Osteoarthritis of the shoulder joint (omarthrosis) is a chronic disease in which irreversible degenerative-dystrophic processes occur in the tissues of the joint. Pathology disrupts the normal functioning of the extremities. The range of motion of the shoulders is gradually reduced to complete immobility. Osteoarthritis of the shoulder joint causes severe pain and reduces the quality of life. In the absence of treatment, disability occurs.
To stop the processes of joint destruction and maintain the mobility of the shoulder joint, it is necessary to contact an orthopedic traumatologist after the first symptoms appear.
Causes of osteoarthritis of the shoulder joint
The disease is polyetiological. The development of deforming arthrosis of the shoulder joint can be associated with various factors:
- Professional sports or intensive training.
- Endocrine diseases.
- Hormonal disorders.
- Congenital pathologies of the development of the musculoskeletal system.
- Hereditary predisposition, etc.
In most cases, secondary arthrosis is diagnosed: the pathology occurs after exposure of the joint to one or another factor. The primary or idiopathic form of the disease is rarely registered. In this case, it is impossible to determine the exact cause of tissue degeneration.
Symptoms of osteoarthritis of the shoulder
Changes in cartilage and bone tissue begin long before the first signs of osteoarthritis appear. Joint structures have great potential for self-healing, so pathologies are rarely diagnosed at a young age, when all metabolic processes are quite active. As the body ages, recovery processes give way to degeneration. The first signs of destruction can appear after 40-50 years, and in the deforming type of disease, patients notice changes as early as 16-18 years.
Symptoms of osteoarthritis of the shoulder:
- Cracking of the wrist during movement.
- Pain, especially strong after exercise.
- Stiffness of movement, expressed after sleep or prolonged rest.
- Increased pain during weather changes.
Degrees of arthrosis
The clinical classification defines three degrees of arthrosis of the shoulder joint:
- 1 degree. The patient complains of a slight creaking that occurs during movement. The pain syndrome is absent. Discomfort is felt when the hand is brought to an extreme position.
- 2nd degree. Pain occurs when the limb is raised above shoulder level. The range of motion is reduced. After significant effort, the patient feels pain even at rest.
- 3 degrees. Joint mobility is severely limited. The pain syndrome is almost constant.
Diagnosis of osteoarthritis of the shoulder joint
The doctor should not only correctly diagnose, but also determine the cause of the pathology. Treatment of the underlying disease significantly improves the patient's condition and slows down cartilage degeneration.
Manual inspection
The first phase of the diagnosis is a consultation with an orthopedic traumatologist. The doctor examines the diseased joint for swelling, severe deformity. On the side of the development of arthrosis, the muscles can partially atrophy - this can be seen with the naked eye.
With a manual examination, the doctor evaluates the function of the joint according to several criteria:
- Ability of voluntary hand movements.
- Thickening of the edges of the joint surfaces (large osteophytes can be detected by palpation).
- The presence of crunches, "clicks" that can be heard or felt by the hand during shoulder movements.
- Joint jamming in the presence of free chondromic bodies.
- Pathological movements in the shoulder.
Radiography
To detect 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 bone surfaces, the size and number of osteophytes, the presence of fluid, and inflammation of surrounding tissues.
Ultrasound examination (ultrasound)
A non-invasive method that allows you to examine the joints in pregnant women and young children. On the basis of ultrasound, the doctor determines the thickness of the cartilage, the condition of the synovial membrane. The method visualizes osteophytes, enlarged lymph nodes in the periarticular space.
Magnetic resonance imaging (MRI)
The MRI machine captures images of successive sections. The images clearly show not only the joint but also the adjacent tissues. To date, magnetic resonance imaging is one of the most informative methods in the diagnosis of osteoarthritis.
Laboratory tests
As part of the comprehensive review, they determine:
- General blood test. Based on the results, the doctor can assess the presence and severity of the inflammatory process. The analysis also helps to assess general health.
- Urine analysis. Kidney pathologies often cause secondary deforming arthrosis. Analysis is necessary for an accurate diagnosis.
- Blood chemistry. The data help determine the cause of inflammation. Biochemical analyzes are also performed to monitor complications and side effects during therapy.
Treatment of osteoarthritis of the shoulder joint
The 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 severe cases, surgical intervention is indicated.
Medical therapy
Drugs and dosage are chosen individually. The doctor may prescribe:
- Non-steroidal anti-inflammatory drugs (NSAIDs). Medications reduce inflammation and pain.
- Glucocorticosteroid preparations. Hormone-based products have a more intense effect on the focus of pain. The drugs not only alleviate the patient's condition, but also reduce inflammation, show antihistamine and immunosuppressive properties. Glucocorticosteroids are prescribed in cases where NSAIDs are not effective.
- Painkillers. Drugs of 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. It accelerates the regeneration of the diseased joint, improves trophism. Chondroprotectors have a cumulative effect and have been proven 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 medication in pill form.
Physiotherapy
Courses are conducted after the exacerbation is removed. Physiotherapy as part of a complex therapy helps to improve the transport of drugs to the diseased joint, relieve swelling and reduce pain.
To treat osteoarthritis use:
- Electrophoresis.
- Phonophoresis.
- Shock wave therapy.
Physiotherapy can be combined with massage, exercise therapy, therapeutic baths. It is best to undergo a series of procedures at a specialized clinic. The doctor will make a treatment plan taking into account the condition of a particular patient.
Physiotherapy
Moderate physical activity is important for slowing down degenerative processes. It is better to start exercise therapy for osteoarthritis of the shoulder joint in a medical center, under the supervision of a doctor. The specialist will select the exercises, teach them how to perform them properly and distribute the load so that the disease does not get worse. Gymnastics usually involves warming up, stretching and strength training. Exercises are performed at least 3 times a week.
After a course with a specialist, patients can perform therapeutic exercises for osteoarthritis of the shoulder joint at home.
Operation
The operation is performed for arthrosis of the 3rd degree, 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 mobility. The procedure is minimally invasive, so it is performed on an outpatient basis. The material obtained during the puncture is sent for research 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 of the rotator cuff or the joint capsule if they are damaged. A few stings remain on the skin. The patient recovers quickly.
- Endoprosthetics. Endoprosthetics allows you to completely get rid of chronic pain, restore arm mobility. After surgery, a long (3 to 6 months) rehabilitation is required.