Osteoarthritis of the shoulder joint (omarthrosis) is a chronic disease in which an irreversible degenerative-dystrophic process occurs in the joint tissue. Pathology interferes with the normal functioning of the limbs. The range of shoulder movement is gradually reduced to complete immobility. Osteoarthritis of the shoulder joint causes severe pain and reduces quality of life. If left untreated, disability occurs.
To stop the process of joint destruction 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 deformed arthrosis of the shoulder joint can be attributed to various factors:
- Professional sports or intense training.
- Endocrine diseases.
- Hormonal disorders.
- Congenital pathology of the development of the musculoskeletal system.
- Hereditary tendencies, etc.
In most cases, secondary arthrosis is diagnosed: the pathology occurs after exposure to one joint or another factor. Rarely register the primary or idiopathic form of the disease. It is not possible to determine the exact cause of tissue degeneration in this case.
Symptoms of shoulder osteoarthritis
Changes in cartilage and bone tissue begin long before the first signs of arthrosis appear. Articular structures have great potential for self -healing, so pathology is rarely diagnosed at a young age, when all metabolic processes are quite active. As the body ages, the recovery process gives way to degeneration. The first signs of destruction may appear after 40-50 years, and with this type of disease changing form, patients see changes as early as 16-18 years.
Symptoms of shoulder osteoarthritis:
- Cracked joints during movement.
- Pain, especially severe after exercise.
- Stiffness of movement, expressed after sleep or prolonged rest.
- Increased pain during weather changes.
Stages of arthrosis
The clinical classification defines three degrees of arthrosis of the shoulder joint:
- 1 degree. The patient complained of a slight dryness that appeared during movement. Pain syndrome was not present. Discomfort is felt when the hand is taken to an extreme position.
- 2 degrees. Pain occurs when the limb is raised above shoulder level. The range of motion is reduced. After doing significant exercise, the patient feels pain even at rest.
- 3 degrees. Joint mobility is very limited. The pain syndrome is almost constant.
Diagnosis of osteoarthritis of the shoulder joint
Doctors not only need to correctly diagnose, but also to determine the cause of the pathology. Treatment of the underlying disease significantly improves patient well -being and slows cartilage degeneration.
Manual inspection
The first stage of diagnosis is consultation with an orthopedic traumatologist. Doctors examine diseased joints for swollen, severe deformities. 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 assesses joint function according to several criteria:
- Ability to perform voluntary hand movements.
- Thickening of the edges of the articular surface (large osteophytes can be detected by palpation).
- The presence of a hug, a "click" that can be heard or felt by the hand during shoulder movements.
- Joint congestion in the presence of an independent chondromic body.
- Pathological movements in the shoulder.
Radiography
To detect signs of shoulder joint arthrosis, radiography is performed in two projections, allowing you to assess the degree of joint space narrowing, bone surface condition, size and number of osteophytes, presence of fluid, and surrounding tissue inflammation.
Ultrasound examination
A non-invasive method that allows you to examine the joints in pregnant women and children. According to the sonogram, the doctor determines the thickness of the cartilage, the condition of the synovial membrane. This method describes osteophytes, enlarged lymph nodes in the periarticular space.
Magnetic resonance imaging (MRI)
The MRI machine takes pictures of successive sections. The image clearly shows not only the joint, but also the adjacent tissue. To date, magnetic resonance imaging is one of the most informative methods in the diagnosis of arthrosis.
Lab test
As part of the comprehensive examination, they appoint:
- General blood analysis. Based on the results, the doctor can assess the presence and severity of inflammatory processes. The analysis also helps assess the general state of health.
- Urine analysis. Renal pathology often causes secondary deformed arthrosis. Analysis is required for an accurate diagnosis.
- Blood chemistry. The data help to determine the cause of inflammation. Biochemical analysis was also performed to monitor for 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, medical procedures, a set of special exercises for arthrosis of the shoulder joint. In difficult cases, surgical intervention is indicated.
Medical therapy
Medications and doses are selected individually. The doctor may prescribe:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Medications reduce inflammation and pain.
- Glucocorticosteroid supplies. Hormone -based means have a more intense effect on pain concentration. The drug not only relieves the patient's condition, but also reduces inflammation, exhibiting antihistamine and immunosuppressive properties. Glucocorticosteroids are prescribed in cases where NSAIDs are ineffective.
- Painkillers. Drugs of this group are prescribed for severe pain syndrome. Depending on the severity of symptoms, doctors choose non -narcotic or narcotic analgesics (rare).
- Chondroprotectors. The active ingredient of the drug is involved in the formation of new cartilage tissue. Regeneration of diseased joints is accelerated, trophism is improved. 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, restriction has a better analgesic effect than taking medication in tablet form.
Physiotherapy
The course is carried out after the removal of exacerbations. Physiotherapy as part of complex therapy helps improve drug transport to diseased joints, relieve swelling, and reduce pain.
For the treatment of arthrosis use:
- Electrophoresis.
- Phonophoresis.
- Shock wave therapy.
Physiotherapy can be combined with massage, exercise therapy, therapeutic baths. It is better to undergo a set of procedures based on a specialized clinic. The doctor will make a treatment plan taking into account the specific patient's condition.
Physiotherapy
Moderate physical activity is important to slow down the degenerative process. It is best to start exercise therapy for arthrosis of the shoulder joint in a medical center, under the supervision of a doctor. Specialists will select exercises, teach them how to perform them properly and distribute the load so as not to cause the disease to worsen. Gymnastics usually includes warm -ups, stretching and strength training. Exercise is done at least 3 times a week.
After a course with a specialist, patients can do therapeutic exercises for arthrosis of the shoulder joint at home.
Surgery
Surgery is performed with stage 3 arthrosis, when the disease no longer allows the patient to move normally, causing severe pain, and 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 stress, reduces swelling, increases joint mobility. This procedure is minimally invasive, so it is performed on an outpatient basis. Material obtained during puncture is sent for research to determine infectious agents or other indicators.
- Arthroscopy. With the help of microsurgery instruments, the doctor examines the joint cavity, removes scar tissue, performs suturing of the rotator cuff tendon or joint capsule if it is damaged. Some punctures remain on the skin. The patient recovered quickly.
- Endoprosthetics. Endoprosthetics allow you to completely eliminate chronic pain, restoring arm mobility. After surgery, a long recovery (from 3 to 6 months) is required.