shoulder osteoarthritis

Shoulder pain can come on gradually and significantly reduce a patient's quality of life. To find out why your shoulder hurts, you need to see a doctor and undergo a full examination. The most common cause of such pain is osteoarthritis of the shoulder.

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

What it is?

Shoulder osteoarthritis is a long-term, constantly progressive metabolic-dystrophic disease, which leads to gradual destruction of articular cartilage, protective growth of bone tissue with joint deformity and loss of its function.

Synchronous interaction of the joints of the shoulder complex provides a wide range of arm movements:

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

The shoulder joint is highly mobile, provided by the convex head of the humerus and the relatively flat articular fossa of the scapula. The joint is strengthened by the tendons of the muscles of the upper limb, above it is the coracoid-acromial ligament. Not too reliable reinforcement allows the joint to move in different directions, but at the same time increases the risk of injury.

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

Causes of shoulder osteoarthritis

The main causes of shoulder osteoarthritis:

• consequences of acute injuries: dislocations, subluxations, intra-articular fractures, hematomas;
• long-term permanent microtrauma associated with the profession or sports loads;
• acute and chronic infectious-inflammatory and autoimmune processes transferred in the shoulder joint: acute purulent arthritis, chronic rheumatoid arthritis, psoriatic and others;
• against the background of a chronic inflammatory process in the periarticular tissues - humeroscapular periarthritis, leading to impaired blood circulation and nutrition of cartilage tissue;
• metabolic (exchange) joint disorders - gouty arthritis;
• hormonal disorders;
• congenital malformations (dysplasia), for example, the articular surfaces of the shoulder joints.

Under the influence of any of these reasons (sometimes several at once), the composition and volume of the joint fluid that feeds the cartilage tissue of the joint is disturbed. Cartilage gradually decreases in volume, cracks, loses its cushioning properties. This leads to injuries 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 periodically occurs - synovitis. Due to synovitis, osteoarthritis is called osteoarthritis or osteoarthritis, depending on the prevailing process (inflammatory or metabolic-dystrophic). As a result of inflammation and necrosis of the bone, small pieces of tissue are separated - joint sequestrants or mice.

At risk:

• for microtrauma: blacksmiths, miners, tennis players, weightlifters, discus throwers;
• for acute injuries - gymnasts, athletes, circus performers;
• people with burdened inheritance;
• People with chronic joint disease.

Symptoms of shoulder osteoarthritis

The disease begins gradually, gradually. The speed of its progression depends on the cause, the general condition of the patient and heredity from it.

first signs

Early symptoms of osteoarthritis of the shoulder joint may not be noticed, especially if they occur in the setting of existing shoulder disease. These are minor, occur periodically, mainly after exercise, pain, discomfort during movement of the joint. Pain in the left joint can be confused with pain in the heart. They go by fast, but they are worth paying attention to.

If such symptoms reappear, it is better to immediately consult a doctor, since any disease is easier to treat in the early stages.

Overt symptoms

The pain increases, after exertion it does not go away immediately. Night pains appear, as well as pains associated with a change in weather. Movements in the hand become painful, they are accompanied by a characteristic crunch. In the morning or when staying in a certain position for a long time, stiffness of movements appears, to eliminate it, you need to move. Pain syndrome can be localized not only in the shoulder area, but also radiate to the arm, neck, upper back.

Periodically, the joint swells, a slight reddening of the skin appears, the pain intensifies, becomes permanent. Body temperature may rise slightly. This is a sign of synovitis - aseptic (without infection) inflammation of the synovial membrane. If there are foci of infection in the body (carious teeth, diseases of the 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, the general condition may be greatly altered.

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

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

dangerous symptoms

There are a number of symptoms of osteoarthritis of the shoulder joint, indicating that you need to urgently seek medical help. 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 pains radiate to the arm, neck, or back;
• the previous volume of movements in the arm is impossible, even just lifting it causes severe pain.

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

What is the danger of shoulder osteoarthritis?

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

Degrees of arthrosis of the shoulder joint.

There are three degrees of osteoarthritis of the shoulder joint:

• Arthrosis of the shoulder joint 1 degree.- initial stage. All symptoms appear mildly and mostly after exercise. On x-rays, a slight narrowing of the joint space is sometimes seen, but more often it is not. It is possible to detect small violations in the cartilage tissue at this stage only with the help of magnetic resonance imaging (MRI).
• Osteoarthritis of the shoulder joint 2 degrees.- progressive stage. The shoulder aches constantly, the pains are aggravated by movements of the arm, give way (in the elbow, forearm, hand) or in the neck, back, under the shoulder blade. There are difficulties with the functioning of the limb, signs of synovitis periodically develop. On the radiograph, the joint space is significantly narrowed, bone growths (osteophytes) are visible along the edges of the joint surfaces, bone tissue is compacted (osteosclerosis).
• Osteoarthritis of the shoulder joint 3 degrees.- Advanced stage. 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 immobile due to pain. The joint is deformed, which sometimes leads to pinching of nerves and blood vessels. On the radiograph: the joint space is almost invisible, significant bone growths with joint deformity, severe sclerosis and necrosis of bone tissue, joint mice.

Possible complications

Any location and form of osteoarthritis has serious complications, so treatment should not be delayed.

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

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

What to do with an exacerbation

Exacerbations of the pathological process are usually associated with increased stress on the limb or with the development of inflammation - synovitis. In this case, the joint hurts more, there is a slight swelling, the body temperature rises. In such cases, you must adhere to the following self-help algorithm:

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

Types of shoulder osteoarthritis

According to various criteria, the disease is divided into separate types.

Due to illness

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

Secondary osteoarthritis of the shoulder joint develops after previous injuries and diseases, but the hereditary burden also matters here: in one person, even a minor injury or acute arthritis can lead to the development of osteoarthritis, while in another, severe damage. most significant ends without consequences.

Depending on the characteristics of the flow.

Assign deforming arthrosis of the shoulder, characterized by a rapid progression of bone deformities. A feature of this type of disease is a change in the shape of the joint and frequent infringement of nearby blood vessels and nerves. Compression of blood vessels leads to impaired blood circulation and rapid progression of degenerative dystrophic disorders, and compression of nerves leads to impaired sensitivity of the limb and severe pain along the nerves peripherals.

Origin

Post-traumatic osteoarthritis of the shoulder - the symptoms and treatment of this disease have their own characteristics associated with a traumatic injury to certain joint structures. Exchange dystrophic changes occur after intra-articular fractures, dislocations, subluxations, ruptures of ligaments, tendons, and simply bruises. Injuries occur from a blow to the joint or from a fall on the side with the arm adducted. Joint capsule rupture with dislocation usually occurs during a fall on the abducted arm.

Often, after a minor injury, a person does not notice the first signs of arthrosis for a long time and seeks medical help already at the second stage of the disease. Major injuries require long-term rehabilitation treatment and, as a rule, osteoarthritis begins to be treated in the early stages.

Shoulder osteoarthritis after suffering from inflammatory diseases: the symptoms and course of such pathology depend on the underlying disease. The shoulder joint is often affected in psoriatic arthritis, while osteoarthritis develops in a joint, it develops slowly, but is difficult to treat. With rheumatoid arthritis, both shoulders 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 it is called monoarthrosis. The simultaneous defeat of two shoulder-scapular joints (left and right) is called oligoarthrosis.

Osteoarthritis of other joints of the shoulder complex.

Acromioclavicular osteoarthritis: most of the time it has a post-traumatic origin. It develops against the background of lifting weights with your hands above the horizontal. It is accompanied by pain when raising the arm. With the growth of osteophytes on the articular surfaces, impingement syndrome may appear - infringement of the 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 osteoarthritis and the decline in hand function.

Diagnosis

Without a correct diagnosis, it is impossible to treat this disease. A full examination is only possible 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 are detected: inflammatory, autoimmune and degenerative-dystrophic processes.
• Instrumental:
  1. x-ray of the shoulder joint - changes in bone tissues are detected;
  2. computed tomography (CT) - changes in cartilage and bone tissues in the early stages;
  3. nuclear magnetic resonance (MRI) - changes in the articular and periarticular soft tissues;
  4. diagnostic arthroscopy - performed if necessary to clarify the nature of the pathological process.

Treatment of osteoarthritis of the shoulder joint

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

conservative therapy

Includes pharmacological and non-pharmacological methods.

Medical treatment

The goals of pharmacological treatment are to eliminate pain and suppress the progression of osteoarthritis. To alleviate the patient's condition, appoint:

1. group drugsnonsteroidal anti-inflammatory drugs (NSAIDs). The drugs are administered intramuscularly, orally, or rectally; at the same time, drugs from the NSAID group are prescribed externally in the form of ointments, gels or creams.
2. group drugsmuscle relaxants- relax the muscles surrounding the joint; the spastic state of these muscles increases pain;
3. pain blockswith local anesthetics.The drug solution is injected into the joint cavity or periarticular tissues, a rapid analgesic effect.

The course of pathogenetic therapy (influencing the mechanisms of the disease) as part of the medical treatment of shoulder osteoarthritis includes:

1. Chondroprotectors- drugs that have in their composition biologically active substances that restore cartilage tissue. They are prescribed orally in the form of tablets and powders, in the form of intramuscular and intraarticular injections, and also externally in the form of ointments and creams.
2. angioprotectors- Means that improve blood microcirculation. Assign in tablets for oral administration and solutions for intravenous drip.
3. Hyaluronic acid preparations- are introduced into the joint cavity to improve depreciation properties and prevent the destruction of bone tissue.

Vitamin and mineral complexes to improve metabolic processes in joint and periarticular tissues.

Non-pharmacological treatment

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

nutrition, diet

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

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

It is recommended to give preference to boiled, 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 puffiness. But it is not recommended to use it constantly, as this leads to a rapid decrease in the range of motion in the shoulder.

Many specialists include bandaging in the complex treatment of shoulder arthrosis - fixing tissues with adhesive elastic tapes. This gives the elimination of pain, improvement of blood circulation and joint function.

Physiotherapy

Exercise therapy, daily performance of a series of exercises, with shoulder osteoarthritis is the main method of rehabilitation. Gymnastics complexes are prescribed by a doctor, mastered under the supervision of an exercise therapy instructor. Once the patient begins to perform the entire set of exercises correctly, it can be done at home.

Physiotherapy

Physiotherapy is included in complex therapy at any stage of the disease. These are electro- and phonophoresis with the use of analgesics, laser and magnetotherapy, stimulation of regenerative processes in joint tissues, shock wave therapy (SWT) courses, sound exposure, which has a pronounced chondroprotective effect.

Home remedies

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

• Decoction of viburnum branches for oral administration.Pour a glass of crushed raw materials before bedtime 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 anesthetic.
• An ancient recipe for an anesthetic ointment from the herb wild rosemary.Take petroleum jelly or butter and dry chopped grass. In an enameled dish, alternately fold the fat base and grass to the top in layers, close the dish with a lid, cover the cracks with dough and put in the oven (preferably in the oven) on low heat for 2 hours , Remove from the oven, strain through double cheesecloth, store in the refrigerator and rub into the skin over the diseased joint 2-3 times a day.

Surgical operations

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

• arthroscopic operationsallowing to eliminate various defects in the joint cavity. They are performed mainly on young people with post-traumatic osteoarthritis. Arthroscopy allows you to tighten and attach the biceps tendon to the bone (tenodesis - this will remove the slack from the joint), remove bone growths - osteophytes (debridement), restore the joint cavity with a transplant, etc.
• stent- replacement of a destroyed board, lost its function by an artificial one.

Approach to the treatment of the disease in clinics

Clinicians have developed their own approach to treating shoulder osteoarthritis. First of all, each patient is carefully examined using the most modern diagnostic equipment (including MRI). Then it is completely relieved of pain using pharmacological and non-pharmacological methods. At the same time, an individual complex therapy is selected for him, which includes:

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

This approach quickly relieves a person of pain and suppresses the progression of the disease. And regular preventive courses allow patients to forget about the disease and lead a normal life. Numerous patient reviews talk about how effective this treatment is.

It combines proven techniques from the East and innovative methods from Western medicine.

General clinical guidelines

For people suffering from shoulder osteoarthritis, it is recommended:

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

Prevention

It is especially important for people with aggravated heredity to follow certain rules for the prevention of shoulder arthrosis. They should not engage in weightlifting, tennis, traumatic sports, work as hammerers, blacksmiths, miners. Everyone who wants to have healthy joints should lead an active lifestyle and eat well on a regular basis.

Frequently asked questions about the disease

1. What is shoulder osteoarthritis pain?

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

2. Why is the disease dangerous?

   The formation of a permanent pain syndrome and loss of limb function.

3. What doctor treats deforming osteoarthritis of the shoulder?

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

4. Is a block done for shoulder osteoarthritis?

   For severe pain, yes.

5. How effective are physiotherapy methods for this disease?

   Effective as part of a complex treatment.

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

   No, but the doctor can suppress its progression and save the patient from pain.

Shoulder osteoarthritis should be treated for a long time, systematically and strictly under the supervision of a doctor. Attempts to cope with this disease on their own are fraught with complications and disability. But a qualified specialist can stop the process at any stage of the disease, save the patient from pain and significantly improve her quality of life.