Pain in the shoulder can occur gradually and reduce the patient's quality of life significantly. To find out why the shoulder hurts, see a doctor and undergo a complete 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 it?
Shoulder osteoarthritis is a long-term, constantly progressive metabolic-dystrophic disease that leads to gradual destruction of articular cartilage, protective growth of bone tissue with joint deformity, and loss of its function.
A wide range of arm movements is provided by the synchronous interaction between the joints of the shoulder complex:
- humeroscapular or simply humeral;
- acromioclavicular - between the collarbone and the acromial process of the scapula;
- sternoclavicular - between the sternum and the collarbone.
The shoulder joint is very mobile, which is provided by the convex head of the humerus and the relatively flat articular fossa of the scapula. The joint is strengthened by the tendons in the muscles of the upper extremities, above it is the coracoid-acromial ligament. Not for reliable reinforcement allows the joint to move in different directions, but at the same time increases the risk of injury.
The code for shoulder osteoarthritis according to the International Classification of Diseases of the 10th revision (ICD-10) is M19 (other types of osteoarthritis). Treatment of shoulder osteoarthritis should begin as early as possible. However, even advanced stages of the disease can be treated successfully.
Causes of osteoarthritis of the shoulder
The main causes of osteoarthritis of the shoulder:
- consequences of acute injuries - dislocations, subluxations, intra-articular fractures, bruising;
- permanent prolonged microtrauma associated with occupational or sports loads;
- transmitted acute and chronic infectious-inflammatory and autoimmune processes in the shoulder joint - acute purulent arthritis, chronic rheumatoid, psoriasis and other arthritis;
- on the background of a chronic inflammatory process in the periarticular tissue - humeroscapular periarthritis, leading to decreased blood circulation and nutrition of cartilage tissue;
- metabolic (exchange) articular disorders - gout;
- hormonal disorders;
- congenital malformations (dysplasia) - for example, the articular surfaces of the joints of the shoulder.
Under the influence of any of these causes (sometimes several at once), the composition and volume of the synovial fluid that feeds the cartilage tissue of the joint is disturbed. The cartilage gradually decreases in volume, cracks, loses its damping properties. This leads to damage to the bone, its growth along the edges of the articular surfaces, joint deformity and impaired function. In the joint cavity, periodic inflammation occurs in the synovial membrane - synovitis. Due to synovitis, osteoarthritis is called osteoarthritis or osteoarthritis - depending on which process prevails (inflammatory or metabolic-dystrophic). As a result of inflammation and necrosis of the bone, small pieces of tissue are separated from it - sequesters or articular mice.
In danger:
- for micro-trauma - blacksmiths, miners, tennis players, weightlifters, discus throwers;
- for acute injuries - gymnasts, athletes, circus performers;
- persons with inherited inheritance;
- people suffering from chronic joint diseases.
Shoulder osteoarthritis symptoms
The disease begins gradually, gradually. The rate of its progression depends on the cause, the patient's general condition and his heredity.
First sign
The first symptoms of osteoarthritis of the shoulder joint can not be noticed, especially if they occur on the background of an existing shoulder disease. These are minor, occur periodically, mainly after exercise, pain, discomfort during movement of the joint. Pain in the left joint can be confused with heart pain. They pass quickly, but it is worth paying attention to them.
If such symptoms recur, it is better to consult a doctor immediately, because any disease is easier to treat in the early stages.
obvious symptoms
Pain increases, after exertion does not go away immediately. Night pains occur, as well as pains associated with a change of weather. Movements in the hand become painful, they are accompanied by a characteristic crunch. In the morning, or when you stay in a certain position for a long time, stiffness of movements appears, to remove it, you need to move. The pain syndrome can be located not only in the shoulder area, but also radiate to the arm, neck and upper back.
Periodically the joint swells, a slight redness of the skin appears over it, pain intensifies, it becomes permanent. Body temperature may rise slightly. This is a sign of synovitis - aseptic (without infection) inflammation of the synovial membrane. If there are foci of infection in the body (carious 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 severely disturbed.
The combination of degenerative-dystrophic and inflammatory processes in the joint gradually leads to a 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 that signal that you urgently need to seek medical attention. This:
- the appearance of edema and redness of tissues in the joint area, fever;
- sore pain in the joint, accompanied by a change in its shape;
- joint pain radiating to the arm, neck or back;
- the previous volume of movements in the arm is impossible, even just raising it causes severe pain.
These symptoms indicate that your body needs help. Only a doctor can give it.
What is the danger of osteoarthritis of the shoulder
In the absence of medical treatment, brachial osteoarthritis is dangerous with stable progression with the development of a permanent pain syndrome, impaired limb function and various, sometimes life-threatening, complications.
Degrees of osteoarthritis of the shoulder joint
There are three degrees of osteoarthritis in the shoulder joint:
- Osteoarthritis of the shoulder joint 1 degree- preliminary phase. All symptoms show up a little and mostly after exercise. X-rays sometimes show a small narrowing of the joint space, but more often it is not. It is possible to detect small violations in the cartilage tissue at this stage only by means of magnetic resonance imaging (MRI).
- Osteoarthritis of the shoulder joint 2 degrees- progressive phase. The shoulder hurts constantly, the pain is aggravated by the movements of the arm, they give down (to the elbow, forearm, hand) or to the neck, back, under the shoulder blade. There are difficulties with the function of the limb, signs of synovitis develop periodically. On X-ray, the joint space is significantly narrowed, bone growth (osteophytes) is visible along the edges of articular surfaces, bone tissue is compressed (osteosclerosis).
- Osteoarthritis of the shoulder joint 3 degrees- advanced phase. Pain in the joint is strong, constant, with a pronounced crunch when moving 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 squeezing of nerves and blood vessels. On X-ray: the joint space is almost invisible, significant bone growth with joint deformity, severe sclerosis and necrosis of bone tissue, joint mice.
Possible complications
Any localization and form of osteoarthritis has serious complications, so you should not delay treatment.
If you do not treat the disease or treat it yourself with folk remedies, the risk of developing complications is as:
- significant deformity and limitation of articular mobility;
- dislocations, subluxations and intra-articular fractures with minor injuries or sudden movements;
- fractures of tendons around the joint of muscles and ligaments - they atrophy and tear easily;
- aseptic necrosis of the head of the humerus with complete destruction of the articulation and loss of its function;
- purulent-septic complications when an infection enters the joint cavity from other foci.
What to do with an exacerbation
Exacerbations of the pathological process are usually associated with increased stress on the limb or with the development of inflammation - synovitis. In this case, the joint hurts more, there is a slight swelling, the body temperature rises. In such cases, you should adhere to 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 diseased joint;
- tie a sore arm with a bandage scarf - this will reduce the strain;
- take an elevated position - sit down with a pillow under your back - this will reduce swelling of tissues.
Types of shoulder osteoarthritis
According to different criteria, the disease is divided into separate types.
For disease causes
In accordance with this criterion, a distinction is made between primary and secondary osteoarthritis. Primary shoulder osteoarthritis is mainly a result of age-related changes and develops after 50 years. However, sometimes the disease begins at a young age, but the cause of its occurrence can not be determined. In this case, they are talking about primary idiopathic osteoarthritis of the shoulder. An important role in its development is played by hereditary disposition: the presence of a similar disease in one of the close relatives.
Secondary osteoarthritis of the shoulder joint develops after injuries and previous illnesses, but here too the burden of heredity matters: in one person even a minor injury or acute arthritis can lead to the development of osteoarthritis, while in another more significant injuries end without consequences.
According to the functions of the current
Assign deforming osteoarthritis of the shoulder, characterized by rapid progression of bone deformities. A feature of this type of disease is a change in the shape of the joint and frequent violations of nearby blood vessels and nerves. Compression of blood vessels leads to decreased blood circulation and rapid progression of degenerative-dystrophic disorders, and compression of nerves leads to decreased sensitivity of limbs and severe pain along the peripheral nerves.
Origin
Post-traumatic osteoarthritis of the shoulder - the symptoms and treatment of this disease have their own characteristics associated with a traumatic lesion of certain articular structures. Exchange dystrophic changes occur after intra-articular fractures, dislocations, subluxations, ruptures of ligaments, tendons and simply bruises. Injuries occur by a blow to the joint or by a fall on the side with an adductor arm. Rupture of the joint capsule with dislocation usually occurs during a fall on the abducted arm.
Often, after a minor injury, a person does not notice the first signs of osteoarthritis for a long time and seeks medical attention already in the second stage of the disease. Significant injuries require long-term rehabilitation treatment, and osteoarthritis usually begins to be treated already in the early stages.
Shoulder osteoarthritis after suffering from inflammatory diseases - the symptoms and course of such pathology depend on the underlying disease. The shoulder joint is often affected by psoriatic arthritis, while osteoarthritis develops in one joint, it develops slowly but is difficult to treat. With rheumatoid arthritis, both shoulders are affected, osteoarthritis develops in waves with frequent alternation of metabolic-dystrophic and inflammatory processes.
Distribution
Only one left or right joint can be affected and then one speaks of monoarthrosis. The simultaneous defeat of two (left and right) shoulder-scapular joints is called oligoarthrosis.
Osteoarthritis of other joints in the shoulder complex
Acromioclavicular osteoarthritis - most often has a post-traumatic origin. It develops on the background of lifting weights with the hands above the horizontal. Accompanied by pain when lifting the arm. With the growth of osteophytes on the articular surfaces, impingement syndrome can occur - violation of tendons and muscles in the shoulder between the head of the humerus and acromion of the scapula during rotation and abduction of the shoulder. This accelerates the progression of osteoarthritis and the decline in hand function.
Diagnostics
Without a correct diagnosis, it is impossible to treat this disease. A full examination is only possible in the clinic. At the initial consultation, the doctor asks the patient, examines him, prescribes additional research methods and specialist consultations:
- Laboratory tests of blood, synovial fluid - inflammatory, autoimmune and degenerative-dystrophic processes are detected.
- Cast:
- radiography of the shoulder joint - changes in bone tissue are detected;
- computed tomography (CT) - changes in cartilage and bone tissue in the early stages;
- magnetic resonance imaging (MRI) - changes in the soft articular and periarticular tissue;
- diagnostic arthroscopy - performed if necessary to clarify the nature of the pathological process.
Treatment of osteoarthritis of the shoulder joint
After establishing the definitive diagnosis, a complex conservative treatment of shoulder osteoarthritis is prescribed. If conservative therapy is ineffective, surgical treatment is prescribed.
Conservative therapy
It includes pharmacological and non-pharmacological methods.
Medical care
The purpose of drug treatment is to eliminate pain and suppress the development of osteoarthritis. To alleviate the patient's condition, designate:
- Medicine from the groupnon-steroidal anti-inflammatory drugs (NSAIDs). Drugs are administered intramuscularly, orally or rectally; at the same time, drugs are prescribed by the NSAID group externally in the form of ointments, gels or creams.
- Medicine from the groupmuscle relaxants- relax the muscles around the joint; the spastic state of these muscles increases the pain;
- Pain blockswith local anesthesia.The drug solution is injected into the joint cavity or into the periarticular tissue - a rapid analgesic effect.
The course of pathogenetic (influencing the mechanisms of the disease) therapy as part of the medical treatment of shoulder osteoarthritis includes:
- Chondroprotectorsmedicinal products containing in their composition biologically active substances which restore cartilage tissue. They are prescribed orally in the form of tablets and powders, in the form of intramuscular and intra-articular injections and also externally in the form of ointments and creams.
- Angioprotectors- Agents that improve blood microcirculation. Allocate tablets for oral administration and intravenous drip solutions.
- Hyaluronic acid preparationsinserted into the articular cavity to improve the depreciation properties and prevent the destruction of bone tissue.
Vitamin-mineral complexes to enhance metabolic processes in articular and periarticular tissues.
Non-medical treatment
The basis of non-medical methods of treating shoulder osteoarthritis is a healthy active lifestyle and proper nutrition. It is very important to get rid of bad habits like smoking and alcohol abuse - they contribute to circulatory disorders and have a toxic effect on joint tissue.
Nutrition, diet
There is no special diet to treat shoulder osteoarthritis, but proper nutrition is very important in this disease. It is recommended to include in the daily diet: sea fish, shellfish, lean poultry meat, dairy products, cottage cheese, cheese, grains (oatmeal, buckwheat), vegetables, fruits.
Excluded from the diet: easily digestible carbohydrates (sweets, muffins, sweet carbonated beverages), fatty red meat, foods that irritate tissues that cause swelling - salt (too much), spicy and spicy spices.
It is recommended to give preference to cooked, stewed and steamed dishes.
Orthopedic treatment to distribute the load on the limb
To prevent shoulder injuries, it is recommended to periodically wear an elastic protective holder in the form of a short sleeve that connects to the opposite arm. The device improves blood circulation, eliminates swelling. However, it is not recommended to wear it constantly as this leads to a rapid decrease in the range of motion of the shoulder.
Many specialists include taping in the complex treatment of shoulder osteoarthritis - fixation of tissue with sticky elastic tape. This provides elimination of pain, improvement of blood circulation and joint function.
Physiotherapy
Exercise therapy - daily performance of a set of exercises - with shoulder osteoarthritis is the most important method of rehabilitation. Gymnastics complexes are prescribed by a physician, mastered under the supervision of an exercise therapy instructor. After the patient begins to perform the entire set of exercises correctly, it can be done at home.
Physiotherapy
Physiotherapy is included in the complex therapy at any stage of the disease. These are electro- and phonophoresis with the use of painkillers, laser and magnetotherapy - stimulation of regenerative processes in articular tissue, course with shock wave therapy (SWT) - sound exposure, which has a pronounced 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 branches for oral administration.Pour a glass of crushed ingredients before going to bed, with 500 ml of water, bring to a boil, keep on low heat for 5 minutes, insist all night, then sift and drink 100 ml 3 times a day. It is an anesthetic.
- An old recipe for an anesthetic ointment from the herb wild rosemary.Take Vaseline or butter and dry chopped grass. In an enamelled dish, fold alternately fat bottom and grass all the way to the top in layers, close the dish with a lid, line the cracks with dough and put in the oven (preferably in the oven) on a small fire for 2 hours, take out of the oven, strain through doublegauze, store in the refrigerator and rub into the skin over the diseased joint 2-3 times a day.
Surgical operations
With the ineffectiveness of conservative therapy for shoulder osteoarthritis, the following surgical procedures are performed:
- Arthroscopic operationsmakes it possible to eliminate various defects in the articular cavity. They are mainly performed on young people with post-traumatic osteoarthritis. Arthroscopy allows you to tighten and attach the biceps tendon to the bone (tenodesis - this will eliminate the looseness of the joint), remove bone growth - osteophytes (debridement), restore the joint cavity with a transplant, etc.
- Endoprostheticsreplacement of a damaged, lost function with an artificial one.
Approach to treatment of the disease in clinics
Clinical specialists have developed their own approach to treating shoulder osteoarthritis. First of all, each patient is carefully examined using the most modern diagnostic equipment (including MRI). Then he is completely pain relieved using drugs and non-medical methods. At the same time, an individual complex therapy is chosen for him, including:
- the most modern drugs and non-drug methods, including plasma lifting;
- traditional oriental methods of treating and restoring the function of the joints and the whole organism as a whole; these are acupuncture, moxibustion, auriculotherapy, taping, etc.
This approach quickly relieves a person of pain and suppresses the development of the disease. And regular prevention courses allow patients to forget about the disease and live a normal life. Numerous patient reviews talk about how effective this treatment is.
Combined proven techniques from the East and innovative methods in Western medicine.
General clinical guidelines
For people suffering from osteoarthritis of the shoulder, it is recommended:
- lead a healthy, mobile lifestyle, alternating physical activity and rest;
- eat really regularly;
- get rid of all bad habits;
- perform regular therapeutic exercises, avoid sudden movements;
- sleep on your back or on the healthy side at night, put a small pillow under your sore arm;
- give up heavy physical exertion, avoid injuries, prolonged stress and colds;
- during exacerbation (development of synovitis), avoid thermal procedures;
- follow all the recommendations of the attending physician.
Prevention
It is especially important for people with impaired heredity to follow certain rules for the prevention of shoulder arthritis. They should not participate in weightlifting, tennis, traumatic sports, working as hammers, blacksmiths, miners. Anyone who wants to have healthy joints should lead an active lifestyle and regularly eat right.
Frequently asked questions about the disease
- What is the pain of osteoarthritis of the shoulder?
The pain is sore, aggravated by movement and lifting of weights.
Why is the disease dangerous?
The formation of a permanent pain syndrome and loss of limb function.
Which doctor treats deforming osteoarthritis of the shoulder?
Posttraumatic - an orthopedic traumatologist, on the background of inflammatory diseases - a rheumatologist.
Has a blockade been made for osteoarthritis in the shoulder?
In severe pain, yes.
How effective are physiotherapy methods for this disease?
Effective as part of complex treatment.
Is it possible to completely cure deforming osteoarthritis of the shoulder?
No, but the doctor can suppress its development and save the patient from pain.
Shoulder osteoarthritis should be treated for a long time, systematically and strictly under the supervision of a doctor. Attempts to cope with this disease on their own are fraught with complications and disabilities. However, a qualified specialist can stop the process at any stage of the disease, save the patient from pain and significantly improve his quality of life.