Osteoarthritis of the shoulder joint (omarthrosis) is a chronic disease in which irreversible degenerative-dystrophic processes occur in the tissues of the joint. The pathology disrupts the normal functioning of the limb. The shoulder range of motion gradually decreases until immobility is complete. 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 destruction of the joint 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 osteoarthritis of the shoulder joint can be associated with various factors:
- Professional sports or intense training.
- Endocrine diseases.
- Hormonal disturbances.
- Congenital pathologies of the development of the musculoskeletal system.
- Hereditary predisposition, etc.
In most cases, secondary osteoarthritis is diagnosed - pathology occurs after exposure to the joint of one or another factor. The primary or idiopathic form of the disease is rarely recorded. In this case it is impossible to establish the exact cause of the tissue degeneration.
Shoulder Osteoarthritis Symptoms
Changes in cartilage and bone tissue begin long before the first signs of osteoarthritis appear. Joint structures have a great potential for self-healing, so pathologies are rarely diagnosed at a young age, when all metabolic processes are active enough. As the body ages, the recovery processes give way to degeneration. The first signs of destruction can appear after 40-50 years, and with a deforming type of disease, patients notice changes as early as 16-18 years.
Symptoms of shoulder osteoarthritis:
- Breakage of the joint during movement.
- Pain, especially severe after exercise.
- Stiffness of movement, expressed after sleep or a long rest.
- Increased pain during weather changes.
Degrees of osteoarthritis
The clinical classification defines three degrees of osteoarthritis of the shoulder joint:
- 1 degree. The patient complains of a slight crunch that appears during movement. Pain syndrome is absent. The discomfort is felt when the hand is brought to the extreme position.
- 2 degrees. Pain occurs when the limb is raised above shoulder level. The range of motion is reduced. After significant exertion, the patient feels pain even at rest.
- 3 degrees. Joint mobility is severely limited. The pain syndrome is almost constant.
Shoulder Joint Osteoarthritis Diagnosis
The doctor must not only correctly diagnose, but also determine the cause of the pathology. Treatment of the underlying disease significantly improves the patient's well-being and slows down the degeneration of cartilage.
Manual examination
The first stage of diagnosis is a consultation with an orthopedic traumatologist. The doctor examines the diseased joint for swelling, severe deformity. On the development side of arthrosis, 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 to make voluntary hand movements.
- Thickening of the edges of the articular surfaces (large osteophytes can be detected on palpation).
- The presence of a crunch, "click" that can be heard or felt by the hand during the movement of the shoulder.
- Jamming of the joint in the presence of free chondromic bodies.
- Pathological movements in the shoulder.
X-ray
To detect signs of arthrosis of the shoulder joint, radiography is performed in two projections, which allows you to assess the degree of narrowing of the joint space, the state 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 the joints in pregnant women and young children. According to ultrasound, the doctor determines the thickness of the cartilage, the condition of the synovial membrane. The method visualizes the osteophytes well, the enlarged lymph nodes in the periarticular space.
Magnetic resonance imaging (MRI)
The MRI machine takes pictures of consecutive sections. The images clearly show not only the joint, but also the adjacent tissues. To date, MRI is one of the most informative methods in diagnosing osteoarthritis.
Laboratory tests
As part of a comprehensive review, they name:
- 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 disease often causes secondary deforming osteoarthritis. Analysis is necessary for an accurate diagnosis.
- Blood chemistry. The data helps establish the cause of the inflammation. Biochemical analyzes are also performed to monitor complications and side effects during therapy.
Treatment of arthrosis of the shoulder joint
Therapy is long and difficult. The course of treatment includes medications, wellness procedures, a set of special exercises for arthrosis of the shoulder joint. In difficult cases, surgical intervention is indicated.
Medical therapy
Medicines and dosage are selected individually. The doctor can prescribe:
- Non-steroidal anti-inflammatory drugs (NSAIDs). Medicines reduce inflammation and pain.
- Preparations based on glucocorticosteroids. Hormone-based means have a more intense effect on the focus of pain. Drugs not only relieve the patient's condition, but also reduce inflammation, show antihistamine and immunosuppressive properties. Glucocorticosteroids are prescribed in cases where NSAIDs are not effective.
- Pain relievers. Drugs of this group are prescribed for severe pain syndrome. Depending on the severity of the symptoms, the doctor selects non-narcotic or narcotic pain relievers (rarely).
- Chondroprotectors. The active ingredients of the drugs are involved in the formation of new cartilage tissue. Regeneration of the diseased joint is accelerated, trophism improves. Chondroprotectors have a cumulative effect and have been shown to be effective in the treatment of osteoarthritis of varying severity.
Some drugs are injected directly into the joint cavity. For example, blocking has a better analgesic effect than taking medications in the form of tablets.
Physiotherapy
Courses are carried out after the removal of the exacerbation. Physiotherapy as part of complex therapy helps improve drug delivery to the diseased joint, relieve swelling and reduce pain.
For the treatment of osteoarthritis use:
- Electrophoresis.
- Phonophoresis.
- Shock wave therapy.
Physiotherapy can be combined with massage, physical therapy, therapeutic baths. It is best to undergo a series of procedures based on a specialized clinic. The doctor will draw up a treatment plan taking into account the condition of a particular patient.
Physiotherapy
Moderate physical activity is important to slow down degenerative processes. It is best to start physical 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 correctly and distribute the load so as not to cause an exacerbation of the disease. Gymnastics usually includes 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.
Surgery
The operation is performed with 3rd degree osteoarthritis, 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:
- Sting. 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 in order to determine the infectious agent or other indicators.
- Arthroscopy. With the help of microsurgical tools, the doctor examines the joint cavity, removes scar tissue, sutures the tendons of the rotator cuff or joint capsule if they are damaged. Several stings remain on the skin. The patient recovers quickly.
- Endoprosthesis. Endoprosthesis allows you to completely get rid of chronic pain, restore arm mobility. After the operation, a long rehabilitation is required (3 to 6 months).