Periarthritis of the shoulder joint refers to degenerative lesions that occur at the site of attachment of tendons to the bone. The subsequent course of the disease causes reactive inflammation in the affected tendon and adjacent serous bags.
Periarthritis of the shoulder joint is often diagnosed and accounts for up to eighty percent of all cases of shoulder diseases that are rheumatic in nature. This is due to the functional constant excessive tension of the tendons of the muscles, which is associated with rotation and abduction of the shoulder. Excessive stress leads to the early occurrence of a degenerative process.
Periarthritis of the shoulder is most often observed in women after forty years. As a rule, it is right-sided, which is caused by microtraumatization and a greater load. However, in some cases there is a bilateral development of the disease.
Predisposing factors that are important in the development of the disease include a stay in damp for a long time, cooling. Periarthritis of the shoulder joint can develop against the background of sciatica, spondylosis, neuropsychiatric disorders, arthrosis, as well as in the presence of congenital defects in the development of the upper portion of the shoulder girdle.
The main etiological factors are micro and macro injuries. Periarthritis of the shoulder joint is also characteristic of persons suffering from coronary disease, often its manifestations are observed in the phase of subsiding or during an attack of angina pectoris. According to some observations, this degenerative lesion occurs in ten to fifteen percent of patients after myocardial infarction. A common cause of the disease is cervical spondylosis. The presence of radicular syndrome in this case explains trophic disturbance in the periarticular tissues of the shoulder. However, in some cases, a degenerative lesion develops for no apparent reason.
There are simple, acute and chronic forms (stages) of the disease.
The most common form is simple periarthritis. It is isolated by tendon tendonitis of the infraspinatus or supraspinatus muscle. Clinically, this stage is manifested in the form of small restrictions on the movement of the shoulder and moderate pain, which are localized in the anterior upper region. An invariable symptom is an increase or occurrence of pain during certain movements. As a rule, the patient is not able to raise his hand up and bring his fingers closer to the spine when trying to put it behind his back. Other movements a person commits freely. Pain can occur at night.
The acute form can develop independently or manifest as a simple complication. It is believed that the basis of its development is acute tendobursitis, accompanied by calcification in the tendons. As a rule, after physical exertion, a manifestation of diffuse growing pain in the shoulder, resistant to analgesics, is observed. Usually it is accompanied by irradiation in the back of the arm and neck. There are sharp restrictions on limb movements.
The most unfavorable are the chronic form of the lesion. As a rule, it is a consequence of acute, but can occur on its own. The most characteristic manifestation of this is the progressive stiffness of the shoulder. A sharp violation of both the abduction and its rotation is observed.
Periarthritis of the shoulder joint. Treatment.
The main goal of therapy is to unload the affected tendon. At the same time, anti-inflammatory and painkillers, balneological treatment are prescribed. In special cases, there is a need for surgical intervention.