The symptoms and methods of treatment of arthrosis of the shoulder joint

Arthrosis of the shoulder joint, the symptoms and treatment of which are the topic of this article, has a lower prevalence than arthrosis of the joints of the feet, spine and fingers, but its implications for musculoskeletal not less severe because this disease can lead to a sharp restriction of functions of one or both hands.

Osteoarthritis – a disease in which due to various reasons starts the process of destruction of joint tissues. Arthritis has a chronic progressive course, accompanied by pain and reduced physical activity. His treatment in the early stages allows you to pause the degenerative process, and the later – to restore lost joint function through joint replacement.

arthrosis of the shoulder joint

What is arthrosis of the shoulder joint

Arthritis, osteoarthritis, deforming osteoarthritis – all names for one disease. In osteoarthritis degenerative changes affect cartilage, bone and other joint tissues.

The structure of the shoulder joint includes a spherical end portion of the humerus and the articular cavity of the scapula, covered with a thin layer of cartilage, as well as encompassing them on all sides the joint capsule. Inner layer of joint capsule is formed is sealed by the synovial membrane filled with synovial fluid. This substance is similar composition with hyaluronic acid. It serves to lubricate the joint and nourish the cartilage with all the necessary for their regeneration substances.

Arthrosis of the shoulder joint begins with changes in the composition of synovial fluid, which can be a consequence of different reasons. Because of the lack of power in cartilage degenerative changes start, it becomes softer, prone to defects, wears out faster and becomes thinner. Over time, under the layer of cartilage the bone is laid bare and deformed, it formed the boundary growths – osteophytes, which serve as end stops for movement of the joint and can completely block it.

Causes

The main reasons for the start of osteoarthritis of the shoulder are:

  • A shoulder injury;
  • Congenital defects of structure – dysplasia;
  • The inflammatory processes.
pain in the shoulder joint

The shoulder joint is the most movable joint of the musculoskeletal system of man. For more freedom of movement he has to pay a strength – dislocations of the shoulder occur more frequently than similar injuries of other joints. It sprains are the most common factor that triggers the beginning of the shoulder osteoarthritis.

Traumatic factor can also be a surgery on the shoulder joint, heavy load on this part of the musculoskeletal system, caused by sports or professional activities.

Dysplasia of the joint – it is a congenital defect, which is manifested in inexact line forms interfacedn surfaces. It leads to deterioration of working conditions of the shoulder joint, the emergence of microtrauma to the articular cartilage and prerequisites to dislocations, which also contributes to the development of osteoarthritis.

There is such a thing as a secondary shoulder osteoarthritis, which develops on the background of inflammation in the joint caused by various diseases. To cause the inflammation in the joint tissues can disease:

  • Infectious (encephalitis, tuberculosis);
  • Metabolic;
  • Endocrine;
  • Autoimmune (rheumatoid arthritis);
  • Hereditary.

Osteoarthritis most often affects people aged 60 and older in this age group it occurs in approximately every second. Shoulder joints affected by osteoarthritis less common than knee or hip, but the shoulder arthritis makes a significant contribution to the disability population.

Risk factors

Main categories of persons who are at increased risk of developing shoulder osteoarthritis:

  1. Older adults (over 60-65 years). With age, slowing the regeneration of cartilage, worsens the absorption of the necessary substances of the cartilage tissue. All this leads to accelerated wear of the shoulder joint and progression of osteoarthritis.
  2. Workers whose professional activity involves heavy manual labor. Excessive stress on the shoulder joints undergo masons, porters, plasterers, miners. A negative impact on your shoulders working with a jackhammer and other tools, creating shock loads. Because of the action of this factor, osteoarthritis of the right shoulder joint are much more common than the left.
  3. Athletes: gymnasts, athletes, wrestlers, whose training is aimed at achieving high results.
  4. Patients with congenital abnormalities of the structure of the shoulder joint.
  5. Patients with rheumatoid arthritis and other diseases that cause inflammation in the joints.Especially high risk of developing osteoarthritis of the shoulder in individuals that fall simultaneously under several of the risk factors.
the symptoms of osteoarthritis of the shoulder joint

The clinical picture

Symptoms of osteoarthritis of the shoulder joint in the early development of the pathological process usually absent or weakly expressed. This can lead to the fact that the disease is detected when the cartilage of the shoulder joint has already undergone substantial degenerative changes. So you need to be attentive to the condition of the joints and consult a doctor at the first alarm signals:

  • The crunch in the shoulder;
  • Pain under load and with pressure on the shoulder;
  • Pain in the joint in the abduction hands back and to the side;
  • Limited movement;
  • The redness and swelling of the shoulder joint.

Any of these symptoms require examination. With the development of osteoarthritis its symptoms increase, respectively, the degree of destruction of cartilage.

Identification of shoulder osteoarthritis with the appearance of its first signs allows you to stop the process of destruction of the joint and to preserve its functions.

The extent of the disease

Stages of shoulder osteoarthritis are determined by x-ray, which gives an idea of how far the pathological process. And the extent of the disease is characterized by the combination and the severity of his symptoms.

1 degree

Osteoarthritis of 1 degree of the shoulder joint can last for several years. At the initial stage of its manifestation may only relate to changes in the composition of synovial fluid, which leads to poor nutrition of the articular cartilage. With the development of pathology, modifications being made to the synovium appear:

  • Reduced endurance of the shoulder joint to normal loads;
  • Mild pain during movement;
  • Some stiffness and pain when movement of an arm back and to the side.

2 degree

Arthrosis 2 degrees the shoulder joint cannot begin unnoticed, as the pain during movement is enhanced, and often occurs even at rest. When movements of the shoulder felt a clicking, stiffness amplitude, sharp pain when you try to take your arm back.

On x-ray joint space is markedly reduced, there is thickening of the articular surfaces, around their perimeter appear bony outgrowths – osteophytes.

3 degree

Osteoarthritis of the shoulder joint grade 3 is characterized by almost constant pain, severe stiffness, allowing you to move your arm forward and backward with a small amplitude. Abstraction ago, and the rise of the hands is impossible.

In the region of the shoulder joint osteophytes stand out due to the pain the patient is forced to keep a hand only in a certain position.

X-ray shows a sharp decrease in the articular gap due to the destruction of cartilage. Bone surface strain observed volumetric growths of osteophytes. In this stage, patients can only help the surgery to replace the joint with artificial implant.

diagnosis

Diagnosis

For diagnosis of deforming osteoarthritis of the shoulder is a laboratory study of the blood for the presence of diseases that cause inflammation in the joints. Also produced a medical examination with carrying out tests with high probability to assume the presence of shoulder osteoarthritis. Ask the patient to take your arm back, make her head. If these movements are accompanied by pain or even impossible, it is almost a direct indication of arthritis, as in other diseases of the joints such difficulties do not arise.

To determine the stage of osteoarthritis x-ray in two projections.

Treatment

Wondering how to treat arthrosis of the shoulder joint, you need to understand that the processes of destruction of articular cartilages, is almost irreversible. Therefore, it is highly advisable to start the treatment when the degeneration of cartilage tissue has not yet caused serious joint damage in the initial stage of the disease.

Depending on what stage of diagnosed with osteoarthritis of the shoulder joint, treatment may include the following methods:

  • Medication;
  • Physiotherapy;
  • Physical therapy;
  • Diet;
  • Massages;
  • Sanatorium-resort treatment;
  • The endoprosthesis.

As a complement to these methods can be used methods of folk medicine.

Drug therapy

drug therapy

The main aims of drug therapy for shoulder osteoarthritis is pain relief and inflammation, as well as improved nutrition and ensuring regeneration of tissues of the shoulder joint. For this purpose the following tools:

  1. Nonsteroidal anti-inflammatory drugs. These include nimesulide, diclofenac, aspirin. They have anti-inflammatory and analgesic effect. Use them orally in form of tablets and capsules, in the form of injections and in the form of ointments and gels for topical use. NSAIDs are very effective but have side effects. Therefore, they prescribe limited courses, to the extent possible, replace the internal receiving external funds – apply ointment for osteoarthritis of the shoulder, gels, compresses.
  2. When severe pain prescribe intra-articular blockade corticosteroids/ These potent agents are administered directly into the joint cavity, which allows to quickly arrest pain and relieve inflammation.
  3. To strengthen and repair the articular cartilage using chondroprotectors. Their application gives effect only on 1 and 2 stages of osteoarthritis of the shoulder, until the process of degeneration of joint tissues has not gone too far. Treatment of osteoarthritis of chondroprotectors requires long – up to 1 year. Earlier than 3 months, the results won't be noticeable.
  4. To improve the quality of synovial fluid inside the joint is injected hyaluronic acid to joint tissue getting enough nutrients.

Physiotherapy

In the periods between exacerbations of osteoarthritis of the shoulder joint is necessary to regularly carry out a complex of therapeutic exercises. This will ensure that the necessary joint range of motion to prevent muscle atrophy and ligaments, and to improve metabolism in joint tissues. Rotating, lifting and lowering of the shoulder, the swing arm cause a rush of blood to the muscles and the influx of synovial fluid to the cartilage, which contributes to the normalization of metabolic processes in the shoulder joint.

The amount of physical activity of the patient's joint must be strictly potionatus. Invalid overload, however, the lack of movement affects the state of the shoulder joint affected by osteoarthritis. Therefore, the complex therapeutic exercises should be prepared by the attending physician.

Physical therapy

physical therapy

In the treatment of shoulder osteoarthritis are widely used physiotherapy methods. They are usually prescribed in the acute phase of the disease in conjunction with medical treatment and they continue after the removal of the inflammatory process. In the Arsenal of the means of procedures such as laser therapy, ultrasound, electrophoresis, magnetic therapy, light therapy. Their application allows to reduce doses of painkillers and anti-inflammatory drugs, which reduces their harmful effects and side effects. A doctor orders physical therapy treatment based on the stage of disease and condition of the patient.

Arthroplasty

Patients who are not helped treatment, it is possible to restore functions affected by arthrosis of the shoulder joint by performing joint replacement. It is to replace the shoulder joint-hinge of metal, ceramic or plastic, that will last 15-20 years. This treatment has been used since 2009, and has already performed in many clinics around the world. The contraindications to fitting of the prosthesis is advanced age.

Prevention

Prevention of arthrosis of the shoulder joints is the avoidance of traumatic stress. If you have heavy work or carrying loads, try to do the workout and how to warm up the joint. Work slowly, evenly distributing stress. When the load on the verge of possibilities, ask someone to help you.

If your professional activities involve excessive loads on the joints of the shoulders and hands, then at the first signs of trouble, it is recommended to change jobs.

When pain or crunching in your shoulder, do not delay your visit to the doctor. The sooner revealed osteoarthritis and treatment is started the better the prognosis. In the period of remission cannot be overloaded sore shoulder, but to abandon the movement is also impossible. Exercise regularly treatment of joint exercises, follow all doctor's orders, a full eat, watch your weight remained in the normal range.

03.01.2019