Shoulder 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 joint damage.
The disease can develop for several years without showing itself. At some point, under the influence of unfavorable factors (hypothermia, trauma, severe concomitant disease), 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 shoulder arthrosis
The causes of degenerative-dystrophic joint tissue damage are numerous and varied. Among them, injuries play a major role, so post-traumatic arthrosis of the shoulder joint is considered the most common form of pathology. It can be provoked even by a slight, but repeatedly repeated damage to cartilage tissues.
In addition, the disease can occur under the influence of the following pathological factors:
- Severe joint damage: synovitis, gout, acute or chronic arthritis, aseptic necrosis of the humerus.
- Regular joint strain. It is most often observed in athletes involved in volleyball, tennis, basketball.
- Congenital pathology of the shoulder joint.
- Endocrine diseases.
- Advanced and senile age.
- Overweight (obesity).
- Avitaminosis.
- Autoimmune lesions and weakening of the immune system.
- genetic predisposition.
Most of the patients are people engaged in monotonous physical work. Therefore, arthrosis of the right shoulder joint is diagnosed much more often than the left.
The disease usually develops under the influence of not one, but several adverse factors at once. Based on this, the treatment should be comprehensive and aimed not only at fighting the disease, but also at eliminating all the causes that caused it.
Characteristic signs of the disease
Shoulder arthrosis, imperceptibly beginning and gradually developing, can suddenly appear after an injury, hypothermia or serious physical exertion. In this case, there are symptoms characteristic of damage to the shoulder joints and nearby tissues:
- pain;
- crunching and clicking during hand movement;
- stiffness and reduced range of motion in the shoulder.
Most often, the disease occurs in a chronic form. Aggravation of the disease can be caused by excessive load on the joint or injury.
The intensity of the manifestation of the symptoms largely depends on the severity of the damage to the cartilage and bone tissue, so it is common to distinguish several degrees of the disease. Such systematization greatly facilitates the diagnosis and allows you to accurately predict the outcome of the disease.
Shoulder arthrosis I degree
During this period, the tissues of the joint are slightly affected. The pain is observed extremely rarely and only after excessive physical exertion or prolonged monotonous work. The patient most often ignores these symptoms, attributing them to fatigue or muscle tension. The defeat of the 1st degree is treated only with conservative methods.
At the beginning of the disease, there are no obvious changes in the cartilaginous tissues on X-rays, only an oval ring is noticed around the joint cavity.
Shoulder arthrosis II degree
At this stage, the symptoms of the disease become more pronounced. Cartilage tissues become thinner and deformed, intra-articular connections are damaged. During the movement of the hand, a crunch is heard, the inner layer of the joint bag becomes inflamed. Over time, the pain becomes constant. Morning stiffness and limited movements appear, which can lead to muscle atrophy.
Shoulder arthrosis III degree
During this period, the joint is already significantly deformed, there are practically no movements in it. The patient suffers from sharp pain that may radiate to the arm and scapula. If you do not stop the further destruction of the tissues, the pathological process can lead to disability.
The disease of the third degree 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 the transition to a chronic form.
Which doctor should I contact?
Often people who experience joint pain do not know who to turn to. At the first symptoms of the disease, you should visit a rheumatologist. The specialist will not only perform a complete physical examination and make a diagnosis, but also, if necessary, relieve severe pain with the help of an intra-articular injection of anesthetic.
In an advanced form of the disease, the rheumatologist will probably be powerless. In this case, you will need a surgeon or orthopedist. In big cities, you can make an appointment with an arthrologist who deals only with joint diseases.
How to deal with shoulder arthritis
After a medical examination and diagnosis, the doctor prescribes a specific therapy that allows you to achieve a long and stable remission of the disease. It is impossible to treat degenerative changes in the joints, but slowing down the course of the destructive process and alleviating the patient's condition is a completely feasible task.
The main goal of anti-arthrosis 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 expressed and does not force patients to seek help from specialists. Most often, they are treated independently with folk remedies. Some patients engage in therapeutic exercise to reduce joint pain and stiffness. Medicines prescribed by a doctor are used for the treatment of arthrosis, subject to the recommended dosage and duration of administration. The following groups of drugs are most effective:
- nonsteroidal anti-inflammatory drugs;
- chondroprotectors;
- corticosteroid drugs;
- non-narcotic analgesics;
- vasodilators;
- muscle relaxants.
Many drugs for this pathology are sometimes prescribed for a long time. Depending on the severity of the disease, the drugs are taken orally, used externally, injected intramuscularly or into the cavity of the shoulder joint.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs are contraindicated for long-term use due to the presence of side effects from the digestive tract.
Treatment of the disease with drugs is possible even at an early stage of development of the pathological process. The course is determined based on the patient's condition and the severity of the symptoms. As an independent treatment, ointments included in this group are not prescribed. They are used in combination with similar groups of drugs used intramuscularly or orally. Their task is to reduce inflammation and alleviate the patient's condition.
Chondroprotectors
Almost all patients include in the treatment regimen drugs aimed at improving the metabolic processes in the cartilage tissue. They also increase cartilage elasticity. 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. Chondroitin sulfate's job is to nourish and soften the shoulder.
Monotherapy preparations have proven themselves better in the market compared to a combination of substances.
The polysaccharide contained in the intercellular space is hyaluronic acid. It is also able to reduce the sensitivity of receptors that respond to pain. Combined chondroprotectors, which contain several active ingredients, have the greatest advantage.
The most effective use of chondroprotectors in the initial stages of the disease. The task of the drugs is the synthesis of new cells from healthy cartilage tissue that replace the damaged tissue. In the presence of pain and swelling, drugs from this group will be less effective. Therefore, it will first be necessary to use anti-inflammatory drugs to relieve the patient's condition.
To achieve the maximum effect, injectable preparations are used for intra-articular or intramuscular administration. The course of treatment with chondroprotectors takes up to six months, some patients notice the first results after 3 months of therapy. It is important to follow certain rules when treating such drugs.
With the beginning of the course of therapy, physical overloads, stressful situations should be excluded. The patient will get the greatest effect if he starts taking chondroprotectors, improves nutrition and engages in physical therapy. Many patients with arthrosis of the shoulder joint engage in Dr. Bubnovsky's method, perform a specially developed set of exercises to achieve gradual restoration of the joints or stop the progression of the disease.
Corticosteroid agents
In severe pain, if anti-inflammatory drugs do not give a positive effect, corticosteroids are prescribed. Ointments or injections are prescribed to alleviate the patient's condition.
Analgesics
In the initial stages of the disease, analgesics are prescribed to reduce pain.
Compared to nonsteroidal anti-inflammatory drugs, drugs of this group have a less negative effect on the mucous membrane of the digestive tract.
Having a mild anti-inflammatory effect, they effectively fight pain.
Vasodilators
Vasodilators are a mandatory tool in the treatment of arthrosis. They eliminate vascular spasms, normalize blood flow in the affected area. Many patients complain of the appearance of night pains, which are effectively treated with drugs from this group.
Muscle relaxants
In the case of arthrosis of the shoulder joint, muscle spasms, which are relieved by muscle relaxants, are considered a common phenomenon. When prescribing them, the principle of complexity is observed, they are applied together with pain relievers and anti-inflammatory drugs. If necessary, the minimum dose is initially prescribed with a gradual increase.
Surgical treatment
The main goal of the operation is to restore the working capacity of the joint and improve the patient's quality of life. If conservative therapy is ineffective, the constant pain syndrome continues, the joint is gradually deformed and the range of motion in it is sharply limited, the patient is indicated for surgical intervention.
The decision on the need for surgery is made by the orthopedist or traumatologist together with the patient. After that, the dimensions of the endoprosthesis and the material from which it will be made are determined. Today, implants are made of titanium and high-strength polymers, close in weight to the natural joint. The durability and reliability of endoprostheses is beyond doubt.
Recovery period
The operation to replace the affected joint usually proceeds without complications. For the first 14 days, fixation with a supporting bandage is necessary. Early passive performance of a complex of physical exercises on special devices and devices is allowed. Power loads are allowed after 45-60 days.
Physiotherapy
Any complex of exercises against arthritis is useful only during remission. If there is an increase in temperature, soreness and other symptoms of exacerbation of the disease, charging is contraindicated.
Exercise therapy should not cause pain or discomfort. At the slightest feeling of discomfort, the exercises should be abandoned.
Charging should be done daily. After the load, it is useful to do a self-massage in the area of the affected joint and nearby muscles, using a healing cream, which the attending physician will help you choose.
Physiotherapy
Physiotherapy allows you to improve the effect of drugs, reduce their dosage and minimize the risk of complications. The type of physiotherapy is determined by the doctor, guided by the patient's condition, the abandonment of the process and possible contraindications due to concomitant diseases.
The following physiotherapeutic procedures are most often used in the treatment:
- magnetic therapy;
- ultrasound with hydrocortisone;
- electrophoresis with anti-inflammatory and analgesic substances;
- ultraviolet radiation
- laser and infrared treatment.
Physiotherapy is carried out in courses of 10-15 sessions several times a year.
Treatment with folk methods
By combining folk remedies with drug therapy, exercise therapy, proper nutrition and physical therapy, you can achieve a long and stable remission.
One of the best recipes is a compress with birch leaves, which have an anti-inflammatory and warming effect. Young leaves are most suitable, since closer to autumn their beneficial properties decrease. Before making a compress, a light massage of the affected limb is necessary. The leaves are then applied to the skin, secured with stretch film and a bandage. The compress is left overnight. The duration of treatment is 10 days.
Salt baths have a healing effect. Before the procedure, the crystals are pre-dissolved in hot water. Then the resulting solution is poured into the bath. The procedure will require approximately 3 kg of salt. You can also add a few drops of any essential oil. It is best to take a bath before going to bed, and the duration of the bath should not exceed 30 minutes.
A hot compress made of oatmeal helps a lot. They should be poured with boiling water, insisted and used as intended. It is recommended that such procedures be carried out at night.
No less useful herbal poultices. Crushed plants with anti-inflammatory action (yarrow, ginger, turmeric, gentian, yarrow) are infused with boiling water, left for 10 minutes under a lid and applied to the sore spot. After the procedure, the affected shoulder should be smeared with a healing cream and lie down.
Inside, it is recommended to take an infusion of corn lollipops. One teaspoon of raw material or 1 filter bag is brewed with 200 ml of boiling water, insisted under the lid for 30 minutes and consumed 1 tablespoon. spoon half an hour before meals.
Prevention of osteoarthritis of the shoulder joint
Prevention of the disease can be primary and secondary. Primary prevention includes the following activities:
- regular exercise - jogging or fast walking, exercises for the muscles of the shoulder girdle;
- cold and hot shower;
- eliminating excessive loads and avoiding traumatic situations.
- timely treatment of diseases that can provoke arthrosis of the shoulder;
Secondary prevention is aimed at early diagnosis and treatment of arthritis.
Conclusion
Restoring joint functions is a long and difficult process. Treatment of arthrosis of the shoulder should be aimed mainly at eliminating the symptoms of the disease. Only complex therapy, combining medical and folk methods, will bring relief and restore working capacity.