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 receives a lot of stress every day when performing household or work duties. If an injury occurs, metabolic processes are disturbed, tissues wear out due to age - dystrophic changes in cartilage tissue begin. This pathology is called osteoarthritis of the shoulder joint.
Depending on the manifestations and the degree of damage to the glenohumeral joint, four degrees of pathology are diagnosed. There is also a distinction between acute and chronic shoulder arthropathy. If the treatment is not carried out in time or in bad faith, the joint continues to deform and collapse, which eventually leads to a significant limitation of the functions of the upper limb and loss of mobility.
Today, only grade 1 shoulder arthropathy can be completely cured. But this does not mean that you can give up and do nothing with pathology grade 2 and above. Complete and adequate treatment of arthropathy of the shoulder joint with the help of drugs or surgery helps to slow down the destruction of the joint, preserve at least partial mobility of the arm and shoulder, and prevent disability.
Symptoms and causes
Deformative arthropathy of the shoulder joint does not develop in a day. At first the changes are small. Cartilage gradually loses its elasticity under the influence of various factors - these could be age-related changes or disorders of metabolic processes in tissues. Microcracks appear on its surface, in which calcium salts accumulate. Then it becomes thin, brittle and begins to fall apart.
Often this process is accompanied by inflammation, which also spreads to the surrounding muscle, connective and bone tissues. This mainly manifests as pain - at first a small, pain. Then they become more intense and in advanced stages they never disappear, which significantly reduces the performance and quality of life of the person.
The main reasons why DOA of the shoulder joint develops are as follows:
- Disturbance of blood circulation in the cartilaginous tissues of the shoulder in atherosclerosis and other chronic diseases related to blood vessels.
- Chronic pathologies of an autoimmune nature, for example, rheumatoid arthritis, systemic lupus erythematosus.
- Dysfunction of the endocrine system (diabetes mellitus).
- Congenital abnormalities of the shoulder joint, birth injuries in infants and other injuries that lead to pathological deformity and dysfunction of the limb.
- Acquired pathologies of joint structures after injury or accident, unsuccessful surgical operations, including inflammation due to arthritis, arthritis, osteoporosis, etc.
In addition, there are causative factors, under the influence of which the risk of developing shoulder arthritis increases several times. These include:
- professional activity in which the shoulder joint receives heavy loads day after day for many years - shoulder arthropathy is rightly called the 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 in combination with the previous factor; with obesity, a person is not able to move actively, while the joints receive additional pressure due to extra pounds.
- hereditary predisposition?
- old age - about 80% of people over the age of 70 experience symptoms of osteoarthritis.
Most often, when examining and interviewing a patient, the doctor identifies a combination of several diseases and causative factors. A typical patient diagnosed with osteoarthritis of the shoulder joint is a man or woman over the age of 50, engaged in heavy physical work, overweight and other chronic pathologies (diabetes mellitus, arterial hypertension, varicose veins, knee arthritis, etc. ). In this case, injuries to the right shoulder are more common than 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 left-handed relatives.
How to recognize the disease
Symptoms of shoulder joint arthrosis 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 an ointment with a warming effect and calms down. But sooner or later there comes a time when pills and ointments no longer help, the pain becomes constant, intense and bothers you at rest and at night. In addition to this symptom, the following signs will indicate dystrophic changes in the shoulder joint:
- swelling and deformation of the joint, noticeable with the naked eye.
- redness of the skin over the joint, local increase in temperature.
- characteristic tingling in the joint. Crackling sounds when the hand moves sharply is explained by the accumulation of salts in the cracks of the cartilage and between the elements of the joint. At first, the tingling occurs only with sudden movements; it is quiet and barely audible. In advanced forms of the disease, the shoulder cracks with every movement, the sound is heard by others.
- limitation of limb mobility. When examining a patient, the doctor will ask him to comb his hair. This examination is enough to diagnose osteoarthritis of the shoulder joint: the patient will experience sharp pain, perform a rotational movement with the shoulder, it will be difficult for him to move the shoulder back, the doctor will hear popping and clicking injoint.
DOA of the shoulder must be treated or over time the patient will lose full upper extremity mobility and performance. If the process of destruction of the 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 deal with the problem and prevent disability, complex treatment using drugs of various effects and natural processes will be required.
Degrees
There are several stages of DOA of the shoulder joint, each of them manifests itself differently and requires a different approach to treatment.
- 1st grade.At this stage, the disease is just beginning to develop, the changes in the cartilage tissue are still small. The main symptoms of grade 1 DOA are joint and limb weakness and periodic nagging pain. Pain occurs after physical exertion, during monotonous, repetitive movements of the hands 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 still disappears without drugs and natural procedures - a slight warm-up is enough. If you take an x-ray at this stage, the image will not show significant changes in the structures of the joints, although thinning and deformation of the cartilage may be noticeable.
- 2nd grade.The pathological process progresses and manifests itself more actively. A person already gets used to the fact that after work his shoulder will hurt, he "expects" pain, has analgesics and ointments for joint pain, pharmacy or homemade, ready. X-ray diagnosis will show noticeable changes in the joint: thinning and deformation of the cartilage, inflammation of the synovial membrane. From time to time, the joint becomes red and swollen; creaking, grinding and clicking are heard on movement.
- 3rd grade.The shoulder joint hurts and cracks constantly, to reduce the discomfort, the person tries not to touch it and not to move the limb at all. The deformity is noticeable visually; the affected shoulder differs in size and shape from the healthy one; it often becomes red and swollen, which is accompanied by increased pain. It is not possible to remove them with painkillers.
If nothing is done in 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 pointless to prescribe drugs and physiotherapy; only endoprosthetic surgery will help to at least partially restore the functionality of the hand. But even this is not always successful.
On a note:In medical practice, it is extremely rare to encounter grade 3 shoulder arthropathy. Usually, the patient seeks medical help earlier and starts the treatment. Severe cartilage destruction can occur against a background of extensive trauma, if for some reason the patient could not see a doctor, or if the person lives in disadvantaged social conditions where there are no qualified doctors.
How is osteoarthritis diagnosed and treated?
A good doctor will be able to make a preliminary diagnosis after a conversation with the patient and his external examination. Instrumental diagnostic methods are needed more to exclude other pathologies and complications or to identify them. To accurately determine how seriously the joint is affected and if inflammation occurs, the following diagnostic measures are performed:
- x-ray;
- The CT scan?
- Magnetic resonance imaging?
- in some cases, ultrasound to get a complete picture of the state of the joint.
- clinical tests of urine and blood - the number of leukocytes and the sedimentation rate of erythrocytes will be assessed. If they are too high, an inflammatory process develops in the body.
The best way to treat the pathology is determined by the doctor on an individual basis, taking into account the age, profession and general condition of the patient.
Traditional treatment includes the use of the following methods and means:
- A course of treatment with non-steroidal 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 when the pain is unbearable.
- A course of taking chondroprotectors - drugs that promote the restoration of cartilage tissue and prevent further destruction. They also partially relieve pain and swelling, as well as deformity of the shoulder joint. Such drugs do not work immediately, they must be taken for at least 3-4 months.
- A course of muscle relaxants - tablets or injections that relax muscle spasms. These are optional drugs 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 the treatment, speedy recovery and prevent new lesions, a special therapeutic diet 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 marine fish and seafood. A gelatin diet is followed, as gelatin helps to restore the elasticity of cartilage tissue. The menu includes jellied meat from veal hooves and tails, aspic and various jellies. It is useful to take gelatin in its pure form, previously soaked in warm water.
Physical therapy is the next important step in the complex treatment of shoulder osteoarthritis. They start only when the inflammatory process stops. Depending on the degree of the disease, its dynamics and the effectiveness of drug therapy, the doctor chooses a combination of the following natural procedures:
- cryotherapy;
- acupuncture;
- electrophoresis?
- laser therapy;
- magnetic therapy;
- mud therapy;
- massage of various types;
- physiotherapy.
Physiotherapy procedures are aimed at activating metabolic processes in joint tissues, normalizing blood circulation and restoring limb mobility. With their help, it is possible to reduce the number of drugs taken and their dosage, which is especially valuable if the pathology is observed in a teenager, an elderly person or a breastfeeding woman.
Helpful tips:It is possible to treat grade 1-2 injuries of the shoulder joint at home, with the additional use of folk remedies. The main thing is that the patient does not forget to take medication on time and does not skip physical procedures - the effect will be noticeable and last only if all the doctor's prescriptions are followed regularly and conscientiously.
If conservative treatment is ineffective, the doctor is forced to offer the patient surgical intervention. The remains of the damaged joint will be removed and a prosthesis will be implanted in its place. Such an intervention is not unusual, but requires highly skilled doctors, precision and attention at every stage. In addition, prostheses do not always take root well, and the recovery period after the operation lasts at least six months. Therefore, if you notice that your shoulder starts to hurt regularly, pull, numb or hear a creak when you move, do not postpone the visit to a doctor, examine in time and, if necessary, start treatment.
Shoulder joint arthropathy is a fairly common pathology of the musculoskeletal system, which occurs mainly in people over 50 years old. The pathology develops gradually, little by little, under the influence of adverse factors, the joint structures begin to collapse, which is manifested by pain, swelling and stiffness of the joint. In the initial stages, the progression of the disease can be stopped with the help of comprehensive treatment: drugs, vitamin supplements, diet therapy and physical therapy. Advanced osteoarthritis can only be treated surgically.