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 to complete immobility. Osteoarthritis of the shoulder joint causes severe pain and reduces the quality of life. In the absence of treatment, disability occurs.
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 can 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: pathology occurs after exposure to the joint of 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.
Shoulder osteoarthritis symptoms
Changes in cartilage and bone tissues begin long before the first signs of arthrosis 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.
Shoulder osteoarthritis symptoms:
- Cracking joint during movement.
- Pain, especially severe after exercise.
- Stiffness of movement, expressed after sleep or long rest.
- Increased pain during weather changes.
Degrees of arthrosis
The clinical classification defines three degrees of arthrosis 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 taken to the extreme position.
- 2 degree. 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.
- 3 degree. 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.
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 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 by palpation).
- The presence of a crunch, "clicks" that can be heard or felt by the hand during shoulder movement.
- Jamming of the joint in the presence of free chondromic bodies.
- Pathological movements in the shoulder.
To detect signs of arthrosis of the shoulder joint, radiography 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 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 the sonogram, the doctor determines the thickness of the cartilage, the condition of the synovial membrane. The method well visualizes osteophytes, 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 adjacent tissues. To date, magnetic resonance imaging is one of the most informative methods in the diagnosis of arthrosis.
As part of a comprehensive examination, they appoint:
- General blood analysis. 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.
- Analysis of urine. Kidney pathologies often cause secondary deforming arthrosis. Analysis is necessary for accurate diagnosis.
- Blood chemistry. The data helps to establish the cause of the inflammation. Biochemical analyzes are also performed to monitor complications and side effects during therapy.
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, surgical intervention is indicated.
Medicines and dosage are selected individually. The doctor may prescribe:
- Non-steroidal anti-inflammatory drugs (NSAIDs). Medicines reduce inflammation and pain.
- Glucocorticosteroid preparations. Means based on hormones have a more intense effect on the focus of pain. Medicines not only alleviate the patient's condition, but also reduce inflammation, exhibit antihistamine and immunosuppressive properties. Glucocorticosteroids are prescribed in cases where NSAIDs are not effective.
- Painkillers. Medicines of this group are prescribed for severe pain syndrome. Depending on the severity of the symptoms, the doctor selects non-narcotic or narcotic (rarely) analgesics.
- Chondroprotectors. The active ingredients of the drugs are involved in the formation of new cartilage tissue. The regeneration of the diseased joint is accelerated, trophism improves. Chondroprotectors have a cumulative effect and have proven themselves in the treatment of arthrosis of varying severity.
Some drugs are injected directly into the joint cavity. For example, the blockade has a better analgesic effect than taking drugs in the form of tablets.
Courses are carried out after the removal of exacerbation. Physiotherapy as part of 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 make a treatment plan taking into account the condition of a particular patient.
Moderate physical activity is important to slow down degenerative processes. It is better to start exercise therapy for arthrosis of the shoulder joint in a medical center, 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 cause 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 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 in order to determine the infectious agent or other indicators.
- Arthroscopy. With the help of microsurgery instruments, the doctor examines the joint cavity, removes scar tissue, performs a suture of the tendons of the rotator cuff or joint capsule if they are damaged. Several punctures remain on the skin. The patient recovers quickly.
- Endoprosthetics. Endoprosthetics allows you to completely get rid of chronic pain, restore arm mobility. After the operation, a long (from 3 to 6 months) rehabilitation is needed.