The shoulder joint is one of the most vulnerable in the human skeleton. This is due to the rather complex structure of the joint with weak attachment to the scapula. The shoulder receives a great deal of stress every day when performing household or professional tasks. If an injury occurs, metabolic processes are disturbed, tissues wear out due to age, and dystrophic changes in cartilage tissue begin. This pathology is called osteoarthritis of the shoulder joint.
Depending on the manifestations and the degree of damage to the glenohumeral joint, four degrees of pathology are diagnosed. There is also a distinction between acute and chronic shoulder osteoarthritis. If treatment is not performed in time or in bad faith, the joint continues to deform and collapse, ultimately resulting in significant limitation of upper limb functions and loss of mobility.
Today, only first degree shoulder osteoarthritis can be completely cured. But this does not mean that you can give up and do nothing with pathology of grade 2 and higher. Comprehensive and adequate treatment of osteoarthritis of the shoulder joint with the help of medications or surgery helps to slow down the destruction of the joint, at least partially preserve the mobility of the arm and shoulder, and prevent disability.
Symptoms and causes
Deforming osteoarthritis of the shoulder joint does not develop in one day. At first the changes are minor. Cartilage gradually loses its elasticity under the influence of various factors; these could be age-related changes or alterations of metabolic processes in tissues. Microcracks appear on its surface in which calcium salts accumulate. It then becomes thin, brittle and begins to collapse.
Often this process is accompanied by inflammation, which also spreads to the surrounding muscle, connective and bone tissues. This manifests itself mainly as pain, at first mild, painful. They then become more intense and in advanced stages never disappear, which significantly reduces the person's performance and quality of life.
The main reasons why DOA develops in the shoulder joint are as follows:
- Disturbance of blood circulation in the cartilaginous tissues of the shoulder in atherosclerosis and other chronic diseases associated with blood vessels.
- Chronic autoimmune pathologies, for example, rheumatoid arthritis, systemic lupus erythematosus.
- Dysfunction of the endocrine system (diabetes mellitus).
- Congenital anomalies of the shoulder joint, birth injuries in babies and other injuries that cause pathological deformations and dysfunction of the limb.
- Acquired pathologies of the joint structures after an injury or accident, failed surgery, including inflammation due to arthritis, synovitis, osteoporosis, etc.
In addition, there are provoking factors, under the influence of which the risk of developing osteoarthritis of the shoulder increases several times. These include:
- professional activity in which the shoulder joint receives heavy loads day after day for many years: osteoarthritis of the shoulder is rightly called a disease of plasterers, painters and loaders;
- sedentary lifestyle, lack of physical activity: with insufficient exercise, blood circulation slows down, joint tissues do not receive the necessary amount of nutrients and begin to atrophy;
- overweight - often combined with the previous factor; with obesity, a person cannot actively move, while the joints receive additional stress due to extra pounds;
- hereditary predisposition;
- Old age: Approximately 80% of people over 70 years of age have symptoms of osteoarthritis.
Very often, when examining and interviewing a patient, the doctor identifies a combination of several diseases and provoking factors. A typical patient diagnosed with osteoarthritis of the shoulder joint is a man or woman over 50 years of age, who performs intense physical work, is overweight and has other chronic pathologies (diabetes mellitus, high blood pressure, varicose veins, knee arthritis, etc. ). In this case, injuries to the right shoulder are more common than those to the left. This is due to the fact that most people actively use their right hand at work and at home, with the exception of congenital left-handers.
How to recognize the disease.
Symptoms of osteoarthritis of the shoulder joint may not appear for a long time. If the shoulder starts to hurt from time to time, the person attributes it to fatigue, takes painkillers, uses an ointment with a warming effect and calms down. But sooner or later there comes a time when pills and ointments no longer help, the pain becomes constant, intense and bothersome at rest and at night. In addition to this symptom, the following signs will indicate dystrophic changes in the shoulder joint:
- swelling and deformation of the joint, noticeable to the naked eye;
- redness of the skin over the joint, local increase in temperature;
- Characteristic crunch in the joint. Cracking sounds when the hand moves sharply are explained by the accumulation of salts in the cracks of the cartilage and between the elements of the joint. At first, the crunching occurs only with sudden movements, it is silent and barely audible. In advanced forms of the disease, the shoulder creaks with every movement, others hear the sound;
- limitation of limb mobility. When examining a patient, the doctor will ask him to comb his hair. This test is sufficient to diagnose osteoarthritis of the shoulder joint: the patient will experience sharp pain, perform a rotational movement of the shoulder, it will be difficult for him to move the shoulder back, the doctor will hear crunches and clicking sounds in the joint.
DOA of the shoulder must be treated; Otherwise, over time the patient will lose complete upper limb mobility and performance. If the process of destruction of cartilage and surrounding tissues has already begun, it will not stop on its own. Proper nutrition, folk remedies, a healthy lifestyle and exercise are not enough here. To cope with the problem and prevent disability, complex treatment will be necessary through the use of medications of various effects and physical procedures.
Degrees
There are several stages of DOA of the shoulder joint, each of them manifests differently and requires a different treatment approach.
- 1st grade.At this stage, the disease is just beginning to develop and the changes in the cartilage tissue are even minor. The main symptoms of grade 1 DOA are joint and limb weakness and periodic persistent pain. The pain appears after physical exertion, during monotonous and repeated hand movements for a long time. After a night's sleep or a long period of rest, a person feels stiffness in the shoulder joint, but as it develops, the stiffness still goes away without medications and physical procedures; a slight warm-up is sufficient. If an x-ray is taken at this stage, the image will not show significant changes in the joint structures, although thinning and deformation of the cartilage may be noted.
- 2nd grade.The pathological process progresses and manifests itself more actively. A person already gets used to the fact that his shoulder hurts after work, he "waits" for the pain, he has analgesics and ointments for joint pain, pharmacy or homemade, ready. X-ray diagnosis will show noticeable changes in the joint: thinning and deformation of the cartilage, inflammation of the joint membrane. From time to time, the joint becomes red and swollen, creaking, squeaking and clicking sounds are heard when moving.
- Grade 3.The shoulder joint constantly hurts and creaks, to reduce the discomfort the person tries not to touch it and not move the limb at all. The deformity is noticeable visually; The affected shoulder differs in size and shape from the healthy shoulder, often becoming red and swollen, which is accompanied by increased pain. It is not possible to eliminate them with painkillers.
If nothing is done at the third stage of the disease, the fourth stage will occur - complete immobility of the shoulder joint and limb. In this case, prescribing medications and physiotherapy no longer makes sense, only endoprosthetic surgery will help to at least partially restore the functionality of the hand. But even this is not always successful.
On a note:In medical practice, it is extremely rare to encounter grade 3 shoulder osteoarthritis. Typically, the patient seeks medical help earlier and begins treatment. Severe cartilage destruction can occur against the background of extensive trauma, if for some reason the patient was unable to consult a doctor, or if the person lives in disadvantaged social conditions where qualified doctors are not available.
How is osteoarthritis diagnosed and treated?
A good doctor will be able to make a preliminary diagnosis after talking with the patient and conducting an external examination. Instrumental diagnostic methods are more necessary to exclude other pathologies and complications or to identify them. To accurately determine the severity of joint involvement and whether inflammation occurs, the following diagnostic measures are performed:
- bone scan;
- computed tomography;
- Magnetic resonance imaging;
- in some cases, ultrasound to obtain a complete picture of the condition of the joint;
- Clinical analyzes of urine and blood: the number of leukocytes and the erythrocyte sedimentation rate will be evaluated. If they are too high, an inflammatory process develops in the body.
The best way to treat pathology is determined by the doctor individually, taking into account the age, occupation and general condition of the patient.
Traditional treatment involves the use of the following methods and means:
- A course of therapy with nonsteroidal anti-inflammatory drugs. Medicines are prescribed in the form of tablets or powders for oral administration or in the form of ointments for external use to eliminate the main symptoms of inflammation: pain, swelling, redness and increased body temperature.
- Anesthetics for severe pain in the form of tablets or injections. These drugs cannot be taken continuously, they do not eliminate the cause of the disease and are intended only for extreme cases when the pain is unbearable.
- A course of chondroprotectors - drugs that promote the restoration of cartilage tissue and prevent further destruction. They also partially relieve pain, swelling and deformation of the shoulder joint. These medications do not work right away; They should be taken for at least 3 to 4 months.
- A course of muscle relaxants: tablets or injections that relax muscle spasms. These are optional drugs in the complex treatment of osteoarthritis and are not always prescribed.
- A course of taking vitamin and mineral complexes and dietary supplements with collagen and hyaluronic acid.
To increase the effectiveness of treatment, rapid recovery and prevention of new injuries, special therapeutic nutrition is also prescribed. The patient's diet includes foods rich in vitamins B, A, C, E: fresh fruits and vegetables, cabbage of any variety, cereals, legumes. Polyunsaturated fatty acids can be obtained from fish and shellfish. A gelatin diet is practiced, since gelatin helps restore the elasticity of cartilage tissue. The menu includes jellied meat made from beef hooves and tails, gelatin and various jellies. It is useful to take pure gelatin, previously soaked in warm water.
Physiotherapy is the next important point in the complex treatment of shoulder osteoarthritis. They start only when the inflammatory process stops. Depending on the degree of the disease, its dynamics and the effectiveness of drug treatment, the doctor selects a combination of the following physical procedures:
- cryotherapy;
- acupuncture;
- electrophoresis;
- laser therapy;
- magnetic therapy;
- mud therapy;
- massages of various types;
- physiotherapy.
Physiotherapy procedures are aimed at activating metabolic processes in joint tissues, normalizing blood circulation and restoring mobility of the limbs. With its help, it is possible to reduce the number of medications taken and their dosage, which is especially valuable if the pathology is observed in a teenager, an elderly person or a nursing woman.
Helpful Tip:Treatment of grade 1-2 injuries of the shoulder joint is possible at home, with the additional use of folk remedies. The main thing is that the patient does not forget to take medications in a timely manner and does not skip physical procedures; The effect will be noticeable and long-lasting only if all the doctor's prescriptions are regularly and conscientiously followed.
If conservative treatment is ineffective, the doctor is forced to offer the patient surgery. The remains of the destroyed joint will be removed and a prosthesis will be implanted in its place. Such an intervention is not uncommon, but requires highly qualified doctors, precision and attention at every stage. In addition, prostheses do not always take root well and the recovery period after surgery lasts at least six months. Therefore, if you notice that your shoulder begins to hurt, pull, go numb regularly or hear a crunch when moving, do not postpone visiting the doctor, get examined in a timely manner and, if necessary, start treatment.
Osteoarthritis of the shoulder joint is a fairly common pathology of the musculoskeletal system and occurs mainly in people over 50 years of age. Pathology develops gradually, little by little, under the influence of unfavorable factors, the joint structures begin to collapse, which is manifested by pain, swelling and stiffness of the joint. In the early stages, the progression of the disease can be stopped with the help of comprehensive treatment: medications, vitamin supplements, diet therapy and physiotherapy. Advanced osteoarthritis can only be treated surgically.