Shoulder arthrosis is a widespread chronic disease associated with damage to joint structures. The pathological process is accompanied by degenerative deformation of the articulation surfaces. In this case, not only the cartilage tissue is damaged, but also the bone tissue. Pathology symptoms and treatment methods depend on the degree of joint damage.
The disease can develop for several years without showing itself. At some point, under the influence of unfavorable factors (hypothermia, trauma, severe concomitant disease), the first signs of the disease appear. It is at this time that it is necessary to consult a doctor, since it is especially effective to fight dystrophic changes of the cartilage at the beginning of the disease.
Causes of shoulder arthrosis
The causes of degenerative-dystrophic joint tissue damage are numerous and diverse. Among them, injuries play the main role, so post-traumatic arthrosis of the shoulder joint is considered the most common form of pathology. It can be provoked even by minor, but repeatedly repeated damage to cartilage tissues.
In addition, the disease can occur under the influence of the following pathological factors:
- Severe joint damage: synovitis, gout, acute or chronic arthritis, aseptic necrosis of the humerus.
- Regular reloading of funds. It is most often observed in athletes involved in volleyball, tennis, basketball.
- Congenital shoulder joint pathology.
- Endocrine diseases.
- Old people and old people.
- Overweight (obesity).
- Avitaminosis.
- Autoimmune injuries and weakening of the immune system.
- genetic predisposition.
Most of the patients are people engaged in monotonous physical work. Therefore, arthrosis of the right shoulder joint is diagnosed much more often than the left.
The disease usually develops under the influence of not one, but several adverse factors at the same time. Based on this, the treatment should be comprehensive and aimed not only at fighting the disease, but also at eliminating all its causes.
characteristic signs of the disease
Shoulder arthrosis, which starts unnoticed and develops gradually, can appear suddenly after trauma, hypothermia or serious physical exertion. In this case, symptoms characteristic of damage to the shoulder joints and surrounding tissues are revealed:
- pain
- Cramping and clicking during hand movement;
- Stiffness and decreased range of motion in the shoulder.
The disease most often occurs in a chronic form. Exacerbation of the disease can be caused by excessive stress or damage to the joint.
The intensity of symptoms largely depends on the severity of cartilage and bone tissue damage, so it is common to distinguish between several degrees of the disease. Such systematization greatly facilitates the diagnosis and allows you to accurately determine the outcome of the disease.
Shoulder arthrosis of the first degree
During this period, joint tissues are slightly damaged. Pain is observed extremely rarely and only after excessive physical exertion or long monotonous work. The patient most often does not pay attention to these symptoms, attributing them to overwork or muscle strain. Defeat of the 1st degree is treated only by conservative methods.
At the beginning of the disease, no obvious changes in cartilage tissue are observed on X-rays, only an oval ring is observed around the joint cavity.
Shoulder arthrosis of the II degree
At this stage, the symptoms of the disease are more pronounced. Cartilage tissues are thinned and deformed, intra-articular ligaments are damaged. Cramping is heard during hand movement, the inner layer of the joint bag is inflamed. Over time, the pain becomes constant. There is morning stiffness and limited movement, which can lead to muscle atrophy.
Shoulder arthrosis of the III degree
During this period, the joint is already significantly deformed, there are practically no movements in it. The patient suffers from acute pain that may spread to the arm and shoulder blade. If you do not stop further tissue destruction, the pathological process can lead to disability.
Third-degree disease is not amenable to conservative treatment and requires surgical intervention.
Shoulder-shoulder arthrosis rarely reaches the third phase. Most often, the second stage is diagnosed with the transition to the chronic form.
Which doctor should I contact?
Often people who suffer from joint pain do not know who to turn to. You should consult a rheumatologist at the first symptoms of the disease. The specialist will not only conduct a complete physical examination and make a diagnosis, but also, if necessary, relieve severe pain with the help of an intra-articular injection of anesthetic.
In the advanced form of the disease, the rheumatologist is probably powerless. In this case, you will need a surgeon or orthopedist. In big cities, you can appoint an arthrologist who deals only with joint diseases.
How to deal with shoulder arthritis
After medical examination and diagnosis, the doctor will prescribe a specific therapy that allows you to achieve long-term and stable remission of the disease. Degenerative changes in the joints cannot be cured, but slowing down the destructive process and alleviating the patient's condition is a completely feasible task.
The main goal of antiarthrosis therapy is to relieve pain and restore joint mobility.
Modern drug therapy
In some patients, it is difficult to make an accurate diagnosis in the early stages of the disease. At this stage, the pain is not expressed and does not force patients to refer to specialists. Most often, they are treated independently with folk remedies. Some patients do therapeutic exercises to reduce joint pain and stiffness. Medicines prescribed by a doctor are used for the treatment of arthrosis, observing the recommended dosage and duration of administration. The following groups of drugs are most effective:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors;
- Corticosteroid drugs;
- non-narcotic analgesics;
- vasodilators;
- Muscle relaxants.
Many drugs for this pathology are sometimes prescribed for a long time. Depending on the severity of the disease, drugs are taken orally, used externally, intramuscularly or in the cavity of the shoulder joint.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs are contraindicated for long-term use due to the presence of side effects from the digestive tract.
Treatment of the disease with drugs is already possible at the early stage of the development of the pathological process. The course is determined according to the patient's condition and severity of symptoms. As an independent treatment, ointments included in this group are not prescribed. They are used together with similar groups of drugs that are used intramuscularly or orally. Their task is to reduce inflammation and alleviate the patient's condition.
Chondroprotectors
Almost all patients include in the treatment regimen drugs aimed at improving the metabolic processes of cartilage tissue. In addition, they increase the elasticity of the cartilage. Chondroprotectors have such properties. These medicinal substances differ according to the main active ingredient on the basis of which they are prepared:
- hyaluronic acid;
- chondroitin sulfate;
- glucosamine;
- Combined Funds.
Glucosamine is a substance that plays an important role in the formation of healthy cartilage tissue. Chondroitin sulfate's job is to nourish and cushion the shoulder.
Monotherapy drugs have proven themselves better in the market compared to the combination of substances.
The polysaccharide in the intercellular space is hyaluronic acid. It can additionally reduce the sensitivity of receptors that respond to pain. Combined chondroprotectors, which contain several active ingredients, have the greatest advantage.
The most effective use of chondroprotectors in the initial stages of the disease. The task of the drugs is to synthesize new cells of healthy cartilage tissue that replace the damaged tissue. In the presence of pain and swelling, drugs of this group will be less effective. Therefore, to relieve the patient's condition, it will be necessary to use anti-inflammatory drugs first.
To achieve the maximum effect, injectable drugs are used for intra-articular or intramuscular administration. The course of treatment with chondroprotectors takes up to six months, some patients notice the first results after 3 months of therapy. It is important to follow certain rules when treating such drugs.
At the beginning of the course of therapy, physical overload, stressful situations should be excluded. The patient will get the greatest effect if he starts taking chondroprotectors, improves nutrition and engages in physical therapy exercises. Many patients with arthrosis of the shoulder joint are engaged in the method of Dr. Bubnovsky, they perform a specially designed set of exercises to achieve a gradual restoration of the joints or to stop the progression of the disease.
Corticosteroid agents
When severe pain is detected, if anti-inflammatory drugs do not have a positive effect, corticosteroids are prescribed. Ointments or injections are prescribed to alleviate the patient's condition.
Analgesics
Analgesics are prescribed to reduce pain in the initial stage of the disease.
Compared to non-steroidal anti-inflammatory drugs, drugs of this group have a less negative effect on the mucous membrane of the digestive tract.
With a pronounced anti-inflammatory effect, they effectively fight pain.
Vasodilators
Vasodilators are a mandatory tool for the treatment of arthrosis. They eliminate vascular spasms, normalize blood flow in the affected area. Many patients complain of the occurrence of night pains, which are effectively combated by drugs of this group.
Muscle relaxants
When osteoarthritis of the shoulder joint is affected, muscle spasm is considered a common occurrence, which is relieved by muscle relaxants. When prescribing them, the principle of complexity is observed, they are used together with painkillers and anti-inflammatory drugs. If necessary, the minimum dose is initially prescribed with a gradual increase.
surgical treatment
The main goal of the operation is to restore the working capacity of the joint and improve the patient's quality of life. If conservative therapy is ineffective, constant pain syndrome continues, the joint is gradually deformed and the range of motion is sharply limited, the patient is indicated for surgical intervention.
The orthopedist or traumatologist together with the patient decides on the need for surgery. Then the dimensions of the endoprosthesis and the material from which it will be made are determined. Today, implants are made of titanium and high-strength polymers, close in weight to the natural joint. The durability and reliability of endoprostheses is beyond doubt.
recovery period
Surgery to replace the damaged joint is most often performed without complications. Fixation with a support bandage is required for the first 14 days. Early passive performance of a complex of physical exercises on special equipment and devices is allowed. Power loading is allowed after 45-60 days.
Physiotherapy
Any complex of anti-arthritis exercises is useful only during remission. If there is an increase in temperature, pain and other symptoms of exacerbation of the disease, charging is contraindicated.
Exercise therapy should not cause pain or discomfort. If you feel the slightest discomfort, you should stop exercising.
Charging should be done daily. After exercise, it is useful to do self-massage in the area of the injured joint and surrounding muscles using a healing cream, which the attending physician will help you choose.
Physiotherapy
Physiotherapy allows you to enhance the effect of medications, reduce their dosage and minimize the risk of complications. The type of physiotherapy is determined by the doctor, guided by the patient's condition, neglect of the process and possible contraindications due to concomitant diseases.
Most often, the following physiotherapeutic procedures are used in the treatment:
- magnetotherapy;
- Ultrasound with hydrocortisone;
- electrophoresis with anti-inflammatory and analgesic substances;
- Ultraviolet radiation
- Treatment with laser and infrared rays.
Physiotherapy is carried out several times a year in courses of 10-15 sessions.
Treatment with folk methods
Along with drug therapy of folk remedies, exercise therapy, proper nutrition and physical therapy, you can achieve a long and stable remission.
One of the best recipes is a compress using birch leaves, which has an anti-inflammatory and warming effect. Young leaves are best suited, because closer to autumn, their beneficial properties decrease. Before making a compress, it is necessary to massage the affected limb a little. Then the leaves are applied to the skin, fixed with cling film and a bandage. Compress remains overnight. Duration of treatment is 10 days.
Salt baths have a healing effect. Before the procedure, the crystals are pre-dissolved in hot water. Then the resulting solution is poured into the bath. About 3 kg of salt is needed for the procedure. In addition, you can add a few drops of any essential oil. It is better to wash before going to bed, the duration of the bath should not exceed 30 minutes.
A hot oat compress helps a lot. They should be poured into boiling water, insisted and used as intended. It is recommended to carry out such procedures at night.
Herbal decoctions are no less useful. Crushed anti-inflammatory plants (yarrow, ginger, turmeric, cynicus, calamus) are boiled in boiling water, kept for 10 minutes under a cap and applied to the painful area. After the procedure, you should apply a healing cream to the affected shoulder and go to sleep.
Inside, it is recommended to take an infusion of corn stigma. One teaspoon of raw material or 1 filter bag is boiled in 200 ml of boiling water, boiled under the lid for 30 minutes and taken 1 tbsp. spoon half an hour before meals.
Prevention of shoulder joint osteoarthritis
Disease prevention can be primary and secondary. Primary prevention includes the following activities:
- Regular exercise - jogging or brisk walking, exercises for shoulder girdle muscles;
- cold and hot shower;
- Elimination of excessive loads and avoidance of traumatic situations.
- timely treatment of diseases that can provoke shoulder arthrosis;
Secondary prevention aims at early diagnosis and treatment of arthritis.
conclusion
Restoring joint functions is a long and difficult process. Treatment of arthrosis of the shoulder should first of all be aimed at eliminating the symptoms of the disease. Only complex therapy, which combines medical and folk methods, will bring relief and restore working capacity.