Shoulder arthropathy

Shoulder pain can occur gradually and significantly reduce the patient's quality of life. To find out why your shoulder hurts, you should see a doctor and have a full examination. The most common cause of such pain is osteoarthritis of the shoulder.

The disease requires long-term adequate treatment, which can only be prescribed by an experienced specialist.

What is?

Shoulder arthropathy is a long-term, constantly evolving metabolic-dystrophic disease, which leads to gradual destruction of articular cartilage, protective development of bone tissue with deformity of the joint and loss of its function.

A wide range of arm movements is provided by the synchronous interaction of the shoulder joints:

• arm or just arm;
• acromioclavicular - between the key and the acromion of the scapula.
• sternum - between the sternum and the key.

The shoulder joint is very mobile, which is provided by the convex head of the arm and the relatively flat articular fossa of the scapula. The joint is strengthened by the tendons of the muscles of the upper extremity, above it is the crow's-acromion joint. The not very reliable reinforcement allows the joint to move in different directions, but at the same time increases the risk of injury.

The code for shoulder arthropathy according to the International Classification of Diseases of the 10th revision (ICD-10) is M19 (other types of joints). Treatment for shoulder arthropathy should begin as early as possible. But even the advanced stages of the disease can be successfully treated.

Causes of osteoarthritis of the shoulder

The main causes of shoulder arthropathy:

• Consequences of acute injuries - dislocations, subluxations, intra-articular fractures, bruises.
• permanent long-term micro-injury related to the profession or sports load.
• transmitted acute and chronic infectious-inflammatory and autoimmune processes in the shoulder joint - acute purulent arthritis, chronic rheumatoid, psoriatic and other arthritis.
• against the background of a chronic inflammatory process in the periarticular tissues - brachial periarthritis, which leads to disruption of blood circulation and nutrition of cartilage tissue.
• metabolic (exchange) joint disorders - gout.
• hormonal disorders?
• congenital malformations (dysplasia) - for example, the articular surfaces of the shoulder joints.

Under the influence of any of these reasons (sometimes several at the same time), the composition and volume of synovial fluid that supplies the cartilage tissue of the joint is disrupted. The cartilage gradually decreases in volume, cracks, loses its anti-vibration properties. This leads to bone injury, its development along the edges of the articular surfaces, joint deformity and reduced function. In the joint cavity, inflammation of the synovial membrane occurs periodically - arthritis. Because of arthritis, arthropathy is called osteoarthritis or osteoarthritis - depending on which process is prevalent (inflammatory or metabolic-dystrophic). As a result of inflammation and necrosis of the bone, small pieces of tissue are separated from it - isolators or articular mice.

In danger:

• for minor injuries - blacksmiths, miners, tennis players, weightlifters, discus throwers.
• for acute injuries - gymnasts, athletes, circus performers.
• persons with impaired heredity;
• people suffering from chronic joint diseases.

Symptoms of osteoarthritis of the shoulder

The disease begins gradually, gradually. The rate of progression depends on the cause, the general condition of the patient and his heredity.

First signs

The initial symptoms of arthritis of the shoulder joint may go unnoticed, especially if they occur in the context of an existing shoulder disease. These are minor, occurring periodically, mainly after exercise, pain, discomfort during joint movement. Pain in the left joint can be confused with pain in the heart. They pass quickly, but they are worth watching.

If such symptoms recur, it is best to consult a doctor immediately, because any disease is easier to treat in the early stages.

Obvious symptoms

The pain increases, after exercise it does not subside immediately. There are nocturnal pains as well as pains associated with changing weather. The movements in the hand become painful, accompanied by a characteristic stinging. In the morning or when you stay in a certain place for a long time, there is stiffness of movements, to remove it, you have to move. The pain syndrome can be located not only in the shoulder area, but also spread to the arm, neck and upper back.

Periodically, the joint swells, a slight redness of the skin appears on it, the pain intensifies, it becomes permanent. Body temperature may rise slightly. This is a sign of arthritis - aseptic (without infection) inflammation of the synovial membrane. If there are foci of infection in the body (decayed teeth, diseases of the ENT organs, etc. ), then it can enter the joint through the blood and lymph vessels, causing a purulent inflammatory process. In this case, high fever, headache may occur, the general condition may be disturbed abruptly.

The combination of degenerative-dystrophic and inflammatory processes in the joint leads to gradual permanent loss of limb function and constant pain.

But even such patients can be helped, you just have to go to the clinic.

Dangerous symptoms

There are a number of symptoms of osteoarthritis of the shoulder joint, which signal that you need to seek medical help urgently. This:

• the appearance of swelling and redness of the tissues in the joint area, fever.
• joint pain, accompanied by a change in its shape.
• Joint pain radiates to the arm, neck or back.
• the previous volume of movements in the hand is impossible, even if only it gets up it causes severe pain.

These symptoms indicate that your body needs help. Only a doctor can offer it.

What is the risk of osteoarthritis of the shoulder?

In the absence of medical care, brachial arthropathy is dangerous with a steady progression with the development of permanent pain syndrome, reduced limb function and various, sometimes life-threatening, complications.

Degrees of the joints of the shoulder joint

There are three degrees of shoulder joint pain:

• Grade 1 shoulder joint disease- primary stage. All symptoms appear mild and especially after exercise. On X-rays, a slight narrowing of the joint space is sometimes visible, but most of the time it is not. It is possible to detect small violations in the cartilage tissue at this stage only with the help of magnetic resonance imaging (MRI).
• Arthropathy of the shoulder joint 2 degrees- progressive stage. The shoulder hurts constantly, the pain is aggravated by the movements of the hand, it subsides (in the elbow, in the forearm, in the hand) or in the neck, the back, below the shoulder. There are difficulties with limb function, the signs of arthritis develop periodically. On X-ray, the joint space narrows significantly, bone growths (osteophytes) are visible along the edges of the joint surfaces, bone tissue is compressed (osteosclerosis).
• Arthritis of the shoulder joint 3 degrees- advanced stage. The pain in the joint is strong, constant, with intense cracking during the movement of the arm. The range of motion is limited, sometimes the arm is completely immobile due to pain. The joint is deformed, which sometimes leads to pinching of nerves and blood vessels. On X-ray: the joint area is almost invisible, significant bone growths with joint deformity, severe sclerosis and necrosis of bone tissue, joint mice.

Possible Complications

Any localization and form of arthritis has serious complications, so you should not delay treatment.

If you do not treat the disease or do not treat it yourself with folk remedies, then the risk of developing complications such as:

• significant deformation and restriction of joint mobility.
• Dislocations, subluxations and intra-articular fractures with minor injuries or sudden movements.
• ruptures of the tendons surrounding the joint of the muscles and ligaments - they atrophy and tear easily.
• aseptic necrosis of the head of the arm with complete destruction of the joint and loss of its function.
• purulent-septic complications when an infection enters the joint cavity from other foci.

What to do with an outburst

Exacerbations of the pathological process are usually associated with increased stress on the extremities or the development of inflammation - arthritis. In this case, the joint hurts more, there is a slight swelling, the body temperature rises. In such cases, you should follow the following self-help algorithm:

• call a doctor at home.
• take a tablet of one of the painkillers inside.
• apply an anesthetic ointment to the skin in the area of the affected joint.
• tie a sore arm with a bandage - this will reduce the load.
• take an elevated position - sit with a pillow under your back - this will reduce tissue swelling.

Types of shoulder joints

According to various criteria, the disease is divided into separate types.

For reasons of illness

According to this criterion, primary and secondary osteoarthritis are distinguished. Primary shoulder arthropathy is mainly the result of age-related changes and develops after 50 years. But sometimes the disease starts at a young age, but the cause of its appearance can not be determined. In this case they talk about primary idiopathic arthropathy of the shoulder. An important role in its development is played by hereditary predisposition: the presence of a similar disease in one of the close relatives.

Secondary arthropathy of the shoulder joint develops after injuries and previous diseases, but here too the burdened heredity is important: in one person, even a small injury or acute arthritis can lead to the development of arthropathy, while in another, more significant damageend without consequences.

According to the characteristics of the flow

Have deforming shoulder joint disease, which is characterized by rapid progression of bone deformities. A feature of this type of disease is the change in the shape of the joint and the frequent involvement of nearby blood vessels and nerves. Compression of blood vessels leads to impaired blood circulation and rapid development of degenerative-dystrophic disorders and compression of the nerves leads to reduced limb tenderness and severe pain along the peripheral nerves.

Origin

Post-traumatic shoulder disease - the symptoms and treatment of this disease have their own characteristics associated with a traumatic injury to certain joint structures. Exchange-dystrophic changes occur after intra-articular fractures, dislocations, subluxations, ruptures of ligaments, tendons and simply bruises. Injuries occur from a blow to the joint or from a fall to the side with an adductor arm. Ruptured articular capsule rupture usually occurs during a fall in the abducted arm.

Often, after a minor injury, a person does not notice the first signs of arthritis for a long time and seeks medical help already in the second stage of the disease. Significant injuries require long-term rehabilitation treatment and arthritis, as a rule, begins to be treated from the early stages.

Shoulder arthropathy after inflammatory diseases - the symptoms and course of such a pathology depend on the underlying disease. The shoulder joint is often affected in psoriatic arthritis, while the arthropathy develops in one joint, it develops slowly, but it is difficult to treat. With rheumatoid arthritis, both shoulders are affected, the arthropathy develops in waves with frequent alternation of metabolic-dystrophic and inflammatory processes.

Distribution

Only one left or right joint can be affected and then they talk about single joints. The simultaneous defeat of two (left and right) shoulder-shoulder joints is called oligoarthritis.

Arthropathy of other joints of the shoulder complex

Acromioclavicular joint disease - most often has a post-traumatic origin. It grows on the background of weightlifting with his hands above the horizontal. Accompanied by pain when lifting the arm. With the development of osteophytes on the articular surfaces, a collision syndrome may occur - involving the tendons and muscles of the shoulder between the head of the arm and the scapula of the shoulder during rotation and abduction of the shoulder. This accelerates the progression of arthritis and the decline of hand function.

Diagnostics

Without proper diagnosis, it is impossible to treat this disease. Full examination is possible only in the clinic. During the initial consultation, the doctor asks the patient, examines him, prescribes additional research methods and special consultations:

• Laboratory tests for blood, synovial fluid - inflammatory, autoimmune and degenerative-dystrophic processes are detected.
• Organic:
  1. X-ray of the shoulder joint - changes in bone tissue are detected.
  2. Computed tomography (CT) - changes in cartilage and bone tissue in the early stages.
  3. magnetic resonance imaging (MRI) - changes in the soft joint and periarticular tissues.
  4. diagnostic arthroscopy - performed if necessary to clarify the nature of the pathological process.

Treatment of osteoarthritis of the shoulder joint

After establishing the final diagnosis, a complex conservative treatment of shoulder arthropathy is prescribed. If conservative treatment is ineffective, surgery is prescribed.

Conservative therapy

It includes pharmacological and non-pharmacological methods.

Medical care

The goals of drug therapy are to eliminate pain and suppress the progression of osteoarthritis. To alleviate the patient's condition, set:

1. Drugs from the groupnon-steroidal anti-inflammatory drugs (NSAIDs). The drugs are administered intramuscularly, orally or rectally. At the same time, NSAIDs are prescribed externally in the form of ointments, gels or creams.
2. Drugs from the groupmuscle relaxants- relax the muscles surrounding the joint. the spastic condition of these muscles increases the pain.
3. Exclusions of painwith local anesthetics.The drug solution is injected into the joint cavity or periarticular tissues - a rapid analgesic effect.

The course of pathogenetics (which affects the mechanisms of the disease) as part of the medical treatment of shoulder arthropathy includes:

1. Chondroprotective- medicines containing biologically active substances that repair cartilage tissue. They are prescribed orally in the form of tablets and powders, in the form of intramuscular and intra-articular injections, as well as externally in the form of ointments and creams.
2. Vascular protection- Means that improve blood microcirculation. Assign tablets for oral administration and solutions for intravenous instillation.
3. Hyaluronic acid preparations- are inserted into the articular cavity to improve the damping properties and prevent the destruction of bone tissue.

Vitamin-mineral complexes to improve metabolic processes in joint and periarticular tissues.

Non-drug treatment

The basis of non-pharmacological methods of treatment of shoulder arthropathy is a healthy active lifestyle and proper nutrition. It is very important to get rid of bad habits such as smoking and alcohol abuse - they contribute to circulatory disorders and have a toxic effect on joint tissues.

Nutrition, diet

There is no specific diet for the treatment of shoulder joint, but proper nutrition is very important in this disease. It is recommended to include in the daily diet: seafood, seafood, lean poultry, dairy products, cottage cheese, cheese, cereals (oatmeal, buckwheat), vegetables, fruits.

Excluded from the diet: digestible carbohydrates (sweets, muffins, sweet carbonated drinks), fatty red meat, foods that irritate the tissues that cause swelling - salt (excessive amount), spicy and spicy spices.

It is recommended to prefer boiled, cooked and steamed.

Orthopedic treatment to distribute the load on the limb

To avoid shoulder injuries, it is recommended that you periodically wear a short-sleeved rubber grip attached to the opposite arm. The device improves blood circulation, eliminates swelling. But its continuous use is not recommended, as this leads to a rapid reduction in range of motion in the shoulder.

Many specialists include taping in the complex treatment of the shoulder joint - fixing tissues with adhesive elastic bands. This helps eliminate pain, improve blood circulation and joint function.

Physiotherapy

Exercise treatment - daily performance of a set of exercises - with shoulder arthropathy is the main method of rehabilitation. Fitness groups are prescribed by a doctor, which are acquired under the supervision of an exercise therapy instructor. Once the patient begins to perform the entire set of exercises correctly, it can be done at home.

Physiotherapy

Physiotherapy is included in the complex treatment at any stage of the disease. These are electro- and phonophoresis using painkillers, lasers and magnetotherapy - stimulation of regenerative processes in the joint tissues, shock wave therapy (SWT) courses - exposure to sound, which has a strong chondroprotective effect.

Folk remedies

Folk remedies will only be of great benefit when prescribed by a doctor. Here are some of them:

• Decoction of viburnum twigs for oral administration.Pour a glass of crushed raw materials before going to bed with 500 ml of water, let it boil, keep it on low heat for 5 minutes, insist overnight, then strain and drink 100 ml 3 times a day. It is anesthetic.
• An old recipe for an anesthetic ointment from the herb wild rosemary.Take Vaseline or butter and dry the chopped grass. In an enameled dish, fold the fat base and the grass alternately to the top in layers, close the dish with a lid, cover the cracks with dough and put it in the oven (preferably in the oven) on a low heat for 2 hours. remove from the oven, cover with double gauze, store in the refrigerator and rub on the skin over the affected joint 2-3 times a day.

Surgical procedures

With the ineffectiveness of conservative treatment for shoulder arthropathy, the following surgeries are performed:

• Arthroscopic surgeriesallowing the elimination of various defects in the joint cavity. They occur mainly in young people with post-traumatic arthritis. Arthroscopy allows you to tighten and connect the biceps tendon to the bone (stretching - this will eliminate the looseness of the joint), you will remove the bone growths - the osteophytes (restoration), the restoration of the joint cavity by transplantation, etc.
• Endoprosthesis- replacement of a damaged joint that lost its function with an artificial one.

Approach to the treatment of the disease in clinics

Clinical specialists have developed their own approach to treating shoulder arthropathy. First of all, every patient is carefully examined using the most modern diagnostic equipment (including MRI). It then completely relieves the pain using pharmaceutical and non-pharmaceutical methods. At the same time, an individual complex treatment is chosen for him, which includes:

• state-of-the-art drugs and non-pharmaceutical methods, including plasmolifting.
• traditional oriental methods of treatment and restoration of the function of the joints and the whole organism as a whole. These are acupuncture, spawning, earmuffs, tape, etc.

This approach quickly relieves a person of pain and suppresses the progression of the disease. And regular preventive courses allow patients to forget about the disease and live a normal life. Numerous patient reviews talk about how effective this treatment is.

It combines tried and tested techniques of the East and innovative methods of Western medicine.

General clinical instructions

For people suffering from osteoarthritis of the shoulder, it is recommended:

• lead a healthy, mobile lifestyle, alternating physical activity and rest.
• eat right regularly.
• get rid of all bad habits.
• perform therapeutic exercises regularly, avoiding sudden movements.
• sleep on your back or on the healthy side at night, placing a small pillow under your pain.
• Avoid strenuous exercise, avoid injuries, prolonged stress and colds.
• During the flare-up (development of arthritis), avoid any thermal processes.
• follow all the recommendations of the treating physician.

Prevention

It is especially important for people with impaired heredity to follow certain rules to prevent shoulder arthropathy. They should not be involved in weightlifting, tennis, traumatic sports, working as hammers, blacksmiths, miners. Everyone who wants to have healthy joints should follow an active lifestyle and eat properly regularly.

Frequently asked questions about the disease

1. What is the pain of osteoarthritis of the shoulder?

   Pains are aches, aggravated by movement and weight lifting.

2. Why is the disease dangerous?

   The formation of permanent pain syndrome and loss of limb function.

3. Which doctor treats deforming shoulder arthropathy?

   Post-traumatic - an orthopedic-traumatologist, in the context of inflammatory diseases - a rheumatologist.

4. Is shoulder arthroplasty ruled out?

   For severe pain, yes.

5. How effective are physical therapy methods for this disease?

   Effective as part of complex therapy.

6. Is it possible to completely cure deforming shoulder arthropathy?

   No, but the doctor can suppress its progression and save the patient from pain.

Shoulder arthropathy should be treated for a long time, systematically and strictly under the supervision of a doctor. Efforts to treat this disease on their own are fraught with complications and disability. But a specialist can stop the process at any stage of the disease, save the patient from pain and significantly improve his quality of life.