The shoulder joint is one of the most vulnerable in the human skeleton. This is due to the rather complex structure of the joint with weak fixation to the scapula. The shoulder receives a great deal of stress every day when performing household or professional tasks. If an injury occurs, metabolic processes are disrupted, tissues wear out due to age: dystrophic changes in cartilaginous tissue begin. This pathology is called osteoarthritis of the shoulder joint.
Depending on the manifestations and degree of damage to the glenohumeral joint, four degrees of pathology are diagnosed. There is also a distinction between acute and chronic shoulder osteoarthritis. If treatment is not carried out promptly or in bad faith, the joint continues to deform and collapse, resulting in significant limitation of the functions of the upper limb and loss of mobility.
Today only grade 1 shoulder arthritis can be completely cured. But this does not mean that you can give up and do nothing with pathology of grade 2 and above. Comprehensive and adequate treatment of arthrosis of the shoulder joint with the help of drugs or surgical intervention 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. At first the changes are minor. Cartilage gradually loses its elasticity under the influence of various factors: these could be age-related changes or disruption of metabolic processes in the tissues. Microcracks appear on its surface in which calcium salts accumulate. Then it becomes thin, fragile and begins to collapse.
Often this process is accompanied by inflammation, which also spreads to the surrounding muscle, connective and bone tissues. This manifests itself mainly as pain, initially mild, aching. Then they become more intense, and in advanced stages they never disappear, which significantly reduces a person's performance and quality of life.
The main reasons why DOA of the shoulder joint develops are as follows:
- Impairment of blood circulation in the cartilaginous tissues of the shoulder in atherosclerosis and other chronic diseases associated with blood vessels.
- Chronic autoimmune diseases, for example rheumatoid arthritis, systemic lupus erythematosus.
- Dysfunction of the endocrine system (diabetes mellitus).
- Congenital anomalies of the shoulder joint, birth injuries in newborns and other injuries leading to pathological deformation and dysfunction of the limb.
- Acquired pathologies of joint structures after injuries or accidents, unsuccessful surgical interventions, 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. These include:
- professional activity in which the shoulder joint receives heavy loads day after day for many years - shoulder arthrosis is rightly called the disease of plasterers, painters and loaders;
- sedentary lifestyle, lack of physical activity - with insufficient exercise, blood circulation slows down, joint tissues do not receive the necessary amount of nutrients and begin to atrophy;
- overweight - often combined with the previous factor; with obesity, a person is not able to actively move, while the joints receive additional stress due to extra pounds;
- hereditary predisposition;
- Old age: About 80% of people over the age of 70 have symptoms of osteoarthritis.
Very often, when examining and interviewing a patient, the doctor identifies 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 of age, engaged in heavy physical labor, overweight and other chronic pathologies (diabetes mellitus, arterial hypertension, varicose veins, knee arthritis, etc. ). In this case, injuries to the right shoulder are more common than those to the left. This is due to the fact that most people actively use their right hand at work and at home, with the exception of congenital left-handers.
How to recognize the disease
Symptoms of arthrosis of the shoulder joint may not appear for a long time. If the shoulder starts to hurt from time to time, a person attributes this to fatigue, takes painkillers, uses an ointment with a warming effect and calms down. But sooner or later the moment comes when pills and ointments no longer help, the pain becomes constant, intense and bothersome at rest and at night. In addition to this symptom, the following signs will indicate dystrophic changes in the shoulder joint:
- swelling and deformation of the joint, evident to the naked eye;
- redness of the skin over the joint, local increase in temperature;
- characteristic creaking in the joint. Creaking sounds when the hand moves sharply are explained by the accumulation of salts in the cracks of the cartilage and between the joint elements. At first the creaking occurs only with sudden movements; it is silent and barely audible. In advanced forms of the disease, the shoulder creaks with every movement, the sound is heard by others;
- limitation of limb mobility. While examining a patient, the doctor will ask him to comb his hair. This test is enough to diagnose arthrosis of the shoulder joint: the patient will feel sharp pain, perform a rotational movement with the shoulder, it will be difficult for him to move the shoulder back, the doctor will hear creaks and clicks in the joint.
DOA of the shoulder must be treated, otherwise over time the patient will lose full upper extremity mobility and performance. If the process of destruction of the cartilage and surrounding tissues 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 using drugs of various effects and physical procedures will be required.
Degrees
There are several stages of DOA of the shoulder joint, each of them manifests itself differently and requires a different approach to treatment.
- 1st degree.At this stage, the disease is just beginning to develop, changes in the cartilage tissue are even minor. The main symptoms of grade 1 DOA are weakness of the joints and limbs and periodic nagging pain. Pain occurs after physical exertion, during monotonous and repeated movements of the hands for a long time. After a night's sleep or a long period of rest, a person feels stiffness in the shoulder joint, but as it develops, the stiffness still disappears without medications and physical procedures - a light warm-up is enough. If an x-ray is taken at this stage, the image will not show significant changes in the joint structures, although thinning and deformation of the cartilage may be noted.
- 2nd degree.The pathological process proceeds and manifests itself more actively. A person already gets used to the fact that after work his shoulder hurts, he "expects" the pain, he has analgesics and ointments for joint pain, pharmacy or homemade, ready. X-ray diagnostics will show obvious changes in the joint: thinning and deformation of the cartilage, inflammation of the joint membrane. Occasionally the joint becomes red and swollen; creaks, squeaks and clicks can be heard during movement.
- 3rd degree.The shoulder joint constantly hurts and creaks, to reduce discomfort, the person tries not to touch it and not move the limb at all. The deformity is evident 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. You cannot remove them with painkillers.
If no action is taken in the third stage of the disease, the fourth stage will occur: complete immobility of the shoulder joint and limb. In this case it is already useless to prescribe drugs and physiotherapy, only endoprosthetic surgery will help to at least partially restore the functionality of the hand. But even this is not always successful.
In a note:In medical practice, it is extremely rare to encounter grade 3 shoulder arthritis. Typically, the patient seeks medical help first and begins treatment. Severe cartilage destruction can occur against the background of extensive trauma, if for some reason the patient cannot consult a doctor, or if the person lives in disadvantaged social conditions where qualified doctors are not available.
How is osteoarthritis diagnosed and treated?
A good doctor will be able to make a preliminary diagnosis after a conversation with the patient and his external examination. Instrumental diagnostic methods are more necessary to exclude other pathologies and complications or to identify them. To accurately determine the severity of the joint and possible inflammation, the following diagnostic measures are performed:
- radiography;
- CT;
- Magnetic resonance imaging;
- in some cases, ultrasound to obtain a complete picture of the condition of the joint;
- clinical tests of urine and blood: the number of leukocytes and the sedimentation rate of erythrocytes will be evaluated. If they are too high, an inflammatory process develops in the body.
The best way to treat the pathology is determined by the doctor on an individual basis, taking into account the patient's age, profession and general condition.
Traditional treatment involves the use of the following methods and means:
- A course of therapy with nonsteroidal anti-inflammatory drugs. Drugs 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 drugs cannot be taken continuously, they do not eliminate the cause of the disease and are intended only for extreme cases, when the pain is unbearable.
- A course of taking chondroprotectors - drugs that promote the restoration of cartilage tissue and prevent further destruction. They also partially relieve pain, swelling and 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 osteoarthritis and are not always prescribed.
- A course of taking vitamin-mineral complexes and food supplements with collagen and hyaluronic acid.
To increase the effectiveness of treatment, rapid recovery and prevention of new injuries, 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 variety, cereals, legumes. Polyunsaturated fatty acids can be obtained from sea fish and seafood. A gelatin diet is practiced, as gelatin helps restore the elasticity of cartilage tissue. The menu includes jellied meat from beef hooves and tails, jelly and various jellies. It is useful to take gelatin in its pure form, pre-soaked in warm water.
Physiotherapy is the next important point in the complex treatment of shoulder arthrosis. They are started only when the inflammatory process is 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;
- magnetotherapy;
- mud therapy;
- various types of massages;
- Physiotherapy.
Physiotherapy procedures are aimed at activating metabolic processes in joint tissues, normalizing blood circulation and restoring mobility of the limbs. With their help it is possible to reduce the number of drugs taken and their dosage, which is especially useful if the pathology is observed in a teenager, an elderly person or a breastfeeding woman.
Useful tips:It is possible to treat grade 1-2 injuries 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 in a timely manner and does not skip physical procedures: the effect will be noticeable and long-lasting only if all the doctor's prescriptions are followed regularly and conscientiously.
If conservative treatment is ineffective, the doctor is forced to propose surgery to the patient. The remains of the destroyed joint will be removed and a prosthesis will be 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 begins to hurt, pull, numb or hear a crunch when you move, do not postpone the visit to the doctor, get examined promptly and, if necessary, start treatment.
Osteoarthritis of the shoulder joint is a fairly common pathology of the musculoskeletal system, occurring mainly 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 initial stages, the progression of the disease can be stopped with the help of comprehensive treatment: medications, vitamin supplements, diet therapy and exercise therapy. Advanced osteoarthritis can only be treated surgically.