Shoulder joint arthrosis is a widespread chronic 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. Pathology symptoms and treatment methods depend on the degree of damage to the joints.
The disease can develop for several years without becoming apparent. At a certain point, as a result of unfavorable factors (hypothermia, trauma, serious accompanying illness), the first signs of the disease appear. At this time, it is necessary to consult a doctor, since the fight against dystrophic changes in the cartilage is especially effective at the beginning of the disease.
Causes of arthrosis of the shoulder joint
The causes of degenerative-dystrophic damage to joint tissues are numerous and varied. Among them, injuries play the main role, therefore post-traumatic arthrosis of the shoulder joint is considered the most common form of pathology. Mild but repeated damage to cartilaginous tissues can also trigger it.
In addition, the disease can occur under the influence of the following pathological factors:
- Severe joint damage: arthritis, gout, acute or chronic arthritis, aseptic necrosis of the humerus.
- Regular overexertion of the joints. It is most often observed in volleyball, tennis, and basketball athletes.
- Congenital pathology of the shoulder joint.
- Endocrine diseases.
- Old and senile age.
- Overweight (obesity).
- Avitaminosis.
- Autoimmune changes and weakening of the immune system.
- genetic predisposition.
Most of the patients are people who do monotonous physical work. Therefore, arthrosis of the right shoulder joint is diagnosed much more often than the left.
The disease usually develops as a result of several adverse factors, rather than one. Based on this, the treatment must be comprehensive and aimed not only at overcoming the disease, but also at eliminating the causes that cause it.
Typical signs of the disease
Arthrosis of the shoulder joint, which begins unnoticed and develops gradually, can appear suddenly after injury, hypothermia or serious physical exertion. In this case, there are symptoms typical of damage to the shoulder joints and nearby tissues:
- pain;
- crunching and clicking during hand movements;
- stiffness and reduced range of motion in the shoulder.
The disease most often occurs in a chronic form. The aggravation of the disease can be triggered by excessive stress or injury to the joint.
The intensity of the manifestation of the symptoms depends to a large extent on the severity of the damage to the cartilage and bone tissue, which is why it is customary to distinguish several degrees of the disease. Such systematization significantly facilitates diagnosis and enables accurate prediction of the outcome of the disease.
Shoulder joint arthrosis grade I
During this period, the tissues of the joint are slightly affected. Pain is observed extremely rarely and only after excessive physical exertion or prolonged monotonous work. Most often, the patient does not pay attention to these symptoms, attributing them to overwork or muscle tension. 1 degree defeat is treated only with conservative methods.
At the beginning of the disease, there are no obvious changes in the cartilage tissue on X-rays, only an oval ring is seen around the joint cavity.
Shoulder joint arthrosis II degree
At this stage, the symptoms of the disease become more pronounced. Cartilage tissues become thinner and deformed, intra-articular ligaments are damaged. When the hand moves, a crack is heard, 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.
Shoulder joint arthrosis grade III
During this period, the joint is already significantly deformed, there are practically no movements in it. The patient suffers from acute pain that may radiate to the arm and shoulder blade. If you do not stop the further destruction of tissues, 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 a transition to a chronic form.
Which doctor should you see?
People with joint pain often do not know who to turn to. At the first symptoms of the disease, you should visit a rheumatologist. The specialist not only performs a complete physical examination and makes a diagnosis, but also, if necessary, relieves severe pain by intra-articular injection of anesthetic.
With an advanced form of the disease, the rheumatologist is probably powerless. In this case, you will need a surgeon or orthopedist. In big cities, you can only make an appointment with an arthrologist who deals with joint diseases.
How to treat shoulder arthritis
After a medical examination and diagnosis, the doctor prescribes a specific therapy that makes it possible to achieve a long and stable remission of the disease. Degenerative changes in the joints cannot be cured, but slowing down the course of the destructive process and alleviating the patient's condition is a completely feasible task.
The main goal of antiarthrosis 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. They are most often treated independently with folk remedies. Some patients do therapeutic exercises to reduce joint pain and stiffness. Medicines prescribed by a doctor are used to treat arthrosis, observing the recommended dosage and duration of administration. The most effective are the following drug groups:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors;
- corticosteroid medications;
- non-narcotic pain relievers;
- vasodilators;
- muscle relaxants.
Many drugs are sometimes prescribed for this pathology for a long time. Depending on the severity of the disease, the drugs are administered orally, externally, intramuscularly or injected into the cavity of the shoulder joint.
Non-steroidal anti-inflammatory drugs (NSAIDs)
Long-term use of NSAIDs is contraindicated due to the presence of side effects from the digestive system.
Drug treatment of the disease is already possible in the early stages of the development of the pathological process. The course is determined based on the patient's condition and the severity of the symptoms. Ointments belonging to this group are not prescribed as independent treatment. They are used in combination with similar groups of drugs administered intramuscularly or orally. Their task is to reduce inflammation and alleviate the patient's condition.
Chondroprotectors
Almost every patient's treatment regimen includes drugs aimed at improving the metabolic processes of the cartilage tissue. They also increase the elasticity of the cartilage. Chondroprotectors have such properties. These medicinal substances differ depending on the main active ingredient on the basis of 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. The role of chondroitin sulfate is to nourish and cushion the shoulder.
Monotherapy preparations are more successful in the market than combinations of substances.
The polysaccharide found in the intercellular space is hyaluronic acid. In addition, it can reduce the sensitivity of receptors that respond to pain. Combined chondroprotectors containing several active ingredients have the greatest advantage.
The most effective use of chondroprotectors is 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 case of pain and swelling, drugs belonging to this group are less effective. Therefore, anti-inflammatory drugs should first be used to alleviate the patient's condition.
In order to achieve the maximum effect, injectable preparations are used for intra-articular or intramuscular administration. Treatment with chondroprotectors lasts up to six months, some patients notice the first results after 3 months of treatment. It is important to follow certain rules when handling such drugs.
At the beginning of the therapy, physical overload and stressful situations must be excluded. The patient will get the greatest effect if he starts taking the chondroprotector, improves his diet and performs physiotherapy exercises. Many patients with shoulder arthrosis use Dr. Bubnovsky's method.
Corticosteroid drugs
In case of severe pain, if anti-inflammatory drugs do not bring a positive effect, corticosteroids are prescribed. Ointments or injections are prescribed to alleviate the patient's condition.
Pain relievers
In the initial stages of the disease, painkillers are prescribed to reduce pain.
Compared to non-steroidal anti-inflammatory drugs, drugs belonging to this group have a less negative effect on the mucous membrane of the digestive system.
Due to their unexpressed anti-inflammatory effect, they effectively fight against pain.
vasodilators
Vasodilators are mandatory tools for the treatment of arthrosis. They eliminate vascular spasms and normalize blood flow in the affected area. Many patients complain of the appearance of pains at night, which are effectively treated by drugs belonging to this group.
Muscle relaxants
When arthrosis of the shoulder joint is involved, muscle spasms are common, which are relieved by muscle relaxants. The principle of complexity is observed during their prescription, and they are used together with painkillers and anti-inflammatory drugs. If necessary, initially the minimum dose is gradually increased.
Surgical treatment
The main goal of the surgery 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 is gradually deformed, and the range of motion is sharply limited, the patient is prescribed surgical intervention.
The orthopedist or traumatologist decides on the need for surgery together with the patient. Then the dimensions of the endoprosthesis and the material from which it is made are determined. Nowadays, implants are made of titanium and high-strength polymers, with a weight close to natural joints. The durability and reliability of endoprostheses is beyond doubt.
Healing period
The operation to replace the affected joint usually takes place without complications. In the first 14 days, fixation with a support bandage is required. Early passive performance of a complex of physical exercises on special equipment and devices is allowed. Performance load is allowed after 45-60 days.
Physiotherapy
Any complex of anti-arthritis exercises is useful only during remission. If there is a rise in temperature, pain and other symptoms of disease exacerbation, charging is contraindicated.
Exercise therapy should not cause pain or discomfort. If you feel the slightest discomfort, exercise should be stopped.
Charging must be done daily. After exercise, it is useful to self-massage the area of the affected joint and nearby muscles, using a healing cream, the selection of which will be helped by the attending physician.
Physiotherapy
Physiotherapy makes it possible to increase the effect of drugs, reduce doses and minimize the risk of complications. The type of physiotherapy is determined by the doctor, based on the patient's condition, neglect of the process and possible contraindications due to concomitant diseases.
During the treatment, the following physiotherapy procedures are most often used:
- magnetotherapy;
- ultrasound with hydrocortisone;
- electrophoresis with anti-inflammatory and pain-relieving substances;
- ultraviolet radiation
- treatment with laser and infrared rays.
Physiotherapy is carried out several times a year in courses consisting of 10-15 sessions.
Treatment with folk methods
Folk remedies can be combined with drug therapy, exercise therapy, proper nutrition and physiotherapy to achieve a long and stable remission.
One of the best recipes is a poultice made from birch leaves, which has an anti-inflammatory and warming effect. Young leaves are the most suitable, because their beneficial properties decrease as autumn approaches. Before making a poultice, a small massage of the affected limb is necessary. The leaves are then applied to the skin, secured with adhesive film and a bandage. Leave the poultice overnight. The duration of treatment is 10 days.
Salt baths have a healing effect. Before the procedure, the crystals are dissolved in hot water. The resulting solution is then poured into the bath. About 3 kg of salt will be needed for the procedure. You can also add a few drops of any essential oil. It is best to take a bath before going to bed, the duration of the bath should not exceed 30 minutes.
A hot oatmeal poultice helps a lot. Pour it with boiling water, stick to it and use it as intended. Such procedures are recommended to be performed at night.
Herbal poultices are no less useful. Crushed anti-inflammatory plants (yarrow, ginger, turmeric, cinquefoil, calamus) are boiled in boiling water, kept covered for 10 minutes and applied to the painful area. After the procedure, the affected shoulder should be covered with a healing cream and laid down.
Internally, it is recommended to take an infusion of corn cobs. Boil a teaspoon of raw material or 1 filter bag with 200 ml of boiling water, insist for 30 minutes under the lid and consume 1 tablespoon. spoon half an hour before meals.
Prevention of osteoarthritis of the shoulder joint
Disease prevention can be primary or secondary. Primary prevention includes the following activities:
- regular exercise - jogging or brisk walking, exercises for the muscles of the shoulder girdle;
- hot and cold shower;
- eliminating excessive loads and avoiding traumatic situations.
- timely treatment of diseases provoking shoulder arthrosis;
The goal of secondary prevention is the early diagnosis and treatment of arthritis.
Conclusion
Restoring joint function is a long and difficult process. The treatment of shoulder joint arthrosis should primarily be aimed at eliminating the symptoms of the disease. Only complex therapy, which combines medical and folk methods, brings relief and restoration of working capacity.