between the bones, which causes severe pain along with inflammation. The joints swell, and the pain becomes continuous. As for the movements, they are so limited that people are forced to abandon the usual actions such as driving a car, cooking, working at a computer and the like. With arthrosis of the second degree, the arm muscles can also atrophy, which will indicate a neglected pathological process. In such a situation, the doctor will be forced to assess the chances of success with conservative treatment. If the deformation of the joint is irreversible, then only the operation will help the patient.
The list of glucocorticoids that are effective in this disease, we consider below.
Pathology treatment
In the event that the doctor whom the patient has contacted prescribes only painkillers, he should be wary. This disease does not tolerate a careless approach, without complex therapy there are few chances for positive results. Of crucial importance in the treatment of this disease are the methods of physiotherapy, gymnastics and massage. The treatment program in each situation is individual.
Drug Therapies
The main goals of the treatment of DOA of the shoulder joint are:
- The elimination of pain.
- Restoring blood circulation in the tissues of the joint.
In drug therapy of this pathology, the conservative method is most often used, in which drugs are used in the form of pills, injections or ointments. In advanced cases, patients are prescribed surgery. Fast healing of the patient is carried out only at the initial stage of the disease. Depending on the result of the patient’s diagnosis, the doctor selects medications. The following medications are usually prescribed:
- Taking non-steroidal anti-inflammatory drugs in the form of “Diclofenac”, “Aceclofenac” and “Nimesulide” (instructions for use, price and reviews of the drug will be presented below).
- The use of muscle relaxants in the form of "Sirdaluda" and "Midokalma".
- The list of chondroprotective drugs includes Glucosamine along with Chondroitin and hyaluronic acid.
Along with medicines, doctors prescribe the use of glucocorticoid ointments, which help relieve the inflammatory process and reduce pain. Such ointments as, for example, Voltaren, Ibuprofen and indomethacin ointment have proven themselves as effective external agents.
- Sometimes doctors are forced to prescribe direct hormonal injections into the joint cavity, for example, Hydrocortisone and Diprospan. The list of glucocorticoids can be continued with Kenalog, Phlosterone, Celeston.
Hormonal injections, as a rule, do not treat the underlying disease, but only help alleviate the patient’s serious condition, reduce inflammation and reduce the harmful effects of drugs on the body. The described method of therapy can be applied only as part of complex treatment.
If the conservative methods of drug therapy are ineffective, when the drugs from the list of chondroprotectors or glucocorticoids do not work fully, the doctor may resort to surgical intervention, which consists in the complete replacement of the diseased shoulder joint. It must be emphasized that the level of medicine in this direction is constantly developing, in this regard, the implementation of high-tech operations significantly improves the quality of life for patients.
Instructions for use "Nimesulide"
According to reviews, the price of the drug is quite reasonable. It costs about 180-250 rubles. A large number of contraindications suggests that the instruction is very important for familiarization. An adult patient needs to consume 100 mg of powder 2 times a day after meals. Pellets need to be bred in warm water. If such a dose does not produce a result, it can be doubled. The course of treatment lasts no more than 15 days.
Surgery
In the event that it is not possible to stop the symptoms of the disease by the conservative method, then surgical treatment may be prescribed:
- Carrying out a puncture of the shoulder joint is a minimally invasive method that allows you to eliminate the inflammatory fluid from the articular region and inject the medication there.
- Arthroscopy involves a mini-operation, which is carried out under the control of a video camera through a puncture in the joint area. This treatment option alleviates the symptoms without requiring prolonged rehabilitation.
- Endoprosthetics is a relatively new type of surgical intervention, in which a pathologically changed joint is replaced with a bioprosthesis. Such an operation allows you to finally cope with the disease, but, like any other surgical intervention, it has risks.
Physiotherapy
This treatment method involves the following treatment methods:
- Shock wave treatment is a method based on the action of acoustic waves that are generated by a special apparatus. During the session, the doctor brings the applicator closer to the pathological region, through which impulses act on the diseased tissue. This leads to an improvement in metabolic processes and relieves pain, increasing shoulder mobility.
- Laser therapy at an early stage may be one of the main treatment methods. This approach makes it possible to abandon drug loads on the body, and in the long run even avoid surgery.
- Miostimulation allows patients to restore strength in a sick limb, thanks to this, after 2-3 sessions, patients begin active physical education. This technique is especially indicated for weakened and elderly people.
- Phonophoresis involves the use of ultrasound with the simultaneous application of a drug in the form of a gel on the skin over the joint. Due to this effect, the effectiveness of the drug is increased, since through the ultrasound rays its penetration through the skin to the affected shoulder joint is facilitated.
- Conducting ozone therapy, as a rule, is prescribed as an adjuvant. Like other physiotherapeutic methods, it reduces pain and accelerates the recovery process.
Kinesitherapy
The following methods for the treatment of DOA of the shoulder joint (according to ICD-10 code M19) can be additionally used:
- Physical therapy classes are prescribed between exacerbations of the disease, when the inflammatory processes subside and patients feel the strength for sparing training. A properly selected exercise program will help strengthen muscles and prevent regular attacks of osteoarthritis.
- Massage and lymphatic drainage along with manual therapy lead to significant relief. True, as in the case of physiotherapy exercises, they are prescribed outside the period of exacerbation. Only professionals should carry out such effects on the body, since damage to a diseased joint can be very easy.
- Carrying out mechanotherapy involves exercises using special simulators available in the gyms of professional orthopedic clinics. Instructors explain to patients how to deal with each of these devices correctly and with benefit.
- Stretching the joints helps to slightly increase the space inside the joint, reduces bone friction with active or passive hand movement. In the presence of osteoarthrosis of the shoulder joint, similar manipulation is performed by experienced manual therapists.
Exercises
Especially with DOA of the right shoulder joint or the left, it is important to undergo treatment with physical education and gymnastics. Exercise effectively slows down the progression of the disease, improving blood circulation, so that the nutrients enter the joint cavity very quickly. With the help of gymnastics, the shoulder girdle is strengthened, thereby reducing the load on the joint. In the event that physical education is carried out with the use of weight, it is necessary to know that with a diagnosis of “arthrosis of the shoulder” it is impossible to lift more than 5 kg. The appearance of pain suggests that it is time to stop the exercises with DOA of the shoulder joint or at least switch to a light complex.
It is mandatory to warm up to warm up and to prepare for a more difficult physical complex of exercises. Warming up involves performing circular movements with the shoulders along with rotation, hitching of the hands behind the back and other types of stretching, which are well known.
Improving and gymnastic exercises are carried out under the supervision of a physiotherapist or attending doctor. One of them should demonstrate the correctness of the complex. Best when exercises are designed specifically for a particular case. It must be remembered that gymnastics is also capable of destroying joints in the event that training will load them beyond normal.
Physical education should not be performed if the patient has septic arthritis of the shoulder joint. After gymnastics, you must definitely take a contrast shower, lubricate the joints with anesthetic ointment. It is very useful to do easy self-massage of the shoulder and collar area. Gymnastics should be carried out every day at any convenient time. In the event that a person regularly performs the complex developed for him, then very soon he will notice the long-awaited result.
Conclusion
Thus, deforming arthrosis is a very serious disease. At stake is the ability to work the upper limbs. At the initial stage, the prognosis is usually always favorable. But with the passage of time, as degenerative and dystrophic changes develop, it can deteriorate significantly. In the case of ankylosis, even the threat of death from any causes increases, which is directly associated with increased risks of injuries and thromboembolic complications.