Osteoarthritis of the shoulder joint (omarthrosis) is a chronic disease in which irreversible degenerative-dystrophic processes occur in the joint tissues. The pathology disrupts the normal functioning of the limb. The range of motion of the shoulder is gradually reduced to complete immobility. Osteoarthritis of the shoulder joint causes severe pain and reduces quality of life. In the absence of treatment, disability occurs.
To stop the processes of destruction of the joint and to maintain the mobility of the shoulder joint, it is necessary to contact an orthopedic traumatologist after the first symptoms.
Causes of osteoarthritis of the shoulder joint
The disease is polyetiological. The development of deformed arthrosis of the shoulder joint can be related to various factors:
- Professional sports or intense training.
- Endocrine diseases.
- Hormonal disorders.
- Congenital pathologies of the development of the musculoskeletal system.
- Hereditary predisposition and a. Sh.
In most cases, secondary arthrosis is diagnosed: the pathology occurs after exposure to this or that factor in the joint. The primary, or idiopathic, form of the disease is rarely reported. In this case it is impossible to determine the exact cause of tissue degeneration.
Symptoms of shoulder osteoarthritis
Cartilage and bone tissue changes begin long before the first signs of osteoarthritis appear. Joint structures have great potential for self-healing, so the diagnosis of pathologies rarely occurs at a young age, when all metabolic processes are quite active. The recovery processes with the aging of the body leave the way for degeneration. The first signs of destruction may appear after 40-50 years, and in the case of deformed type of disease, patients notice changes already at the age of 16-18 years.
Symptoms of shoulder osteoarthritis:
- Fracture of the joint during movement.
- Pain, especially after strenuous exercise.
- Strength of movement, expressed after sleep or prolonged rest.
- Increased pain during weather change.
Degree of arthrosis
The clinical classification defines three degrees of osteoarthritis of the shoulder joint:
- 1 degree. The patient complains of a slight convulsion that occurs during movement. There is no pain syndrome. Discomfort is felt when moving the hand in an extreme position.
- 2 degrees. The pain occurs when the limb is raised to shoulder level. The range of motion decreases. After a significant load, the patient feels pain even at rest.
- 3 degrees. Fund mobility is severely limited. The pain syndrome is almost permanent.
Diagnosis of osteoarthritis of the shoulder joint
The doctor needs not only a correct diagnosis, but also to determine the cause of the pathology. Treatment of the underlying disease significantly improves patient well-being and slows cartilage degeneration.
Manual examination
The first stage of diagnosis is to consult an orthopedic traumatologist. The doctor examines the diseased joint for swelling, severe deformity. With the development of osteoarthritis, the muscles can become partially atrophied - this can be seen even with the naked eye.
By manual examination, the doctor evaluates the function of the joint according to several criteria:
- Ability to voluntarily move the hand.
- Thickening of the edges of the joint surfaces (large osteophytes can be detected by palpation).
- Existence of a seizure, a "click" that is heard or felt during hand-to-shoulder movement.
- Joint stretching in the presence of free chondromatic bodies.
- Abnormal movements of the shoulder.
Radiography
To show signs of osteoarthritis of the shoulder joint, radiography 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 (Ultrasound)
A non-invasive method that allows you to examine joints in pregnant women and young children. According to the sonography, the doctor determines the thickness of the cartilage, the condition of the synovial membrane. The method well reflects osteophytes, enlarged lymph nodes in the periarticular space.
Magnetic resonance imaging (MRI)
The MRI machine takes pictures of sequential sections. The pictures clearly show not only the joint but also the surrounding tissues. Magnetic resonance imaging is one of the most informative methods in the diagnosis of osteoarthritis today.
Laboratory tests
As part of a comprehensive review, they mean:
- General blood test. Based on the results, the doctor can judge the presence and severity of the inflammatory process. The analysis also helps to assess the general state of health.
- Urine analysis. Kidney pathologies often lead to secondary deformed arthrosis. Analysis is necessary for an accurate diagnosis.
- Blood chemistry. The data help to determine the cause of inflammation. Biochemical tests are also performed to monitor complications and side effects during therapy.
Treatment of osteoarthritis of the shoulder joint
Therapy is long and difficult. The course of treatment includes medication, wellness procedures, a set of special exercises for osteoarthritis of the shoulder joint. In difficult cases, surgical intervention is indicated.
Medical therapy
Medications and dosage are selected individually. Your doctor may prescribe:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Medications reduce inflammation and pain.
- Glucocorticosteroid drugs. Hormone-based remedies have a more intense effect on the pain focus. Medications not only alleviate the patient's condition, but also reduce inflammation, exhibit antihistamine and immunosuppressive properties. Glucocorticosteroids are prescribed in cases where nonsteroidal anti-inflammatory drugs are not effective.
- Painkillers. Medications in this group are prescribed for severe pain syndrome. Depending on the severity of the symptoms, the doctor chooses non-narcotic or narcotic (rarely) analgesics.
- Chondroprotectors. The active ingredients of the drug are involved in the formation of new cartilage tissue. The regeneration of the diseased joint is accelerated, the trophism improves. Chondroprotectors have a cumulative effect and have proven themselves in the treatment of osteoarthritis of varying severity.
Some drugs are injected directly into the joint cavity. For example, blockade has a better analgesic effect than taking the drug in tablet form.
Physiotherapy
Courses are conducted after the aggravation is removed. Physiotherapy, as part of complex therapy, facilitates the transport of drugs into the diseased joint, relieves swelling, and reduces pain.
Use to treat osteoarthritis:
- Electrophoresis.
- Phonophoresis.
- Shock wave therapy.
Physiotherapy can be combined with massage, exercise therapy, healing baths. It is best to undergo a set of procedures based on a specialized clinic. The physician will develop a treatment plan based on the specific patient's condition.
Physiotherapy
Moderate physical activity is important for slowing down degenerative processes. Exercise therapy for osteoarthritis of the shoulder is best done at a medical center, under the supervision of a physician. The specialist selects the exercises, teaches them to perform and load correctly so as not to aggravate the disease. Gymnastics usually involves warm-ups, stretching, and strength training. Exercises are held at least 3 times a week.
After a course with a specialist, patients can perform shoulder joint osteoarthritis treatment exercises at home.
Surgery
Surgery is performed with grade 3 arthrosis, 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 reduces pressure, reduces swelling, increases joint movement. The procedure is minimally invasive, so it is performed on an outpatient basis. Material obtained during the puncture is sent for examination to determine the infectious agent or other indicators.
- Arthroscopy. With the help of microsurgical instruments, the doctor examines the joint cavity, removes scar tissue, and sutures the tendons or joint capsule sutures if they are damaged. Several punctures remain on the skin. The patient recovers quickly.
- Endoprosthesis. Endoprosthesis allows you to completely eliminate chronic pain, restore hand movement. Prolonged (3 to 6 months) rehabilitation is required after surgery.