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 interrupts the normal functioning of the limb. The shoulder range of motion gradually decreases 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 joint destruction processes and maintain the mobility of the shoulder joint, it is necessary to contact an orthopedic traumatologist after the appearance of the first symptoms.
Causes of shoulder joint osteoarthritis
The disease is polyetiological. The development of deforming arthrosis of the shoulder joint can be associated with several factors:
- Professional sports or intense 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 to the joint of one or another factor. Rarely record the primary or idiopathic form of the disease. It is impossible to establish the exact cause of tissue degeneration in this case.
Symptoms of Shoulder Osteoarthritis
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 quite active. As the body ages, recovery processes give way to degeneration. The first signs of destruction may 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:
- Crack in joint during movement.
- Pain, especially severe after exercise.
- Stiffness of movement, expressed after sleep or prolonged rest.
- Increased pain during weather changes.
degrees of arthrosis
The clinical classification defines three grades of osteoarthritis of the shoulder joint:
- 1 degree. The patient complains of a slight crunch that appears during the movement. Pain syndrome is absent. Discomfort is felt when the hand is brought to the extreme position.
- 2 degrees. Pain occurs when the limb is elevated above shoulder level. Range of motion is reduced. After significant exertion, the patient feels pain even at rest.
- 3 degrees. Joint mobility is severely limited. Pain syndrome is almost constant.
Diagnosis of osteoarthritis of the shoulder joint
The doctor needs not only to correctly diagnose, but also to determine the cause of the pathology. Treating the underlying disease significantly improves the patient's well-being and slows cartilage degeneration.
manual exam
The first stage of diagnosis is a consultation with an orthopedic traumatologist. The doctor examines the diseased joint for swelling and severe deformity. On the developing side of osteoarthritis, muscles can partially atrophy - this can be seen with the naked eye.
With a manual exam, the doctor assesses joint function according to several criteria:
- Ability to make voluntary hand movements.
- Thickening of the edges of joint surfaces (large osteophytes can be detected by palpation).
- The presence of a crunch, "clicks" that can be heard or felt by the hand during shoulder movement.
- Joint blockage 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 makes it possible 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 surrounding tissues.
Ultrasound exam (ultrasound)
A non-invasive method that allows you to examine the joints in pregnant women and young children. According to the ultrasound, the doctor determines the thickness of the cartilage, the condition of the synovial membrane. The method visualizes well osteophytes, 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, magnetic resonance imaging is one of the most informative methods for diagnosing osteoarthritis.
lab tests
As part of a comprehensive exam they nominate:
- General blood analysis. Based on the results, the doctor can assess the presence and severity of the inflammatory process. The analysis also helps to assess the general state of health.
- Urine analysis. Renal pathologies usually cause secondary deforming arthrosis. Analysis is necessary for an accurate diagnosis.
- Blood chemistry. The data help establish the cause of the inflammation. Biochemical analyzes 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 medications, 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. The doctor may prescribe:
- Non-steroidal anti-inflammatory drugs (NSAIDs). Medications reduce inflammation and pain.
- Glucocorticosteroid preparations. Hormone-based means have a more intense effect on the focus of pain. Medications not only relieve the patient's condition, but also reduce inflammation, exhibit antihistamine and immunosuppressive properties. Glucocorticosteroids are prescribed in cases where NSAIDs are not effective.
- Painkillers. Medications in this group are prescribed for severe pain syndrome. Depending on the severity of 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 arthrosis of varying severity.
Some drugs are injected directly into the joint cavity. For example, blocking has a better analgesic effect than taking medication in pill form.
Physiotherapy
Courses are carried out after the exacerbation is removed. 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.
- Shockwave Therapy.
Physiotherapy can be combined with massage, exercise therapy, therapeutic baths. It is best to undergo a set of procedures based on 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 to slow down degenerative processes. It is best to start exercise therapy for osteoarthritis of the shoulder joint in a medical facility under the supervision of a physician. The specialist will select the exercises, teach you how to perform them correctly and distribute the load so as not to cause an exacerbation of the disease. Gymnastics usually includes a warm-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:
- Puncture. A long needle is inserted into the joint cavity and the accumulated fluid is pumped out. The 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, sutures the tendons of the rotator cuff or joint capsule if they are damaged. Several perforations remain in the skin. The patient recovers quickly.
- Endoprostheses. Endoprosthesis allows you to completely get rid of chronic pain, restore arm mobility. After the operation, a long rehabilitation (from 3 to 6 months) is required.