Osteoarthritis (osteoarthritis) is a degenerative disease of cartilage tissue, in which the normal functioning of the joint is disturbed. In most cases, the disease is chronic. Osteoarthritis of the shoulder is characterized by pain and gradual loss of hand functionality. The pathology is most often detected in old age. The causes of osteoarthritis are senile changes in the body, shoulder injuries, birth defects and constant stress on the shoulder girdle. If a person faces discomfort in the shoulder girdle, it is necessary to consult a doctor and undergo an examination. With the help of complex action it is possible to stop the development of degenerative changes.
What is shoulder arthrosis
Osteoarthritis of the shoulder - damage to the cartilaginous tissue of the joint, which causes degenerative changes. The blood supply to the cartilage tissue is disrupted, so it stops receiving enough nutrients and oxygen.At risk are people who experience excessive stress on their shoulders on a daily basis and have congenital joint tissue defects.In the early stages, the person feels pain, but normal shoulder functionality is preserved. If the provoking factors are not eliminated, the disease will cause serious damage to health.
Diagnosis plays an important role in the treatment of osteoarthritis. With the help of X-rays, it is possible to precisely determine the cause of the problem and the degree of damage.
Anatomical background
The causes of the disease can be congenital disorders of the structure of the joints and connective tissue. If a person has characteristics in the structure of the shoulder girdle, then even a simple load can cause the appearance of arthrosis. To avoid problems, you will need to take preventative measures and visit your doctor regularly. Congenital dysplasia can be controlled with massage and exercise therapy.
Causes and risk factors
All the elderly are in danger.According to WHO statistics, the probability of developing arthrosis after 45 years increases significantly.By age 65, more than 50% of people suffer from this disease. Among the reasons that cause the early onset of the disease are:
- damage to the rotator cuff of the shoulder;
- shoulder injury;
- constant stress related to sports or work;
- infectious and autoimmune pathologies;
- obesity;
- improper metabolism.
The older a person is, the higher the risk of developing degenerative joint damage.
Reviews
The defeat of cartilage tissue is divided into primary and secondary. The diagnosis of primary arthrosis is made if there are no concomitant diseases. It is usually detected in old age. The reason for its appearance is the changes associated with age. Secondary vision occurs due to injury or in the background of another disease. In addition, the disease is classified according to location.Degenerative changes in the shoulder can occur in the area of the shoulder joint itself or the acromioclavicular joint.
Stages of development and symptoms
Symptoms depend on the stage of development of shoulder arthrosis. The pathology is divided into three phases:
- The first. . . Painful pains appear, which intensify at night, and the functionality of the shoulder girdle is preserved.
- Others. . . When moving the arms, a crunch is heard, the pain is constant, there is limited mobility of the shoulders.
- Third. . . Severe pain, the arm is fixed in one position, protrusions are visible in the affected area, a strong deformation of the joint is visible on the X-ray.
The disease may not develop for a long time. If a person continues to strain the shoulder girdle, the condition worsens.
Which doctor to go to
Osteoarthritis of the shoulder joint is treated by various doctors. The initial examination is performed by a therapist or rheumatologist. In addition, the following specialists may be involved in the treatment:
- surgeon;
- orthopedist;
- neurologist.
In most cases, the treatment regimen is developed by a rheumatologist.The help of a surgeon is necessary if the disease requires surgical treatment or intra-articular manipulations.Consultation with a neurologist is necessary if the nerve bundle is compressed due to the disease.
Only after the diagnostic examination, the therapist or rheumatologist will determine whether the help of other specialists is needed.
Diagnosis
Hardware and laboratory tests, as well as manual examination, are used to make an accurate diagnosis. First of all, various tests are performed. A person's history is studied. All this helps in making a preliminary diagnosis. In addition, MR and X-rays are used to determine the degree of narrowing of the joint space, the condition of blood vessels, synovium, tendons.
Manual inspection
Manual examination includes palpation of the affected area and performing diagnostic tests. Pain usually occurs on palpation of the acromioclavicular joint. If a person has problems putting his hand behind his head, it can signal the presence of arthrosis of the shoulder joint. During the manual examination, the doctor will be able to detect the inflammation. The information obtained during the manual examination plays an important role in the diagnosis.The examination should be performed by an experienced rheumatologist or therapist, in order to avoid damage during testing and functional tests.
Instrumental methods
Instrumental research methods allow you to determine:
- degree of joint space narrowing;
- uneven joint surface;
- localization of arthrosis.
After using instrumental diagnostic methods, the required therapy is selected. Radiography, CT or MRI are used for diagnosis. These methods provide the necessary information. Instrumental examination may be repeated during treatment.
Laboratory
Laboratory tests allow you to assess the condition of the body as a whole, as well as to rule out inflammatory arthritis. First of all, blood is taken for analysis. In arthrosis, all indications of the clinical and biochemical blood test are within normal limits. In arthritis, the rate of erythrocyte sedimentation, the amount of immunoglobulins and other markers of the inflammatory process in the body significantly increases. Based on the obtained results, the doctor makes the final diagnosis and chooses an effective treatment regimen.
To get accurate results, give blood in the morning on an empty stomach.
Treatment
The approach to treatment is complex. Medications, physiotherapy, physiotherapy exercises are used. If the disease has progressed or does not respond to treatment, surgery is used. Basic principles of therapy:
- relieve pain;
- stop the development of the disease;
- initiate cartilage tissue regeneration mechanisms.
In the initial stage, the result is achieved by the use of drugs.It is important to exclude provoking factors. Stable remission is achieved with physiotherapy and exercise therapy.
Medications
The following groups of drugs can be used for treatment:
- nonsteroidal anti-inflammatory drugs;
- chondroprotectors;
- corticosteroids;
- vasodilators.
NSAIDs and corticosteroids are used to relieve pain. They apply for a limited period of time. Chondroprotectors can accelerate the regeneration of cartilage tissue. Vasodilators help improve blood flow and relieve spasm of small blood vessels.
Before prescribing this or that drug, it is necessary to carefully study the contraindications. Only a doctor can properly combine all medications.
Surgically
Surgical intervention is performed only in an emergency, when irreversible degenerative processes have occurred. The reasons for the operation are:
- lack of effect of conservative therapy;
- occurrence of complications;
- occurrence of severe degenerative changes.
If the joint has lost its original appearance, then arthroplasty is performed.The diseased joint is replaced with an artificial one. The operation is complex and requires a highly qualified surgeon. Puncture and arthroscopy can also be performed to treat osteoarthritis.
Puncture
A puncture is performed if a large amount of fluid has accumulated in the joint cavity. Also, this procedure is performed on infectious inflammations to determine the type of infection. Getting rid of excess fluid helps reduce pressure on the shoulder joint and increase its mobility. The procedure is minimally invasive, so recovery after its completion takes place in the shortest possible time. The puncture has indications and contraindications. It is used only in case of accumulation of fluid in the joint capsule or if there is a suspicion of an infectious complication of arthrosis.
Arthroscopy
Arthroscopy is a minimally invasive surgical technique that removes damaged shoulder cartilage. The operation is performed using endoscopic equipment and a micro-camera. The advantage of this method of treatment is fast rehabilitation. Removing the destroyed cartilage allows you to relieve stress and restore joint mobility. The disadvantage of the procedure is that access to the affected area is somewhat limited.
Endoprosthetics
Endoprosthetics is the complete replacement of a damaged joint with a biocompatible analogue.Titanium construction is most often used. Surgery allows you to get rid of even the 3rd stage of arthrosis. Long-term rehabilitation is performed after endoprosthetics. As a result, it is possible to achieve complete removal of the affected areas and chronic pain, as well as restore mobility of the shoulder girdle.
Surgery is not always possible. In the elderly, the rehabilitation period is much more difficult. Other treatment options are used before naming arthroplasty.
Physiotherapy
Physiotherapy procedures play an important role in resolving shoulder girdle arthrosis. With their help, it is possible to restore normal joint mobility and reduce the intensity of pain. The following procedures are performed:
- electrophoresis;
- local cryotherapy;
- magnetotherapy.
Physiotherapy can be used if there are no acute manifestations of the disease (severe pain, limited mobility). Regular exposure will completely eliminate the discomfort. Each procedure must be performed by a qualified technician.Before visiting the physiotherapy rooms, it is necessary to consult with your doctor.
Kinesitherapy
Kinesitherapy refers to the use of active and passive methods to restore shoulder functionality. If the disease is mild, then the person can begin to use an active method of recovery through exercise. The passive method consists of external exposure through massage or mechanotherapy. Kinesitherapy helps to quickly get rid of the manifestations of arthrosis of the shoulder joint.
The passive method of recovery through mechanotherapy is available to people of any age.
Exercise therapy
Physiotherapy exercises allow you to load the muscles and restore the mobility of the shoulder joint. Static exercises are mostly used. Dynamic loading in which active shoulder rotation is performed is undesirable. The following exercises can be performed:
- Rocking shoulders- it is necessary to take the starting position, sitting on a chair and put your hands on your knees. Relax your shoulders, then start waving your elbows. At the same time, his hands are on his knees.
- Slow turning- it is necessary to sit on a chair and put your hands on your knees, and then slowly begin to rotate your shoulders with short breaks. Circular back and forth movements are performed.
Physiotherapy can be used only during remission, when pain and limited movement are almost completely absent.
Massage
By massaging the affected area, you can achieve the following effects:
- improve tissue nutrition;
- relieve swelling;
- to tone muscles;
- remove pain.
It is recommended that all operations be performed by a qualified professional.Strong pressure and sudden movements should be avoided when performing self-massage.The result of the massage effect is visible within a few weeks after regular use.
Massage should be accompanied by other activities. If a person performs exercises from the therapy exercise complex and visits the massage room, he will achieve great results.
Mechanotherapy
Mechanotherapy is a set of exercises that are performed on specialized mechanisms. This method allows you to recover in the shortest possible time. Mechanotherapy is ideal for rehabilitation after surgery. Special mechanisms allow you to adjust the load, allowing faster recovery of muscles and ligaments. All operations are performed in stationary conditions. Teaching on rehabilitation mechanisms should be performed with an instructor. He will correctly select the load and the required simulator.
Traction of the joints
The joints are stretched using a specialized device. This procedure can achieve the following effects:
- improve blood circulation;
- increase joint space;
- relieve ligament tension.
Narrowing of the joint space is one of the main manifestations of arthrosis. You can fix the situation with this procedure. The load level is selected individually. Initially, traction is performed with minimal weights.
An examination for possible contraindications should be performed before prescribing joint traction.
Folk methods
Traditional methods allow you to get rid of pain and speed up the process of cartilage tissue regeneration. The following medications can be used:
- Burdock leaves- fresh burdock leaves are crushed until they soften and applied to the affected area for 30-60 minutes. Fixation is done with gauze.
- Salt compress- 50 g of salt is dissolved in 450 ml of water, after which gauze is placed in the liquid. The gauze is removed, warmed and applied to the shoulder for 45 minutes.
- Gelatin- 2 teaspoons of gelatin should be diluted in 100 ml of warm water, after which the liquid is heated to boiling. Gelatin is taken orally once a day before meals. Promotes cartilage tissue regeneration.
Traditional methods will help to achieve a good result in therapy. It is recommended to use them during remission.
Diet for osteoarthritis
With any type of osteoarthritis (shoulder, wrist, ankle), you need to provide your body with all the nutrients to quickly rebuild cartilage. You will need to add the following foods to your diet:
- nuts;
- bran;
- gelatinous jellies;
- buckwheat porridge;
- eggs.
The diet should be balanced. Vitamin supplements can be taken to obtain essential vitamins and minerals. It is recommended to eat 4-5 times a day. Alcohol and sweets are excluded during the treatment of arthrosis. If a person wants to achieve permanent remission, he will have to constantly adhere to the principles of proper nutrition.
Complications and prognosis
The prognosis depends on the age of the person, the degree of damage, and the individual characteristics of the organism. At a young age, it is possible to achieve complete restoration of cartilage tissue and joint functionality. In old age, you will have to follow certain rules in order to achieve lasting improvement. Osteoarthritis of the shoulder responds better to therapy than arthrosis of the feet, because the shoulder girdle is easily isolated from stress. This allows for more effective conservative treatment.
Differences between shoulder arthrosis and arthritis
Osteoarthritis and arthritis have the same manifestations, but differ in the clinical picture. The main difference is that osteoarthritis is a non-inflammatory disease.In the early stages, the pain in arthrosis worries a person only after exercise, and in arthritis it is constant.Arthritis is an inflammatory-degenerative disease. Its treatment is somewhat different from the treatment of osteoarthritis.
In order not to confuse these diseases, differential diagnosis methods are used. Laboratory and instrumental studies will help to accurately determine the presence or absence of inflammation.
Prophylaxis
Prevention of arthrosis consists in removing provoking factors and maintaining a healthy lifestyle. You will need to do the following:
- give moderate physical activity;
- avoid hypothermia;
- use chondroprotectors;
- avoid hard physical work;
- reduce body weight to normal.
Preventive actions will help keep the joints healthy until old age. Prevention should be monitored especially carefully by people older than 45 or who are actively involved in sports.
conclusions
- Osteoarthritis of the shoulder is a degenerative disease in which there is a gradual destruction of the cartilaginous tissue of the joint.As a result, the person has pain and movement is limited.
- Treatment of the disease includesuse of medications, conducting physiotherapy and performing exercises from a complex of physiotherapy exercises.
- In the early stage of the disease, the prognosis for complete recovery is favorable.
- Prevention can significantly reduce the likelihood of osteoarthritis of the shoulder joint.