Shoulder arthrosis is a widespread chronic disease associated with damage to articular structures. The pathological process is accompanied by degenerative deformation of the articulating surfaces. In this case, not only cartilage tissue is damaged, but also bone tissue. Pathology symptoms and treatment methods depend on the degree of joint damage.
The disease can develop for several years without appearing. At some point, under the influence of negative factors (hypothermia, trauma, serious concomitant diseases), the first signs of the disease appear. It is at this time that it is necessary to consult a doctor, since the fight against dystrophic changes in the cartilage is especially effective at the beginning of the disease.
Causes of shoulder arthrosis
The causes of degenerative-dystrophic joint tissue damage are many and varied. 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 also be provoked by a slight but repeatedly repeated injury to cartilage tissue.
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 joint over strain. It is most often observed in athletes involved in volleyball, tennis, basketball.
- Congenital pathology of shoulder joints.
- Endocrine diseases.
- Elderly and old age.
- Overweight (obesity).
- Avitaminosis.
- Autoimmune lesions and weakening of the immune system.
- genetic predisposition.
Most of the sick 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 negative factors at the same time. Based on this, the treatment should be comprehensive and aim not only to fight the disease, but also to eliminate all the causes that have caused it.
Characteristic signs of the disease
Shoulder arthrosis, which begins imperceptibly and develops gradually, can appear suddenly after an injury, hypothermia or a severe physical strain. In this case, there are characteristic symptoms of damage to the shoulder joints and nearby tissues:
- pain;
- crackling and clicking when moving the hand;
- stiffness and reduced range of motion in the shoulder.
The disease most often appears in a chronic form. An aggravation of the disease can be caused by excessive stress on the joint or injury.
The intensity of the manifestation of symptoms depends mainly 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 significantly facilitates the diagnosis and allows you to accurately predict the outcome of the disease.
Shoulder arthrosis grade I
During this period, the joint tissues are slightly affected. Pain is observed extremely rarely and only after excessive physical strain or prolonged monotonous work. The patient most often does not pay attention to these symptoms, attributing them to overwork or muscle strain. Loss of 1 degree is treated only with conservative methods.
At the beginning of the disease, there are no visible changes in cartilage tissue on X-rays, only an oval ring around the articular cavity is observed.
Shoulder arthrosis grade II
At this stage, the symptoms of the disease become more pronounced. Cartilage tissues become thinner and deformed, intra-articular ligaments are damaged. During the movement of the hand, a crack is heard, the inner layer of the joint bag becomes inflamed. Over time, the pain becomes constant. Morning stiffness and limited movement appear, which can lead to muscle atrophy.
Shoulder arthrosis grade III
During this period, the joint is already significantly deformed, there is practically no movement in it. The patient suffers from acute pain that may radiate 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.
Osteoarthritis of the shoulder rarely reaches the third stage. Most often, the second stage is diagnosed with the transition to a chronic form.
Which doctor to contact?
Often, people dealing with 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 an 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 big cities, you can make an appointment with an arthrologist who deals only with joint diseases.
How to deal with shoulder arthritis
After a medical examination and diagnosis, the doctor prescribes a specific therapy 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 easing the patient's condition is a completely feasible task.
The main goal of anti-arthrosis 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 pronounced and does not force patients to seek help from specialists. Most often they are treated independently with folk remedies. Some patients engage in therapeutic exercises to reduce joint pain and stiffness. For the treatment of arthrosis, drugs prescribed by the doctor are used, in accordance with the recommended dose and duration of administration. The following groups of drugs are most effective:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors;
- corticosteroid drugs;
- non-narcotic analgesic;
- vasodilators;
- muscle relaxants.
Many drugs for this pathology are sometimes prescribed for a long time. Depending on the severity of the disease, medications are taken orally, used externally, injected intramuscularly or into the cavity of the shoulder joint.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs are contraindicated for long-term use due to the presence of side effects from the digestive tract.
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 severity of symptoms. As an independent treatment, the ointments included in this group are not prescribed. They are used in combination with similar groups of drugs used intramuscularly or orally. Their task is to reduce inflammation and relieve the patient's condition.
Chondroprotectors
Almost all patients include in the treatment regimen drugs aimed at improving metabolic processes in cartilage tissue. In addition, they increase the elasticity of the cartilage. Chondroprotectors have such properties. These medicinal substances differ depending on the main active ingredient on the basis of which they are made:
- 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 soothe the shoulder.
Preparations for monotherapy have proven themselves more on the market compared to a combination of substances.
The polysaccharide found in the intercellular space is hyaluronic acid. It is also able to 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 the synthesis of new cells of healthy cartilage tissue, which replace the damaged tissue. In the presence of pain and swelling, drugs from this group will be less effective. Therefore, it will first be necessary to use anti-inflammatory drugs to alleviate the patient's condition.
To obtain 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 therapy. It is important to follow certain rules in the treatment of such medicines.
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 physiotherapy exercises. Many patients with arthrosis of the shoulder joints are engaged in the method of Dr. Bubnovsky, they perform a set of exercises specially designed to achieve gradual restoration of the joints or to stop the progression of the disease.
Corticosteroid agents
When severe pain occurs, if anti-inflammatory drugs do not bring 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 mucosa of the digestive tract.
Having an inexpressible anti-inflammatory effect, they effectively fight pain.
Vasodilators
Mandatory tools in the treatment of arthrosis 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 respected, 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 objective 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, a persistent pain syndrome persists, the joint is gradually deformed and the range of motion in it is severely limited, the patient is indicated for surgical intervention.
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, close to the weight of a natural joint. Durability and reliability of endoprostheses is without doubt.
Recovery period
Surgery to replace the affected joint most often goes 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 equipment is allowed. Power loads are 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 an aggravation of the disease, charging is contraindicated.
Exercise therapy should not cause pain or discomfort. At the slightest feeling of discomfort, the exercise should be abandoned.
Charging should be done daily. After the load, it is useful to do self-massage in 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 improve the effect of medicines, 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 accompanying diseases.
Most often, the following physiotherapy procedures are used in treatment:
- magnetic therapy;
- ultrasound with hydrocortisone;
- electrophoresis with anti-inflammatory and analgesic substances;
- ultraviolet radiation
- laser and infrared treatment.
Physiotherapy is carried out in courses of 10-15 sessions several times a year.
Treatment with popular methods
By combining folk remedies with drug therapy, exercise therapy, proper nutrition and physiotherapy, you can achieve a long and lasting remission.
One of the best recipes is a compress with birch leaves, which have anti-inflammatory and warming effects. Young leaves are the most suitable, because close to autumn their beneficial properties decrease. Before making a compress, a small massage of the affected limb is necessary. Then the leaves are applied to the skin, strengthened with adhesive film and a bandage. The compress is left 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. The procedure requires about 3 kg of salt. Additionally, you can add a few drops of any essential oil. It is good to take a shower before going to bed, the duration of the bath should not exceed 30 minutes.
Hot oatmeal compress helps a lot. They should 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 (yardi, ginger, turmeric, milkweed, calamus) are boiled 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 bed.
It is recommended to take an infusion of corn stigmas inside. A teaspoon of raw material or 1 filter bag is boiled with 200 ml of boiling water, insisted under the lid for 30 minutes and 1 tablespoon is consumed. spoon half an hour before meals.
Prevention of osteoarthritis of the shoulder joints
Disease prevention 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 provoke shoulder arthrosis;
Secondary prevention aims at early diagnosis and treatment of arthritis.
Conclusion
The recovery of joint functions is a long and difficult process. Treatment of shoulder arthrosis should be aimed mainly at eliminating the symptoms of the disease. Only complex therapy, combining medical and folk methods, will bring relief and restore work capacity.