Arthrosis of the shoulder joint (omarthrosis) is a chronic disease in which irreversible degenerative-dystrophic processes occur in the tissues of the joint. Pathology disrupts the normal functioning of the limb. The range of motion of the shoulder gradually decreases to complete immobility. Osteoarthritis of the shoulder joint causes severe pain and reduces the quality of life. Without treatment, disability occurs.
In order to stop the destructive processes of the joint and maintain mobility of the shoulder joint, it is necessary to contact an orthopedic traumatologist after the first symptoms appear.
Causes of osteoarthritis of the shoulder joint
The disease is polyetiological in nature. The development of deforming arthrosis of the shoulder joint can be associated with various factors:
- Professional sport or intense training.
- endocrine diseases.
- hormonal disorders.
- Congenital pathologies of the development of the musculoskeletal system.
- hereditary predisposition etc.
In most cases, secondary arthrosis is diagnosed: the pathology appears after exposure to the joint of one or another factor. Rarely register the primary or idiopathic form of the disease. It is impossible to establish the exact cause of tissue degeneration in this case.
Symptoms of shoulder osteoarthritis
Changes in cartilage and bone tissue begin long before the first signs of osteoarthritis appear. Joint structures have great potential for self-healing, so pathologies are rarely diagnosed at an early age, when all metabolic processes are quite active. As the body ages, recovery processes give way to degeneration. The first signs of destruction can appear after 40-50 years, and with a deforming disease, patients notice changes as early as 16-18 years.
Symptoms of shoulder osteoarthritis:
- Cracking joint when moving.
- Pain, especially severe after exercise.
- Stiffness of movement expressed after sleep or long rest.
- Increased pain with weather changes.
degree of osteoarthritis
The clinical classification distinguishes three degrees of arthrosis of the shoulder joint:
- 1 degree. The patient complains of a slight crunch that occurs during movement. The pain syndrome is absent. Discomfort is felt when the hand is brought to the extreme position.
- 2 degrees. Pain occurs when the limb is raised above shoulder height. The range of movement is reduced. After significant exertion, the patient feels pain even at rest.
- 3 degrees. The mobility of the joints is severely restricted. The pain syndrome is almost constant.
Diagnosis of osteoarthritis of the shoulder joint
The doctor must not only correctly diagnose, but also determine the cause of the pathology. Treatment of the underlying disease significantly improves the patient's well-being and slows down cartilage degradation.
Manual check
The first stage of diagnosis is a consultation with an orthopedic traumatologist. The doctor examines the diseased joint for swelling, severe deformity. From the side of the development of arthrosis, the muscles can partially atrophy - this can be seen with the naked eye.
During a manual examination, the doctor assesses the function of the joint according to several criteria:
- Ability to make arbitrary hand movements.
- Thickening of the edges of the articular surfaces (large osteophytes can be detected by palpation).
- The presence of a crunch, "clicks, " that can be heard or felt by the hand during shoulder movement.
- Jamming of the joint in the presence of free chondroma bodies.
- Pathological movements in the shoulder.
radiography
To detect signs of arthrosis of the shoulder joint, an x-ray is performed in two projections, which allows you to assess the degree of narrowing of the joint space, the condition of the bone surfaces, the size and number of osteophytes, the presence of fluid. and inflammation of the surrounding tissue.
Ultrasound examination (ultrasound)
A non-invasive method that allows you to examine the joints of pregnant women and young children. After the sonogram, the doctor determines the thickness of the cartilage, the condition of the synovial membrane. The method well visualizes osteophytes, enlarged lymph nodes in the periarticular space.
Magnetic resonance imaging (MRI)
The MRI machine takes pictures of consecutive sections. The images clearly show not only the joint, but also adjacent tissues. To date, magnetic resonance imaging is one of the most meaningful methods in osteoarthritis diagnostics.
laboratory tests
As part of a comprehensive review, they appoint:
- General blood analysis. Based on the results, the doctor can assess the presence and severity of the inflammatory process. The analysis also helps to assess the general state of health.
- Analysis of the urine. Kidney pathologies often cause secondary deforming arthrosis. Analysis is required for an accurate diagnosis.
- blood chemistry. The data helps determine the cause of the inflammation. Biochemical analyzes are also performed to monitor complications and side effects during therapy.
Treatment of osteoarthritis of the shoulder joint
Therapy is long and difficult. The course of treatment includes medication, wellness procedures and a set of special exercises for osteoarthritis of the shoulder joint. In difficult cases, surgical intervention is indicated.
Medical therapy
Drugs and dosage are selected individually. The doctor may prescribe:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Medications reduce inflammation and pain.
- glucocorticosteroid preparations. Hormone-based agents have a more intense effect on the pain site. Drugs not only alleviate the patient's condition, but also reduce inflammation, exhibit antihistamine and immunosuppressive properties. Glucocorticosteroids are prescribed in cases where NSAIDs are not effective.
- Painkiller. Medicines of this group are prescribed for severe pain syndrome. Depending on the severity of the symptoms, the doctor selects non-narcotic or narcotic (rarely) analgesics.
- chondroprotectors. The active ingredients of the drugs are involved in the formation of new cartilage tissue. Regeneration of the diseased joint is accelerated, trophism improves. Chondroprotectors have a cumulative effect and have proven themselves in the treatment of arthrosis of varying degrees of severity.
Some drugs are injected directly into the joint cavity. For example, the blockade has a better pain-relieving effect than taking medication in pill form.
physical therapy
Courses are conducted after the removal of the exacerbation. Physiotherapy as part of complex therapy helps to improve drug delivery to the diseased joint, reduce swelling and reduce pain.
To treat osteoarthritis use:
- electrophoresis.
- phonophoresis.
- shock wave therapy.
Physiotherapy can be combined with massage, exercise therapy, medicinal baths. It is best to undergo a series of procedures based on a specialized clinic. The doctor draws up a treatment plan, taking into account the condition of a particular patient.
physical therapy
Moderate physical activity is important to slow down degenerative processes. It is better to start exercise therapy for arthrosis of the shoulder joint in a medical center under the supervision of a doctor. The specialist selects the exercises, teaches them how to perform them correctly and distributes the load so that the disease is not aggravated. Gymnastics usually involves a warm-up, stretching, and strength training. Exercises are performed at least 3 times a week.
After a specialist course, patients can do therapeutic exercises for arthrosis of the shoulder joint at home.
surgery
The operation is performed for osteoarthritis of the 3rd degree, when the disease no longer allows the patient to move normally, causes severe pain, and the prescribed therapy does not help.
There are several methods of surgical treatment:
- puncture. A long needle is inserted into the joint cavity and the accumulated fluid is pumped out. Puncture reduces pressure, reduces swelling, increases joint mobility. The procedure is minimally invasive, so it is performed on an outpatient basis. The material obtained during the puncture is sent for examination to determine the infectious agent or other indicators.
- arthroscopy. With the help of microsurgical instruments, the doctor examines the joint cavity, removes scar tissue, sutures the tendons of the rotator cuff or the joint capsule if they are damaged. Several punctures remain on the skin. The patient recovers quickly.
- endoprosthetics. Endoprosthetics allows you to completely get rid of chronic pain and restore mobility in the arms. After the operation, a long (3 to 6 months) rehabilitation is required.