shoulder arthrosis

Shoulder pain can appear gradually and significantly reduce the patient's quality of life. To find out why shoulder pain occurs, you need to see a doctor and do a thorough examination. As suchThe most common cause of knee pain is osteoarthritis of the shoulder.

The disease requires long-term adequate treatment, which can be prescribed only by an experienced specialist.

What is this?

Shoulder arthrosis is a long-term, persistently progressive metabolic-dystrophic disease causing gradual destruction of articular cartilage, protective growth of bone tissue with joint deformity and loss of its function.

A wide range of motion of the hands is provided by the synchronous interaction of the joints of the shoulder complex:

• humeroscapular or simply humeral;
• acromioclavicular - between the acromial process of the clavicle and scapula;
• sternoclavicular - between the sternum and collarbone.

The shoulder joint is very mobile, which is provided by the convex head of the humerus and the relatively flat articular fossa of the scapula. The joint is strengthened by tendons of the muscles of the upper limb, on top of it is the coracoid-acromial ligament. Very reliableReinforcement does not allow the joint to move in different directions, but at the same time increases the risk of injury.

The code for arthrosis of the shoulder according to the International Classification of Diseases of the 10th Revision (ICD-10) is M19 (other types of arthrosis). Treatment of shoulder arthrosis should begin as soon as possible. But advanced stages of the disease can also be successfully treated. can be treated.

Causes of Osteoarthritis of the Shoulder

The main causes of shoulder arthrosis:

• Consequences of acute injuries - dislocation, subluxation, intra-articular fracture, bruises;
• permanent long-term microtrauma associated with occupational or sports loads;
• Acute and chronic infectious-inflammatory and autoimmune processes transferred to the shoulder joint - acute purulent arthritis, chronic rheumatoid, psoriatic and other rheumatism;
• Against the background of a chronic inflammatory process in the periarticular tissues - humeroscapular periarthritis, which leads to impaired blood circulation and nutrition of the cartilage tissue;
• metabolic (exchange) articular disorders - gouty arthritis;
• hormonal disorders;
• Congenital malformations (dysplasia) - eg, articular surfaces of the shoulder joints.

Under the influence of any of these causes (sometimes several at once), the composition and amount of joint fluid that feeds the cartilaginous tissue of the joint is disturbed. The cartilage gradually decreases in volume, cracking. This leads to injury to the bone, its growth along the edges of the joint surfaces, joint deformity and decreased function. In the joint cavity, inflammation of the synovial membrane occurs periodically -Synovitis. Caused by synovitis, arthrosis is called osteoarthritis or osteoarthritis - depending on which process predominates (inflammatory or metabolic-dystrophic). As a result of bone inflammation and necrosis, small pieces of tissue are separated from it - sequester orArticular rats.

In danger:

• for microtrauma - blacksmiths, miners, tennis players, weightlifters, discus throwers;
• for acute injuries - gymnasts, athletes, circus performers;
• persons with burdened heredity;
• A person suffering from any chronic disease of the joints.

Symptoms of Shoulder Osteoarthritis

The disease begins slowly, gradually. The rate of its progression depends on the cause, the general condition of the patient and his heredity.

first sign

Early symptoms of arthrosis of the shoulder joint may go unnoticed, especially if they occur against the background of an existing shoulder disease. These are minor, which occur from time to time, mainly exercise, pain, followed by discomfort during movement of the joint. Pain in the left joint can be confused with heart pain. They pass quickly, but it is worth paying attention to them.

If such symptoms recur frequently, it is better to consult a doctor immediately, as any disease is easier to treat in its early stages.

obvious symptoms

The pain intensifies, does not go away immediately after exertion. At night, as well as pain associated with a change in the weather, the movements of the hands become painful, they are accompanied by a characteristic crunch. In the morningOr when you stay in a certain position for a long time, stiffness of movements appears, to overcome it, you need to move. Pain syndrome can be localized not only in the shoulder area, but also the arm, may also radiate to the neck and upper back.

Periodically the joint swells, a slight reddening of the skin appears on it, the pain intensifies, becomes permanent. The body temperature may rise slightly. This is a sign of synovitis - aseptic of the synovial membrane (without infection). Inflammation. If there are foci of infection in the body (ragged teeth, diseases of ENT organs, etc. ), it can enter the joint through the blood and lymphatic vessels, causing a purulent inflammatory process. In this case, high fever, headache may appear, there may be rapid disturbances in the general condition.

The combination of degenerative-dystrophic and inflammatory processes in the joint gradually leads to permanent loss of organ function and constant pain.

But such patients can also be helped, you just need to go to the clinic.

alarming symptoms

There are several symptoms of osteoarthritis of the shoulder joint, which indicate that you need to seek immediate medical attention. This:

• the appearance of edema and redness of the tissues in the joint area, fever;
• aching pain in the joint, accompanied by a change in its shape;
• joint pain radiating to the arms, neck or back;
• The former volume of movements in the hand is impossible, even raising it up causes severe pain.

These symptoms indicate that your body needs help. Only a doctor can provide it.

What is the risk of osteoarthritis of the shoulder

In the absence of medical care, brachial arthrosis is dangerous with continued progression with the development of a permanent pain syndrome, loss of function of organs, and various, sometimes life-threatening, complications.

degree of arthrosis of the shoulder joint

There are three degrees of arthrosis of the shoulder joint:

• Arthrosis of the shoulder joint 1 degree- early stage. All symptoms appear after little and most exercise. On X-ray, a slight narrowing of the joint space is sometimes visible, but more often than not. Only magnetic resonance imaging at this stageWith the help of (MRI) it is possible to detect small violations in the cartilage tissue.
• Arthrosis of the shoulder joint 2 degrees- progressive phase. There is a persistent pain in the shoulder, pain increases with movement of the arm, they give below (elbow, forearm, hand) or under the neck, back, shoulder blade. There are difficulties with the functioning of the limb, Symptoms of synovitis develop periodically. On X-ray, the joint space is significantly narrowed, bone growths (osteophytes) are visible along the edges of the articular surfaces, bone tissue is compressed (osteosclerosis).
• Arthrosis of the shoulder joint 3 degrees- high phase. The pain in the joint is strong, constant, with a pronounced crunch when moving the arm. The range of motion is limited, sometimes the arm is completely immobilized because of the pain. The joint is deformed, This sometimes leads to pinching of nerves and blood vessels. On X-ray: joint space almost invisible, significant bone growth with joint deformity, severe sclerosis and necrosis of bone tissue, articular rats.

possible complications

There are serious complications in the form of any localization and arthrosis, so you should not delay treatment.

If you do not treat the disease or treat yourself with folk remedies, the risk of developing complications such as:

• significant deformity and limitation of articular mobility;
• Dislocations, subluxations and intra-articular fractures with minor injuries or sudden movements;
• rupture of the tendons surrounding the joint of muscles and ligaments - they atrophy and tear easily;
• aseptic necrosis of the head of the humerus with complete destruction of the articulation and loss of its function;
• Purulent-septic complications when an infection enters the joint cavity from other foci.

what to do with exaggeration

The exacerbation of the pathological process is usually associated with increased stress on the organ or the development of inflammation - synovitis. In this case there is more pain in the joint, mild swelling, increased body temperature. In such cases, you should have the followingSelf-help algorithm should follow:

• call the doctor at home;
• Take a pill of one of the painkillers inside;
• apply an anesthetic ointment to the skin in the area of the diseased joint;
• tie a sore hand with a bandage-scarf - this will reduce the load;
• Take an elevated position – sit with a pillow under your back – this will reduce swelling of the tissue.

Types of shoulder arthrosis

According to different criteria, the disease is divided into different types.

due to disease

According to this criterion, primary and secondary osteoarthritis are distinguished. Primary shoulder arthrosis is mainly a consequence of age-related changes and develops after 50 years. But sometimes the disease begins at an early age, But the cause of its onset cannot be established. In this case, they speak of primary idiopathic arthrosis of the shoulder. An important role in its development is played by a hereditary predisposition: the presence of a similar disease in a close relative.

Secondary arthrosis of the shoulder joint develops after injuries and previous diseases, but even here, heredity matters: in one person, even a minor injury or acute arthritis can lead to the development of arthrosis, while in anotherIn this case, the more significant damage is eliminated without consequence.

according to flow characteristics

Allocate deforming arthrosis of the shoulder characterized by rapid progression of bone deformities. A characteristic feature of this type of disease is a change in the shape of the joint and frequent infringement of nearby blood vessels and nerves. Impaired by compression of blood vessels. Increased blood circulation occurs and there is a rapid progression of degenerative-dystrophic disorders, and compression of the nerves leads to a decrease in the sensitivity of the limb and severe pain along the peripheral nerves.

Original

Post-traumatic arthrosis of the shoulder - this disease has its own characteristics of symptoms and treatment that are associated with traumatic lesion of certain structures. Exchange-dystrophic changes Intra-articular fractures, dislocations, subluxations, ruptures of ligaments, tendons and simply bruisesOccur after an injury. Injuries result from injury to a joint or a joint injury caused by a fall from the hand. Rupture of the joint capsule with dislocation usually occurs during a fall on the abducted arm.

Often, after a minor injury, a person does not notice the first symptoms of arthrosis for a long time and seeks medical help already in the second stage of the disease. Significant injuries require long-term rehabilitation treatment, and arthrosisAs a rule, treatment begins already at an early stage.

Arthrosis of the shoulder after suffering inflammatory diseases - the symptoms and course of this type of pathology depend on the underlying disease. In psoriatic arthritis often the shoulder joint is affected, while arthrosis develops in one joint, it gradually-Develops slowly, but is difficult to treat. With rheumatoid arthritis, both tendons are affected, arthrosis develops in waves with frequent alternation of metabolic-dystrophic and inflammatory processes.

Distribution

Only one left or right joint can be affected and then they talk about monoarthrosis. Simultaneous defeat of two (left and right) shoulder-scapular joints is called oligoarthrosis.

Arthrosis of other joints of the shoulder complex

Acromioclavicular arthrosis - most often of post-traumatic origin. It develops against the background of lifting weights with the hands above the horizontal. With pain when lifting the arm. With the growth of osteophytes on the articular surfaces, impingement syndrome appearsMay - Violation of tendons and muscles of the shoulder, between the head of the humerus and the acromion of the scapula during rotation and abduction of the shoulder. This accelerates the progression of arthrosis and deterioration of hand function.

diagnosis

Without a correct diagnosis, it is impossible to cure this disease. Full investigation is possible only in the clinic. At the initial consultation, the doctor asks the patient, examines him, prescribes additional research methods and specialist consultations:

• Laboratory tests of blood, joint fluid - inflammatory, autoimmune and degenerative-dystrophic processes are detected.
• Instrumental:
  1. Radiography of the shoulder joint - changes in bone tissue are detected;
  2. Computed tomography (CT) - changes in cartilage and bone tissue in the early stages;
  3. Magnetic resonance imaging (MRI) - changes in soft articular and periarticular tissues;
  4. Diagnostic arthroscopy - is performed if necessary to clarify the nature of the pathological process.

Treatment of osteoarthritis of the shoulder joint

After establishing the final diagnosis, a complex conservative treatment of arthrosis of the shoulder is prescribed. If conservative therapy is ineffective, surgical treatment is prescribed.

conservative medicine

This includes medicinal and non-pharmacological methods.

medical treatment

Drug treatment is aimed at eliminating pain and stopping the progression of osteoarthritis. To alleviate the patient's condition, appoint:

1. drugs from the groupNon-steroidal anti-inflammatory drugs (NSAIDs), drugs are administered intramuscularly, orally or in the rectum; At the same time, drugs of the NSAID group are prescribed externally in the form of ointments, gels or creams.
2. drugs from the groupmuscle relaxants- relax the muscles around the joint; The spastic position of these muscles exacerbates the pain;
3. pain blockadewith local anesthetic,The drug solution is injected into the joint cavity or into the periarticular tissues - a quick analgesic effect.

The course of pathogenetic (affecting the mechanism of the disease) therapy as part of the medical treatment of arthrosis of the shoulder includes:

1. chondroprotectors- drugs whose composition contains biologically active substances that restore cartilage tissue. They are taken orally in the form of tablets and powder, in the form of intramuscular and intraarticular injections, and also externally in the form of ointments and creamsare determined.
2. angioprotectors- Means that improve blood microcirculation. Assign in tablets for solution for oral administration and intravenous drip.
3. Hyaluronic Acid Preparation- is introduced into the articular cavity to improve the depreciating properties and prevent the destruction of bone tissue.

Vitamin-mineral complexes for improving metabolic processes in articular and periarticular tissues.

non-drug treatment

The basis of non-drug methods of treatment of arthrosis of the shoulder is a healthy active lifestyle and proper nutrition. It is very important to get rid of such bad habits as smoking and alcohol abuse - they contribute to circulatory disorders and toxic effects on joint tissuesput.

Nutritious food

There is no specific diet for the treatment of arthrosis of the shoulder, but proper nutrition is very important in this disease. It is recommended to include in the daily diet: sea fish, seafood, lean poultry meat, dairy products, cottage cheese, cottage cheese, cereals (oatmeal, buckwheat), vegetables, fruits.

Excluded from the diet: easily digestible carbohydrates (sweets, muffins, sweet carbonated drinks), fatty red meat, foods that cause bloating - salt (excessive amounts), spicy and spicy seasonings.

It is recommended to give preference to steamed, stewed and steamed dishes.

Orthopedic treatment to distribute the load on the limb

To prevent shoulder injuries, it is recommended to periodically wear an elastic protective retainer in the form of a short sleeve that connects to the opposite arm. The device improves blood circulation, eliminates swelling. ButIt is not recommended to wear it continuously, as this leads to a sharp decrease in the range of motion in the shoulder.

The complex treatment of shoulder arthrosis in many experts includes taping - fixing the tissues with sticky elastic tape. This relieves pain, improves blood circulation and improves joint function.

physical treatment

Exercise therapy - the daily performance of a set of exercises - is the main method of rehabilitation with arthrosis of the shoulder. Gymnastic complexes are prescribed by a doctor, who has mastered the supervision of an exercise therapy instructor. When the patient completes the exercise regimenIf one starts doing the set correctly, it can be done at home.

physical treatment

Complex therapy at any stage of the disease includes physiotherapy. These are electro- and phonophoresis with the use of pain relievers, laser and magnetotherapy - stimulation of regenerative processes in articular tissues, courses of shock wave therapy (SWT) - sound exposure, Which has a pronounced chondroprotective effect.

folk remedies

Folk remedies will be of great benefit only if prescribed by a doctor. Here are some of them:

• Decoction of viburnum branches for oral administration.Pour a glass of crushed raw materials before going to bed with 500 ml of water, bring to a boil, keep on low heat for 5 minutes, insist all night, then strain and drink 100 ml 3 times a day. It is an anestheticIs.
• An old recipe for an anesthetic ointment from the herb wild rosemary.Take Vaseline or butter and dry shredded grass. In an enameled dish, alternately fold the fat base and grass in layers to the very top, close the dish with a lid, coat the cracks with flour and put in the oven (preferablyin the oven) put on a small fire for 2 hours, remove from the oven, strain through double gauze, store in the refrigerator and rub into the skin on the diseased joint 2-3 times a day.

surgical operation

With the ineffectiveness of conservative therapy for arthrosis of the shoulder, the following surgical interventions are performed:

• arthroscopic operationAllows to eliminate various defects in the articular cavity. They are mainly performed for young people with post-traumatic arthrosis. Arthroscopy allows you to tighten and attach the biceps tendon to the bone (tenodesis - thisWill eliminate loosening of the joint), remove bone growths - osteophytes (debris), restore the articular cavity with an implant, etc.
• Endoprosthetics- replacement of a destroyed, lost its function joint with an artificial one.

Approaches to the treatment of disease in the clinic

Clinical experts have developed their own approach to the treatment of arthrosis of the shoulder. First, each patient is carefully examined using the most modern diagnostic equipment (including MRI). Then that using drug and non-drug methodsCompletely relieves pain. At the same time, an individual complex therapy is selected for him, which includes:

• the most modern pharmaceutical and non-drug methods, including plasmolifting;
• traditional oriental methods of treatment and restoration of the function of the joints and the whole organism; These are acupuncture, moxibustion, auriculotherapy, taping, etc.

This approach gives a person quick relief from pain and suppresses disease progression. And regular preventive courses allow patients to forget about the disease and lead a normal life. Many patient reviews show how effective this treatment is.

Combined Siddha Techniques of the East and New Methods of Western Medicine.

general clinical guidelines

For people suffering from osteoarthritis of the shoulder, it is recommended to:

• lead a healthy, mobile lifestyle, alternating physical activity and rest;
• eat right regularly;
• get rid of all bad habits;
• regularly perform therapeutic exercises, avoiding sudden movements;
• sleep on your back or on a healthy side at night, placing a small pillow under your sore throat;
• give up heavy physical exertion, avoid injuries, prolonged stress and colds;
• during exacerbation (development of synovitis), avoid any thermal procedures;
• Follow all the recommendations of the attending physician.

Redressal

It is especially important for people with increased heredity to follow certain rules for the prevention of arthrosis of the shoulder. They should not work in weightlifting, tennis, traumatic sports, hammers, blacksmiths, miners. Everyone who is healthyOne who wants to keep fit must lead an active lifestyle and eat right on a regular basis.

Frequently asked questions about disease

1. What is the pain of osteoarthritis of the shoulder?

   The pains are aching, aggravated by movement and weight lifting.

2. Why is the disease dangerous?

   Formation of a permanent pain syndrome and loss of organ function.

3. Which doctor treats deforming arthrosis of the shoulder?

   Traumatic - an orthopedist-traumatologist, against the background of inflammatory diseases - a rheumatologist.

4. Is there a blockade for arthrosis of the shoulder?

   For severe pain, yes.

5. How effective are physiotherapy methods for this disease?

   Effective as part of complex treatment.

6. Is it possible to completely cure deforming arthrosis of the shoulder?

   No, but doctors can suppress its progress and save the patient from pain.

Shoulder arthrosis should be treated for a long time, systematically and strictly under the supervision of a physician. Efforts to cope with this disease on their own are fraught with complications and inefficiency. But a qualified specialist procedure at any stage of the diseasecan prevent the disease, save the patient from pain and significantly improve his or her quality of life.