One of the main components of the human skeleton is the shoulder joint. It consists of three bones: the humerus, clavicle and scapula, each part of the bone is covered with a membrane containing fluid.
About pathology
The joint capsule is a shell that prevents the bones of the joint from rubbing together. Adhesive shoulder capsulitis (ICD 10) is damage to the capsule, manifested by severe pain and limited mobility in the shoulder area. This disease is also called "frozen shoulder." Because, if you do not take measures for her treatment, then it can completely lose mobility, and a person will become disabled.
Several factors contributing to the development of the disease were identified. Most often, adhesive capsulitis appears after injuries and injuries of the shoulder joint. Various metabolic disorders in the body, such as diabetes, also contribute to the development of this disease.
Causes
It is important to treat spinal diseases in a timely manner, because adhesive capsulitis of the shoulder can develop due to cervical or thoracic osteochondrosis. Even hormonal disruptions that occur in a woman’s body during menopause, leading to changes in metabolism, can give an impetus to the development of this disease called adhesive shoulder capsulitis. The reasons may be different.
Work, in which the hands are constantly raised up, heavily loads the shoulder joint, which leads to the development of the disease. Particularly at risk are people who have suffered a heart attack, stroke, and other heart diseases, as well as surgical intervention. Adhesive capsulitis is also promoted by inflammatory processes in the cartilage and articular tissues. It can provoke diseases of the respiratory system.
Stages of the disease
The adhesive capsulitis of the shoulder proceeds in three stages:
- The first appears pain in the shoulder area. She can be very strong. The pains are not constant, they appear often. Get stronger from physical exertion or work done by hand. There is also an increase in pain at night. For some time the pain progresses. The patient tries to make fewer movements with a sick limb, looking for a comfortable position for her. This period is quite long, about 6-8 months.
- In the second stage, the mobility of the shoulder joint is limited. The person suffering from this disease cannot raise his arm high. In this case, the mobility of the hand and elbow are not impaired. The duration of this stage depends on the therapy used. If the treatment was effective, then the next stage will follow.
- At the last stage, recovery occurs. The joint becomes completely mobile. The disease can last a long time - 1.5-4 years. Some patients cannot normally move their hands all their lives.
Diagnostics
However, if the adhesive capsulitis of the shoulder is not treated or the wrong method of therapy is chosen, the disease will end in disability.
In order to begin treatment of a disease, first it must be correctly diagnosed, and this can be done by a rheumatologist. Diagnosis begins with listening to the patient's complaints and a simple examination. On palpation, pain is found at some points of the shoulder. The patient is asked to hold his head with both hands, put his hands on his belt, and take his hands away from the body as much as possible. After this, the patient is assigned a more detailed examination: radiography of the shoulder joint, blood for analysis. But the most reliable way to identify adhesive shoulder capsulitis is to conduct a study of the joint itself, called arthrography. This method allows you to see how much the volume of the joint capsule has actually decreased.
When it is normal, its volume is 12 ml. With articular pathology, the fluid decreases to 2-3 ml.
It is worth noting the fact that an experienced doctor and without expensive diagnostic methods will identify pathology. He will examine the contour of the shoulder and joint, detect thinning and sagging of the muscle.
What is the treatment for an adhesive shoulder capsulitis?
Therapy
Based on the results of the examination, the doctor chooses the optimal treatment for the affected joint. There are several directions:
- At the first stage of the disease, symptoms consisting in severe pain are stopped. This is achieved by the use of pain relievers.
- It is necessary to stop the inflammatory process, because it is the cause of all ills. To do this, nonsteroidal anti-inflammatory drugs, for example, Diclofenac, Indomethacin and the like, are most often used. A chiropractor with an adhesive shoulder capsule can also help.
- Joint immobilization is not required. This can even harm him, because the forced restriction of the joint makes it difficult to return his mobility. The recovery phase is slowing down. But hand movements must be careful. They should not bring pain.
- In case of very severe pain, a doctor may prescribe intra-articular injections of glucocorticosteroids. Injections can be replaced by taking pills, but they cause more adverse reactions. To eliminate severe pain, blockade of the suprascapular nerve can be prescribed.
Adhesive shoulder capsulitis: physiotherapy
At the stage of recovery, a set of exercises is prescribed that will help restore lost mobility to the damaged joint. In order for the recovery process to bring the expected effect, it is necessary to perform special exercises several times every day.
Raising their arms as much as possible, they make rotational movements, raise and lower them. You can try to take your hand behind your back and grab it with your other hand, and then pull it a little to the buttocks. A set of exercises will also be effective, helping to maintain muscle tone, as well as preventing the appearance of pain. This complex contains the following exercises:
- head alternately tilted to the side;
- the head is turned in different directions;
- shoulders raise and lower;
The neck muscles must be trained. To do this, in the supine position, raise and lower the head, while holding it up.
Simple exercises for the neck and shoulder will help stretch the muscles. When neck is flowing, it is not recommended to make active head movements in a circle.
- Exercises should not bring pain. Proceed to their implementation only after consultation with a doctor, so as not to harm your health and not reduce to zero the result achieved with medical treatment. Do not overwork the joint. Excessive loading can damage it. Increase it gradually. Appointments of therapeutic massage, laser, magnetic or sound therapy are also made. Unfortunately, these treatments do not always bring the expected effect. Its productivity depends on the degree to which the joint is affected.
- In the event that a significant area was affected and as a result of treatment the joint mobility was not restored or restored, but not completely, then surgical intervention is necessary. Arthroscopy is necessary. This is an operation aimed at restoring the motor function of the shoulder joint.
The shoulder is pierced in several places. An arthroscope with a camera that is inserted into the joint cavity searches for a sore spot. The area of another puncture is used to insert a special instrument. It acts on the joint with cold plasma, as a result of which splicing and puckering is eliminated.
After such surgical intervention, the limb can be moved freely and painlessly.
Adhesive shoulder capsulitis: treatment with folk remedies
Before starting treatment with alternative methods, it is necessary to consult a doctor.
In compresses, Dimexide is often used. Cold blue clay, wax or paraffin is also effective. The camphor alcohol mixture can be rubbed into the sore shoulder. Also used in folk medicine are mustard and egg white, an ointment from the roots of burdock and butter.
It is recommended to take decoctions from the following plants inside:
- hawthorn;
- St. John's wort
- eucalyptus;
- Melissa;
- buds of pine.
You need to drink this for at least 4 weeks for a visible result.
Complications
Like any surgery, arthroscopy can cause complications. This may be due to the following negative factors:
- chronic diseases that have been recently transmitted;
- bad habits (alcohol, nicotine);
- taking medications that provoke bleeding;
- operations on the shoulder, transferred earlier.
Possible complications are bleeding, infections, damage to soft tissues or nerve endings, a negative reaction to anesthesia, joint immobility, and fracture.
It is urgent to consult a doctor if:
- an anesthetic was taken, but the pain did not subside;
- the person is shivering and fever, which means that the infection began to develop;
- numbness, tingling in the arm and shoulder;
- swelling, inflammation, bleeding in the puncture area;
- vomiting, nausea appeared.
After arthroscopy, pain can last for several weeks, and a full cure occurs in six months.
In order for recovery after surgery to take place without complications, one must adhere to the following points:
- in the first two postoperative days, ice should be applied to the swollen area and kept for 20-30 minutes;
- take painkillers;
- constantly change dressings;
- after surgery, the first time to sleep with a pillow under the elbow, it is better not in bed, but in a chair, for example;
- Do the exercises recommended by your doctor.
How can adhesive shoulder capsulitis be prevented? The reasons and treatment we have considered.
Prevention
There are a number of preventative measures that can help prevent the development of adhesive capsulitis. It is important to maintain emotional calm. Avoid stressful situations, they provoke muscle cramps, contribute to the appearance of seizures. In addition, anxiety, stress lead to rapid muscle fatigue. Breathe correctly.
When working at a computer, it is important to sit properly. The pose should be comfortable. Hold the phone correctly. Clutching his shoulder when talking is not recommended. This can lead to pain in the shoulder joint. Drink plenty of water. Muscle fatigue will be less developed if the body maintains water balance.
Conclusion
Shoulder capsulitis is a long-term disease. It happens that a person throughout his life can not completely get rid of the discomfort in this joint. Usually people over 40 years old and mostly women suffer from capsulitis.