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 disrupts the normal functioning of the limb. The range of movement of the shoulder 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.
An orthopedic traumatologist should be consulted after the first symptoms appear to stop the destruction of the joint and to maintain the mobility of the shoulder joint.
Causes of shoulder arthrosis
The disease is polyethiological in nature. The development of deforming arthrosis of the shoulder joint can be caused by various factors:
- Professional sports or intense training.
- Endocrine diseases.
- Hormonal disorders.
- Congenital pathologies of the musculoskeletal system.
- Hereditary predisposition, etc.
In most cases, secondary arthrosis is diagnosed: the pathology occurs after exposure to one or another factor joint. It rarely registers the primary or idiopathic form of the disease. In this case, it is impossible to determine the exact cause of tissue degeneration.
Symptoms of shoulder osteoarthritis
Changes in cartilage and bone tissue begin long before the first signs of arthrosis appear. There is great potential for self-healing in joint structures, 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 death may appear after 40-50 years, and in the case of a deforming disease, patients notice the changes as early as 16-18 years of age.
Symptoms of osteoarthritis of the shoulder:
- Cracked joint in motion.
- Pain, especially after a strong workout.
- Stiffness of movement after sleep or long rest.
- Increased pain during changes in the weather.
Degrees of arthrosis
The clinical classification defines three stages of arthrosis of the shoulder joint:
- 1 degree. The patient complains of a slight crackling that appears during movement. Pain syndrome is missing. Feeling uncomfortable when placing your hand in an extreme position.
- 2 degrees. Pain occurs when the limb rises above the level of the shoulder. The range of motion decreases. After a significant load, the patient feels pain even at rest.
- 3 degrees. The mobility of the joints is severely limited. 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 cartilage degeneration.
Manual examination
The first stage of diagnosis is consultation with an orthopedic traumatologist. The doctor examines the patient's joint for swelling and severe deformity. From the side of developing arthrosis, the muscles can partially atrophy - this is visible to the naked eye.
With a manual examination, the doctor evaluates the function of the joint from several aspects:
- Ability to make voluntary hand gestures.
- Thickening of the edges of the joint surfaces (large osteophytes are palpable).
- The presence of a crackle, "clicks" that the hand can hear or feel during shoulder movement.
- Joint obstruction in the presence of free chondromal bodies.
- Pathological movements in the shoulder.
Radiography
Radiography is performed in two projections to detect signs of arthrosis of the shoulder joint, allowing the degree of narrowing of the joint gap, the condition of the bone surfaces, the size and number of osteophytes, the presence of fluid, and inflammation of the surrounding tissues.
Ultrasound examination (ultrasound)
It is a non-invasive method that allows the examination of the joints of pregnant women and young children. According to the sonogram, the doctor determines the thickness of the cartilage, the condition of the joint membrane. The method makes osteophytes, the enlarged lymph nodes in the periarticular space, clearly visible.
Magnetic resonance imaging (MRI)
The MRI image is taken from consecutive sections. In the pictures, not only the joint but also the adjacent tissues are clearly visible. To date, magnetic resonance imaging is one of the most informative methods for diagnosing arthrosis.
Laboratory tests
The following will be designated as part of a comprehensive study:
- General blood test. Based on the results, the doctor can judge the presence and severity of the inflammatory process. The analysis also helps in assessing general health.
- Analysis of urine. Renal pathologies often cause secondary deforming arthrosis. Analysis is required for accurate diagnosis.
- Blood chemistry. The data will help determine 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 treatment process includes medication, wellness procedures, special exercises for shoulder arthrosis. In severe cases, surgery is prescribed.
Medical therapy
Drugs and dosage are selected individually. Your doctor may prescribe:
- Non-steroidal anti-inflammatory drugs (NSAIDs). Medications reduce inflammation and pain.
- Glucocorticosteroid preparations. Hormone-based devices have a more intense effect on the focus of pain. The drugs not only alleviate the patient's condition but also reduce inflammation, show antihistamine and immunosuppressive properties. Glucocorticosteroids are prescribed in cases where NSAIDs are ineffective.
- Analgesics. Drugs in this group are prescribed for severe pain syndrome. Depending on the severity of your symptoms, your doctor will prescribe non-narcotic or narcotic (rarely) painkillers.
- Chondroprotectors. The active ingredients of the drugs are involved in the formation of new cartilage tissue. Regeneration of the diseased joint is accelerated and trophism is improved. Chondroprotectors have a cumulative effect and have been shown to treat arthrosis of varying severity.
Some medicines are injected directly into the joint cavity. For example, blockade has a better analgesic effect than taking medications in tablet form.
Physiotherapy
Courses are taken after exacerbation is removed. Physiotherapy, as part of a complex therapy, improves the delivery of drugs to the patient’s joint, relieves swelling, and reduces pain.
To treat arthrosis, use:
- Electrophoresis.
- Phonophoresis.
- Shockwave therapy.
Physiotherapy can be combined with massages, gymnastics and spas. It is best to perform a procedure based on a special clinic. The doctor will make a treatment plan, taking into account the condition of the patient.
Physiotherapy
Moderate physical activity is important to slow down degenerative processes. It is better to start gymnastics exercises for shoulder joint arthrosis in a health center under the supervision of a doctor. The specialist selects the exercises, teaches them to perform them correctly, and distributes the load so as not to cause aggravation of the disease. Gymnastics usually involves warming 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 shoulder arthrosis at home.
Surgery
Surgery is performed for grade 3 arthrosis, when the disease no longer allows the patient to move normally, causes severe pain, and the prescribed therapy does not help either.
There are several ways to treat surgery:
- Thrust. A long needle is inserted into the joint cavity and the accumulated fluid is pumped out. The puncture reduces pressure, reduces swelling, and increases joint mobility. The procedure is minimally invasive and is therefore outpatient. 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 the scar tissue, and sutures the rotator cuff or joint capsule in case of injury. Many punctures remain on the skin. The patient recovers quickly.
- Endoprosthesis. The endoprosthesis allows you to completely get rid of chronic pain, restore arm mobility. Long-term (3-6 months) rehabilitation is required after surgery.