Osteoarthritis of the shoulder joint (omarthrosis) is a chronic disease in which irreversible degenerative-dystrophic processes occur in the tissues of the joint. Pathology disrupts the normal function of the limb. The range of motion of the shoulder gradually decreases to complete immobility. 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 disorders.
- Congenital pathologies in the development of the musculoskeletal system.
- Hereditary disposition, etc.
In most cases, secondary osteoarthritis is diagnosed: pathology occurs after exposure of the joint by some factor. Rarely detect the primary or idiopathic form of the disease. It is impossible to determine the exact cause of tissue degeneration in this case.
Shoulder osteoarthritis symptoms
Changes in cartilage and bone tissue begin long before the first signs of osteoarthritis appear. Articular 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, 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 already in 16-18 years.
Symptoms of shoulder arthritis:
- Cracking joints in motion.
- Pain, especially severe after exercise.
- Movement stiffness, expressed after sleep or long rest.
- Increased pain during weather changes.
Degrees of osteoarthritis
Clinical classification defines three degrees of osteoarthritis of the shoulder joint:
- 1 degree. The patient complains of a slight crunch that occurs during movement. Pain syndrome is absent. Discomfort is felt when the hand is taken to the extreme position.
- 2 degrees. Pain occurs when the limb is raised above shoulder level. The range of motion is reduced. After considerable exertion, the patient feels pain even at rest.
- 3 degrees. Joint mobility is severely limited. The pain syndrome is almost constant.
Diagnosis of osteoarthritis of the shoulder joint
The doctor must not only diagnose correctly, but also determine the cause of the pathology. Treatment of the underlying disease significantly improves the patient's well-being and slows down cartilage degeneration.
Manual examination
The first stage of diagnosis is a consultation with an orthopedic traumatologist. The doctor examines the diseased joint for swelling, severe deformity. From the side of the development of osteoarthritis, the muscles can partially atrophy - this can be seen with the naked eye.
With a manual examination, the doctor assesses 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 by palpation).
- The presence of a crunch, "click" that can be heard or felt by the hand during shoulder movement.
- Jamming of the joint in the presence of free condom bodies.
- Pathological movements in the shoulder.
Radiography
To detect signs of osteoarthritis of the shoulder joint, radiography is performed in two protrusions, which allows you 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 the surrounding tissue.
Ultrasound examination (ultrasound)
A non-invasive method that allows you to examine the joints of pregnant and young children. According to the sonogram, the doctor determines the thickness of the cartilage, the condition of the synovial membrane. The method well visualizes osteophytes, enlarged lymph nodes in the periarticular space.
Magnetic resonance imaging (MRI)
The MRI machine takes pictures of successive sections. The images clearly show not only the joint but also adjacent tissues. To date, magnetic resonance imaging is one of the most informative methods for diagnosing osteoarthritis.
Lab tests
As part of a comprehensive study, they identify:
- General blood test. 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.
- Analysis of urine. Kidney pathologies often cause secondary deforming osteoarthritis. Analysis is necessary for accurate diagnosis.
- Blood chemistry. The data help determine the cause of the inflammation. Biochemical analyzes are also performed to monitor complications and side effects during treatment.
Treatment of osteoarthritis of the shoulder joint
The therapy is long and difficult. The course of treatment includes medication, wellness procedures, a set of special exercises for osteoarthritis of the shoulder joint. In difficult cases, surgery is indicated.
Medical therapy
Medicine and dosage are chosen individually. The doctor may prescribe:
- Non-steroidal anti-inflammatory drugs (NSAIDs). Medication reduces inflammation and pain.
- Glucocorticosteroid preparations. Hormone-based drugs 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.
- Painkiller. Medications of this group are prescribed for severe pain syndrome. Depending on the severity of the symptoms, the doctor will choose non-narcotic or narcotic (rarely) analgesics.
- Chondroprotectors. The active ingredients in the drugs are involved in the formation of new cartilage tissue. The regeneration of the diseased joint is accelerated, trophism is improved. Chondroprotectors have a cumulative effect and have been shown in the treatment of osteoarthritis of varying severity.
Some drugs are injected directly into the joint cavity. The blockade, for example, has a better analgesic effect than taking medication in the form of tablets.
Physiotherapy
Courses are performed after removal of exacerbation. Physiotherapy as part of complex therapy helps improve the transport of drugs to the diseased joint, relieve swelling and reduce pain.
For the treatment of osteoarthritis are used:
- Electrophoresis.
- Phonophoresis.
- Shock wave 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 better to start exercise 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 to perform them correctly and distribute the load so as not to cause an exacerbation of the disease. Gymnastics usually includes warm-ups, 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 osteoarthritis of the 3rd degree, 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. 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. Using microsurgical instruments, the doctor examines the joint cavity, removes scar tissue, performs a suture of tendons in the rotator cuff or joint capsule if they are damaged. Several punctures remain on the skin. The patient recovers quickly.
- Endoprosthetics. Endoprosthetics allow you to completely get rid of chronic pain, restore arm mobility. After the operation, a long (from 3 to 6 months) rehabilitation is needed.