Osteoarthritis of the shoulder joint (omarthrosis) is a chronic disease in which irreversible degenerative-dystrophic processes occur in the tissues of the joint. 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 reduces quality of life. In the absence of treatment, disability occurs.
In order to stop the processes of destruction 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 may be associated with various factors:
- Professional sports 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 - the pathology occurs after exposure to the joint of one or another factor. The primary or idiopathic form of the disease is rarely recorded. It is impossible to establish the exact cause of tissue degeneration in this case.
Symptoms of shoulder osteoarthritis
Changes in cartilage and bone tissues begin long before the first signs of osteoarthritis appear. Articular structures have great self-healing potential, therefore 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, changes are noted by patients at 16-18 years.
Symptoms of shoulder osteoarthritis:
- Cracked joint during movement.
- Pain, especially intense after exercise.
- Stiffness of movement, expressed after sleeping or resting a lot.
- Increased pain during weather changes.
Osteoarthritis grades
The clinical classification defines three degrees of osteoarthritis of the shoulder joint:
- 1 degree. The patient complains of a slight crunch that appears during movement. Pain syndrome is absent. Discomfort is felt when the hand is brought to the extreme position.
- 2nd grade. The pain occurs when the limb is raised above shoulder level. The range of motion is reduced. After significant exertion, the patient feels pain even at rest.
- 3rd grade. Joint mobility is severely limited. The pain syndrome is almost constant.
Diagnosis of osteoarthritis of the shoulder joint.
The doctor needs not only to correctly diagnose, but also to determine the cause of the pathology. Treatment of the underlying disease significantly improves the patient's well-being and slows down cartilage degeneration.
hand exam
The first stage of diagnosis is a consultation with an orthopedic traumatologist. The doctor examines the diseased joint for swelling, severe deformity. From 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 assesses the function of the joint according to several criteria:
- Ability to perform voluntary movements of the hands.
- Thickening of the edges of the joint surfaces (large osteophytes can be detected on palpation).
- The presence of a crunch, "clicks" that the hand can hear or feel during movement of the shoulder.
- Jamming of the joint in the presence of free chondromic bodies.
- Pathological movements in the shoulder.
Bone scan
To detect signs of arthrosis of the shoulder joint, the X-ray is performed in two projections, which allows you to assess the degree of narrowing of the joint space, the condition of the bone surfaces, the size and number of osteophytes, the presence of fluid, and swelling of surrounding tissues.
Ultrasound exam (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 state of the synovial membrane. The method well visualizes osteophytes, enlarged lymph nodes in the periarticular space.
Magnetic resonance imaging (MRI)
The MRI machine takes images of consecutive sections. The images clearly show not only the joint, but also the adjacent tissues. To date, MRI is one of the most informative methods in the diagnosis of arthrosis.
Lab tests
As part of a comprehensive examination, they appoint:
- General blood tests. 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 help establish the cause of the inflammation. Biochemical tests are also performed to monitor for complications and side effects during therapy.
Treatment of osteoarthritis of the shoulder joint
Therapy is long and difficult. The course of treatment includes medications, wellness procedures, a set of special exercises for arthrosis of the shoulder joint. In difficult cases, surgical intervention is indicated.
medical therapy
Medications and dosage are selected individually. The doctor may prescribe:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Medications reduce inflammation and pain.
- Glucocorticosteroid preparations. Hormonal-based means 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. Medicines of this group are prescribed for severe pain syndrome. Depending on the severity of the symptoms, the doctor selects non-narcotic or narcotic pain relievers (rarely).
- Chondroprotectors. The active ingredients of the 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 their effectiveness in the treatment of arthrosis of varying severity.
Some medications are injected directly into the joint cavity. For example, the blockade has a better analgesic effect than taking medication in tablet form.
Physiotherapy
Courses are carried out after the elimination of the exacerbation. Physiotherapy as part of complex therapy helps to improve the transport of drugs to the diseased joint, relieve inflammation and reduce pain.
For the treatment of arthrosis use:
- Electrophoresis.
- Phonophoresis.
- 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 make a treatment plan taking into account the condition of a particular patient.
Physiotherapy
Moderate physical activity is important to stop degenerative processes. It is better to start exercise therapy for arthrosis of the shoulder joint in a medical facility, under the supervision of a doctor. The specialist will select the exercises, teach them how to perform them correctly and distribute the load so as not to provoke a recrudescence of the disease. Gymnastics typically 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.
Surgery
The operation is performed with arthrosis of the third degree, when the disease no longer allows the patient to move normally, causes severe pain, and the prescribed therapy 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. With the help of microsurgical instruments, the doctor examines the joint cavity, removes scar tissue, sutures the rotator cuff tendons or the joint capsule if they are damaged. Several punctures remain in the skin. The patient recovers quickly.
- endoprosthesisEndoprosthesis allows you to completely get rid of chronic pain and restore mobility of the arm. After the operation, a long rehabilitation (3-6 months) is needed.