Our joints experience constant stress throughout our lives. As a result, the cartilaginous tissue wears out and the bone tissue is deformed and arthrosis of the shoulder joint occurs, which has become one of the most common problems of the elderly.
The development of the disease can lead to a complete limitation of movements and constant pain in the joints. Therefore, the treatment of arthrosis should begin at the first manifestations of the disease.
What is arthrosis of the shoulder joint
Dystrophic changes in the cartilage and adjacent bone tissue of the shoulder joint are defined in medicine as arthrosis of the shoulder joint ICD-10 - M19. 91. Most often, arthrosis occurs in the acromioclavicular joint of the shoulder, which most often experiences constant stress and strong stress during the day.
Under the influence of injuries and various inflammatory processes, cartilage tissue is damaged and gradually weakens, becomes fragile and thin. Cracks form in the cartilage, where salts begin to be deposited, accelerating the destructive processes in the cartilage tissues. As a result of such salt deposits, the bone tissue becomes dense and begins to deform, and acromioclavicular arthrosis develops.
This process is slow and chronic, at first it is asymptomatic, but gradually the manifestations of the disease increase and over time can lead to complete immobility in the joint area.
The following factors can provoke the appearance of the pathological process:
- Shoulder injuries that have caused deformity of the joint and cause inflammation.
- Insufficient blood supply to the shoulder joint that lasts for a long time - this condition can be caused by vascular disorders.
- Constantly high joint loads are observed in construction workers, athletes and loaders.
- Congenital joint pathologies.
- Poor nutrition and resulting metabolic disorders.
important! The most common form of the disease is post-traumatic arthrosis of the shoulder joint, ICD-10 code - M19. 91.
The shoulder joint is one of the most mobile in humans, which provokes quite frequent joint injuries. Even a small trauma to the joint, which is repeated regularly and over a long period of time, leads to the development of arthrosis. Arthrosis of the right shoulder joint is most common, because the majority of the population is "right-handed" and the load on the right side is always greater.
Causes and factors for the development of the disease
Most often, arthrosis is diagnosed in the elderly, and the older the person, the greater the probability of detecting a pathology.
Causes and prerequisites for the development of shoulder arthrosis:
- Injuries. Fractures, bruises and dislocations affect the bone and cartilage tissue of the shoulder joint, causing various complications - damage to the capsule, rupture of ligaments. Timely treatment prevents the development of complications and the appearance of arthrosis.
- Vascular pathologies. Diabetes mellitus, atherosclerosis and varicose veins can influence the development of arthrosis. Also, the risk of the disease increases in people who abuse smoking.
- Lack of physical activity. Lack of physical activity combined with overeating causes extra pounds. As a result, the metabolism is disturbed, which leads to impaired blood circulation in the cartilage and peri-articular tissues - arthrosis develops.
- Hormonal and immune disorders- gout, psoriasis, etc.
- Diseases of the joints– synovitis, chronic and acute arthritis, aseptic tissue necrosis.
- Diseases of the endocrine system and metabolic disorders. These conditions cause the body to lack vitamins and minerals needed for joint health (such as calcium and phosphorus). This negatively affects the condition of the joints and complicates the recovery processes in them.
Most often, arthrosis does not occur under the influence of one factor, its development is promoted by a combination of several reasons at the same time.
Types and symptoms of shoulder arthrosis
Since the development of arthrosis continues for a long time, at first the disease may practically not manifest itself, only sometimes it is felt after severe physical overload or hypothermia.
The main symptoms of arthrosis:
Shoulder pain. This is the main sign of arthrosis - the pain is of a different nature, usually intensifies when moving and loading the shoulder joint. The pain causes discomfort, which limits the mobility of the shoulder.Crunching when moving . Salt deposits in the shoulder joints cause a characteristic crunching (or clicking) sound in the joint when moving.Movement restrictions . It manifests itself depending on the stage of arthrosis - at the beginning of the disease there are no restrictions, during an exacerbation the patient cannot freely rotate and move the arm.
Sometimes the location of the pain may be atypical and may hurt in the hand or elbow. With palpation, you can determine the main sources of pain - the lower edge of the scapula and collarbone.
Note! In the initial stage, arthrosis of the 1st degree does not cause any symptoms. This is due to the lack of nerve endings in the cartilage tissue, as a result of which the disease begins to manifest itself when the pathological process extends far beyond the joints .
Depending on the nature and degree of damage to the bone and cartilage tissue, there are three stages of arthrosis, which are characterized by certain symptoms.
| pain | It occurs rarely - usually in the evening or morning, after physical exertion or hypothermia | Severe pain that occurs with any movement | The pain is constant, even at rest |
| Movement restrictions | Easy | The range of possible movements is reduced | Abrupt and sometimes complete limitation of mobility. Abduction of the arm and lifting it become impossible. The hand must be held in a forced position, which is very painful |
| Grinding and crunching in the shoulder joint | Slight crunch on sudden movement - no pain | With every movement there is a squeak and a clear crunch | Constant crunching clicks are heard with every movement |
| Local manifestations (redness and swelling in the joint area, increased temperature at the site of the disease) | Not present | Appears in periods of exacerbation | There is inflammation in the joint all the time |
| Stiffening of the joint | Not present | It is rare | There is stiffness and deformity of the shoulder |
| Changes in the joint visible on an X-ray | Not present | Signs of joint deformity, narrowing of the joint space and the appearance of osteophytes are visible | Signs of joint destruction are visible |
The period of the first stage can last from several months to several years. Osteoarthritis of the shoulder joint of the 3rd degree is treated only with the help of surgical measures, becausethe condition threatens the disability.
One of the types of pathology is deforming arthrosis of the shoulder joint. This condition means the destruction of the articular cartilage, which leads to irreversible changes in the bones of the articular surfaces. In addition to cartilage tissue, such changes also affect the joint capsule and synovial membrane, which leads to destruction and deformation of the shoulder joint.
Deforming arthrosis manifests itself with aches and dull pains in the shoulder joint, which intensify when the weather changes and at night. The pathology is chronic, which does not allow it to be completely cured, but it will help relieve the unpleasant symptoms and stop the destructive processes in the tissues.
How to treat arthrosis of the shoulder joint
Before the treatment of arthrosis of the shoulder, a number of diagnostic measures are carried out aimed at determining the form and stage of arthrosis. Among these measures, it is necessary to conduct laboratory and biochemical blood tests that can confirm the presence of an inflammatory process in the body.
If shoulder arthrosis is suspected, the patient is asked to perform a number of self-diagnostic measures:
- Put your hands between the shoulder blades in the form of a lock;
- Tie a belt behind your waist;
- Bend the elbow at the level of the shoulders and comb the hair at the back of the head.
If the patient performs all these activities without difficulty, then he is not at risk of arthrosis. But if the performance of the tasks is difficult and causes pain in the collarbone and shoulder area, a more thorough examination is needed - for a more accurate diagnosis, fluoroscopy and nuclear magnetic resonance are used.
Arthrosis of the 2nd degree and the first stage of the disease are treated with conservative methods, only if there is no result, surgical treatment can be used.
Conservative methods for the treatment of arthrosis are carried out in combination, when the treatment is carried out simultaneously in several directions:
- Treatment with medication;
- Physiotherapy;
- Treatment with traditional methods;
- Therapeutic gymnastics and acupuncture;
- Special diet;
- Balneotherapy.
important! An important condition for the treatment of shoulder arthrosis is to ensure rest of the shoulder joint (this is easier to do when arthrosis of the left shoulder joint is observed), and such a sparing scheme should be used even after the end of the therapy course. If the patient continues to stress the shoulder girdle, the disease will progress, eventually leading to surgery.
Operative measures include endoprosthetics - replacement of a diseased (worn) joint with an artificial one. This operation is expensive and although it greatly improves the patient's quality of life, it has the disadvantage that the operation must be repeated every 10-15 years.
Medication treatment
Drug treatment has several directions - pain relief, relief of inflammatory processes and direct restoration of cartilage tissue.
Medicines and pills
To eliminate inflammation and pain, the following groups of drugs are used:
- Nonsteroidal anti-inflammatory drugs;
- Analgesics and antispasmodics.
These drugs can be prescribed orally or intramuscularly (in the form of injections). They relieve pain and relieve inflammation well, but they cannot be taken for a long time - treatment is carried out in short courses.
The destruction of cartilage tissue is treated with drugs from the group of chondroprotectors, which include active ingredients: glucosamine, chondroitin sulfate and hyaluronic acid.
Chondroprotectors are a valuable building material for cartilage tissue, but the drugs have a restorative effect only in the first two stages. The first results of the use of chondroprotectors are observed only 3 months after use, and the total course of treatment is about a year.
In the treatment of arthrosis, it is mandatory to take nutritional supplements and vitamin-mineral complexes containing substances that prevent the demineralization of joint tissues.
In severe inflammatory processes, a method called "intra-articular blockade" is used. The essence of the technique is the introduction of hormonal drugs into the cavity of the acromial joint. Such injections have a powerful anti-inflammatory effect, but have many side effects, so they cannot always be used in treatment.
Ointments
For external use, ointments are effectively used, which are applied to the skin in the area of the shoulder joint. Ointments for arthrosis have an anesthetic effect, contain anti-inflammatory substances and agents that improve blood circulation.
important! Ointments for arthrosis help relieve unpleasant symptoms, but they cannot cure the disease.
The advantages of ointments over painkillers are that they have a local anesthetic effect without damaging the gastrointestinal tract. But they also have a drawback - with the intensity of the pain syndrome, they cannot always quickly relieve the pain.
Physiotherapy
The main method of treating arthrosis in the first stages is taking drugs. Physiotherapy procedures can improve the effect of medication and also reduce the likelihood of side effects.
The following therapeutic methods are used in the treatment of arthrosis:
- Electrophoresis;
- Exposure to a magnetic field;
- Exposure to radiation (ultraviolet, infrared, laser);
- Ultrasound.
Physiotherapy activities are held several times a year - in courses. The type and method of treatment are selected individually for each patient depending on the degree of the disease, the patient's age and other indications.
Home treatment
Treatment of arthrosis of the shoulder joint at home is carried out as an addition to drug therapy, with the permission of the attending physician.
Gymnastics and exercise therapy
Physiotherapy for arthrosis of the shoulder joint should be performed only in the remission stage, during an exacerbation, gymnastic exercises are contraindicated.
Exercise therapy exercises can be found on the Internet, but all of them should be approved by your doctor.
important! You cannot choose exercises for arthrosis on your own, regardless of what authoritative sites describe these procedures and whatever flattering reviews accompany them. Many of them have contraindications and can cause more harm than good - therefore, before starting exercises, you should definitely consult a doctor.
Rules for home exercises for arthrosis:
- Physical therapy cannot be performed if there are decompensated lung and heart diseases, if there is a high temperature, or if there are diseases in which any physical activity is contraindicated.
- Exercise should not cause pain. Otherwise, they are chosen incorrectly and can cause complications.
- In the treatment of arthrosis of the shoulder joint, gymnastics requires regularity - it must be done daily. Initially, training should take no more than 5 minutes a day, gradually increasing the time to 20 minutes.
- You need to do the exercises gradually - first with a quarter strength, then gradually increase the load. The intensity of the movements and their amplitude should be increased gradually. The older the age and the longer the duration of a sedentary lifestyle, the slower the process of increasing intensity.
- The exercises are performed in a light, semi-relaxed state - sitting or lying down.
A number of simple exercises can be done independently every day at any convenient time: raising and lowering the shoulders, swinging the arm back and forth, rotating the shoulders.
Massage
Massage for arthrosis of the shoulder joint is best done immediately after exercise therapy and gymnastics. This will help improve blood circulation in the shoulder joint and promote cartilage tissue repair.
The massage can be performed only if the acute pain subsides and the inflammatory process decreases.
During the procedure, not only the sore shoulder is massaged, but also the collar area on both sides, as well as the forearm area.
Diet
Dietary rules for arthrosis - elimination of factors affecting the development of the disease and metabolic disorders.
Basic principles of the diet:
- Limiting sweet, starchy, fatty and salty foods.
- Keep salt intake to a minimum.
- Reduce portion sizes but increase the number of meals (eat small portions but often).
- Replace the consumption of animal fats with dairy and vegetable fats.
- Increase the amount of dairy dishes in your diet, which are sources of calcium, as well as seafood and fish (a source of collagen and phosphorus).
- Include more fresh fruits and vegetables in your menu.
If you have arthrosis, you should never starve - the menu should be composed in such a way as to increase the supply of nutrients without harm to the body and reduce the amount of harmful foods.
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Doctors recommend treatment at home with folk remedies as a supplement to medical therapy:
- Pork fat is mixed in equal proportions with propolis. The resulting ointment is rubbed with massaging movements in the area of the shoulder joint.
- Herbal baths with decoctions of chamomile, burdock and nettle are recommended for pain relief.
- Oatmeal is a folk remedy for arthrosis. They are steamed in boiling water, after which compresses are made from the decoction for the shoulder, which are done at night.
Folk remedies do not cause side effects and have no contraindications for use.
Prevention
Preventive measures to prevent arthrosis include minimizing the factors that cause the disease.
General recommendations:
- Elimination of inadequate loads on the joint related to sports or professional activities.
- Minimizing the risk of shoulder joint injury.
- Mandatory consultations with a therapist in case of injury or pain in the shoulder joint to minimize the risk of complications.
- Prevent the appearance of excess weight - control your diet and perform daily physical activity (gymnastics, walking, swimming).
- In old age, use drugs that promote the regeneration of cartilage and bone tissue.
Osteoarthritis of the shoulder joint is a dangerous disease that can lead to complete immobility of the joint and disability. You should consult a doctor at the first signs of illness. Treatment of arthrosis should be comprehensive and include both conservative and alternative treatment methods.