Shoulder osteoarthritis is a chronic generalized disease associated with damage to joint structures. The pathological process is accompanied by degenerative deformation of the articular surfaces. In this case, not only cartilage tissue is damaged, but also bone tissue. Symptoms of the pathology and methods of treatment depend on the degree of damage to the joints.
The disease can develop for several years without manifesting itself. At some point, under the influence of adverse factors (hypothermia, trauma, severe concomitant disease), the first signs of the disease appear. It is at this time that it is necessary to consult a doctor, since the fight against dystrophic changes in cartilage is especially effective at the onset of the disease.
Causes of shoulder osteoarthritis
The causes of degenerative-dystrophic damage to the tissues of the joint are numerous and varied. Among them, injuries play the leading role, so post-traumatic arthrosis of the shoulder joint is considered the most common form of pathology. It can be caused by even slight but repeatedly repeated damage to cartilage tissues.
Also, the disease can occur under the influence of the following pathological factors:
- Severe joint damage: synovitis, gout, acute or chronic arthritis, aseptic necrosis of the humerus.
- Regular overexertion of the joints. It is most often seen in athletes who participate in volleyball, tennis, basketball.
- Congenital pathology of the shoulder joint.
- endocrine diseases.
- Elderly and senile age.
- Overweight (obesity).
- Avitaminosis.
- Autoimmune lesions and weakening of the immune system.
- genetic predisposition.
Most of the patients are people who perform monotonous physical work. Therefore, arthrosis of the right shoulder joint is diagnosed much more often than the left.
The disease usually develops under the influence of not one, but several adverse factors at once. Based on this, the treatment should be comprehensive and aimed not only at combating the disease, but also at eliminating all the causes that provoked it.
Characteristic signs of the disease.
Osteoarthritis of the shoulder, which begins inconspicuous and develops gradually, can manifest itself suddenly after injury, hypothermia, or severe physical exertion. In this case, there are characteristic symptoms of damage to the shoulder joints and nearby tissues:
- pain;
- crackling and clicking sounds during hand movement;
- stiffness and decreased range of motion in the shoulder.
The disease most often occurs in a chronic form. An exacerbation of the disease can be triggered by excessive stress on the joint or injury.
The intensity of the manifestation of symptoms largely depends on the severity of damage to cartilage and bone tissue, therefore it is customary to distinguish between various degrees of the disease. Such systematization significantly facilitates diagnosis and allows you to accurately predict the outcome of the disease.
Shoulder osteoarthritis grade I
During this period, the tissues of the joint are slightly affected. Pain is observed extremely rarely and only after excessive physical exertion or long monotonous work. Most of the time, the patient does not pay attention to these symptoms, attributing them to overwork or muscle tension. Defeat of 1 degree is treated only by conservative methods.
At the beginning of the disease, there are no obvious changes in the cartilage tissues on radiographs, only an oval ring around the joint cavity is observed.
Shoulder osteoarthritis II degree
At this stage, the symptoms of the disease become more pronounced. Cartilage tissues become thin and deformed, intra-articular ligaments are damaged. During the movement of the hand, a crunch is heard, the inner layer of the articular bag swells. Over time, the pain becomes constant. Morning stiffness and limitation of movement appear, which can lead to muscle atrophy.
Shoulder osteoarthritis III degree
During this period, the joint is already significantly deformed, there are practically no movements in it. The patient suffers from acute pain that may radiate to the arm and shoulder blade. If you do not stop the further destruction of tissues, the pathological process can lead to disability.
Third degree disease is not amenable to conservative treatment and requires surgical intervention.
Shoulder-shoulder arthrosis rarely reaches the third stage. Most often, the second stage is diagnosed with the transition to a chronic form.
Which doctor to contact
Often people dealing with joint pain don't know where to turn. At the first symptoms of the disease, you need to visit a rheumatologist. The specialist will not only conduct a complete physical examination and make a diagnosis, but also, if necessary, relieve severe pain with the help of an intra-articular injection of an anesthetic.
With the advanced form of the disease, the rheumatologist is likely to be powerless. In this case, you will need a surgeon or orthopedist. In large cities, you can make an appointment with an arthrologist who deals only with joint diseases.
How to deal with shoulder arthritis
After a medical examination and diagnosis, the doctor prescribes a specific therapy that allows you to achieve a long and stable remission of the disease. It is impossible to cure degenerative changes in the joints, but slowing down the course of the destructive process and alleviating the patient's condition is a completely feasible task.
The main goal of antiarthrosis therapy is to relieve pain and restore joint mobility.
Modern drug therapy
In some patients, it is difficult to make an accurate diagnosis in the early stages of the disease. At this stage, the pain is not pronounced and does not force patients to seek help from specialists. Most often they are treated independently with folk remedies. Some patients perform therapeutic exercises to reduce joint pain and stiffness. For the treatment of arthrosis, drugs prescribed by a doctor are used, according to the recommended dose and duration of administration. The most effective are the following groups of drugs:
- nonsteroidal anti-inflammatory drugs;
- chondroprotectors;
- corticosteroid drugs;
- non-narcotic analgesics;
- vasodilators;
- muscle relaxants
Many drugs for this pathology are sometimes prescribed for a long time. Depending on the severity of the disease, the drugs are taken orally, used externally, injected intramuscularly or into the cavity of the shoulder joint.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs are contraindicated for long-term use due to the presence of side effects from the digestive tract.
It is possible to treat the disease with drugs already at an early stage of the development of the pathological process. The course is determined based on the patient's condition and the severity of symptoms. As an independent treatment, ointments included in this group are not prescribed. They are used in combination with similar groups of drugs that are used intramuscularly or orally. Its task is to reduce inflammation and alleviate the patient's condition.
Chondroprotectors
Almost all patients include in the treatment regimen drugs aimed at improving metabolic processes in cartilage tissue. In addition, they increase the elasticity of the cartilage. Chondroprotectors have such properties. These medicinal substances differ depending on the main active ingredient on the basis of which they are manufactured:
- hyaluronic acid;
- chondroitin sulfate;
- glucosamine;
- combined funds.
Glucosamine is a substance that plays an important role in the formation of healthy cartilage tissue. The task of chondroitin sulfate is to nourish and provide cushioning for the shoulder.
Monotherapy preparations have proven their effectiveness on the market compared to a combination of substances.
The polysaccharide contained in the intercellular space is hyaluronic acid. In addition, it is capable of reducing the sensitivity of the receptors that respond to pain. Combined chondroprotectors, which contain several active ingredients, have the greatest advantage.
The most effective use of chondroprotectors in the initial stages of the disease. The task of drugs is the synthesis of new cells of healthy cartilage tissue, which replace damaged tissue. In the presence of pain and swelling, the drugs of this group will be less effective. Therefore, it will first be necessary to use anti-inflammatory drugs to alleviate the patient's condition.
For maximum effect, injection preparations are used for intra-articular or intramuscular administration. The course of treatment with chondroprotectors lasts up to six months, some patients notice the first results after 3 months of therapy. It is important to follow some rules in the treatment of such drugs.
With the beginning of the course of therapy, physical overload and stressful situations should be excluded. The patient will receive the greatest effect if he begins to take chondroprotectors, improves nutrition and performs physiotherapy exercises. Many patients with osteoarthritis of the shoulder joint participate in Dr. Bubnovsky's method, they perform a series of specially designed exercises to achieve gradual restoration of the joints or stop the progression of the disease.
Corticosteroid agents
When severe pain appears, if anti-inflammatory drugs do not have a positive effect, corticosteroids are prescribed. To alleviate the patient's condition, ointments or injections are prescribed.
Analgesics
In the initial stages of the disease, analgesics are prescribed to reduce pain.
Compared with nonsteroidal anti-inflammatory drugs, drugs of this group have a less negative effect on the mucosa of the digestive tract.
Having an unexpressed anti-inflammatory effect, they effectively fight pain.
Vasodilators
Mandatory means in the treatment of arthrosis are vasodilators. They eliminate vascular spasms, normalize blood flow in the affected area. Many patients complain of the appearance of night pains, which are effectively treated with drugs from this group.
muscle relaxants
When osteoarthritis of the shoulder joint is affected, muscle spasms are considered a common occurrence, which are relieved with muscle relaxants. When prescribing them, the principle of complexity is observed, they are used in conjunction with painkillers and anti-inflammatory drugs. If necessary, the minimum dose is initially prescribed with a gradual increase.
surgical treatment
The main goal of the operation is to restore the working capacity of the joint and improve the patient's quality of life. If conservative therapy is ineffective, a persistent pain syndrome persists, the joint gradually deforms, and range of motion is severely limited, the patient is indicated for surgical intervention.
The decision on the need for surgery is made by the orthopedist or traumatologist together with the patient. Then the dimensions of the stent and the material from which it will be made are determined. Today, implants are made of titanium and high-strength polymers, with a weight similar to that of a natural joint. The durability and reliability of stents is beyond question.
Recovery period
The operation to replace the affected joint is usually uncomplicated. Fixation with a support bandage is required for the first 14 days. Early passive execution of a complex of physical exercises on special devices and devices is allowed. Power charges are allowed after 45-60 days.
Physiotherapy
Any complex of exercises against arthritis is useful only during remission. If there is an increase in temperature, pain and other symptoms of an exacerbation of the disease, the load is contraindicated.
Exercise therapy should not cause pain or discomfort. At the slightest feeling of discomfort, the exercise should be abandoned.
Charging should be done daily. After loading, it is useful to self-massage the affected joint area and nearby muscles with a healing cream, which the attending physician will help you choose.
Physiotherapy
Physiotherapy allows you to enhance the effect of drugs, reduce their dose and minimize the risk of complications. The type of physiotherapy is determined by the doctor, guided by the patient's condition, neglect of the process and possible contraindications due to concomitant diseases.
Most often, the following physiotherapy procedures are used in treatment:
- magnet therapy;
- ultrasound with hydrocortisone;
- electrophoresis with anti-inflammatory and analgesic substances;
- ultraviolet irradiation
- treatment with laser and infrared rays.
Physiotherapy is carried out in courses of 10-15 sessions several times a year.
Treatment with folk methods
Combining folk remedies with drug therapy, exercise therapy, proper nutrition, and physical therapy, you can achieve a long and stable remission.
One of the best recipes is a compress with birch leaves, which have anti-inflammatory and warming effects. Young leaves are best suited, because closer to autumn their beneficial properties decrease. Before making a compress, a small massage of the affected limb is necessary. Then the sheets are applied to the skin, strengthened with cling film and a bandage. The compress is left overnight. The duration of treatment is 10 days.
Salt baths have a healing effect. Before the procedure, the crystals are pre-dissolved in hot water. Then the resulting solution is poured into the bath. The procedure will require approximately 3 kg of salt. Also, you can add a few drops of any essential oil. It is best to take a bath before bedtime, the duration of the bath should not exceed 30 minutes.
The hot oatmeal compress helps a lot. They must be poured with boiling water, insist and used for their intended purpose. It is recommended to carry out such procedures at night.
No less useful herbal poultices. Crushed plants with anti-inflammatory action (yarrow, ginger, turmeric, cinquefoil, calamus) are brewed with boiling water, kept for 10 minutes under a lid and applied to a sore spot. After the procedure, the affected shoulder should be smeared with a healing cream and go to bed.
Inside it is recommended to take an infusion of corn stigmas. A teaspoon of raw materials or 1 filter bag is brewed from 200 ml of boiling water, insisted under the lid for 30 minutes, and 1 tablespoon is consumed. spoon half an hour before meals.
Prevention of osteoarthritis of the shoulder joint.
Disease prevention can be primary and secondary. Primary prevention includes the following activities:
- regular exercise - jogging or brisk walking, exercises for the muscles of the shoulder girdle;
- hot and cold shower;
- elimination of excessive loads and avoidance of traumatic situations.
- timely treatment of diseases that can provoke shoulder arthrosis;
Secondary prevention is aimed at early diagnosis and treatment of arthritis.
conclusion
The recovery of joint functions is a long and difficult process. The treatment of shoulder osteoarthritis should be aimed primarily at eliminating the symptoms of the disease. Only complex therapy, combining medical and folk methods, will bring relief and restore working capacity.