The shoulder joint is one of the most vulnerable in the human skeleton. This is due to the rather complex structure of the articulation with a weak fixation with the scapula. The shoulder receives a large amount of stress every day when performing household or professional duties. If an injury occurs, metabolic processes are disturbed, tissues wear out due to age - dystrophic changes in cartilage tissue begin. This pathology is called arthrosis of the shoulder joint.
Depending on the manifestations and degree of damage to the glenohumeral joint, four degrees of pathology are diagnosed. There is also a difference between acute and chronic shoulder arthrosis. With untimely or bad faith treatment, the joint continues to deform and collapse, which ultimately leads to a significant limitation of the functions of the upper limb and loss of mobility.
Today, only grade 1 shoulder arthrosis can be completely cured. But this does not mean that you can give up and do nothing with pathology of degree 2 and higher. Comprehensive and adequate treatment of osteoarthritis of the shoulder joint with the help of drugs or surgery helps to slow down the destruction of the joint, at least partially preserve the mobility of the arm and shoulder, and prevent damage.
Symptoms and causes
Deforming arthrosis of the shoulder joint does not develop in a day. Initially, the changes are minor. Cartilage gradually loses its elasticity under the influence of various factors - these can be age-related changes or disruption of metabolic processes in tissues. Microcracks appear on its surface, in which calcium salts accumulate. Then it becomes thin, fragile and begins to collapse.
Often this process is accompanied by inflammation, which also spreads to the surrounding muscle, connective and bone tissues. This manifests itself mainly as pain - at first mild, painful. Then they become more intense and in an advanced stage they never disappear, which significantly reduces a person's ability to work and quality of life.
The main reasons why DOA of the shoulder joint develops are as follows:
- Impaired blood circulation in the cartilaginous tissues of the shoulder in atherosclerosis and other chronic diseases related to blood vessels.
- Chronic pathologies of an autoimmune nature, for example, rheumatoid arthritis, systemic lupus erythematosus.
- Dysfunction of the endocrine system (diabetes).
- Congenital abnormalities of the shoulder joint, childbirth in infants and other injuries that lead to pathological deformation and dysfunction of the limb.
- Acquired pathologies of joint structures after injury or accident, failed operation, including inflammation due to arthritis, synovitis, osteoporosis, etc.
In addition, there are provoking factors under the influence of which the risk of developing shoulder arthrosis increases several times. They include:
- professional activity in which the shoulder joint receives heavy loads day after day for many years - shoulder arthrosis is quite rightly called the disease of plasterers, painters and loaders;
- sedentary lifestyle, lack of physical activity - with insufficient physical activity, blood circulation slows down, joint tissues do not receive the necessary amount of nutrients and begin to atrophy;
- overweight - often combined with the previous factor; with obesity, a person cannot move actively, while the joints receive additional stress due to extra pounds;
- hereditary predisposition;
- advanced age - approximately 80% of people over the age of 70 show symptoms of osteoarthritis.
Most often, when examining and interviewing a patient, the doctor identifies a combination of several diseases and provoking factors. A typical patient with a diagnosis of arthrosis of the shoulder joint is a man or woman over the age of 50, engaged in heavy physical work, overweight and other chronic pathologies (diabetes, arterial hypertension, varicose veins, knee arthritis, etc. ). In this case, lesions on the right shoulder are more common than the left. This is due to the fact that most people actively use their right hand at work and at home, with the exception of congenital left-handers.
How to recognize the disease
Symptoms of arthrosis of the shoulder joint may not appear for a long time. If the shoulder starts to hurt from time to time, one puts it down to fatigue, takes painkillers, uses an ointment with a warming effect and calms down. But sooner or later there comes a time when pills and ointments no longer help, the pain becomes constant, intense and bothers you at rest and at night. In addition to this symptom, the following signs will indicate dystrophic changes in the shoulder joint:
- swelling and deformation of the joint, noticeable with the naked eye;
- redness of the skin over the joint, local increase in temperature;
- characteristic crunch in the joint. Creaking sounds when the arm is moved sharply are explained by the accumulation of salts in the cracks of the cartilage and between the joint elements. At first, the crunch appears only during sudden movements, it is quiet and barely audible. In advanced forms of the disease, the shoulder crunches with every movement, the sound is heard by others;
- limitation of limb mobility. When examining a patient, the doctor will ask him to comb his hair. This examination is enough to diagnose arthrosis of the shoulder joint: the patient will feel sharp pain, make a rotational movement with the shoulder, it will be difficult for him to move the shoulder back, the doctor will hear a crack and click in the joint.
DOA of the shoulder must be treated, otherwise, over time, the patient will lose full mobility of the upper limb and ability to work. If the process of destruction of cartilage and surrounding tissues has already begun, it will not stop on its own. Proper nutrition, folk remedies, a healthy lifestyle and exercise are not enough here. To deal with the problem and prevent damage, complex treatment using drugs with different effects and physical procedures will be necessary.
Degrees
There are several stages of DOA of the shoulder joint, each of which manifests itself in a different way and requires a different approach to treatment.
- 1st degree.At this stage, the disease is just beginning to develop, the changes in cartilage tissue are still insignificant. The main symptoms of DOA grade 1 are joint and limb weakness and intermittent pain. The pain appears after physical exertion, with monotonous, repetitive movements of the hands for a long time. After a night's sleep or a long period of rest, a person feels stiffness in the shoulder joint, but as it develops, the stiffness still passes without drugs and physical procedures - a slight warm-up is enough. If you take an X-ray at this stage, the image will not show significant changes in the joint structures, although thinning and deformation of the cartilage may be noticed.
- 2nd degree.The pathological process proceeds and manifests itself more actively. A person is already used to the fact that his shoulder will hurt after work, he "waits" for the pain, there are ready-made analgesics and ointments for joint pain, pharmacy or home. X-ray diagnostics will show noticeable changes in the joint: thinning and deformation of the cartilage, inflammation of the joint membraneFrom time to time the joint becomes red and swollen, crunching, creaking and clicking are heard when moving.
- 3rd degree.The shoulder joint constantly hurts and crunches, to reduce the discomfort, the person tries not to touch it and not to move the limb at all. The deformation is visually noticeable, the affected shoulder differs in size and shape from the healthy one, it often becomes red and swollen, which is accompanied by increased pain. It is not possible to remove them with painkillers.
If nothing is done in the third stage of the disease, the fourth stage will occur - complete immobility of the shoulder joint and limb. In this case, it is already pointless to prescribe drugs and physiotherapy, only endoprosthetics will help to at least partially restore the functionality of the hand. But even this is not always successful.
Note:In medical practice, it is extremely rare to encounter grade 3 shoulder arthrosis. Usually, the patient seeks medical help earlier and begins treatment. Severe destruction of cartilage can occur against the background of extensive trauma, if for some reason the patient could not visit a doctor or if the person lives in unfavorable social conditions where there are no qualified doctors.
How is osteoarthritis diagnosed and treated?
A good doctor will be able to make a preliminary diagnosis after a conversation with the patient and his external examination. Instrumental diagnostic methods are needed more to exclude other pathologies and complications or to identify them. In order to determine exactly how badly the joint is affected and whether there is inflammation, the following diagnostic measures are performed:
- radiography;
- CT;
- Magnetic resonance;
- in some cases, ultrasound to get a complete picture of the state of the joint;
- clinical examinations of urine and blood - the number of leukocytes and the sedimentation rate of erythrocytes will be evaluated. If they are too high, an inflammatory process develops in the body.
The best way to treat the pathology is determined by the doctor individually, taking into account the age, profession and general condition of the patient.
Traditional treatment includes the use of the following methods and means:
- A course of treatment with nonsteroidal anti-inflammatory drugs. Medicines are prescribed in the form of tablets or powders for oral administration or in the form of ointments for external use to eliminate the main symptoms of inflammation - pain, swelling, redness, increased body temperature.
- Anesthetics for severe pain in the form of tablets or injections. These drugs cannot be taken continuously, they do not eliminate the cause of the disease and are intended only for extreme cases when the pain is unbearable.
- A course of taking chondroprotectors - drugs that promote the recovery of cartilage tissue and prevent further destruction. They also partially relieve pain and swelling, as well as deformity of the shoulder joint. Such drugs do not work immediately, they must be taken for at least 3-4 months.
- A course of muscle relaxants - tablets or injections that relieve muscle spasms. These are optional drugs in the complex treatment of osteoarthritis, they are not always prescribed.
- A course of taking vitamin-mineral complexes and dietary supplements with collagen and hyaluronic acid.
To increase the effectiveness of the treatment, quick recovery and prevent new lesions, a special therapeutic diet is also prescribed. The patient's diet includes foods rich in vitamins B, A, C, E - fresh fruits and vegetables, cabbage of any variety, cereals, legumes. Polyunsaturated fatty acids can be obtained from marine fish and seafood. A gelatin diet is practiced because gelatin helps to restore the elasticity of cartilage tissue. The menu includes jellied beef hooves and tails, toppings and various jellies. It is useful to take gelatin in its pure form, pre-soaked in warm water.
Physiotherapy is the next important point in the complex treatment of shoulder arthrosis. They begin only when the inflammatory process is stopped. Depending on the degree of the disease, its dynamics and the effectiveness of drug treatment, the doctor chooses a combination of the following physical procedures:
- cryotherapy;
- acupuncture;
- electrophoresis;
- laser therapy;
- magnetic therapy;
- mud therapy;
- different types of massage;
- physiotherapy.
Physiotherapy procedures are aimed at activating metabolic processes in joint tissues, normalizing blood circulation and restoring limb mobility. With their help, it is possible to reduce the number of drugs taken and their dose, which is especially valuable if the pathology is observed in a teenager, an elderly person or a nursing mother.
Good advice:Treatment of lesions of the shoulder joint of the 1-2 degree is possible at home, with the additional use of folk remedies. The main thing is that the patient does not forget to take medicines on time and does not miss physical procedures - the effect will be noticeable and lasting only if all the doctor's prescriptions are followed regularly and conscientiously.
If conservative treatment is ineffective, the doctor is forced to offer the patient surgery. The remains of the destroyed joint will be removed and a prosthesis will be implanted in their place. Such an intervention is not rare, but it requires highly qualified doctors, precision and attention at every stage. In addition, prostheses do not always take root well, and the recovery period after surgery lasts at least six months. Therefore, if you notice that your shoulder begins to regularly hurt, pull, tingle, or you hear a crunch when you move, do not delay the visit to the doctor, get yourself examined in a timely manner and, if necessary, start treatment.
Osteoarthritis of the shoulder joint is a fairly common pathology of the musculoskeletal system, which occurs mainly in people over 50 years of age. The pathology develops gradually, little by little, under the influence of adverse factors, the joint structures begin to collapse, which is manifested by pain, swelling and stiffness of the joint. In the early stages, the progression of the disease can be stopped with the help of complex treatment: drugs, vitamin supplements, dietary therapy and physiotherapy. Advanced osteoarthritis can only be treated surgically.