Shoulder osteoarthritis

The shoulder joint is one of the most vulnerable joints in the human skeleton. This is due to the rather complex structure of the joint with weak fixation to the scapula. When performing domestic or professional tasks, the shoulder is put under a lot of strain every day. If an injury occurs, metabolic processes are disrupted, tissue wears out due to age - dystrophic changes in the 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. A distinction is also made between acute and chronic shoulder arthrosis. If treatment is not carried out in a timely manner or with malicious intent, deformation and collapse of the joint will occur again and again, which ultimately leads to significant functional limitations of the upper extremity and loss of mobility.

Today, only grade 1 shoulder osteoarthritis can be completely cured. However, this does not mean that you can give up and do nothing about pathologies of the 2nd degree and above. Comprehensive and adequate treatment of arthrosis of the shoulder joint with the help of medication 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

Deforming arthrosis of the shoulder joint does not develop in one day. The changes are initially minor. The cartilage gradually loses its elasticity under the influence of various factors - these can be age-related changes or disorders of metabolic processes in the tissue. Microcracks form on its surface in which calcium salts accumulate. Then it becomes thin, brittle and begins to collapse.

This process is often accompanied by inflammation, which also spreads to the surrounding muscle, connective and bone tissue. This manifests itself primarily in pain – initially minor, aching. Then they become more intense and never go away in advanced stages, which significantly impairs performance and quality of life.

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

• Impaired blood flow to the cartilage tissue of the shoulder in atherosclerosis and other chronic diseases of blood vessels.
• Chronic pathologies of autoimmune nature, for example rheumatoid arthritis, systemic lupus erythematosus.
• Dysfunction of the endocrine system (diabetes mellitus).
• Congenital anomalies of the shoulder joint, birth injuries in infants and other injuries leading to pathological deformities and dysfunction of the limb.
• Acquired pathologies of joint 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 shoulder arthrosis increases many times over. These include:

• professional activity in which the shoulder joint is exposed to heavy loads day after day for many years - shoulder arthrosis is rightly called a disease of plasterers, painters and shippers;
• Lack of exercise, lack of physical activity - with insufficient exercise, blood circulation slows down, the joint tissue does not receive the required amount of nutrients and begins to atrophy;
• Overweight – often combined with the previous factor; with obesity, a person is unable to move actively, while additional stress is placed on the joints due to extra pounds;
• hereditary predisposition;
• Age – around 80% of people over 70 show symptoms of osteoarthritis.

Most often, when examining and questioning a patient, the doctor detects a combination of several diseases and provoking factors. A typical patient diagnosed with arthrosis of the shoulder joint is a man or woman over 50 years old who perform heavy physical work, are overweight and have other chronic diseases (diabetes mellitus, arterial hypertension, varicose veins, knee arthritis, etc. ). In this case, lesions of the right shoulder occur more often than the left. This is because most people, with the exception of congenital left-handers, actively use their right hand at work and at home.

How do you recognize the disease?

The symptoms of osteoarthritis of the shoulder joint may not occur for a long time. If your shoulder starts to hurt from time to time, you attribute this to fatigue, take painkillers, use an ointment with a warming effect and calm down. But sooner or later the time comes when pills and ointments no longer help, the pain becomes permanent and intense and disturbs both at rest and at night. In addition to this symptom, the following signs indicate dystrophic changes in the shoulder joint:

• Swelling and deformation of the joint visible to the naked eye;
• Redness of the skin over the joint, local increase in temperature;
• characteristic crunching in the joint. Creaking sounds during sharp hand movements are explained by the accumulation of salts in the cartilage cracks and between the articular elements. The crunching initially only occurs with sudden movements; it is quiet and barely audible. In advanced forms of the disease, the shoulder crunches with every movement, the noise is heard by others;
• Restriction of mobility of the limbs. When examining a patient, the doctor asks him to comb his hair. This test is enough to diagnose arthrosis of the shoulder joint: the patient feels severe pain, makes a rotational movement with the shoulder, it is difficult for him to move the shoulder back, the doctor hears a cracking and clicking in the joint.

DOA of the shoulder must be treated, otherwise the patient will lose complete mobility of the upper extremity and performance over time. If the process of destruction of the cartilage and surrounding tissue has already begun, it will not stop on its own. Proper nutrition, folk remedies, a healthy lifestyle and exercise are not enough here. To cope with the problem and prevent disability, complex treatment with drugs of different effects and physical procedures is required.

degrees

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

• 1 degree.At this stage, the disease is just beginning to develop, the changes in the cartilage tissue are still small. The main symptoms of DOA grade 1 are weakness of the joints and limbs and periodic, excruciating pain. Pain occurs after physical exertion, with monotonous, repeated hand movements over a long period of time. After a night's sleep or a long period of rest, a person feels stiffness in the shoulder joint, but as it develops, it disappears even without medication and physical interventions - a light warm-up is enough. If you take an x-ray at this stage, no significant changes in the joint structures will be visible in the image, although thinning and deformation of the cartilage may be noticeable.
• 2 degrees.The pathological process proceeds and manifests itself more actively. You already get used to the fact that your shoulder hurts after work, you "wait" for pain, you have painkillers and ointments for joint pain, from the pharmacy or homemade, ready. X-ray diagnostics show noticeable changes in the joint: thinning and deformation of the jointCartilage, inflammation of the joint membrane. From time to time the joint changes color and swells; grinding, squeaking and clicking can be heard when moving.
• 3 degrees.The shoulder joint hurts and grinds constantly. To relieve the discomfort, the person tries not to touch it and not to move the limb at all. The deformity is visually noticeable; The affected shoulder differs in size and shape from the healthy one, it often turns red and swells, which is accompanied by increased pain. Removal with painkillers is not possible.

If nothing is done in the third stage of the disease, the fourth stage will occur - complete immobility of the shoulder joint and limbs. In this case, prescribing medications and physiotherapy is already meaningless; Only an endoprosthetic operation helps to at least partially restore the functionality of the hand. But that doesn't always work either.

On a note:In medical practice, it is extremely rare for grade 3 shoulder arthrosis to occur. Typically, the patient seeks medical attention sooner and begins treatment. Against the background of extensive trauma, severe cartilage destruction can occur if the patient was unable to see a doctor for some reason or if the person lives in disadvantaged social conditions where qualified doctors are not available.

How is osteoarthritis diagnosed and treated?

A good doctor can make a preliminary diagnosis after talking to the patient and examining him externally. In order to rule out or identify other pathologies and complications, instrumental diagnostic methods are more needed. To determine exactly how badly the joint is affected and whether inflammation is present, the following diagnostic measures are carried out:

• x-ray;
• 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 – the number of leukocytes and the erythrocyte sedimentation rate are assessed. If they are too high, an inflammatory process occurs in the body.

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

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

• Therapy with non-steroidal anti-inflammatory drugs. Medications 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 medications cannot be taken long-term, they do not eliminate the cause of the disease and are intended only for extreme cases when the pain is unbearable.
• Taking chondroprotectors - drugs that promote the restoration of cartilage tissue and prevent further destruction. They also partially relieve pain and swelling as well as deformation 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 relax muscle spasms. These are optional drugs in the complex treatment of arthrosis, 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 treatment, rapid recovery and prevention of 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, all kinds of cabbage, cereals, legumes. Polyunsaturated fatty acids can be obtained from marine fish and seafood. A gelatin diet is practiced because gelatin helps restore the elasticity of cartilage tissue. The menu includes jellied meat from beef hooves and tails, brawn and various jellies. It is useful to take gelatin in pure form, having previously soaked it in warm water.

Physiotherapy is the next important point in the complex treatment of shoulder arthrosis. They are only started when the inflammatory process has stopped. Depending on the degree of the disease, its dynamics and the effectiveness of drug treatment, the doctor selects a combination of the following physical procedures:

• cryotherapy;
• Acupuncture;
• electrophoresis;
• laser therapy;
• magnetic field therapy;
• mud therapy;
• Massage of various types;
• Physical therapy.

Physiotherapeutic procedures are aimed at activating metabolic processes in the joint tissue, normalizing blood circulation and restoring limb mobility. With their help, it is possible to reduce the number of medications taken and their dosage, which is especially valuable if the pathology is observed in a teenager, an elderly person or a nursing woman.

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 medications on time and does not skip physical procedures - the effect will be noticeable and lasting only if all doctor's prescriptions are followed regularly and conscientiously.

If conservative treatment remains ineffective, the doctor is forced to offer the patient surgery. The remains of the destroyed joint are removed and a prosthesis is implanted in its place. Such an operation is not uncommon, but 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 regularly hurts, pulls, becomes numb, or you hear a grinding sound when you move, do not hesitate to consult a doctor, undergo a timely examination and, if necessary, start treatment.

Osteoarthritis of the shoulder joint is a fairly common disease of the musculoskeletal system that occurs primarily in people over 50 years of age. The pathology develops gradually, little by little, under the influence of unfavorable 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 comprehensive treatment: medications, vitamin preparations, diet therapy and physiotherapy. Advanced osteoarthritis can only be treated surgically.