Shoulder arthropathy is a widespread chronic disease associated with damage to joint structures. The pathological process is accompanied by degenerative deformation of the articular surfaces. In this case, not only the cartilage tissue is destroyed, but also the bone tissue. Symptoms of the pathology and treatment methods depend on the degree of damage to the joints.
The disease can develop for several years without appearing. At some point, under the influence of adverse factors (hypothermia, trauma, serious concomitant disease), the first signs of the disease appear. At this time it is necessary to consult a doctor, since the fight against dystrophic changes in the cartilage is especially effective at the onset of the disease.
Causes of shoulder joint
The causes of degenerative-dystrophic damage to joint tissues are numerous and varied. Among them, injuries play the main role, so post-traumatic arthropathy of the shoulder joint is considered the most common form of pathology. It can be caused even by a slight, but repeatedly repeated damage to cartilaginous tissues.
In addition, the disease can appear under the influence of the following pathological factors:
- Severe joint damage: arthritis, gout, acute or chronic arthritis, aseptic necrosis of the humerus.
- Regular overstrain of the joints. It is more often observed in athletes who play volleyball, tennis, basketball.
- Congenital pathology of the shoulder joint.
- Endocrine diseases.
- Old age and senility.
- Excess weight (obesity).
- Devitaminosis.
- Autoimmune damage and weakening of the immune system.
- genetic predisposition.
Most of the patients are people engaged in monotonous physical work. Therefore, arthropathy 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 the causes that caused it.
Characteristic signs of the disease
Shoulder arthropathy, which begins imperceptibly and develops gradually, can appear suddenly after injury, hypothermia or severe physical exertion. In this case, there are symptoms that characterize damage to the shoulder joints and nearby tissues:
- pain;
- creaking and clicking when moving the hand.
- stiffness and reduced range of motion in the shoulder.
The disease occurs more often in a chronic form. An exacerbation of the disease can be caused by excessive pressure on the joint or injury.
The intensity of the manifestation of symptoms largely depends on the severity of damage to the cartilage and bone tissue, so it is common to distinguish between several degrees of the disease. Such systematization greatly facilitates the diagnosis and allows you to accurately predict the outcome of the disease.
Shoulder arthropathy grade I
During this period, the tissues of the joint are slightly affected. Pain is observed extremely rarely and only after excessive physical exertion or prolonged monotonous work. The patient most often does not pay attention to these symptoms, attributing them to excessive work or muscle strain. Defeat of 1 degree is treated only with conservative methods.
At the beginning of the disease, there are no obvious changes in the cartilage tissues on X-rays, only an oval ring is noted around the joint cavity.
Grade II shoulder arthropathy
At this stage, the symptoms of the disease become more intense. Cartilage tissues become thinner and deformed, inter-articular ligaments are destroyed. During the movement of the hand, a tingling is heard, the inner layer of the joint bag becomes inflamed. Over time, the pain becomes constant. Morning stiffness and limited movement occur, which can lead to muscle atrophy.
Grade III shoulder arthropathy
During this period, the joint is already significantly deformed, there are practically no movements in it. The patient suffers from acute pain that may radiate to the arm and shoulder blade. If you do not stop the further destruction of tissues, the pathological process can lead to disability.
Third-degree disease is not amenable to conservative treatment and requires surgery.
Shoulder-shoulder arthropathy rarely reaches stage three. Most often, the second stage is diagnosed with the transition to a chronic form.
Which doctor should I contact?
Often, people experiencing joint pain do not know who to turn to. At the first symptoms of the disease, you should visit a rheumatologist. The specialist will not only perform 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.
With the advanced form of the disease, the rheumatologist is likely to be powerless. In this case, you will need a surgeon or orthopedist. In the big cities, you can make an appointment with an arthrologist who only deals with joint diseases.
How to treat shoulder arthritis
After a medical examination and diagnosis, the doctor prescribes a specific treatment that allows you to achieve a long and stable remission of the disease. It is impossible to cure degenerative changes in the joints, but slowing down the course of the destructive process and alleviating the patient's condition is a completely feasible task.
The main goal of anti-arthrosis treatment 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 severe and does not force patients to seek help from specialists. Most often they are treated independently with folk remedies. Some patients participate in therapeutic exercises to reduce joint pain and stiffness. For the treatment of arthropathy, drugs prescribed by a doctor are used, according to the recommended dosage and duration of administration. The most effective are the following groups of drugs:
- 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, the drugs are taken orally, used externally, injected intramuscularly or into the cavity of the shoulder joint.
Non-steroidal anti-inflammatory drugs (NSAIDs)
NSAIDs are contraindicated for long-term use due to the presence of side effects from the digestive system.
It is possible to treat the disease with drugs already at an early stage of the development of the pathological process. The course is determined based on the patient's condition and the severity of the symptoms. As an independent treatment, ointments included in this group are not prescribed. They are used in combination with similar groups of drugs that are used intramuscularly or orally. Their task is to reduce inflammation and alleviate the patient's condition.
Carboprotectors
Almost all patients include in the treatment regimen drugs aimed at improving the metabolic processes in the cartilage tissue. In addition, they increase the elasticity of the cartilage. Chondroprotectants 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.
Formulations for monotherapy have been more proven in the market compared to a combination of substances.
The polysaccharide contained in the intercellular space is hyaluronic acid. It is additionally able to reduce the sensitivity of receptors that respond to pain. Combined chondroprotectants, which contain several active ingredients, have the greatest advantage.
The most effective use of chondroprotectors in the early stages of the disease. The task of the drugs is the synthesis of new cells of healthy cartilage tissue, which replace the damaged tissue. In the presence of pain and swelling, drugs of this group will be less effective. Therefore, it will first be necessary to use anti-inflammatory drugs to relieve the patient's condition.
To achieve the maximum effect, injectable preparations are used for intra-articular or intramuscular administration. The course of treatment with chondroprotectors lasts up to six months, some patients notice the first results after 3 months of treatment. It is important to follow certain rules in the treatment of such drugs.
At the beginning of the course of treatment, physical overload, stressful situations should be excluded. The patient will get the greatest result if he starts taking chondroprotectors, improves nutrition and participates in physiotherapy exercises. Many patients with arthropathy of the shoulder joint engage in Dr. Bubnovsky's method, perform a specially designed set of exercises to achieve gradual restoration of the joints or stop the progression of the disease.
Corticosteroid agents
When severe pain occurs, if anti-inflammatory drugs do not have a positive effect, corticosteroids are prescribed. To alleviate the patient's condition, ointments or injections are prescribed.
Analgesics
In the initial stages of the disease, analgesics are prescribed to reduce pain.
Compared to non-steroidal anti-inflammatory drugs, drugs of this group have a less negative effect on the mucous membrane of the digestive tract.
Having an inexpressible anti-inflammatory effect, they effectively combat pain.
Vasodilators
Mandatory means in the treatment of arthropathy are vasodilators. They eliminate vascular spasms, normalize blood flow in the affected area. Many patients complain of the occurrence of night pains, which are effectively treated with drugs of this group.
Muscle relaxants
When osteoarthritis of the shoulder joint is affected, muscle spasms are considered a common occurrence, which are 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 treatment is ineffective, persistent pain syndrome persists, the joint is gradually deformed and the range of motion in it is severely limited, the patient is indicated for surgery.
The decision on the need for surgery is made by the orthopedist or traumatologist together with the patient. 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, at a weight close to that of a natural joint. The durability and reliability of stents is undeniable.
Recovery period
Surgery to replace the affected joint usually goes without complications. A support bandage is required for the first 14 days. Early passive performance of a complex of physical exercises on special devices and devices is allowed. Power loads are allowed after 45-60 days.
Physiotherapy
Any complex of anti-arthritis exercises is only useful during remission. If there is an increase in temperature, pain and other symptoms of an exacerbation of the disease, loading is contraindicated.
Exercise therapy should not cause pain or discomfort. At the slightest sensation of discomfort, the exercise should be abandoned.
Charging must be done daily. After the load, it is useful to self-massage the area of the affected joint and nearby muscles, using a healing cream, which the attending physician will help you choose.
Physiotherapy
Physiotherapy allows you to enhance the effect of drugs, reduce their dosage and minimize the risk of complications. The type of physical therapy is determined by the doctor, based on the patient's condition, neglect of the procedure and possible contraindications due to accompanying diseases.
Most often, the following physiotherapy procedures are used in the treatment:
- magnetotherapy?
- ultrasound with hydrocortisone;
- electrophoresis with anti-inflammatory and analgesic substances.
- ultraviolet radiation
- laser and infrared therapy.
Physiotherapy is carried out in courses of 10-15 sessions several times a year.
Treatment with folk methods
By combining folk remedies with drug therapy, exercise therapy, proper nutrition and physiotherapy, you can achieve a long and stable remission.
One of the best recipes is a compress with birch leaves, which have anti-inflammatory and warming effects. Young leaves are better suited, because closer to autumn their beneficial properties decrease. Before making a compress, a small massage on the affected limb is necessary. Then the leaves are applied to the skin, reinforced with a film and a bandage. The compress is left overnight. The duration of treatment is 10 days.
Salt baths have a therapeutic effect. Before the process, the crystals are predissolved in hot water. Then the resulting solution is poured into the bath. The process will require about 3 kg of salt. In addition, you can add a few drops of any essential oil. It is best to take a bath before going to bed, the duration of the bath should not exceed 30 minutes.
Warm oatmeal compress helps a lot. They must be poured with boiling water, insisted and used for their intended purpose. Such procedures are recommended to be done at night.
No less useful herbal poultices. Crushed plants with anti-inflammatory action (yarrow, ginger, turmeric, cinquefoil, calamus) are prepared with boiling water, kept for 10 minutes under a lid and applied to a sore spot. After the procedure, the affected shoulder should be smeared with a healing cream and go to sleep.
Internally it is recommended to take an infusion of corn spots. A teaspoon of raw materials or 1 filter bag is prepared with 200 ml of boiling water, insisted under the lid for 30 minutes and consumed 1 tablespoon. spoon half an hour before meals.
Prevention of osteoarthritis of the shoulder joint
Prevention of the disease can be primary and secondary. Primary prevention includes the following activities:
- regular exercise - jogging or brisk walking, exercises for the muscles of the shoulder girdle.
- cold and hot shower;
- eliminating excessive loads and avoiding traumatic situations.
- timely treatment of diseases that can cause shoulder arthrosis.
Secondary prevention aims at early diagnosis and treatment of arthritis.
conclusion
Restoring joint functions is a long and difficult process. The treatment of shoulder arthropathy should be aimed mainly at eliminating the symptoms of the disease. Only complex treatment, combining medical and folk methods, will bring relief and restore the ability to work.