Somatic cells in the human body are capable of a variety of mitotic divisions.Thanks to this property of our body, it can exist independently in the external environment for a long time and restore damaged tissue or dead cells.
Unfortunately, the number of these divisions is strictly limited and individual for each person.In this context, various diseases occur as people reach old age.Osteoarthritis is considered one of the most common diseases, since the pain syndrome associated with this pathology significantly affects the patient's quality of life.
Omarthrosis or osteoarthritis of the shoulder joint becomes a serious problem that affects normal work performance and daily tasks.It is this disease that will be discussed below;We will analyze the causes of arthrosis of the shoulder joint, symptoms and treatment of this unpleasant pathology.
What is that?
When osteoarthritis of the shoulder occurs, the normal blood supply to this important bone joint is disrupted, causing the thickness of the cartilage tissue to decrease and the head of the bone to become exposed.Due to the increased friction, people notice the appearance of pain, which, depending on the extent, can only be noticeable during physical activity or even when at rest.
Due to injury to the surrounding anatomical structures, an inflammatory process is observed, which aggravates the decrease in the amplitude of active and passive movements in the upper limb.Lack of adequate treatment often leads to complication of the process by joint deformities, called osteoarthritis deformans.
Anatomy of the shoulder joint
The shoulder joint is a ball-and-socket joint;It is this structure that allows a person to perform a variety of movements using the upper limb.Three large bones converge in this anatomical region, including the scapula, clavicle, and humerus.The joint capsule is quite deep and reinforced by a whole complex of ligaments.
Due to some anatomical peculiarities of the structure of the shoulder joint, spontaneous dislocations and subluxations in this area often occur during daily work at home.The ease and variety of movements is due not only to the spherical shape of the articular surfaces, but also to the presence of a large amount of special synovial fluid, which reduces friction between the articular surfaces.
Causes of osteoarthritis of the shoulder joint
The disease presented in the article arises due to the influence of a whole complex of provoking factors.Clinical studies conducted in a number of leading research institutes have made it possible to reliably establish the pathophysiological mechanism of the occurrence of changes in bone and cartilage tissue in arthrosis.However, reliable “triggers” have never been identified.
In most cases, this degenerative disease develops secondarily, i.e. after a pathogenic effect on the shoulder joint.
Through a retrospective analysis of the medical records of patients with this pathology in the shoulder joint area, influences could be identified that could significantly increase the likelihood of the disease occurring.
This includes:
- excessive physical activity, which leads to physical thinning of the articular surfaces;
- frequent falls on the arm and other injuries to the girdle of the upper limbs;
- occupational risks;
- congenital pathologies of connective tissue;
- disturbed mineral metabolism, accompanied by the appearance of crystalloid deposits on the head of the humerus;
- decreased production of synovial fluid;
- age-related changes in the structure of the vascular wall, causing dystrophic changes in the bone;
- Lack of appropriate drug therapy for acute or chronic inflammatory processes in the joint space;
- Pathologies of the nervous system leading to insufficient trophism of the musculoskeletal system;
- the presence of excess weight, constant swelling of the upper extremities;
- Diseases of the endocrine system.
Primary osteoarthritis of the shoulder
The modern medical classification of arthrosis of the shoulder joint distinguishes two forms depending on the cause - primary and secondary.In the primary case, the diagnosis is made only after all diagnostic measures have been carried out to completely exclude the presence of the causes of the onset of the disease described above.It is believed that the starting point of pathogenesis is the deterioration of system-wide blood flow against the background of a decrease in myocardial contractility or vascular wall permeability.
Over time, a person notices the appearance of unpleasant sensations when moving in the shoulder.Symptoms initially arise during training and then do not go away even when you rest.Another reason for the rapid progression of the disease is the appearance of so-called osteophytes.These bone spurs arise from a compensatory increase in the activity of chondroclasts, which attempt to compensate for the loss of mature cartilage cells.They have the appearance of a spike, which, when moved, contributes to injury to the capsule and the occurrence of an aseptic inflammatory process.
Against the background of the changes described, fibrin threads appear in the synovial fluid, which penetrate the ligamentous apparatus during a long period of rest.Due to a decrease in the elasticity of white muscle fibers, a characteristic feeling of “stiffness” arises, which usually disappears after 20-30 minutes of limb development.Shoulder arthrosis has pronounced symptoms, the intensity and treatment of which are directly proportional to the degree of the development process.
Secondary osteoarthritis of the shoulder joint
The secondary form of this disease is a consequence of the presence of an underlying pathology, complicated by dysfunction of the musculoskeletal system.The main causes are traumatic injuries of an acute or chronic nature.This problem is especially relevant in the cold season, when a person often falls and stretches his hand forward to cushion the fall.
Enzymopathies are congenital diseases that are associated with a reduced production of specific enzymes of the ligament system and can also lead to the development of secondary osteoarthritis of the shoulder joint.These patients often experience dislocations and subluxations during everyday activities.Loosening of this bone joint contributes to increased trauma to the contact surfaces, resulting in the disease.
Symptoms and signs
Osteoarthritis of the shoulder has complex symptoms and treatment;Due to some features of the characteristic signs, detection often occurs in the later stages of the development of the pathological process.Experts distinguish three degrees of destruction of cartilage tissue in the upper limb girdle.Accordingly, the symptom complex identified in the patient will also differ.
With stage 1 disease, a person rarely notices pain in the shoulder;Most often, discomfort in the limbs occurs during or immediately after heavy physical exercise.In such situations, the patient needs several days to recover and completely eliminate joint problems.Precisely for the reason that a person tends to attribute pain to the manifestation of a simple, as it seems to him, sprain of the ligamentous apparatus, the disease continues its development and is remembered more and more often.
Grade 2 osteoarthritis of the shoulder joint is associated with a more vivid clinical picture.This is due to the fact that in addition to erosion and disruption of the normal nutrition of the articular surfaces, secondary inflammation occurs, spreading to the ligaments and surrounding muscle fibers.The disease causes pain to occur even with minimal physical exertion.Due to severe pain, the patient is no longer able to make circular movements, which indicates that the process of deforming arthrosis has begun and the amplitude of active movements of the hand in space is limited.
The development of grade 3 leads to an almost complete loss of mobility in the shoulder joint.The patient notes significant muscle atrophy and loss of ability to care for himself.Another characteristic symptom is the appearance of bony protrusions above the surface of the skin.The likelihood that the disease will progress to this extent is primarily in people who, due to professional activity or professional sports, have no opportunity to minimize the strain on their upper limbs.
Diagnosis of osteoarthritis of the shoulder joint
Diagnosis of arthrosis of the shoulder joint is a procedure that requires certain skills from a specialist.After the appearance of pain in the upper extremity, it is advisable to consult an orthopedic traumatologist.It is doctors of this profile who have all the necessary knowledge.
During the examination, you should first pay attention to the patient's complaints and medical history.The doctor finds out why the pain appeared, what its nature is and after which it disappears.Next, occupational hazards and the presence of risk factors must be identified.
The main diagnostic method for detecting deforming arthrosis of the shoulder joint is a simple x-ray.
The next step is a physical examination, during which a specialist uses palpation to identify painful areas and determines the full range of active and passive movements of the limb.In addition, the presence of local edema and increased skin temperature in the area of the bone joint protrusion is assessed.Based on the data obtained, the doctor can make a preliminary diagnosis, but differential diagnosis is required to prescribe the most appropriate therapy.
In order to determine the most correct diagnosis, the extent of the process and possible identification of the cause, various additional laboratory and instrumental diagnostic methods are performed on the patient.
Among the most informative are:
- clinical blood test;
- Determination of biochemical parameters of blood serum;
- clinical urinalysis;
- X-ray of the affected joint;
- ultrasound diagnostics;
- arthroscopic examination;
- magnetic resonance and computed tomography;
- scintigraphy;
- Joint puncture with subsequent biochemical analysis of the synovial fluid.
Signs that directly indicate the development of arthrosis are the appearance of a significant narrowing of the joint space, sclerosis of subcartilaginous structures, thinning of the chondrocyte layer itself, the appearance of osteophytes and the deposition of salt crystals in the intra-articular fluid.
How to treat arthrosis of the shoulder joint?
After establishing this diagnosis, the doctor is faced with the serious question of which therapeutic tactics are most appropriate.Modern medicine has reached a level that allows patients with musculoskeletal disorders to fully return to normal life.
Treatment of arthrosis of the shoulder joint is long-term and therefore often leads to the development of complications.
The chosen method for correcting arthrosis of the shoulder joint directly depends on the following factors:
- degree of process;
- general condition of the patient;
- Age;
- physiological properties.
As a rule, in the early stages it is enough to prescribe medications with general and local effects.
If there is second-degree osteoarthritis of the shoulder joint, the symptoms accompanying the disease can hardly be completely stopped.A person is shown a significant reduction in physical activity to prevent further development of the pathological process;In parallel, a whole range of medications are prescribed.
The third degree is practically inaccessible to conservative influence;In the presence of such an advanced disease, surgical treatment is indicated, the extent of which depends on many factors and is chosen directly by the attending physician.Next, we will talk in more detail about each of the existing methods of eliminating arthrosis.
Medication
The following groups of medications are used for conservative therapy in the presence of this disease:
- glucocorticoids;
- non-steroidal drugs with anti-inflammatory effects;
- analgesics;
- Drugs with chondroprotective effects.
Drugs belonging to this group have a significantly more pronounced anti-inflammatory effect than non-steroidal drugs.
Glucocorticoids are considered the most effective remedies against inflammatory phenomena.These natural and synthetic analogues of adrenal hormones can significantly influence the production of pro-inflammatory neurotransmitters.This reduces local swelling, pain and temperature in the affected area of the musculoskeletal system.
The disadvantages of this treatment include the numerous side effects of glucocorticoids.The medications presented can cause Cushing's syndrome, lead to a disorder of general metabolism and water retention in the intercellular space.In this regard, it is recommended to start treatment with the prescription of NSAIDs.
Nonsteroidal drugs with anti-inflammatory effects act directly on cyclooxygenase molecules that trigger inflammation in injured tissues.
Preference is given to selective drugs that do not have a harmful effect on the mucous membrane of the digestive tract.
Depending on the severity of the patient's disease and the severity of the pain syndrome, narcotic and non-narcotic painkillers are used.
The first group is considered more effective, but the side effect of drug dependence means that their use must be strictly limited.
Non-opioid drugs have a less pronounced analgesic effect, but do not cause dependence and therefore can be prescribed more often.
It is extremely important not to use chondroprotective agents during the acute phase of the disease, as this can lead to increased inflammatory processes.It is necessary to stop the attack, and then prescribe a long course of treatment with drugs that restore the structure of the joint.
Surgical treatment
In some cases, surgical correction of the condition of a patient with shoulder osteoarthritis is indicated.This invasive method is used directly in the joint in the presence of a severe destructive process.In most cases, patients undergoing surgical treatment are unable to perform everyday tasks due to severe limitation of active and passive movements in the shoulder.
After the final diagnosis is made, a series of measurements are carried out, during which the optimal parameters for the future prosthesis are selected.A graft is then made to order from high-strength polymers or titanium.
Surgery for osteoarthritis of the shoulder joint is carried out in the final stages of the disease.
The surgical procedure is quite extensive, so the patient requires a long preparation time.A complete replacement of the affected bone joint is carried out, followed by physiotherapy, which allows to restore full functionality of the upper limb girdle.
Therapeutic exercise
They are physical exercises that make it possible to restore shoulder mobility in the shortest possible time not only after surgical treatment, but also during the period of drug control of the disease.Specially developed complexes relieve morning stiffness, stimulate the normalization of blood supply and lymphatic drainage, and restore the normal composition of the synovial fluid.
It is extremely important that rotation and adduction movements in the upper extremity are performed without additional loading, otherwise the likelihood of additional trauma and cartilage destruction is high.Rehabilitation specialists are engaged in the development of special complexes of physiotherapy.
Each clinical case requires an individual approach.Therefore, if you have any disease or want to prevent its development, contact this doctor.
Recommendations for home treatment
Any illness must be treated in a hospital under the supervision of highly qualified medical professionals.However, in some cases there is no possibility for the patient to stay in the clinic longer.In such situations, you need to independently monitor your recovery process.
Physical exercises for deforming arthrosis of the shoulder joint are extremely important as they slow down the progression of the disease.
The following recommendations should be followed:
- Strictly follow the instructions and prescriptions of the treating doctor.
- Limit the affected arm from physical activity as much as possible.
- get rid of excess body weight by creating a slight calorie deficit and walking in the fresh air;
- Divide the daily amount of food into 5-6 meals;
- drink at least 2 liters of water daily;
- Change the type of work activity to one that requires minimal load on the upper limbs.
Folk remedies
Many older people know from their own experience what arthrosis of the shoulder joint is and how to treat it at home.In addition to the recommendations described above for changing the nature of work activity and getting rid of excess weight, conventional medicine has a whole range of remedies that help relieve pain and swelling in the affected limb.For this purpose, various ointments, decoctions, compresses and baths are used.We will discuss these treatment methods in more detail.
Anoint
Alternative medicine has a large number of original and effective recipes for making anti-inflammatory ointments.The easiest method is to mix an egg yolk with a teaspoon of turpentine and the same amount of apple cider vinegar.Applying the ointment to the affected joint at night significantly reduces pain and inflammation.
Another good remedy for the treatment of arthrosis of the shoulder joint is a mixture of fifty grams of elecampane and one hundred milliliters of vodka.After mixing the components and letting them brew for 12 days, you should rub the resulting ointment daily into the projection area of the inflamed bone joint.
Decoctions and tinctures
Decoctions and tinctures play a key role in folk medicine.One of the easiest to prepare and at the same time most effective infusions against osteoarthritis is a mixture of one tablespoon of ground agave leaves and 150 milliliters of 70% ethyl alcohol.After two weeks of infusion of the drug, the liquid should be taken orally, twenty drops with water, for thirty days.
For supporters of decoctions there is a good remedy.To prepare it, you need two tablespoons of lingonberry leaves and half a liter of boiling water.After mixing the ingredients, let them steep in a thermos overnight.Then take 150 ml of the product three times a day, immediately before meals.The duration of treatment is 30 days.
Compresses and rubs
To relieve pain and inflammation in the area of the shoulder joint affected by osteoarthritis, various compresses are used.A mixture of one liter of vodka and one hundred grams of cinquefoil is considered one of the most effective.The medicine should be infused for two weeks and then taken every evening at bedtime.
Another simple and effective remedy is a compress of finely grated horseradish mixed with a little water until a puree is obtained.Place a handful of medicine in a gauze cloth and apply to the inflamed joint for 20-30 minutes.
Baths
Baths are often used to treat various diseases of the musculoskeletal system.Thanks to the complex action, a good anti-inflammatory and anti-edematous effect is achieved.
Preparing a bath is easy;To do this, follow the following recommendations:
- Fill the bathtub with hot water.
- add about a kilogram of sea or regular table salt;
- throw in a few pine branches;
- pour in a few teaspoons of candied honey;
- At the very end, add a teaspoon of turpentine oil.
The treatment consists of twelve baths.The procedure should last around twenty minutes.Already with the first use of a medicinal bath, the patient notices a significant improvement in his general condition and a reduction in joint problems.
Prevention
In modern medicine there are still no specific measures to prevent osteoarthritis.This is due to the polyetiological nature of the pathology.However, there are non-specific measures that can significantly reduce the risk of illness.There is primary and secondary prevention.
The first includes:
- daily walks outside;
- the use of a contrast shower, which allows you to achieve increased vascular tone;
- Gentle treatment of the joints, avoiding excessive physical activity;
- Moderate exercise 2-3 times a week.
The second group includes the following:
- complete and comprehensive treatment of arthritic processes;
- regular intake of calcium supplements;
- prescription of chondroprotective drugs;
- Physiotherapy.