Shoulder osteoarthritis is a chronic widespread disease associated with damage to joint structures. The pathological process is accompanied by a degenerative deformation of the articular surfaces. In this case, not only the cartilage tissue is damaged, but also the bone tissue. Symptoms of pathology and methods of treatment depend on the degree of damage to the joints.
The disease can develop for several years without showing 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 the cartilage is especially effective at the onset 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 osteoarthritis of the shoulder joint is considered the most common form of pathology. It can also be caused by mild, but repeatedly repeated damage to cartilage tissues.
Also, the disease can manifest itself under the influence of the following pathological factors:
- Severe joint damage: synovitis, gout, acute or chronic arthritis, aseptic necrosis of the humerus.
- Regular strain on the joints. Most often observed in athletes involved in volleyball, tennis, basketball.
- Congenital pathology of the shoulder joint.
- Endocrine diseases.
- Elderly and senile age.
- Overweight (obesity).
- Avitaminosis.
- Autoimmune injuries and weakening of the immune system.
- genetic predisposition.
Most sufferers are people engaged in monotonous physical labor. 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 once. Based on this, the treatment should be comprehensive and aimed 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, which begins imperceptibly and develops gradually, can occur suddenly after an injury, hypothermia, or severe physical exertion. In this case, there are symptoms characteristic of damage to the shoulder joints and nearby tissues:
- ache;
- creaks and clicks during the movement of the hand;
- stiffness and reduced mobility of 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 the cartilage and bone tissue, so it is customary to distinguish between different degrees of the disease. This systematization greatly facilitates the diagnosis and allows you to accurately predict the outcome of the disease.
Osteoarthritis of the shoulder I degree
During this period, the tissues of the joint are slightly affected. Pain is observed very rarely and only after excessive physical exertion or prolonged monotonous work. The patient very often does not pay attention to these symptoms, attributing them to overwork or muscle fatigue. Defeat of 1 degree is treated only by conservative methods.
At the onset of the disease, there are no noticeable changes in the cartilage tissues on X-rays, only an oval ring around the joint cavity is noted.
Osteoarthritis of the shoulder II degree
At this stage, the symptoms of the disease become more pronounced. Cartilage tissues thin and deform, intra-articular ligaments are damaged. A creak is heard during the movement of the hand, the inner layer of the joint bag becomes inflamed. Over time, the pain becomes constant. Morning stiffness and limited movement appear, which can lead to muscle atrophy.
Osteoarthritis of the shoulder III degree
During this period, the joint is already noticeably deformed, there are practically no movements in it. The patient suffers from acute pain which can radiate to the arm and shoulder blade. If the further destruction of tissues is not stopped, the pathological process can lead to disability.
Third degree disease is not amenable to conservative treatment and requires surgical intervention.
Shoulder-shoulder osteoarthritis 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 don't know where to turn. At the first symptoms of the disease, you should visit a rheumatologist. The specialist will not only carry out a complete 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 impotent. In this case, you will need a surgeon or orthopedist. In large cities it is possible to make an appointment with an arthrologist who deals only with joint diseases.
How to deal with shoulder arthritis
After a medical examination and a 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 degenerative changes in the joints, but slowing down the course of the destructive process and relieving the patient's condition is a completely feasible task.
The main goal of osteoarthritis 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 force patients to seek help from specialists. Most often they are treated independently with folk remedies. Some patients engage in therapeutic exercises to reduce pain and stiffness in the joints. For the treatment of arthrosis, drugs prescribed by a doctor are used, in compliance with the recommended dosage and duration of administration. The most effective are the following groups of drugs:
- non-steroidal anti-inflammatories;
- 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 prolonged use due to the presence of side effects from the digestive tract.
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. Their task is to reduce inflammation and relieve the patient's condition.
Chondroprotectors
Almost all patients include drugs aimed at improving metabolic processes in cartilage tissue in the treatment regimen. In addition, they increase the elasticity of the cartilage. Chondroprotectors have such properties. These medicinal substances differ depending on the main active ingredient according to which they are composed:
- 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.
Preparations for monotherapy have proven to be more effective on the market than a combination of substances.
The polysaccharide contained in the intercellular space is hyaluronic acid. It is also able to reduce the sensitivity of the receptors that respond to pain. Combined chondroprotectors, which contain several active ingredients, have the greatest advantage.
The most effective use of chondroprotectors in the initial stages of the disease. The task of the drugs is the synthesis of new cells of 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 achieve 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 certain rules in the treatment of such medicines.
With the onset of the course of therapy, it is necessary to exclude physical overload and stressful situations. The patient will receive the maximum effect if he starts taking chondroprotectors, improves nutrition and engages in physiotherapy exercises. Many patients with arthrosis of the shoulder joint are engaged in Dr. Bubnovsky's method, perform a set of specially designed exercises to achieve a gradual restoration of the joints 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, analgesics are prescribed to reduce pain.
Compared to non-steroidal anti-inflammatory drugs, drugs of this group have a less negative effect on the mucous membrane of the digestive tract.
Having an unexpressed anti-inflammatory effect, they effectively fight pain.
Vasodilators
Mandatory means in the treatment of arthrosis are vasodilators. They eliminate vascular spasms, normalize blood flow to the affected area. Many patients complain of the appearance of night pains, which are effectively coped with by drugs of this group.
Muscle relaxants
When osteoarthritis of the shoulder joint is affected, muscle spasms are considered a common occurrence, which is relieved by muscle relaxants. When they are prescribed, the principle of complexity is observed, they are used together with painkillers and anti-inflammatory drugs. If necessary, the minimum dosage is initially prescribed with a gradual increase.
Surgical treatment
The main goal of the operation is to restore the working capacity of the joint and improve the patient's quality of life. If conservative therapy is ineffective, persistent pain syndrome persists, the joint gradually deforms, and the range of motion in it is severely limited, the patient is indicated for surgery.
The decision on the need for surgery is made by the orthopedist or traumatologist together with the patient. Then the dimensions of the endoprosthesis and the material with which it will be made are determined. Today, implants are made of titanium and high-strength polymers, weighing close to a natural joint. The durability and reliability of endoprostheses are beyond doubt.
Recovery period
The operation to replace the affected joint most often occurs without complications. Fixation with a support bandage is required for the first 14 days. The first passive performance of a complex of physical exercises on special devices and devices is allowed. Power loads 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, reloading is contraindicated.
Physical therapy shouldn't cause pain or discomfort. At the slightest feeling of discomfort, exercise should be abandoned.
Charging should be done daily. After loading, it is useful to perform self-massage in the area of the affected joint and nearby muscles, using a healing cream, which the attending physician will help you choose.
Physiotherapy
Physiotherapy allows you to improve the effect of drugs, reduce their dosage and minimize the risk of complications. The type of physiotherapy is determined by the doctor, guided by the patient's condition, neglect of the process and possible contraindications due to concomitant diseases.
Most often, the following physiotherapy procedures are used in the 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 10-15 sessions several times a year.
Treatment with folk methods
By combining folk remedies with drug therapy, physical therapy, proper nutrition and physiotherapy, you can achieve a long and stable remission.
One of the best recipes is a compress with birch leaves, which have 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 of the affected limb is necessary. Then the leaves are applied to the skin, reinforced with cling film and a bandage. The compress is left overnight. The duration of the 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 about 3 kg of salt. Also, you can add a few drops of any essential oil. It is better to take a bath before going to bed, the duration of the bath should not exceed 30 minutes.
Warm oatmeal compress helps a lot. They should be poured with boiling water, insisted and used for their intended purpose. It is recommended to carry out such procedures 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 must be smeared with a healing cream and go to bed.
Inside it is recommended to take an infusion of corn stigmas. A 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 osteoarthritis of the shoulder joint
Disease prevention can be primary and secondary. Primary prevention includes the following activities:
- regular exercise: jogging or brisk walking, exercises for the muscles of the shoulder girdle;
- cold and hot shower;
- elimination of excessive loads and avoidance of traumatic situations.
- timely treatment of diseases that can provoke arthrosis 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. Treatment of arthrosis of the shoulder should be aimed primarily at eliminating the symptoms of the disease. Only complex therapy, combining medical and folk methods, will bring relief and restore working capacity.