The shoulder joint is one of the most vulnerable in the human skeleton. This is due to the rather complex structure of the joint with weak fixation with the scapula. The shoulder experiences a large amount of stress every day while performing household or work tasks. In case of injury, metabolic processes are disrupted, tissues wear out due to age, and dystrophic changes in cartilage tissue begin. This pathology is called osteoarthritis of the shoulder joint.
Depending on the manifestations and degree of damage to the glenohumeral joint, four degrees of pathology are diagnosed. There is also a distinction between acute and chronic shoulder osteoarthritis. If treatment is not carried out on time or in bad faith, the joint continues to deform and collapse, which ultimately leads to significant limitation of upper limb functions and loss of mobility.
Today, only grade 1 shoulder osteoarthritis can be completely cured. But this does not mean that you can give up and do nothing with pathology of degree 2 and above. Comprehensive and adequate treatment of shoulder osteoarthritis using medications or surgery helps slow down the destruction of the joint, at least partially preserve the mobility of the arm and shoulder andto prevent disability.
Symptoms and causes
Deforming osteoarthritis of the shoulder joint does not develop overnight. At first, the changes are minor. Cartilage gradually loses its elasticity under the influence of various factors - these may be age-related changes or a disruption of metabolic processes in the tissues. Microcracks appear on its surface, in which calcium salts accumulate. Then it becomes thin, fragile and begins to collapse.
This process is often accompanied by inflammation, which also spreads to surrounding muscle, connective and bone tissues. This manifests itself mainly as pain - at first minor, aching. Then they become more intense and never go away in advanced stages, significantly reducing a person's performance and quality of life.
The main reasons why DOA of the shoulder joint develops are:
- Impaired blood circulation in the cartilaginous tissues of the shoulder in atherosclerosis and other chronic diseases associated with blood vessels.
- Chronic pathologies of an autoimmune nature, for example rheumatoid arthritis, systemic lupus erythematosus.
- Dysfunction of the endocrine system (diabetes mellitus).
- Congenital anomalies of the shoulder joint, birth injuries in infants and other injuries leading to pathological deformity and dysfunction of the limb.
- Acquired pathologies of joint structures after injury or accident, unsuccessful surgery, including inflammation due to arthritis, synovitis, osteoporosis, etc.
In addition, there are provoking factors, under the influence of which the risk of developing shoulder osteoarthritis increases several times. These include:
- professional activity in which the shoulder joint receives heavy loads day after day for many years - shoulder osteoarthritis is rightly called a disease of plasterers, painters and loaders;
- sedentary lifestyle, lack of physical activity - with insufficient exercise, blood circulation slows down, joint tissues do not receive the required amount of nutrients and begin to atrophy;
- overweight - often combined with the previous factor: with obesity, a person is not able to actively move, while the joints experience additional stress due to extra pounds;
- hereditary predisposition;
- old age - approximately 80% of people over the age of 70 have symptoms of osteoarthritis.
Most often, when examining and interviewing a patient, the doctor identifies a combination of several diseases and provoking factors. A typical patient diagnosed with osteoarthritis of the shoulder joint is a man or woman over 50 years old, engaged in heavy physical labor, overweight and with other chronic pathologies (diabetes mellitus, high blood pressure, varicose veins, knee arthritis, etc. ). In this case, injuries to the right shoulder are more common than those to the left. This is due to the fact that most people actively use their right hand at work and at home, with the exception of congenital left-handers.
How to recognize the disease
Symptoms of osteoarthritis of the shoulder joint may not appear for a long time. If from time to time the shoulder begins to hurt, a person attributes it to fatigue, takes painkillers, uses ointment with a warming effect and calms down. But sooner or later there comes a time when pills and ointments are no longer effective, the pain becomes constant, intense and bothers at rest and at night. In addition to this symptom, the following signs will indicate dystrophic changes in the shoulder joint:
- swelling and deformity of the joint, visible to the naked eye;
- redness of the skin at the joint, local increase in temperature;
- Characteristic cracking in the joint. The cracks when the hand moves suddenly are explained by the accumulation of salts in the cracks of the cartilage and between the joint elements. At first, the cracking occurs only with sudden movements, it is quiet and barely audible. In advanced forms of the disease, the shoulder cracks with each movement, the sound is heard by others;
- limitation of limb mobility. When examining a patient, the doctor will ask them to comb their hair. This examination is enough to diagnose osteoarthritis of the shoulder joint: the patient will feel sharp pain, will make a rotational movement with the shoulder, it will be difficult to move the shoulder back, the doctor will hear cracking andclicks in the joint.
Shoulder AOD must be treated, otherwise over time the patient will completely lose mobility and performance of the upper limb. If the process of destruction of cartilage and surrounding tissues has already begun, it will not stop on its own. Proper nutrition, folk remedies, healthy lifestyle and exercise are not enough here. To cope with the problem and prevent disability, complex treatment will be required using medications with various effects and physical procedures.
Degrees
There are several stages of DOA of the shoulder joint, each of them manifests itself differently and requires a different treatment approach.
- 1st degree.At this stage, the disease is just beginning to develop and changes to the cartilage tissue are still minor. The main symptoms of grade 1 AOD are joint and limb weakness and periodic persistent pain. The pain occurs after physical exertion, during monotonous and repeated hand movements for a long time. After a night's sleep or a long period of rest, a person feels stiffness in the shoulder joint, but as it develops, the stiffness always disappears without medications or physical procedures - a light warm-up is enough. If you take an x-ray at this point, the image will not show significant changes in the joint structures, although thinning and deformation of the cartilage may be noticeable.
- 2nd degree. The pathological process proceeds and manifests itself more actively. A person already gets used to the fact that after work his shoulder will hurt, he "waits out" the pain, has painkillers and ointments for joint pain, pharmacy or homemade, ready. Radiological diagnosis will show noticeable changes in the joint: thinning and deformation of the cartilage, inflammation of the joint membrane. From time to time, the joint turns red and swells; creaks, squeaks and rattles are heard during movement.
- 3rd degree.The shoulder joint constantly hurts and creaks, to reduce discomfort the person tries not to touch it and not move the limb at all. The deformation is visually visible; the affected shoulder differs in size and shape from the healthy shoulder; it often turns red and swells, which is accompanied by increased pain. It is not possible to eliminate them with painkillers.
If nothing is done at the third stage of the disease, the fourth stage will occur - complete immobility of the shoulder joint and limb. In this case, it is already useless to prescribe medications and physiotherapy, only endoprosthetic surgery will allow at least partial restoration of the functionality of the hand. But even this is not always successful.
On a note:In medical practice, it is extremely rare to encounter shoulder arthrosis of grade 3. As a rule, the patient consults a doctor earlier and begins treatment. Severe cartilage destruction can occur against the background of significant trauma, if for some reason the patient could not consult a doctor or if the person lives in disadvantaged social conditions where there is noqualified doctors.
How is osteoarthritis diagnosed and treated?
A good doctor will be able to make a preliminary diagnosis after an interview with the patient and his external examination. Instrumental diagnostic methods are more necessary to exclude other pathologies and complications or to identify them. To accurately determine the severity of damage to the joint and whether inflammation occurs, the following diagnostic measures are carried out:
- x-ray;
- CT scan;
- Magnetic resonance imaging;
- in some cases, an ultrasound to obtain a complete picture of the condition of the joint;
- clinical urine and blood tests - leukocyte count and erythrocyte sedimentation rate will be assessed. If they are too high, an inflammatory process develops in the body.
The best way to treat pathology is determined by the doctor on an individual basis, taking into account the age, profession and general condition of the patient.
Traditional treatment involves the use of the following methods and means:
- Treatment with nonsteroidal anti-inflammatory drugs. Medicines are prescribed in the form of tablets or powders for oral administration or in the form of ointments for external use to eliminate the main symptoms of inflammation - pain, swelling, redness, increased body temperature.
- Anesthetics for severe pain in the form of tablets or injections. These drugs cannot be taken continuously, they do not eliminate the cause of the disease and are intended only for extreme cases where the pain is unbearable.
- A course of chondroprotectors - drugs that promote the restoration of cartilage tissue and prevent further destruction. They also partially relieve pain, swelling and deformity of the shoulder joint. These medications do not work immediately, they must be taken for at least 3 to 4 months.
- A course of muscle relaxants - tablets or injections that relax muscle spasms. These are optional medications in the complex treatment of osteoarthritis; they are not always prescribed.
- A course of taking vitamin-mineral complexes and food supplements with collagen and hyaluronic acid.
To increase the effectiveness of treatment, rapid recovery and prevention of new lesions, special therapeutic nutrition is also prescribed. The patient's diet includes foods rich in vitamins B, A, C, E - fresh fruits and vegetables, cabbage of all varieties, cereals, legumes. Polyunsaturated fatty acids can be obtained from sea fish and seafood. A gelatin diet is practiced, since gelatin helps restore the elasticity of cartilage tissue. The menu includes jellied meat made from ox hooves and tails, aspic and various jellies. It is useful to take gelatin in its pure form, previously soaked in warm water.
Physiotherapy is the next important point in the complex treatment of shoulder osteoarthritis. They only start when the inflammatory process has stopped. Depending on the degree of the disease, its dynamics and the effectiveness of drug treatment, the doctor selects a combination of the following physical procedures:
- cryotherapy;
- acupuncture;
- electrophoresis;
- laser therapy;
- magnetic therapy;
- mud therapy;
- massages of various types;
- physiotherapy.
Physiotherapy procedures are aimed at activating metabolic processes in joint tissues, normalizing blood circulation and restoring mobility of the limbs. With their help, it is possible to reduce the number of medications taken and their dosage, which is especially valuable if the pathology is observed in a teenager, an elderly person or a breastfeeding woman.
Useful advice:It is possible to treat injuries of the shoulder joint of grade 1-2 at home, additionally using folk remedies. The main thing is that the patient does not forget to take medications on time and does not skip physical procedures - the effect will be noticeable and lasting only if all the doctor's prescriptions are followed regularly and conscientiously.
If conservative treatment turns out to be ineffective, the doctor is obliged to offer the patient surgical intervention. The remains of the destroyed joint will be removed and a prosthesis will be implanted in its place. Such an intervention is not uncommon, but requires highly qualified doctors, precision and attention to every step. In addition, prosthetics do not always take root well, and the recovery period after surgery lasts at least six months. Therefore, if you notice that your shoulder regularly begins to hurt, pull, numb or you hear a cracking sound when you move, do not delay in seeing a doctor, get yourself examined in time and, ifnecessary, start treatment.
Osteoarthritis of the shoulder joint is a fairly common pathology of the musculoskeletal system, occurring mainly in people over 50 years old. The pathology develops gradually, little by little, under the influence of unfavorable factors, the joint structures begin to collapse, which is manifested by pain, swelling and stiffness of the joint. In the early stages, the progression of the disease can be stopped with comprehensive treatment: medications, vitamin supplements, diet therapy and physiotherapy. Advanced osteoarthritis can only be treated surgically.