One-third of people over sixty years old have pain in the shoulder joint. The cause of pain in this area in most cases is the development of arthritis. The disease also affects young people whose profession involves constant heavy physical activity - miners, masons, stevedores, etc. v.
This disease causes many inconveniences in daily life and greatly reduces working capacity. In severe cases, shoulder arthritis can lead to disability. It is important to identify the disease in its early stages. There are now treatments that help stop the progression of the disease when treatment is started promptly.
What is pathology?
Shoulder arthritis is a chronic disease in which degenerative processes destroy and thin the cartilage. Shoulder osteoarthritis is classified as a group of non-infectious diseases. First, the cartilage tissue covering the joint surface is destroyed.
Cartilage loses strength and elasticity. It gradually thins and flattens. Due to changes in the cartilage layer, it loses its ability to absorb shock. The ability to reduce shock loads that occur during arm flexion or extension is impaired.
Osteoarthritis also affects all structures, such as the joint capsule, its shell, the bone surface adjacent to the cartilage, ligaments and adjacent muscles. This is accompanied by pathological changes in other soft tissues located near the joint. The consequence of the disease is the growth of bone on the joint surface.
Pathology is manifested by pain and crunching in the affected shoulder area. In the later stages of the disease, the range of motion of the shoulder joint is sharply reduced. Inflammation in it by the nature of this process is either absent or weakly expressed. The pathology has a chronic, gradually progressive course.
reason
A series of pathological changes in osteoarthritis is triggered by the natural aging of tissues. Cartilage damage due to strong mechanical stress can contribute to cartilage destruction. This is also facilitated by various pathological processes.
Primary shoulder arthritis is often diagnosed in older adults. Secondary joint damage develops against the background of previous diseases. It happens at all ages. The main causes of the disease are considered:
- Developmental abnormalities. The pathology is often found in patients with underdevelopment of the humeral head or glenoid cavity, as well as the presence of other defects of the upper extremity.
- Injury. Traumatic arthritis often develops after a fracture in a joint. Sometimes the cause is shoulder dislocation, usually due to habit. Sometimes, severe bruises provoke the development of pathology.
- Inflammation. Arthritis often occurs when patients have inflammation around the glenoid joint for a long time. This is also facilitated by previous nonspecific purulent arthritis, as well as specific joint lesions arising from tuberculosis, syphilis and other diseases.
There is a group of risk factors that contribute to the occurrence of such a multifactorial disease. The following phenomena increase the likelihood of developing joint disease:
- Genetic predisposition. Relatives of many patients also suffer from joint disease. They also have lesions with other local sites. Typically the knees, ankles and other joints are affected.
- Overvoltage. It commonly occurs in athletes participating in volleyball, tennis, basketball, and throwing sports equipment. This condition also occurs in people if their occupation is characterized by constant high loads on the upper limbs (porters, miners and others).
- Diseases. Osteoarthritis often develops in patients with autoimmune joint diseases. Certain endocrine diseases, metabolic disorders and connective tissue deterioration, characterized by excessive joint mobility, also contribute to degenerative processes in cartilage.
The rate of degenerative joint damage in patients increases sharply with age. Frequent hypothermia also negatively affects the joints.
Symptom
At the beginning of the disease, patients with arthritis experience moderate discomfort and pain in the shoulder area. The pain depends on the weather. They become more intense after physical activity. Pain increases in a certain body position. After resting or changing positions, the pain will disappear.
When the patient moves his hand, there will be a crunching feeling. There are no external changes in the joint, no swelling. Over time, the pain becomes more intense. It constantly bothers the patient, regardless of body position. The pain is pulling or aching in nature.
Shoulder pain becomes habitual and constant. Pain occurs both during exercise and at rest. They may disturb the patient at night. Characteristic features of pain syndrome in osteoarthritis of the joints are as follows:
- along with the appearance of pain over time, sharp pain occurs during physical activity;
- Discomfort is noted only in the joint area, it spreads to the elbow area and can then spread to the entire surface of the arm;
- The pain may radiate to the back and neck on the affected side.
After a short time, the patient felt uncomfortable with morning stiffness in the shoulder. Active range of motion in the joint is reduced. After physical activity, as well as hypothermia, slight swelling of the soft tissues in the shoulder area is detected.
As joint damage progresses, an increase in the range of motion limitation is observed. Patients experience contractures (stiffness), which significantly impairs limb function. If osteoarthritis is on the right side, the person cannot take care of themselves.
Stages of development
With this disease, there are three stages of the pathological process in the joints. They reflect the severity of damage to joint structures and the presence of certain symptoms of damage to the shoulder joint. Experts distinguish the following stages of the pathological process:
- Firstly. No overall structural changes in cartilage tissue thickness were noted. The composition of the fluid in the joints changes. Cartilage nutrition is disrupted. He tolerates stress poorly, which leads to periodic pain.
- Monday. At this stage, thinning of cartilage tissue occurs. Its structure is changing. The surface becomes rough. Cysts form in the thickness of the cartilage layer and calcifications appear. The bony areas adjacent to the joint are moderately deformed. The edges of the joint base are covered with bony growths. The discomfort becomes constant.
- The third day. A marked degree of thinning of the cartilage and disruption of its structure is noted. Areas of extensive cartilage destruction are identified. A significant deformation of the joint base was found. Limitations of range of motion are revealed. There is weakness of the ligaments, as well as a decrease in the size and tenderness of the muscles around the joint.
This approach to the classification of damage to the shoulder joint allows the doctor to choose the appropriate treatment tactic, taking into account the severity of the pathological process.
Diagnose
The appearance of arthritis symptoms forces the patient to see a doctor. He needs to see a therapist. The specialist will conduct an initial diagnosis. After determining the cause of joint damage, the doctor will refer the patient to a rheumatologist, endocrinologist, surgeon or orthopedic-traumatologist.
Doctors make a diagnosis when there are typical clinical manifestations and X-ray signs of joint disease. During the initial examination, the tissues of the joint will be palpated to determine the level of pain.
The ability to perform active and passive movements in the affected area is being studied. The doctor detects deformation of the joint or an increase in its volume. To confirm the presence of arthritis, the following studies are recommended:
- X-ray. The presence of dystrophic changes in the cartilage layer is detected in the joint. Characteristic bony growths are identified along the edges of the joint cavity. In the later stages, they noticed that the common space was shrinking. A change in the shape and structure of the bone adjacent to the cartilage is determined. The shape of the joint space becomes wedge-shaped. In the thickness of the bones, signs of osteoporosis and the presence of cyst-like formations can be seen.
- CT scan. This study of the early stages of the disease provides the opportunity to evaluate the condition of bone and cartilage using layer-by-layer imaging.
- Magnetic resonance imaging. Method for assessing the condition of soft tissue formation (cartilage, ligaments, joint capsule, etc. ). Clear images of each layer help determine the extent of damage to joint and peri-articular structures.
- supersonic. Changes in the joints are detected using ultrasound. This method is safe for the body because there is no harmful radiation.
- arthroscopy. It is performed using an endoscope. A manipulator with a camera attached is inserted into the joint. The doctor clearly sees the damaged areas. Soft areas in the thickness of the cartilage are identified. It shows the presence of deep cracks penetrating deep into the subchondral plate of the bone. Detect deep cartilage ulcers, surface erosions and cracks.
Diagnosing shoulder osteoarthritis in the later stages does not pose any difficulty for doctors. When assessing the nature of joint damage, it is necessary to take into account the possible secondary origin of joint pathology compared to other diseases.
Treatment
Osteoarthritis treatment is performed by orthopedic traumatologists or rheumatologists. At the motor rehabilitation stage, rehabilitation specialists are actively involved in the treatment process.
To relieve pain and restore function in cases of limb arthritis, it is important to receive prompt medical care and follow all your doctor's orders. It is necessary to limit the load on the joints and avoid sudden hand movements. It is important to avoid lifting or carrying heavy objects for long periods of time.
The joint needs a measured load under the supervision of specialists, since complete inactivity has a negative effect on the affected limb. Treatment options include conservative therapy and surgical intervention. The choice of method depends on the prevalence of certain symptoms and the stage of the disease.
Treatment with medication
The important goal in treating joint disease is to eliminate pain. To eliminate discomfort and reduce the severity of inflammation, the following drugs are prescribed:
- Prepare for general anesthesia. Nonsteroidal drugs are prescribed to patients for short periods during exacerbations. With uncontrolled prolonged use, they will irritate the stomach lining and slow down the recovery process in the joints.
- On-site remedies. Gels and ointments containing nonsteroidal anti-inflammatory compounds are used when symptoms increase. Topical hormonal drugs are less commonly used. They reduce inflammation and swelling.
- Means of intra-articular injection. For persistent and severe pain that cannot be eliminated by other means, glucocorticoid drugs are injected into the joint. Blockades can be carried out no more than four times a year.
In the first and second stages, chondroprotective drugs are prescribed to restore and strengthen the joints. These products contain chondroitin sulfate, hyaluronic acid and glucosamine. They are used in courses of six months or more in length. The therapeutic effect only becomes apparent after three months of continuous use of the drug.
Additionally, vasodilators are used for shoulder arthritis. They increase blood flow and reduce capillary constriction. Muscle relaxants are prescribed to relax the muscles in the shoulder area when spasms are detected.
Surgical method
In the third stage of arthritis, when there is significant joint destruction, limited mobility and loss of ability to work, arthroscopic surgery is performed. Before deciding whether to perform an intervention, age, physical activity level and general health are all taken into account.
The installation of modern prostheses made of ceramic, plastic and metal completely restores joint function. The devices have a guaranteed lifespan of more than fifteen years.
Non-drug treatment
Physiotherapy techniques are actively used during the exacerbation phase of osteoarthritis treatment. The use of their course gives good results when included in a complex therapy program. For arthritis, the following physiotherapy methods are used:
- amplified pulse. The treatment method acts locally on the joint using alternating current. It relieves pain and has a vasodilating effect. The procedure improves tissue nutrition.
- UHF. Joints are exposed to extremely high frequency waves. The method reduces pain, inflammation and swelling.
- Magnetic field therapy. Joint structures are affected by pulsed magnetic fields. It improves blood flow. Cartilage is saturated with nutrients. Magnets remove decomposition products from cells. It suppresses autoimmune reactions.
- Electrophoresis. This technique promotes the penetration of the drug into the affected joint, which is ensured by the action of electric current on the tissue. During treatment, blood flow to joint structures increases. The procedure reduces inflammation and swelling. The feeling of discomfort in the hands is reduced. Muscle spasms are eliminated.
- Treatment with nourishing oils. Radon therapeutic baths, salt water and other beneficial solutions are actively used for shoulder arthritis. Blood flow is improved, which enhances nutrition and speeds up cell recovery. Inflammation is reduced.
- Electrical stimulation. With this method of treatment, electrical stimulation of the nerves and muscles is carried out using electrodes that transmit an electric current with certain parameters.
Massage therapy is performed after the exacerbation has subsided. It restores blood flow and increases the elasticity of ligaments. Muscle spasms in joints are reduced. Range of motion increases. For arthritis, exercise therapy is very helpful.
The gymnastic complex is performed when the pain subsides. When conducting mechanotherapy, special simulators are used for rehabilitation. Active-passive movements are performed on them. They restore the function of the affected joint.
How to treat at home?
Laser therapy is considered an effective method in treating shoulder joint disease. The laser beam has a beneficial effect on the affected joint tissue. The devices produce low-intensity infrared laser beams used for therapy. Laser therapy is prescribed to speed up cellular metabolism.
All physicochemical reactions are stimulated in the tissue. The functions of cartilage cells are activated. Laser treatment provides pain relief. Blood flow is improved and swelling is eliminated. Local immunity is enhanced. The storage capillaries expand. Laser therapy has an anti-inflammatory effect.
To receive the procedure, you do not need to constantly visit a medical facility. Treatment of shoulder arthrosis at home is performed using handheld laser therapy devices. With regular use, pain reduces. The function of the shoulder joint is improved thanks to laser arthritis treatment at home.
Prognosis and prevention
Shoulder arthritis cannot be completely cured. But it is possible to slow down the progression of pathological changes in the joints. With regular treatment, the ability to work is maintained. It is important to follow your doctor's recommendations.
It is necessary to prevent injury to the hands. It is important to avoid excessive impact on the shoulder joint when performing professional tasks as well as when playing sports. It is necessary to promptly treat diseases that contribute to the development of arthritis.