One-third of all seniors over the age of sixty report pain in the shoulder joint. In most cases, the cause of pain in this area is the development of arthrosis. The disease also affects young people whose profession involves constant heavy physical activity - miners, builders, loaders, etc.
The disease causes great discomfort in everyday life and drastically reduces the ability to work. In severe cases, shoulder arthrosis causes disability. It is important to identify the disease at an early stage. Now there are treatment methods that suppress the progression of the disease if the therapy is started on time.
What is pathology?
Osteoarthritis of the shoulder joint is a chronic disease in which degenerative processes destroy and thin the cartilage. Osteoarthritis of the shoulder is classified as a group of pathologies that are non-infectious in nature. First, the cartilage tissue covering the articular surfaces is destroyed.
Cartilage loses its strength and elasticity. It gradually thins and flattens. Due to changes in the cartilage layer, it loses its shock absorption properties. Its ability to reduce shock loads that occur during arm flexion or extension is impaired.
Osteoarthritis also affects all structures, such as the joint capsule, its shell, bone surfaces adjacent to 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 the disease, bone growths occur on the articular surfaces.
The pathology manifests itself with pain and stiffness in the affected shoulder area. In the later stages of the disease, the range of motion in the shoulder joint decreases sharply. With this nature of the process, inflammation in it is either absent or weakly expressed. The pathology has a chronic, gradually progressive course.
Reasons
The cascade of pathological changes in osteoarthritis is triggered by the natural aging of tissues. Cartilage damage from intense mechanical stress can contribute to the initiation of cartilage destruction. This is 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 the disease are considered to be:
- Developmental anomalies. Pathology is often found in patients with underdevelopment of the humeral head or glenoid cavity, as well as in the presence of other defects of the upper limb.
- Injuries. Traumatic arthrosis often develops after intra-articular fractures. Sometimes the cause of the pathology is shoulder dislocation, in most cases it is common. Sometimes severe caries lead to the development of pathology.
- Inflammation. Osteoarthritis often occurs when a patient suffers from glenohumeral periarthritis for a long time. This is also contributed by previously exposed non-specific purulent arthritis, as well as specific joint damage caused by tuberculosis, syphilis and other diseases.
There is a group of risk factors that contribute to the appearance of such a polyetiological disease. The following events increase the likelihood of developing arthrosis:
- Genetic predisposition. Close relatives of many patients also suffer from arthrosis. They also have lesions with other localization. Typically, the knee, ankle, and other joints are affected.
- Excessive tension. It often occurs in athletes involved in volleyball, tennis, basketball and throwing sports equipment. This situation also occurs in people, if their profession is characterized by a constant high load on the upper extremities (loaders, miners, etc. ).
- Diseases. Osteoarthritis often develops in patients suffering from autoimmune joint diseases. Some endocrine diseases, metabolic disorders and connective tissue deficiency characterized by excessive joint mobility also contribute to degenerative processes in cartilage.
The frequency of degenerative articular lesions in patients increases dramatically with age. Often, hypothermia also has a negative effect on the joints.
Symptoms
At the beginning of the disease, patients with arthrosis feel discomfort and moderate pain in the shoulder region. Pain is weather dependent. They are more intense after physical activity. The pain intensifies in a certain position of the body. After resting or changing the position, the pain disappears.
When the patient moves his hand, there is a feeling of creaking. There are no external changes or swelling in the joint. Over time, the pain gets worse. It constantly bothers the patient, regardless of the body position. Painful or painful in nature.
Pain in the shoulder joint is common and constant. Painful sensations appear both during exercise and at rest. They can disturb the patient at night. The characteristic features of the pain syndrome in arthrosis of the joints are as follows:
- along with the appearance of aching pain over time, sharp pain occurs during physical activity;
- unpleasant sensations are registered only in the joint area, radiate to the elbow area, and then can spread to the entire surface of the arm;
- pain may radiate to the back and neck on the affected side.
After a short time, the patient complains of morning stiffness in the shoulder. The range of active movements in the joint decreases. After physical activity, as well as hypothermia, slight swelling of the soft tissues in the shoulder area is detected.
As joint damage progresses, there is an increase in range of motion limitations. The patient develops contracture (stiffness), which significantly impairs the function of the limb. If the arthrosis is on the right side, the patient cannot take care of himself.
Stages of development
There are three stages of the pathological process associated with this disease. They reflect the severity of damage to articular structures and the presence of certain symptoms of shoulder joint damage. Experts distinguish the following stages of the pathological process:
- First. The absence of gross structural changes in the thickness of the cartilage tissue is noted. The content of intra-articular fluid changes. Cartilage nutrition is disturbed. It does not tolerate stress well, which causes periodic pain.
- Second. At this stage, thinning of the cartilage tissue occurs. Its structure changes. The surface becomes rough. Cysts are formed in the thickness of the cartilaginous layer and foci of calcification are formed. Bone areas adjacent to the joint are moderately deformed. The edges of the articular platform are covered with bone growths. Anxiety is constant.
- the third. An obvious thinning of the cartilaginous layer and disruption of its structure is noted. Extensive areas of cartilage destruction are identified. A significant deformation of the articular platform is revealed. Limitation of range of motion is detected. There is weakness of the ligaments, as well as a decrease in the size of the periarticular muscles and flabbiness.
This approach to classifying lesions of the shoulder joint allows doctors to choose 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 should see a therapist. The specialist will make a preliminary diagnosis. After determining the cause of joint damage, he will send the patient to a rheumatologist, endocrinologist, surgeon or orthopedic traumatologist.
Doctors make a diagnosis when there are typical clinical manifestations and X-ray signs of arthrosis. During the initial examination, the tissues of the joint are felt to determine the degree of pain.
The possibility of active and passive actions in the affected area is studied. The doctor detects the deformation or increase in volume of the joint. The following studies are recommended to confirm the presence of arthrosis:
- Radiography. Dystrophic changes in the cartilaginous layer are revealed in the joint. Characteristic bone growths are identified along the edge of the joint cavity. At the next stage, they see a narrowing of the joint space. A change in the shape and structure of the bone adjacent to the cartilage is determined. The shape of the joint cavity is wedge-shaped. Signs of bone thickness thinning and cyst-like formations appear.
- CT scan. This study, carried out in the early stages of the disease, makes it possible to assess the condition of bones and cartilages using layer-by-layer images.
- Magnetic resonance imaging. The method evaluates the condition of soft tissue formations (cartilage, ligaments, joint capsule, etc. ). Layer-by-layer clear images help determine the extent of damage to articular and periarticular structures.
- Ultrasonography. Joint changes are detected using ultrasound. The method is safe for the body because there is no harmful radiation.
- Arthroscopy. It is done using an endoscope. A manipulator with a camera is inserted into the joint. The doctor clearly sees the damaged areas. Softening zones are identified in the cartilage thickness. This reveals the presence of deep cracks penetrating deep into the subchondral (subchondral) plate of the bone. Deep ulcers, erosion and superficial cracks are detected in the cartilage.
Diagnosing arthrosis of the shoulder joint in the later stages does not cause any difficulties for doctors. 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 of arthrosis is carried out by orthopedic traumatologists or rheumatologists. In the stage of recovery of motor functions, rehabilitation specialists actively participate in the treatment process.
In order to relieve pain and restore function during arthrosis of the limbs, it is important to get immediate medical help and follow all the doctor's instructions. It is necessary to limit the joint load and avoid sudden movements of the hand. It is important to avoid lifting or carrying heavy objects for long periods of time.
The joint needs a dosed load under the supervision of specialists, because complete immobility has a negative effect on the affected limb. Treatment options include conservative therapy and surgical interventions. The choice of methods depends on the prevalence of certain symptoms and the stage of the disease.
Drug therapy
An important goal in the treatment of arthrosis is pain relief. The following drugs are prescribed to relieve discomfort and reduce the severity of inflammation:
- Preparations for general anesthesia. Non-steroidal drugs are prescribed to patients for a short course during an exacerbation. With long-term uncontrolled use, they irritate the gastric mucosa and slow down the recovery process in the joint.
- Local remedies. When symptoms increase, gels and ointments containing non-steroidal anti-inflammatory compounds are used. Hormone-containing drugs with local effect are used less often. They eliminate inflammation and swelling.
- Means for intra-articular injection. Glucocorticoids are injected into the joint for persistent and severe pain that cannot be relieved by other means. Blockades can be implemented no more than four times a year.
In the first and second stages, chondroprotectors are prescribed to restore and strengthen the joint. These products contain chondroitin sulfate, hyaluronic acid and glucosamine. They are used in long courses of six months or more. The effect of therapy is noticeable only after three months of continuous use of the drug.
In addition, vasodilators are used for shoulder arthrosis. They increase blood flow and eliminate capillary spasms. When spasms are detected, muscle relaxants are prescribed to relax the muscles in the shoulder area.
Surgical methods
In the third stage of arthrosis, when there is significant destruction along with limited mobility and loss of work ability, endoprosthetic surgery is performed. Age, physical activity level and general health are considered before deciding whether to have an intervention.
Installation of modern endoprostheses made of ceramics, plastic and metal fully restores the function of the joint. The devices have a guaranteed service life of more than fifteen years.
Non-drug treatment
Physiotherapy methods are actively used in the treatment of joint osteoarthritis in the phase of reducing exacerbations. Their course use gives good results when included in a complex therapy program. The following physiotherapeutic methods are used for arthrosis:
- Amplipulse. The treatment method uses alternating electric current to have a local combined effect. It relieves pain and has a vasodilating effect. The procedure improves tissue nutrition.
- UHF. The joint is exposed to ultra high frequency waves. The method reduces pain, removes inflammation and swelling.
- Magnetotherapy. Joint structures are affected by a pulsed magnetic field. Improves blood flow. Cartilage is saturated with nutrients. The magnet removes decayed products from the cells. Inhibits autoimmune reactions.
- Electrophoresis. This technique helps the penetration of drugs into the affected joint, which is provided by the effect of electric current on the tissue. During the treatment, the blood flow in the joint structures increases. The procedure reduces inflammation and swelling. Unpleasant sensations in the hand disappear. Muscle spasm is eliminated.
- Balneotherapy. Therapeutic baths with radon, saline and other useful solutions are actively used for shoulder arthrosis. Blood flow improves, which increases nutrition and accelerates cell regeneration. Inflammation is eliminated.
- Electrical stimulation. With this method of treatment, electrical stimulation of nerve trunks and muscles is carried out through electrodes that transmit current with certain parameters.
Therapeutic massage is performed after the aggravation is removed. It restores blood circulation and increases the flexibility of ligaments. Muscle spasm in the joint decreases. The range of motion increases. Exercise therapy is beneficial for osteoarthritis.
The gymnastics complex is performed when the pain subsides. When conducting mechanotherapy, special simulators are used for rehabilitation. Active-passive actions are performed on them. They restore the function of the affected joint.
How to treat at home?
Laser therapy is considered an effective method in the treatment of shoulder arthrosis. The laser beam has a beneficial effect on the affected joint tissue. Devices that produce low-intensity infrared laser rays are used for therapy. Laser therapy is prescribed to accelerate cell metabolism.
All physicochemical reactions are stimulated in tissues. The functions of cartilage cells are activated. Laser treatment has an analgesic effect. Blood flow improves and swelling is eliminated. Local immunity is strengthened. Reserve capillaries expand. Laser therapy has an anti-inflammatory effect.
It is not necessary to constantly visit a medical institution to receive the procedures. Treatment of shoulder arthrosis at home is carried out using portable laser therapy devices. With their regular use, pain decreases. The function of the shoulder joint improves with laser treatment of arthrosis at home.
Prognosis and prevention
Shoulder arthrosis cannot be completely cured. However, it is possible to slow down the progress of pathological joint changes. Ability to work is maintained with regular treatment. It is important to follow the doctor's recommendations.
Hand injury should be avoided. It is important to avoid excessive impact on the shoulder joint while performing professional duties as well as during sports. Diseases that contribute to the development of arthrosis should be treated in time.