Osteoarthritis (osteoarthritis) is a degenerative disease of cartilage tissue in which the normal functioning of the joint is disrupted. In most cases, the disease is chronic. Osteoarthritis of the shoulder is characterized by pain and gradual loss of functionality of the arm. The pathology is most often found in old age. The causes of osteoarthritis are senile changes in the body, shoulder injuries, birth defects and constant stress on the shoulder girdle. If a person is experiencing discomfort in the shoulder girdle, it is necessary to consult a doctor and undergo an examination. With the help of a complex effect it is possible to stop the development of degenerative changes.
What is shoulder osteoarthritis
Osteoarthritis of the shoulder - damage to the cartilage of the joint, in which degenerative changes occur. The blood supply to the cartilage tissue is disrupted, so it stops getting enough nutrients and oxygen.At risk are people who experience excessive stress on the shoulders on a daily basis and have congenital defects in the joint tissues.In the early stages, the person experiences painful pain, but the normal functionality of the shoulder is preserved. If the provoking factors are not eliminated, the disease will cause serious damage to health.
Diagnosis plays an important role in the treatment of osteoarthritis. With the help of X-rays it is possible to accurately determine the cause of the disease and the degree of damage.
Anatomical background
The causes of the disease can be congenital disorders of the structure of joints and connective tissue. If a person has peculiarities in the structure of the shoulder girdle, then even a simple load can provoke the appearance of osteoarthritis. To avoid problems, you will need to take preventive measures and visit a doctor regularly. Congenital dysplasia can be controlled with massage and exercise.
Causes and risk factors
All older people are at risk.According to WHO statistics, the probability of developing osteoarthritis after 45 years increases significantly.By the age of 65, more than 50% of people suffer from this disease. Among the reasons that provoke the early onset of the disease are:
- damage to the rotator cuff of the shoulder;
- shoulder injury;
- constant stress related to sports or work;
- infectious and autoimmune pathologies;
- obesity;
- improper metabolism.
The older a person gets, the higher the risk of developing degenerative joint damage.
Views
Cartilage tissue damage is divided into primary and secondary. The diagnosis of primary osteoarthritis is made if there are no concomitant diseases. It is usually found in old age. The reason for its appearance are age-related changes. The secondary appearance occurs due to injuries or against the background of another disease. In addition, the disease is classified by location.Degenerative changes in the shoulder can occur in the area of the shoulder joint itself or the acromioclavicular joint.
Stages of development and symptoms
The symptoms depend on the stage of development of osteoarthritis of the shoulder. The pathology is divided into three stages:
- The first. . . There are painful pains that intensify at night, the functionality of the shoulder girdle is preserved.
- The second. . . When the hands move, a squeak is heard, the pain is constant, there is limited mobility of the shoulder.
- Third. . . Severe pain, the arm is fixed in one position, protrusions are visible in the affected area, the X-ray shows a strong deformation of the joint.
The disease may not develop for a long time. If a person continues to strain the shoulder girdle, then the condition worsens.
Which doctor to go to
Osteoarthritis of the shoulder joint is treated by various doctors. The initial examination is performed by a therapist or rheumatologist. In addition, the following specialists can participate in the treatment:
- surgeon;
- orthopedist;
- neurologist.
In most cases, the treatment regimen is prepared by a rheumatologist.The help of a surgeon is needed if the disease requires surgical treatment or intra-articular manipulations.A neurologist should be consulted if the nerve bundle has been compressed due to the disease.
Only after a diagnostic examination will the therapist or rheumatologist assess whether the help of other specialists is needed.
Diagnosis
Hardware and laboratory tests, as well as manual examination, are used to make an accurate diagnosis. In the first place, a check is performed with various tests. The history of the personality is studied. All this helps to make a preliminary diagnosis. In addition, MRI and X-rays are used to determine the degree of narrowing of the joint space, the condition of blood vessels, synovium, tendons.
Manual inspection
The manual examination includes palpation of the affected area and performing diagnostic tests. Pain usually occurs on palpation of the acromioclavicular joint. If a person has problems placing his hand behind his head, this may signal the presence of osteoarthritis of the shoulder joint. During a manual examination, the doctor will be able to detect inflammation. The information obtained during the manual examination plays an important role in the diagnosis.The examination should be performed by an experienced rheumatologist or therapist so that it is not damaged during testing and functional tests.
Instrumental methods
Instrumental research methods allow you to determine:
- the degree of narrowing of the joint space;
- uneven joint surface;
- localization of arthrosis.
After using instrumental diagnostic methods, the necessary therapy is selected. Radiography, CT or MRI are used for diagnosis. These methods provide the necessary information. The instrumental examination may be repeated during treatment.
laboratory
Laboratory tests allow you to assess the condition of the body as a whole, as well as to rule out inflammatory arthritis. Blood is taken first for analysis. In osteoarthritis, all indications of the clinical and biochemical blood test are within normal limits. Arthritis significantly increases the rate of erythrocyte sedimentation, the amount of immunoglobulins and other markers of the inflammatory process in the body. Based on the results obtained, the doctor makes a final diagnosis and selects an effective treatment regimen.
To get accurate results, donate blood in the morning on an empty stomach.
Treatment
The approach to treatment is complex. Medicines, physiotherapy, physiotherapeutic exercises are used. If the disease is advanced or unresponsive to treatment, surgery is used. Basic principles of therapy:
- pain relief;
- stopping the development of the disease;
- the mechanisms for cartilage tissue regeneration start.
In the initial stage, the result is achieved through the use of drugs.It is important to exclude provoking factors. Stable remission is achieved through physiotherapy and exercise therapy.
Medicines
The following groups of drugs can be used for treatment:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors;
- corticosteroids;
- vasodilators.
NSAIDs and corticosteroids are used to relieve pain. They apply for a limited period of time. Chondroprotectors can accelerate the recovery of cartilage tissue. Vasodilators help to improve blood flow and relieve spasm of small vessels.
Before prescribing this or that drug, it is necessary to carefully study the contraindications. Only a doctor can properly combine all medications.
Surgically
Surgical intervention is performed only as a last resort, when irreversible degenerative processes have occurred. The reasons for the operation are:
- lack of effect of conservative therapy;
- the appearance of complications;
- the appearance of severe degenerative changes.
If the joint has lost its original appearance, then arthroplasty is performed.The diseased joint is replaced with an artificial one. The operation is complex and requires highly qualified surgeon. Puncture and arthroscopy can also be performed to treat osteoarthritis.
Puncture
A puncture is performed if a large amount of fluid has accumulated in the joint cavity. Also, this procedure is performed on infectious inflammations to determine the type of infection. Removing excess fluid helps reduce pressure on the shoulder joint and increase its mobility. The procedure is minimally invasive, so recovery after completion is as fast as possible. The puncture has indications and contraindications. It is used only in case of accumulation of fluid in the joint capsule or in case of suspicion of an infectious complication of arthrosis.
Arthroscopy
Arthroscopy is a minimally invasive surgical technique that removes damaged shoulder cartilage. The operation is performed using endoscopic equipment and a microcamera. The advantage of this method of treatment is the rapid rehabilitation. Removing damaged cartilage allows you to relieve stress and restore joint mobility. The disadvantage of the procedure is that access to the affected area is somewhat limited.
Endoprosthesis
Endoprosthesis is the complete replacement of a damaged joint with a biocompatible analogue.Titanium construction is usually used. Surgery allows you to get rid of even osteoarthritis in the 3rd stage. Long-term rehabilitation is performed after endoprosthesis. As a result, it is possible to achieve complete removal of the affected areas and chronic pain, as well as to restore mobility of the shoulder girdle.
Surgery is not always possible. In the elderly, the rehabilitation period is much more difficult. Other treatment options are used before the appointment of arthroplasty.
Physiotherapy
Physiotherapy procedures play an important role in eliminating osteoarthritis of the shoulder girdle. With their help it is possible to restore normal joint mobility and reduce the severity of pain. The following procedures are performed:
- electrophoresis;
- local cryotherapy;
- magnetic therapy.
Physiotherapy can be used if there are no acute manifestations of the disease (severe pain, limited mobility). Regular exposure will completely eliminate the discomfort. Each procedure must be performed by a qualified technician.Before visiting the physiotherapy rooms, you should consult your doctor.
Kinesitherapy
Kinesitherapy refers to the use of active and passive methods to restore the functionality of the shoulder. If the disease is mild, then the person can begin to use an active method of recovery through exercise. The passive method consists of external exposure through massage or mechanotherapy. Kinesitherapy helps to quickly get rid of the manifestations of osteoarthritis of the shoulder joint.
The passive method of mechanotherapy recovery is available to people of all ages.
Exercise therapy
Physiotherapy exercises allow you to strain the muscles and restore mobility of the shoulder joint. Mostly static exercises are used. Dynamic loading, which actively rotates the shoulder, is undesirable. The following exercises can be performed:
- Shaking shoulders- You need to take a starting position, sit in a chair and put your hands on your knees. Relax your shoulders, then start swinging your elbows. At the same time, his hands are on his knees.
- Slow rotation- You should sit in a chair and put your hands on your knees, then slowly begin to rotate your shoulders with short pauses. Circular movements back and forth are performed.
Physiotherapy can be used only during remission, when pain and limited movement are almost completely absent.
Massage
Massaging the affected area allows you to get the following effects:
- improving tissue nutrition;
- swelling relief;
- tones muscles;
- eliminate pain.
It is recommended that all actions be performed by a qualified professional. When performing self-massage, strong pressure and sudden movements should be avoided.The result of the massage effect is noticeable within a few weeks after regular use.
The massage should be accompanied by other activities. If a person performs exercises from the treatment complex and visits a massage room, he will achieve great results.
Mechanotherapy
Mechanotherapy means a set of exercises that are performed on specialized mechanisms. This method allows you to recover in the shortest possible time. Mechanotherapy is ideal for rehabilitation after surgery. Special mechanisms allow you to adjust the load, allowing faster recovery of muscles and ligaments. All actions are performed under stationary conditions. Rehabilitation classes should be conducted with an instructor. He will correctly choose the load and the required simulator.
Tightening of the joints
The joints are stretched with the help of a specialized device. The following effects can be achieved with this procedure:
- improving blood circulation;
- expansion of the joint space;
- relieving tension from relationships.
Narrowing of the joint space is one of the main manifestations of osteoarthritis. With this procedure you can improve the situation. The degree of load is selected individually. Initially, traction is performed with minimal weights.
Before prescribing traction of the joints, it is necessary to conduct an examination for possible contraindications.
Folk methods
Traditional methods allow you to get rid of pain and speed up the process of cartilage tissue repair. The following means may be applied:
- Burdock leaves- Fresh burdock leaves are crushed until soft and applied to the affected area for 30-60 minutes. Fixing is done with gauze.
- Salt compress- 50 g of salt are dissolved in 450 ml of water, then gauze is placed in the liquid. The gauze is removed, heated and applied to the shoulder for 45 minutes.
- Gelatin- 2 teaspoons of gelatin will need to be diluted in 100 ml of warm water, after which the liquid is heated to boiling. Gelatin is taken orally once a day before meals. It promotes the recovery of cartilage tissue.
Traditional methods will help to achieve a good result in therapy. It is recommended to use them during remission.
Diet for osteoarthritis
With any type of osteoarthritis (shoulder, wrist, ankle) you need to provide your body with all the nutrients for the rapid recovery of cartilage tissue. You will need to add the following foods to your diet:
- nuts;
- bran;
- gelatin jelly;
- buckwheat porridge;
- eggs.
Nutrition should be balanced. Vitamin supplements can be taken to obtain essential vitamins and minerals. It is recommended to eat 4-5 times a day. During the treatment of osteoarthritis, alcoholic beverages and sweets are excluded. If a person wants to achieve lasting remission, then he will have to constantly adhere to the principles of proper nutrition.
Complications and prognosis
The prognosis depends on the age of the person, the degree of damage, the individual characteristics of the organism. At a young age it is possible to achieve complete recovery of cartilage tissue and joint functionality. In old age, you will need to follow certain rules to achieve lasting improvement. Osteoarthritis of the shoulder responds better to therapy than osteoarthritis of the foot because the shoulder girdle is easy to isolate from stress. This allows more effective conservative treatment.
Differences between shoulder osteoarthritis and arthritis
Osteoarthritis and arthritis have the same manifestations, but differ in the clinical picture. The main difference is that osteoarthritis is a non-inflammatory disease.In the early stages, the pain of osteoarthritis worries a person only after exercise, and in arthritis it is constant.Arthritis is an inflammatory-degenerative disease. Its treatment is slightly different from that of osteoarthritis.
In order not to confuse these diseases, methods of differential diagnosis are used. Laboratory and instrumental tests will help determine the exact presence or absence of inflammation.
Prevention
Prevention of osteoarthritis consists in eliminating the provoking factors and maintaining a healthy lifestyle. You will need to do the following:
- give moderate physical activity;
- avoid hypothermia;
- use chondroprotectors;
- avoid hard physical work;
- weight loss to normal.
Preventive actions will help keep joints healthy until old age. Prevention should be followed with extreme caution by people over the age of 45 or active athletes.
conclusions
- Osteoarthritis of the shoulder is a degenerative disease in which there is a gradual destruction of the cartilage of the joint.As a result, the person has pain and movement is limited.
- Treatment of the disease includesthe use of drugs, conducting physiotherapy and performing exercises from the complex of physiotherapeutic exercises.
- In the early stages of the disease, the prognosis for full recovery is favorable.
- Prevention can significantly reduce the likelihood of osteoarthritis of the shoulder joint.