Shoulder osteoarthritis is a chronic, widespread disease associated with damage to joint structures. The pathological process is accompanied by degenerative deformation of the joint surfaces. In this case, not only the cartilage tissue is damaged, but also the bone tissue. The symptoms of the pathology and the methods of treatment depend on the degree of damage to the joints.
The disease can develop over several years without manifesting itself. At some point, under the influence of adverse factors (hypothermia, trauma, severe concomitant illness), the first signs of the disease appear. It is at this time that it is necessary to consult a doctor, as the fight against dystrophic changes in cartilage is especially effective at the beginning of the disease.
Causes of osteoarthritis of the shoulder
The causes of degenerative-dystrophic damage to joint tissues are numerous and varied. Among them, injuries play the main role, so post-traumatic arthrosis of the shoulder joint is considered the most common form of pathology. It can be caused by even slight but repeated damage to cartilage tissues.
In addition, the disease can occur under the influence of the following pathological factors:
- Severe joint damage: synovitis, gout, acute or chronic arthritis, aseptic necrosis of the humerus.
- Regular excess of the joints. Most often seen in athletes involved in volleyball, tennis, basketball.
- Congenital pathology of the shoulder joint.
- Endocrine diseases.
- Elderly and senile age.
- Excess weight (obesity).
- avitaminosis.
- Autoimmune injuries and weakening of the immune system.
- genetic predisposition.
Most of the sick are people engaged in monotonous physical work. Therefore, osteoarthritis of the right shoulder joint is diagnosed much more often than the left.
The disease usually develops under the influence of not one, but several adverse factors at the same time. Based on this, treatment must be comprehensive and directed not only at fighting the disease, but also at eliminating all the causes that caused it.
Characteristic signs of the disease
Osteoarthritis of the shoulder, starting imperceptibly and developing gradually, can manifest suddenly after injury, hypothermia, or severe physical exertion. In this case, there are characteristic symptoms of damage to the shoulder joints and nearby tissues:
- pain;
- grinding and clicking during hand movement;
- stiffness and decreased range of motion in the shoulder.
The disease most often occurs in a chronic form. An exacerbation of the disease can be triggered by excessive stress on the joint or injury.
The intensity of the manifestation of symptoms largely depends on the severity of damage to cartilage and bone tissue, so it is customary to distinguish between various degrees of the disease. This systematization significantly facilitates the diagnosis and makes it possible to accurately predict the outcome of the disease.
Arthrosis of the shoulder I grade
During this period, the tissues of the joint are mildly affected. Pain is observed extremely rarely and only after excessive physical exertion or prolonged monotonous work. The patient most often does not pay attention to these symptoms, attributing them to overwork or muscle tension. Defeat of 1 degree is treated only by conservative methods.
At the beginning of the disease, there are no obvious changes in the cartilaginous tissues on radiographs, only an oval ring is noticed around the joint cavity.
Grade II shoulder arthrosis
At this stage, the symptoms of the disease become more pronounced. Cartilage tissues become thinner and deformed, intra-articular ligaments are damaged. During hand movement, a popping sound is heard, the inner layer of the joint bag becomes inflamed. Over time, the pain becomes constant. Morning stiffness and limitation of movement appear, which can lead to muscle atrophy.
Grade III shoulder arthrosis
During this period, the joint is already significantly deformed, there is practically no movement in it. The patient suffers from sharp pain that can radiate to the arm and shoulder blade. If you do not stop further tissue destruction, the pathological process can lead to disability.
Third-degree disease is not amenable to conservative treatment and requires surgical intervention.
Shoulder-shoulder arthrosis rarely reaches the third stage. Most often, the second stage is diagnosed with the transition to a chronic form.
Which doctor to contact
Often, people facing joint pain do not know who to turn to. At the first symptoms of the disease, you should visit a rheumatologist. The specialist will not only perform a thorough physical examination and make a diagnosis, but also, if necessary, relieve severe pain with the help of an intra-articular injection of an anesthetic.
With the advanced form of the disease, the rheumatologist is likely to be powerless. In this case, you will need a surgeon or orthopedist. In big cities, you can make an appointment with an arthrologist who only deals with joint disease.
How to deal with shoulder arthritis
After a medical examination and diagnosis, the doctor prescribes a specific therapy that allows you to achieve a long and stable remission of the disease. It is impossible to cure the degenerative changes in the joints, but slowing the course of the destructive process and alleviating the patient's condition is a completely feasible task.
The main goal of anti-arthrosis therapy is to relieve pain and restore joint mobility.
modern drug therapy
In some patients, it is difficult to make an accurate diagnosis in the early stages of the disease. At this stage, the pain is not pronounced and does not oblige patients to seek help from specialists. Most often they are treated independently with folk remedies. Some patients engage in therapeutic exercises to reduce joint pain and stiffness. For the treatment of osteoarthritis, drugs prescribed by a doctor are used, respecting the recommended dosage and duration of administration. The most effective are the following groups of drugs:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors;
- corticosteroid drugs;
- non-narcotic analgesics;
- vasodilators;
- muscle relaxants.
Many drugs for this pathology are sometimes prescribed for a long time. Depending on the severity of the disease, drugs are taken orally, used externally, injected intramuscularly or into the cavity of the shoulder joint.
Non-steroidal anti-inflammatory drugs (NSAIDs)
NSAIDs are contraindicated for long-term use due to the presence of digestive tract side effects.
It is possible to treat the disease with drugs already at an early stage of the development of the pathological process. The course is determined based on the patient's condition and the severity of symptoms. As an independent treatment, the ointments included in this group are not prescribed. They are used in combination with similar groups of drugs used intramuscularly or orally. Its task is to reduce inflammation and alleviate the patient's condition.
chondroprotectors
Almost all patients include drugs designed to improve metabolic processes in cartilage tissue in the treatment regimen. In addition, they increase the elasticity of cartilage. Chondroprotectors have such properties. These medicinal substances differ depending on the main active ingredient from which they are made:
- hyaluronic acid;
- chondroitin sulfate;
- glucosamine;
- combined funds.
Glucosamine is a substance that plays an important role in the formation of healthy cartilage tissue. Chondroitin sulfate's job is to nourish and provide cushioning to the shoulder.
Monotherapy preparations have proven to be more proven on the market compared to a combination of substances.
The polysaccharide contained in the intercellular space is hyaluronic acid. In addition, it is able to reduce the sensitivity of receptors that respond to pain. Combined chondroprotectors, which contain several active ingredients, have the biggest advantage.
The most effective use of chondroprotectors in the early stages of the disease. The task of drugs is the synthesis of new cells from healthy cartilage tissue, which replace the damaged tissue. In the presence of pain and swelling, drugs in this group will be less effective. Therefore, it will first be necessary to use anti-inflammatory drugs to alleviate the patient's condition.
To obtain the maximum effect, injectable preparations are used for intra-articular or intramuscular administration. The course of treatment with chondroprotectors takes up to six months, some patients notice the first results after 3 months of therapy. It is important to follow some rules in the treatment of such drugs.
With the beginning of the course of therapy, physical overload, stressful situations should be excluded. The patient will have the greatest effect if he starts taking chondroprotectors, improves nutrition and engages in physical therapy exercises. Many patients with osteoarthritis of the shoulder joint are involved in Dr. Bubnovsky, they perform a set of exercises specially designed to achieve gradual joint restoration or stop the progression of the disease.
corticosteroid agents
When severe pain appears, if anti-inflammatory drugs do not bring a positive effect, corticosteroids are prescribed. To alleviate the patient's condition, ointments or injections are prescribed.
Analgesics
In the early stages of the disease, painkillers are prescribed to reduce pain.
Compared with non-steroidal anti-inflammatory drugs, drugs from this group have a less negative effect on the mucosa of the digestive tract.
Having an unexpressed anti-inflammatory effect, they effectively fight pain.
Vasodilators
The mandatory means in the treatment of arthrosis are vasodilators. They eliminate vascular spasms, normalize blood flow in the affected area. Many patients complain of the appearance of nocturnal pain, which is effectively treated by drugs from this group.
muscle relaxants
When osteoarthritis of the shoulder joint is affected, muscle spasms are considered to be a common occurrence, which are relieved by muscle relaxants. When prescribing them, the principle of complexity is observed, they are used in conjunction with analgesics and anti-inflammatory drugs. If necessary, the minimum dosage is prescribed initially with a gradual increase.
Surgical treatment
The main objective of the operation is to restore the joint's working capacity and improve the patient's quality of life. If conservative therapy is ineffective, a persistent pain syndrome persists, the joint gradually deforms, and the range of motion is markedly limited, the patient is indicated for surgical intervention.
The decision about the need for surgery is made by the orthopedist or traumatologist together with the patient. Then, the dimensions of the endoprosthesis and the material from which it will be made are determined. Today, implants are made of titanium and high-strength polymers, weighing close to that of a natural joint. The durability and reliability of endoprostheses are unquestionable.
recovery period
The operation to replace the affected joint most often goes without complications. Fixation with a supportive bandage is required for the first 14 days. Early passive performance of a complex of physical exercises on special devices and devices is allowed. Power charges are allowed after 45-60 days.
Physiotherapy
Any complex of anti-arthritis exercises is useful only during remission. If there is an increase in temperature, pain and other symptoms of an exacerbation of the disease, then loading is contraindicated.
Exercise therapy should not cause pain or discomfort. At the slightest feeling of inconvenience, the exercise should be abandoned.
Charging must be done daily. After loading, it is useful to self-massage the affected joint area and nearby muscles, using a healing cream, which the attending physician will help you to choose.
Physiotherapy
Physiotherapy allows you to potentiate the effect of medications, reduce their dosage and minimize the risk of complications. The type of physiotherapy is determined by the physician, guided by the patient's condition, the negligence of the process and possible contraindications due to concomitant diseases.
Most often, the following physical therapy procedures are used in treatment:
- magnetotherapy;
- ultrasound with hydrocortisone;
- electrophoresis with anti-inflammatory and analgesic substances;
- ultraviolet irradiation
- treatment with laser and infrared rays.
Physiotherapy is carried out in courses of 10 to 15 sessions several times a year.
Treatment with folk methods
Combining folk remedies with drug therapy, exercise therapy, proper nutrition and physical therapy, you can achieve a long and stable remission.
One of the best recipes is a compress with birch leaves, which has anti-inflammatory and warming effects. Young leaves are more suitable, because closer to autumn their beneficial properties decrease. Before making a compress, a small massage on the affected limb is necessary. Then the leaves are applied to the skin, reinforced with plastic wrap and a bandage. The compress is left overnight. The duration of treatment is 10 days.
Salt baths have a healing effect. Before the procedure, the crystals are pre-dissolved in hot water. Then the resulting solution is poured into the bath. The procedure will require approximately 3 kg of salt. Also, you can add a few drops of any essential oil. It is better to take a shower before going to bed, the duration of the shower should not exceed 30 minutes.
Hot oatmeal compress helps a lot. They must be poured with boiling water, insisted and used for their intended purpose. Such procedures are recommended to be done at night.
No less useful herbal poultices. Crushed plants with anti-inflammatory action (yarrow, ginger, turmeric, cinquefoil, calamus) are prepared with boiling water, kept for 10 minutes under a lid and applied to a sore spot. After the procedure, the affected shoulder should be smeared with a healing cream and go to bed.
Inside, it is recommended to take an infusion of corn stigmas. One teaspoon of raw materials or 1 filter bag is prepared with 200 ml of boiling water, insisted under the lid for 30 minutes and consumed 1 tbsp. spoon half an hour before meals.
Prevention of shoulder joint osteoarthritis
Disease prevention can be primary and secondary. Primary prevention includes the following activities:
- regular exercise - jogging or brisk walking, exercises for the shoulder girdle muscles;
- cold and hot shower;
- elimination of excessive loads and avoid traumatic situations.
- timely treatment of diseases that can provoke osteoarthritis of the shoulder;
Secondary prevention is aimed at the early diagnosis and treatment of arthritis.
Conclusion
The recovery of joint functions is a long and difficult process. The treatment of shoulder arthrosis should mainly aim at eliminating the symptoms of the disease. Only complex therapy, combining medical and folk methods, will bring relief and restore the ability to work.