Shoulder arthrosis

The shoulder joint is one of the most vulnerable in the human skeleton. This is due to a rather complex articulation structure with poor fixation with the scapula. Shoulders receive a lot of pressure every day when doing household or professional tasks. If an injury occurs, metabolic processes are disrupted, tissue wears out due to age - dystrophic changes in cartilage tissue begin. This pathology is called osteoarthritis of the shoulder joint.

Depending on the manifestation 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. If treatment is not carried out on time or with bad intentions, the joint will continue to deform and collapse, which will eventually result in a significant limitation of upper limb function 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 pathologies of level 2 and higher. Comprehensive and adequate treatment of arthrosis 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 disability.

Symptoms and causes

Deformation of arthrosis of the shoulder joint does not develop in one day. At first the changes were small. Cartilage gradually loses its elasticity under the influence of various factors - this may be age-related changes or disruption of metabolic processes in the tissue. Microcracks appear on its surface, where calcium salts accumulate. Then it becomes thin, brittle, and begins to crumble.

Often this process is accompanied by inflammation, which also spreads to the surrounding muscles, connective tissue and bones. This manifests itself primarily as pain - at first small, painful. Then they become more intense and in advanced stages never disappear, which significantly reduces a person's performance and quality of life.

The main reasons why shoulder joint DOA develops are as follows:

• Impaired blood circulation in the cartilaginous tissue 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 mellitus).
• Congenital abnormalities of the shoulder joint, birth injuries in infants and other injuries that lead to pathological deformation and limb dysfunction.
• Acquired pathology of articular structures after injury or accident, unsuccessful surgery, 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. This includes:

• professional activities in which the shoulder joint receives heavy loads day after day for many years - shoulder arthrosis is quite correctly called the disease of plasterers, painters and loaders;
• inactive lifestyle, lack of physical activity - with insufficient exercise, blood circulation slows down, joint tissue does not receive the necessary amount of nutrients and begins to atrophy;
• overweight - often combined with the previous factors; with obesity, a person cannot move actively, while the joints receive additional pressure due to extra body weight;
• hereditary predisposition;
• old age - about 80% of people over the age of 70 show symptoms of osteoarthritis.

Often, when examining and interviewing patients, doctors identify a combination of several diseases and provoking factors. A typical patient diagnosed with osteoarthritis of the shoulder joint is a man or woman over 50 years old, engaged in heavy physical work, overweight and other chronic pathologies (diabetes mellitus, 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, except for congenital left-handers.

How to recognize the disease

Symptoms of arthrosis of the shoulder joint may not appear for a long time. If from time to time the shoulder starts to hurt, a person attributes it to fatigue, takes painkillers, uses ointments with a warming effect, and calms down. But sooner or later the time will come when pills and ointments no longer help, the pain becomes constant, intense, and bothers you at rest and at night. In addition to these symptoms, the following signs will indicate dystrophic changes in the shoulder joint:

• swelling and joint deformation, noticeable with the naked eye;
• redness of the skin over the joint, increased local temperature;
• characteristic dryness in the joints. The creaking sound when the hand moves suddenly is explained by the accumulation of salt in the cracks of the cartilage and between the elements of the joints. At first, the crackling sound only occurs with sudden movement; it was quiet and almost inaudible. In the advanced form of the disease, the shoulders crackle with every movement, the sound heard by others;
• limitation of limb movement. When examining the patient, the doctor will ask him to brush his hair. This test is enough to diagnose osteoarthritis of the shoulder joint: the patient will experience sharp pain, perform rotational movements with the shoulder, it is difficult for him to move the shoulder back, the doctor will hear cracks and clicks in the joint.

DOA of the shoulder must be treated, otherwise, over time the patient will lose complete mobility of the upper limbs and performance. If the process of destruction of cartilage and surrounding tissue has already started, it will not stop by itself. Proper nutrition, folk remedies, healthy lifestyle and exercise are not enough here. To overcome the problem and prevent disability, complex treatment will be required using drugs of various effects and physical procedures.

Degree

There are several stages of DOA of the shoulder joint, each of them manifests itself differently and requires a different treatment approach.

• first degree.At this stage, the disease has just begun to develop, the changes in the cartilage tissue are still small. The main symptoms of DOA grade 1 are weakness in the joints and limbs and periodic pain. Pain occurs after physical exercise, during monotonous and repetitive hand movements for a long time. After a night's sleep or a long period of rest, a person feels stiffness in the shoulder joint, but when it develops, the stiffness still disappears without drugs and physical procedures - light warming is enough. If you take an x-ray at this stage, the image will not show significant changes in the structure of the joint, although the thinning and deformation of the cartilage may be significant.
• standard 2.The pathological process continues and manifests itself more actively. A person is used to the fact that after work his shoulder will hurt, he "waits" for pain, has analgesics and ointments for joint pain, pharmacy or homemade, ready. X-ray diagnostics will show significant changes in the joints: thinning and deformation of cartilage, inflammation of the articular membrane. Over time, the joints become red and swollen; pulsing, squeaking and clicking can be heard when moving.
• standard 3.The shoulder joint is painful and throbbing constantly, to reduce the discomfort, the person tries not to touch it and does not move the limb at all. Defects can be seen visually; 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 it with painkillers.

If nothing is done in the third stage of the disease, the fourth stage will occur - complete immobility of the shoulder joints and limbs. In this case, there is no point in prescribing medication and physiotherapy; only endoprosthetic surgery will help at least partially restore hand function. But this is not always successful.

On a note:In medical practice, it is very rare to encounter grade 3 shoulder arthrosis. Usually, patients seek medical help early and start treatment. Severe cartilage destruction can occur against the background of extensive trauma, if for some reason the patient cannot see a doctor, or if the person lives in a disadvantaged social situation where a qualified doctor is not available.

How is arthrosis diagnosed and treated?

A good doctor will be able to make an early diagnosis after a conversation with the patient and his external examination. Instrumental diagnostic methods are needed more to exclude pathologies and other complications or to identify them. To determine exactly how badly the joint is affected and whether inflammation occurs, the following diagnostic steps are performed:

• radiograph;
• CT scan;
• Magnetic resonance imaging;
• in some cases, ultrasound to get a complete picture of the condition of the joint;
• clinical urine and blood tests - leukocyte count and erythrocyte sedimentation rate will be assessed. If they are too high, the inflammatory process develops in the body.

The best way to treat pathology is determined by the doctor individually, taking into account the patient's age, occupation, and general condition.

Traditional treatment involves the use of the following methods and means:

• A course of therapy with non-steroidal anti-inflammatory drugs. The drug is prescribed in the form of tablets or powder for oral administration or in the form of ointment 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 medicines should not be taken continuously; they do not eliminate the cause of the disease and are only intended 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, and deformation of the shoulder joint. Such medicines do not work immediately; it should be taken for at least 3-4 months.
• A course of muscle relaxants - tablets or injections that relieve muscle spasms. This is the drug of choice in the complex treatment of osteoarthritis; they are not always fixed.
• Vitamin-mineral complex intake course and food supplements with collagen and hyaluronic acid.

To increase the effectiveness of treatment, rapid recovery and prevention of new lesions, special therapeutic nutrition is also prescribed. The patient's diet includes foods rich in vitamins B, A, C, E - fresh fruits and vegetables, cabbage of any kind, cereals, legumes. Unsaturated fatty acids can be found in sea fish and seafood. A gelatin diet is practiced, because gelatin helps to restore the elasticity of cartilage tissue. The menu includes jellied meat made from beef hooves and tail, aspic, and various jellies. It is useful to take gelatin in pure form, previously soaked in warm water.

Physiotherapy is the next important point in the complex treatment of shoulder osteoarthritis. They are started only when the inflammatory process is stopped. Depending on the level 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;
• various types of massage;
• physiotherapy.

Physiotherapy procedures aim to activate metabolic processes in joint tissue, normalize blood circulation and restore limb mobility. With their help, it is possible to reduce the number of drugs taken and their dosage, which is very valuable if the pathology is observed in teenagers, the elderly or lactating women.

Helpful advice:It is possible to treat grade 1-2 lesions of the shoulder joint at home, with the additional use of folk remedies. The main thing is that the patient does not forget to take the medicine on time and does not skip physical procedures - the effect will be noticeable and lasting only if all the doctor's prescriptions are followed regularly and carefully.

If conservative treatment does not work, the doctor has to offer the patient surgery. The remains of the destroyed joint will be removed and a prosthesis will be implanted in its place. Such interventions are not common, but require highly qualified doctors, precision and attention at every stage. In addition, the prosthesis does not always take root well, and the recovery period after surgery lasts at least six months. Therefore, if you notice that your shoulder often starts to hurt, pull, numb, or you hear a crackling sound when you move, do not delay to visit a doctor, get a timely examination and, if necessary, start treatment.

Shoulder joint arthrosis is a relatively common pathology in the musculoskeletal system, which occurs mainly in people over 50 years of age. The pathology develops gradually, little by little, under the influence of unfavorable factors, the structure of the joint begins to collapse, which is indicated by pain, swelling, and stiffness of the joint. In the early stages, the progression of the disease can be stopped with the help of comprehensive treatment: drugs, vitamin supplements, diet therapy and physical therapy. Advanced osteoarthritis can only be treated with surgery.