Arthrosis of the shoulder joint (omarthrosis) is a chronic disease in which irreversible degenerative-dystrophic processes occur in the tissues of the joint. The pathology disrupts the normal functioning of the limb. The range of motion of the shoulder gradually decreases until complete immobility. Osteoarthritis of the shoulder joint causes severe pain and reduced quality of life. In the absence of treatment, disability occurs.
To stop the destructive processes of the joint and maintain the mobility of the shoulder joint, it is necessary to contact an orthopedic traumatologist after the first symptoms appear.
Causes of osteoarthritis of the shoulder joint
The disease is polyetiological. The development of deforming arthrosis of the shoulder joint can be associated with various factors:
- Professional sport or intense training.
- Endocrine diseases.
- Hormonal disorders.
- Congenital pathologies of the development of the musculoskeletal system.
- Hereditary predisposition, etc.
In most cases, secondary arthrosis is diagnosed: pathology occurs after exposure to the joint from one or another factor. Rarely register the primary or idiopathic form of the disease. It is impossible to establish the exact cause of tissue degeneration in this case.
Symptoms of osteoarthritis of the shoulder
Cartilage and bone tissue changes begin long before the first signs of osteoarthritis appear. Articular structures have a great potential for self-healing, so pathologies are rarely diagnosed at a young age, when all metabolic processes are quite active. As the body ages, recovery processes give way to degeneration. The first signs of destruction may appear after 40-50 years, and with a deforming type of disease, patients notice changes as early as 16-18 years.
Symptoms of osteoarthritis of the shoulder:
- Joint that creaks during movement.
- Pain, especially severe after exercise.
- Stiffness of movement, expressed after sleep or a long rest.
- Increased pain with weather changes.
The clinical classification defines three degrees of osteoarthritis of the shoulder joint:
- 1 degree. The patient complains of a slight creak that appears during movement. The pain syndrome is absent. Discomfort is felt when the hand is brought into the extreme position.
- 2 degree. The pain occurs when the limb is raised above shoulder level. The range of motion is reduced. After heavy exertion, the patient feels pain even at rest.
- 3 degrees. Joint mobility is severely limited. The pain syndrome is almost constant.
Diagnosis of osteoarthritis of the shoulder joint
The doctor must not only correctly diagnose, but also determine the cause of the pathology. Treatment of the underlying disease significantly improves the patient's well-being and slows cartilage degeneration.
The first step in the diagnosis is a consultation with an orthopedic traumatologist. The doctor examines the diseased joint for severe swelling or deformity. On the side of the development of arthrosis, the muscles can partially atrophy - this can be seen with the naked eye.
With a manual examination, the doctor evaluates the function of the joint according to several criteria:
- Ability to make voluntary hand movements.
- Thickening of the edges of the articular surfaces (large osteophytes can be detected on palpation).
- The presence of a creak, "clicks" that can be heard or felt by the hand when moving the shoulder.
- Impingement of the joint in the presence of free chondromal bodies.
- Pathological movements of the shoulder.
To detect signs of arthrosis of the shoulder joint, the x-ray is performed in two projections, which makes it possible to assess the degree of narrowing of the joint space, the condition of the bone surfaces, the size andthe number of osteophytes, the presence of fluid, and inflammation of the surrounding tissues.
Ultrasound examination (ultrasound)
A non-invasive method that allows you to examine the joints in pregnant women and young children. According to ultrasound, the doctor determines the thickness of the cartilage, the condition of the synovial membrane. The method visualizes well the osteophytes, the enlarged lymph nodes in the periarticular space.
Magnetic Resonance Imaging (MRI)
The MRI machine takes pictures of consecutive sections. The images clearly show not only the joint, but also the adjacent tissues. To date, magnetic resonance imaging is one of the most informative methods in the diagnosis of osteoarthritis.
In the context of a comprehensive examination, they designate:
- General blood test. Based on the results, the doctor can judge the presence and severity of the inflammatory process. The analysis also helps to assess the general state of health.
- Urine analysis. Renal pathologies often cause secondary deforming osteoarthritis. Analysis is necessary for an accurate diagnosis.
- blood chemistry. The data helps establish the cause of the inflammation. Biochemical tests are also done to monitor complications and side effects during treatment.
Treatment of osteoarthritis of the shoulder joint
The therapy is long and difficult. The course of treatment includes medication, wellness procedures, a set of special exercises for arthrosis of the shoulder joint. In difficult cases, surgery is indicated.
Drugs and dosage are selected individually. The doctor can prescribe:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Medications reduce inflammation and pain.
- Glucocorticosteroid preparations. Means based on hormones have a more intense effect on the focus of pain. The drugs not only relieve the patient's condition, but also reduce inflammation, exhibit antihistamine and immunosuppressive properties. Glucocorticosteroids are prescribed in cases where NSAIDs are not effective.
- Analgesics. Drugs of this group are prescribed for severe pain syndrome. Depending on the severity of the symptoms, the doctor selects non-narcotic or narcotic painkillers (rarely).
- Chondroprotectors. The active ingredients of drugs are involved in the formation of new cartilage tissue. Regeneration of the diseased joint is accelerated, trophism improves. Chondroprotectors have a cumulative effect and have proven themselves in the treatment of more or less severe osteoarthritis.
Some drugs are injected directly into the joint cavity. For example, blocking has a better analgesic effect than taking drugs in the form of tablets.
Classes are carried out after the removal of the exacerbation. Physiotherapy as part of a complex therapy helps to improve the transport of drugs to the diseased joint, relieve swelling and reduce pain.
For the treatment of arthrosis use:
- Shock wave therapy.
Physiotherapy can be combined with massage, exercise therapy, therapeutic baths. It is best to undergo a set of procedures based on a specialized clinic. The doctor will draw up a treatment plan taking into account the condition of a particular patient.
Moderate physical activity is important to slow down degenerative processes. It is best to start exercise therapy for osteoarthritis of the shoulder joint in a medical center, under the supervision of a doctor. The specialist will select the exercises, teach them to perform them correctly and distribute the load so as not to provoke an exacerbation of the disease. Gymnastics usually includes a warm-up, stretching, and strength training. Exercises are performed at least 3 times a week.
After a course with a specialist, patients can perform therapeutic exercises for arthrosis of the shoulder joint at home.
The operation is performed with arthrosis of the 3rd degree, when the disease no longer allows the patient to move normally, causes severe pain, and the prescribed treatment does not help.
There are several methods of surgical treatment:
- Puncture. A long needle is inserted into the joint cavity and the accumulated fluid is pumped out. Puncture reduces pressure, reduces swelling, increases joint mobility. The procedure is minimally invasive, so it is performed on an outpatient basis. The material obtained during the puncture is sent for research to determine the infectious agent or other indicators.
- Arthroscopy. Using microsurgical instruments, the doctor examines the joint cavity, removes scar tissue, sutures the tendons of the rotator cuff or the joint capsule if they are damaged. Several bites remain on the skin. The patient recovers quickly.
- Stents. Stents allow you to completely get rid of chronic pain and restore arm mobility. After the operation, a long rehabilitation (from 3 to 6 months) is necessary.