Arthrosis of the shoulder joint

One third of all older people over the age of sixty report pain in the shoulder joint. The cause of pain in this area in most cases is the development of arthrosis. The disease also affects young people whose profession involves constant heavy physical activity - miners, builders, loaders, etc.

This disease causes great discomfort in everyday life and dramatically reduces the ability to work. In severe cases, shoulder arthrosis leads to disability. It is important to identify the disease at an early stage. There are now treatment methods that block the progression of the disease when therapy is started on time.

What is pathology?

Osteoarthritis of the shoulder joint is a chronic disease in which the degenerative process destroys and thins the cartilage. Osteoarthritis of the shoulder is classified as a group of pathologies of a non-infectious nature. First, the cartilage tissue that covers the articular surface is destroyed.

Cartilage loses its strength and elasticity. It gradually thins and evens out. Due to changes in the cartilage layer, it loses its shock-absorbing qualities. Its ability to reduce the shock load that occurs during flexion or extension of the arm is deteriorating.

Osteoarthritis also affects all structures, such as the joint capsule, its shell, the adjacent bone surface with the cartilage layer, ligaments, and adjacent muscles. This is accompanied by pathological changes in other soft tissues located near the joint. As a result of this disease, bone growth is formed on the articular surface.

Pathology is manifested by pain and spasms in the affected shoulder area. In the final stages of the disease, the range of motion in the shoulder joint is dramatically reduced. Inflammation in it with the nature of this process is either absent or weakly expressed. Pathology has a chronic, gradually progressive course.

Cause

The cascade of pathological changes in osteoarthritis is triggered by the natural aging of tissues. Damage to cartilage due to strong mechanical stress can contribute to the onset of cartilage destruction. This is also facilitated by various pathological processes.

Primary shoulder arthrosis is usually diagnosed in older people. Secondary joint damage develops against the background of previous diseases. It happens at any age. The main causes of this disease are considered:

1. Developmental anomalies. Pathology is often found in patients with underdevelopment of the humeral head or glenoid cavity, as well as the presence of other defects in the upper limb.
2. injury. Traumatic arthrosis often develops after an intra-articular fracture. Sometimes the cause of the pathology is shoulder dislocation, often habitual. Sometimes, severe bruising triggers the development of pathology.
3. Inflammation. Arthrosis often occurs when patients suffer from glenohumeral periarthritis for a long period of time. This is also facilitated by previously non-specific purulent arthritis, as well as certain joint lesions arising from tuberculosis, syphilis and other diseases.

There are a group of risk factors that contribute to the emergence of such polyetiological diseases. The following phenomena increase the likelihood of developing arthrosis:

• Genetic predisposition. Close relatives of many patients also suffer from arthrosis. They also have lesions with other localization. Usually knees, ankles and other joints are affected.
• Over voltage. It often occurs in athletes involved in volleyball, tennis, basketball, and throwing sports equipment. This condition also occurs in people if their profession is characterized by a constant high load on the upper limbs (loaders, miners and others).
• Illness. Osteoarthritis often develops in patients with autoimmune joint disease. Some endocrine diseases, metabolic disorders, and lack of connective tissue, characterized by excessive joint mobility, also contribute to the degenerative process in the cartilage.

The incidence of degenerative articular lesions in patients increases dramatically with age. Frequent hypothermia also has a negative effect on the joints.

symptoms

At the beginning of the disease, patients with arthrosis experience discomfort and moderate pain in the shoulder area. There is a pain dependence on the weather. They become more intense after physical activity. The pain gets stronger in certain body positions. After resting or changing position, the pain disappears.

When the patient moves his hand, a throbbing sensation occurs. No external changes in the joints, no swelling. Over time, the pain became stronger. It always bothers the patient, regardless of the position of the body. Pain has an attractive or painful character.

Pain in the shoulder joint becomes habitual and persistent. Painful sensations appear during exercise and at rest. They can disturb patients at night. The characteristics of pain syndrome in joint osteoarthritis are as follows:

• along with the appearance of painful pain over time, sharp pain occurs during physical activity;
• unpleasant sensations are registered only in the joint area, they radiate to the elbow area, and then can spread to the entire surface of the arm;
• pain can spread to the back and neck on the affected side.

After a short time, the patient is bothered by morning stiffness in the shoulders. Active range of motion in the joint is reduced. After physical activity, as well as hypothermia, a slight swelling of the soft tissue in the shoulder area is detected.

As the joint damage progresses, an increase in range of motion restriction is observed. The patient experiences contractures (stiffness), which significantly affects the function of the limbs. If the osteoarthritis is on the right side, the patient cannot take care of himself.

Stage of development

With this disease, there are three stages of the pathological process in the joint. They reflect the severity of damage to the articular structure and the presence of certain symptoms of damage to the shoulder joint. Experts distinguish the following stages in the pathological process:

1. First. The absence of gross structural changes in the thickness of the cartilage tissue was observed. The composition of the intra-articular fluid changes. Cartilage nutrition is disturbed. He does not tolerate pressure well, which leads to periodic pain.
2. Second. At this stage, cartilage tissue thinning occurs. The structure changes. The surface becomes rough. Cysts are formed in the thickness of the cartilaginous layer, and foci of calcification appear. The bony area adjacent to the joint is moderately deformed. The edge of the articular platform is covered with bone growth. The discomfort is constant.
3. Third. A significant degree of thinning of the cartilaginous layer and structural disruption is observed. Wide areas of cartilage destruction are identified. A significant deformation of the articular platform was found. Limited range of motion is revealed. There is weakness of the ligaments, as well as a reduction in the size and flexibility of the periarticular muscles.

The approach to classifying lesions of the shoulder joint allows the doctor to choose the appropriate treatment tactics that take into account the severity of the pathological process.

Diagnostics

The appearance of symptoms of arthrosis forces the patient to go to the doctor. He needs to see a therapist. Specialists will conduct an initial diagnosis. After determining the cause of joint damage, he will refer the patient to a rheumatologist, endocrinologist, surgeon or orthopedic-traumatologist.

Doctors make a diagnosis based on the presence of typical clinical manifestations and X-ray signs of arthrosis. During the initial examination, joint tissue is felt to determine the level of pain.

The possibility of active and passive movement in the affected area is being studied. The doctor detects a deformation of the joint or an increase in its volume. To confirm the presence of arthrosis, the following studies are recommended:

1. Radiography. The presence of dystrophic changes in the cartilaginous layer is detected in the joints. Bone growth features are identified along the edge of the articular cavity. At a later stage, they found that the joint space narrowed. Changes in the shape and structure of the bones adjacent to the cartilage are determined. The shape of the joint space becomes wedge-shaped. In bone thickness, signs rarely occur and the presence of cyst-like formations can be seen.
2. CT scan. Studies in the early stages of the disease provide an opportunity to assess the state of bone and cartilage using layer-by-layer images.
3. Magnetic resonance imaging. Methods of assessing the state of soft tissue formation (cartilage, ligaments, joint capsules, etc. ). Clear layer-by-layer images help determine the extent of damage to articular and periarticular structures.
4. Ultrasonography. Changes in the joints are detected using ultrasound. This method is safe for the body, because there is no harmful radiation.
5. Arthroscopy. It is done using endoscopy. A manipulator with a camera is inserted into the joint. The doctor clearly sees the damage area. The softening zone in the thickness of the cartilage is determined. It reveals the presence of deep cracks that penetrate deep into the subchondral (subchondral) plate of the bone. Ulcers in the cartilage, erosions and superficial cracks are detected.

Making a diagnosis of arthrosis of the shoulder joint at a later stage does not present any difficulties for the doctor. When assessing the nature of joint damage, it is necessary to take into account the possible secondary origin of joint pathology against the background of other diseases.

Treatment

Treatment for osteoarthritis is carried out by an orthopedic traumatologist or a rheumatologist. At the motor function recovery stage, the rehabilitation specialist actively participates in the treatment process.

To relieve pain and restore function in case of limb arthrosis, it is important to receive immediate medical treatment and follow all the doctor's instructions. It is necessary to limit the load on the joints and avoid sudden hand movements. It is important to avoid lifting or carrying heavy objects for long periods of time.

Joints require dosed loading under expert supervision, as complete inactivity has a negative effect on the affected limb. Treatment options include conservative therapy and surgical intervention. The choice of method depends on the prevalence of certain symptoms and the stage of the disease.

Drug therapy

An important goal in the treatment of arthrosis is the elimination of pain. To eliminate discomfort and reduce the severity of inflammation, the following drugs are prescribed:

1. Preparation for general anesthesia. Non-steroid drugs are prescribed to patients for short courses during exacerbations. With prolonged uncontrolled use, they irritate the gastric mucosa and slow down the healing process in the joints.
2. Local medicine. Gels and ointments containing non-steroidal anti-inflammatory compounds are used when symptoms increase. Drugs containing hormones with local action are less commonly used. They relieve inflammation and swelling.
3. Means for intra-articular injection. For persistent and severe pain that cannot be eliminated by other means, glucocorticoid drugs are injected into the joint. Restrictions can be done no more than four times a year.

In the first and second stages, chondroprotectors are prescribed to restore and strengthen the joints. This product contains chondroitin sulfate, hyaluronic acid and glucosamine. It is used in a long course of six months or more. The therapeutic effect becomes noticeable only after three months of continuous use of the drug.

In addition, vasodilators are used for shoulder arthrosis. They increase blood flow and relieve capillary spasm. A muscle relaxant is prescribed to relax the muscles in the shoulder area when spasms are detected.

Surgical method

In the third stage of arthrosis, when there is significant destruction of the joint with limited mobility and loss of ability to work, endoprosthetics surgery is performed. Before deciding whether to do an intervention, age, level of physical activity and general health are taken into account.

Installation of modern endoprostheses made of ceramic, plastic and metal fully restores joint function. The device has a guaranteed service life of more than fifteen years.

Treatment is not medicine

Physiotherapeutic techniques are actively used in the reduced exacerbation phase in the treatment of osteoarthritis of the joints. The use of their courses gives good results when included in a complex therapy program. For arthrosis, the following physiotherapeutic methods are used:

1. Amplipulse. Treatment methods locally affect the joints using alternating electric currents. It relieves pain and has a vasodilator effect. This procedure improves tissue nutrition.
2. UHF. Joints are exposed to ultra high frequency waves. The method reduces pain, relieves inflammation and swelling.
3. Magnetotherapy. The joint structure is affected by a pulsed magnetic field. It increases blood flow. Cartilage is saturated with nutrients. Magnets remove decay products from cells. It suppresses the autoimmune response.
4. Electrophoresis. This technique promotes the penetration of the drug into the affected joint, which is ensured by the effect of electric current on the tissue. During treatment, blood flow in the joint structure increases. This procedure reduces inflammation and swelling. The unpleasant sensation in the hands is relieved. Muscle spasms are eliminated.
5. Balneotherapy. Therapeutic baths with radon, saline and other beneficial solutions are actively used for shoulder arthrosis. Blood flow improves, which improves nutrition and accelerates cell recovery. Inflammation relieved.
6. Electrical stimulation. With this treatment method, electrical stimulation of nerve trunks and muscles is performed using electrodes, which send currents that have certain parameters.

Therapeutic massage is carried out after the exacerbation is relieved. It restores blood flow and improves ligament elasticity. Muscle spasms in the joints are reduced. Increased range of motion. For arthrosis, exercise therapy is useful.

The gymnastic complex is performed when the pain subsides. When conducting mechanotherapy, special simulators are used for rehabilitation. Active-passive movements are carried out on them. They restore the function of affected joints.

How to treat at home?

Laser therapy is considered an effective method in the treatment of shoulder arthrosis. The laser beam has a good effect on the affected joint tissue. Devices that produce low-intensity infrared laser beams are used for therapy. Laser therapy is prescribed to speed up cell metabolism.

All physicochemical reactions are stimulated in tissues. Cartilage cell function is activated. Laser treatment provides an analgesic effect. Blood flow improves and swelling is eliminated. Local immunity is enhanced. Capillary reserve expands. Laser therapy has an anti-inflammatory effect.

To receive the procedure, you do not need to constantly visit a medical facility. Treatment of shoulder arthrosis at home is carried out using a portable laser therapy device. With their regular use, pain is reduced. Shoulder joint function improves with laser treatment of arthrosis at home.

Prognosis and prevention

Shoulder arthrosis cannot be completely cured. But it is possible to delay the development of pathological joint changes. With regular treatment, the ability to work is maintained. It is important to follow the doctor's recommendations.

It is necessary to avoid injury to the hand. It is important to avoid excessive impact on the shoulder joint during professional tasks, as well as during sports. It is necessary to immediately treat diseases that contribute to the development of arthrosis.