As the body ages, the muscles and joints wear out. With regular physical exertion, microtraumas occur in the tissues. If you give the body a rest, they are fully restored. With critical overloads, the muscles do not have time to adapt to them. The result is a place that degenerates after a while. Painful discomfort appears, stiffness in the joints. Such symptoms indicate the development of tendonitis. This is a common disease that most often affects the shoulder joint. The materials of the article discuss the main symptoms of pathology, causes and treatment methods.
Tendonitis - what is it?
Tendonitis is a disease characterized by the development of an inflammatory process in tendons and tissues. They connect muscles to bones. As a result, severe pain in the shoulder appears, and movements are limited. Usually, pathology is diagnosed in adulthood, especially often in women during menopause. The risk group also includes young people who regularly play sports. Shoulder tendinitis in the early stages responds well to treatment. The advanced forms of the disease require surgical intervention. However, even surgery does not always allow to achieve a complete restoration of the function of the hand.
The main causes of the disease
The development of tendonitis can be due to many reasons. Most often, the disease is preceded by prolonged physical activity. Therefore, athletes and people whose labor activity is associated with a serious shoulder load fall into the risk group. Initially, inflammation affects the supraspinatus muscle, then gradually spreads to nearby tissues and the joint capsule. The following problems and disorders can provoke tendonitis of the shoulder joint:
- rheumatoid diseases (gout, arthritis);
- incorrect posture;
- injuries of the shoulder girdle;
- low immunity;
- depression (when it comes to muscle spasm);
- diseases of infectious etiology;
- frequent hypothermia;
- allergy to drugs;
- malfunction of the endocrine system.
These are the most common causes of the disease. The pathological process is aggravated several times if it is accompanied by concomitant pathologies or the lack of timely therapy. In all these cases, adhesions form at the site of inflammation. Over time, they lead to limited mobility of the joint, constant pain and other dangerous consequences.
Clinical manifestations
At the initial stage of the disease, tendons thicken, which is accompanied by pain with certain types of movements. In advanced cases, the discomfort does not go away even at rest. It is severe pain that causes patients to consult a doctor. How else is tendonitis of the shoulder joint manifested ?
Symptoms of the disease can be reduced to four main manifestations:
- pain discomfort;
- impaired mobility of the hand;
- inflammatory process;
- destruction of joint tissues.
Pain with tendinitis can be either acute or dull. It intensifies during physical activity.
The limitation of mobility occurs with the next attempt to perform any movement. In a calm state, patients complain of tolerable pain. Depending on the location of the inflammation, the following symptoms occur:
- damage to the cuff is characterized by severe pain in the upper outer part of the shoulder, it can radiate to the elbow;
- inflammation of the small round muscle is accompanied by discomfort when the arm moves outward;
- the spread of the pathological process to the subscapularis muscle leads to severe pain when the shoulder moves inward;
- tendonitis of the tendon of the biceps muscle does not affect the mobility of the arm, but is also accompanied by discomfort.
An inflammatory reaction entails the compaction of a joint capsule. Its thickness can reach 2 mm. Inflammation is accompanied by swelling and redness of the skin, an increase in temperature in this area.
The pathological process extending to the tendons entails the formation of adhesions. Calcification of tendons is typical for tendonitis. When listening to a joint with a phonendoscope, crepitus is often heard (crunching, creaking). The development of degeneration gradually leads to thinning of the tendons, rupture of the joint capsule is not excluded.
Types of disease
Depending on the localization of the pathological process and the reasons for its appearance, there are:
- Shoulder calcification tendinitis. It develops due to salt deposition, tendon wear or oxygen deficiency in tissues. Pathology is manifested by severe pain when moving the arm.
- Superficial tendinitis. The disease is preceded by injury to the muscle capsule. This form is accompanied by constant pulling pains in the shoulder.
- Biceps tendon inflammation . It is usually diagnosed by swimmers and tennis players.
- Post-traumatic tendonitis. It develops after mechanical damage to the shoulder joint. Therefore, until complete recovery, it is not worth overloading it.
According to the nature of the course, the disease is divided into two forms: acute and chronic.
Diagnostic Methods
Many patients are not even aware of a diagnosis such as tendinitis. What is it, they learn after the onset of symptoms of the disease and going to the doctor. The grounds for confirming the diagnosis are patient complaints, clinical history and physical examination. During the examination, the doctor checks the sensitivity of the muscles and the possibility of active movements.
To exclude doubts about the diagnosis, an additional examination is prescribed. It includes:
- MRI of the shoulder joint;
- Ultrasound of the affected areas;
- arthroscopy;
- roentgenogram;
- CT arthrography.
Based on the results, the doctor confirms the diagnosis and prescribes treatment.
Definition of therapeutic tactics
Treatment of tendonitis of the shoulder joint depends on the severity of the pathological process and its neglect. All therapeutic measures should be carried out under the constant supervision of a specialist. In the initial stages of the disease, the following methods are used:
- physiotherapy;
- the use of drugs;
- Exercise therapy;
- folk remedies.
When the above treatment options are ineffective, you have to resort to surgical intervention - arthroscopy or abdominal surgery. Next, we consider each treatment option in more detail.
Physiotherapy
Treatment of tendonitis of the shoulder joint begins with the immobilization of the arm. To limit its mobility, a special bandage or bandage is used. When the inflammation subsides, physiotherapy is especially effective. Most often, doctors prescribe laser therapy, ultraviolet light, applications with paraffin and mud, electrophoresis with the addition of "Lidase". These procedures are aimed at improving blood circulation in the lesion, relieving muscle spasm and swelling.
Drug treatment
Anti-inflammatory drugs are used to reduce pain and swelling in the affected area. However, do not resort to their help in the first 48 hours after the occurrence of discomfort. When the pain does not have the strength to endure, you can drink the pill "Paracetamol." If after 72 hours the discomfort does not subside, it is necessary to start therapy with non-steroidal anti-inflammatory drugs ("Nise", "Ketorol", "Nurofen"). The course of treatment is usually five days. Drugs must be taken after meals.
Internal therapy should be supplemented with local. What is the treatment for acute tendonitis of the shoulder joint? Ointment or special gels are best chosen with capsaicin (Ibuprofen, Voltaren). They are used to normalize blood flow in the joint bag.
In the second stage of the disease, therapy is also supplemented by injections that are made directly into the joint cavity. To do this, use "Lidocaine" or "Bupivacaine." Injections help to reduce the production of collagen, which is responsible for tendon elasticity. Therefore, hormone therapy is prescribed only with exacerbation. If a patient is diagnosed with tendon tendonitis, such treatment is not recommended.
Physiotherapy
In 90% of cases, exercise therapy helps restore arm mobility. Exercises should be selected by a specialist taking into account the form of the disease. It is important not to overload the damaged joint, but to gradually develop it, increasing the range of motion.
- Exercise 1. A gymnastic stick is required. Place it at arm's length. While holding the projectile in an upright position, try to describe a circle in the air with a sick limb. Doctors recommend this exercise with a diagnosis of supraspinatus muscle of the shoulder joint. Treatment in this way gives positive results in a few days.
- Exercise 2. Lower your hands in front of you. Lift the brushes folded in the lock up. The maximum load falls on a healthy hand. She must "drag" along a sore limb.
- Exercise 2. Lean forward at the back of the chair. With a healthy hand, you must lean against the surface. The patient remains in an arbitrary position. Then you begin to swing from side to side with a damaged hand, gradually increasing the amplitude.
Performing such exercises every day can reduce the manifestation of unpleasant symptoms with tendon inflammation.
Prescriptions for folk healers and tendinitis of the shoulder joint
Medication with this disease usually shows good results. To achieve a better medicinal effect, doctors recommend supplementing conservative therapy with prescriptions for folk doctors. The most popular ones are listed below:
- A decoction of bird cherry has an anti-inflammatory effect. To prepare it, you need to pour three tablespoons of dried berries with a glass of boiling water, put warm in a water bath. To enhance the effect, the obtained medicine can be used not only orally, but also applied to the affected area with gauze moistened in it.
- An infusion from a shepherd’s bag is not taken inside, but an excellent compress is obtained from it. For cooking, you can use the same principles as in the previous recipe.
- Equal shares of sassaparil and ginger roots are poured with boiling water. The resulting broth is consumed throughout the day as tea.
You should not get carried away with folk recipes, and replacing them with conservative treatment is completely prohibited. Neglect of the doctor’s recommendations can adversely affect health, and the disease will continue to progress.
Surgical intervention
The main indication for the operation is the lack of effectiveness of conservative therapy. With tendonitis, the following surgical options are used:
- Reduction under general anesthesia. During the procedure, the doctor “breaks” the joint capsule to restore its mobility.
- Arthroscopy First, the surgeon makes small cuts on the skin. Through them then introduces devices for manipulations, the main of which is an arthroscope. During the procedure, the specialist excises the damaged parts of the capsule. Treatment of tendonitis of the shoulder joint with this method is characterized by a quick recovery period and low trauma. Therefore, surgeons resort to his help most often.
- Salt removal. With calcifying tendonitis, this version of the surgical intervention is indicated. During the procedure, the specialist inserts two needles into the joint, through which the salt deposits are washed out.
After surgery, patients require rehabilitation for several months, during which exercise therapy methods are used.
Preventive actions
Treatment of shoulder tendonitis is a long process. Therefore, it is easier to prevent the development of the disease than to take medicine and injections. What do doctors say about prevention?
Experts recommend that before any, even not too intense physical exertion, do a light workout. Sports must be selected taking into account the individual capabilities of the body. The intensity of the load should be increased gradually, giving the muscles the opportunity to adapt. If after physical activity there is a pain in the shoulder, it is necessary to seek help from a doctor. Early diagnosis of tendonitis and proper treatment can avoid the development of complications. Among them, the most common is bursitis. And tendonitis of the shoulder joint, and many other diseases of a similar etiology are easier to treat at the initial stage.
Conclusion
During the treatment of tendonitis, you must follow the doctor's instructions. A mandatory requirement is the termination of all work associated with excessive loads on the joint. Neglecting the recommendations of a specialist can cause an increase in symptoms, as a result, complete immobilization of the arm.