Osteoarthritis of the shoulder joint (omarthrosis) is a chronic disease in which an irreversible degenerative-dystrophic process occurs in the joint tissues. Pathology interferes with the normal functioning of the limbs. The range of motion of the shoulder gradually decreases until complete immobility. Osteoarthritis of the shoulder joint causes severe pain and reduces quality of life. In the absence of treatment, disability occurs.
In order to stop the process of destruction of the joint 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
This disease is polyetiological. The development of deforming arthrosis of the shoulder joint can be associated with various factors:
- Professional sports or intensive training.
- Endocrine disease.
- Hormonal disorders.
- Congenital pathology of the development of the musculoskeletal system.
- Hereditary predisposition, etc.
In most cases, secondary arthrosis is diagnosed: the pathology occurs after exposure to the joint from one factor or another. It is rare to register a primary or idiopathic form of the disease. It is impossible to determine the exact cause of the 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 can appear after 40-50 years, and with a deformed type of disease, patients notice changes as early as 16-18 years.
Symptoms of shoulder osteoarthritis:
- Joint cracks when moving.
- Pain, especially severe after exercise.
- Stiffness of movement, expressed after sleep or long rest.
- Increased pain during weather changes.
Arthrosis degree
The clinical classification defines three degrees of arthrosis of the shoulder joint:
- 1 degree. The patient complains of a slight crunch that occurs during movement. No pain syndrome. Discomfort is felt when the hand is brought to an extreme position.
- 2 degrees. Pain occurs when the limb is raised above shoulder level. Decreased range of motion. After significant activity, the patient feels pain even at rest.
- 3 degrees. Joint mobility is very limited. Pain syndrome is almost constant.
Diagnosis of shoulder joint osteoarthritis
Doctors need not only to correctly diagnose, but also to determine the cause of the pathology. Treatment of the underlying disease significantly improves the patient's well-being and slows down cartilage degeneration.
Manual check
The first stage of diagnosis is a consultation with an orthopedic traumatologist. The doctor examines the diseased joint for swelling, severe deformity. From the point of view of the development of arthrosis, some muscles can atrophy - this can be seen with the naked eye.
With a manual examination, the doctor evaluates joint function based on several criteria:
- Ability to make voluntary hand movements.
- Thickening of the edges of the articular surfaces (large osteophytes can be detected by palpation).
- There is a crunch, a "click" that the hand can hear or feel during shoulder movement.
- Joint congestion in the presence of free chondromic bodies.
- Pathological movements in the shoulder.
radiography
To detect signs of arthrosis of the shoulder joint, a radiograph is performed in two projections, which allows you to assess the degree of narrowing of the joint space, the condition of the bone surfaces, the size and number of osteophytes, the presence of fluid and inflammation of the surrounding tissues.
Ultrasound examination (USG)
A non-invasive method that allows you to examine the joints in pregnant women and young children. According to the sonogram, the doctor determines the thickness of the cartilage, the condition of the synovial membrane. This method well visualizes 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 tissues. To date, magnetic resonance imaging is one of the most informative methods in the diagnosis of arthrosis.
Laboratory test
As part of a comprehensive examination, they designate:
- General blood analysis. Based on the results, the doctor can assess the presence and severity of the inflammatory process. This analysis also helps assess the general state of health.
- Urine analysis. Renal pathology often leads to secondary deforming arthrosis. Analysis is required for an accurate diagnosis.
- Blood chemistry. The data help determine the cause of inflammation. Biochemical analysis is also performed to monitor 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 series of special exercises for arthrosis of the shoulder joint. In difficult cases, surgical intervention is indicated.
Medical therapy
The drug and dosage are selected individually. The doctor may prescribe:
- Non-steroidal anti-inflammatory drugs (NSAIDs). Medications reduce inflammation and pain.
- Glucocorticosteroid preparations. Means based on hormones have a more intense effect on the focus of pain. The drugs not only relieve the patient's condition, but also reduce inflammation, exhibit antihistamine and immunosuppressive properties. Glucocorticosteroids are prescribed in cases where NSAIDs are ineffective.
- Painkillers. Drugs from this group are prescribed for severe pain syndrome. Depending on the severity of symptoms, doctors choose non-narcotic or narcotic analgesics (rarely).
- Chondroprotector. The active ingredients of the drug are involved in the formation of new cartilage tissue. The regeneration of diseased joints is accelerated, trophism increases. Chondroprotectors have a cumulative effect and have proven themselves in the treatment of arthrosis of varying severity.
Some medications are injected directly into the joint cavity. For example, blockade has a better analgesic effect than taking the drug in tablet form.
Physiotherapy
The course is carried out after the elimination of the exacerbation. Physiotherapy as part of complex therapy helps to improve the transport of drugs to the painful joints, relieve swelling, and reduce pain.
For the treatment of arthrosis use:
- electrophoresis.
- Phonophoresis.
- Shockwave therapy.
Physiotherapy can be combined with massage, exercise therapy, therapeutic baths. It is best to undergo a series of procedures based on a special clinic. The doctor will make a treatment plan taking into account the condition of the particular patient.
Physiotherapy
Moderate physical activity is important to slow down the degenerative process. It is better to start exercise therapy for arthrosis of the shoulder joint in a medical center, under the supervision of a doctor. The specialist will select exercises, teach them how to perform them correctly and distribute the load so as not to cause an exacerbation of the disease. Gymnastics usually includes warm-up, stretching, and strength training. Exercise is done at least 3 times a week.
After a course with a specialist, the patient can perform therapeutic exercises for arthrosis of the shoulder joint at home.
Surgery
The operation is carried out with arthrosis of the 3rd degree, when the disease no longer allows the patient to move normally, causes severe pain, and the 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 relieves pressure, reduces swelling, increases joint mobility. This procedure is minimally invasive, so it is performed on an outpatient basis. The material obtained during the puncture is sent for research to determine the infectious agent or other indicators.
- arthroscopy. With the help of microsurgical instruments, the doctor examines the joint cavity, removes scar tissue, performs sutures on the rotator cuff tendon or joint capsule if damaged. Some punctures remain in the skin. The patient recovered quickly.
- Endoprosthetics. Endoprosthetics allow you to completely eliminate chronic pain, restore the mobility of the arm. After surgery, a long (from 3 to 6 months) rehabilitation is required.