Osteoarthritis of the shoulder joint (omartrosis) is a chronic disease in which irreversible degenerative-dystrophic processes occur in the joint tissues. The pathology disrupts the normal functioning of the limbs. The range of motion of the shoulder is gradually reduced 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 to 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 joints
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 of the development of the musculoskeletal system.
- Hereditary predispositions etc.
In most cases, secondary osteoarthritis is diagnosed: the pathology occurs after exposure to the joint of one or another factor. Rarely record the primary or idiopathic form of the disease. It is impossible to determine the exact cause of tissue degeneration in this case.
Symptoms of osteoarthritis of the shoulders
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, recovery processes give way to degeneration. The first signs of destruction can appear after 40-50 years and with some kind of deforming disease, patients notice changes as early as 16-18 years.
Symptoms of osteoarthritis of the shoulders:
- Crack of the wrist during movement.
- Pain, especially severe after exercise.
- Stiffness of movement, expressed after long sleep or rest.
- Increased pain during weather changes.
Degrees of osteoarthritis
The clinical classification defines three degrees of osteoarthritis of the shoulder joint:
- 1 degree. The patient complains of a slight crackling that appears during movement. Pain syndrome is absent. Discomfort is felt when the hand is taken to the extreme position.
- 2 degrees. The pain appears when the limbs rise above shoulder level. The range of motion decreases. After considerable effort, the patient feels pain even at rest.
- 3 degrees. Joint mobility is very limited. Pain syndrome is almost constant.
Diagnosis of osteoarthritis of the shoulder joints
The doctor must not only correctly diagnose, but also determine the cause of the pathology. Treatment of the underlying disease significantly improves patient well-being and slows cartilage degeneration.
The first stage of diagnosis is a consultation with an orthopedic traumatologist. The doctor examines the diseased joint for swelling, severe deformity. On the development side of osteoarthritis, the muscles may be partially atrophied - this can be seen with the naked eye.
With a manual examination, the doctor evaluates the function of the joint according to several criteria:
- Ability to make voluntary hand movements.
- Thickening of the edges of articular surfaces (large osteophytes can be detected by palpation).
- The presence of a crack, "clicks" that can be heard or felt by the hand while moving the shoulders.
- Ankle sprain in the presence of free chondromic bodies.
- Pathological movements in the shoulder.
To detect signs of osteoarthritis of the shoulder joint, radiography is performed in two projections, which allows you to assess the degree of narrowing of the joint space, the condition of bone surfaces, the size and number of osteophytes, the presence of fluid, and inflammation of thesurrounding tissue.
Ultrasound examination (ultrasound)
A non-invasive method that allows you to examine the joints in pregnant women and young children. According to the sonography, the doctor determines the thickness of the cartilage, the condition of the synovial membrane. The method visualizes well 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 node but also the adjacent tissue. To date, magnetic resonance imaging is one of the most informative methods in the diagnosis of osteoarthritis.
As part of a comprehensive examination, they designate:
- General blood test. Based on the results, the doctor can judge the presence and severity of the inflammatory process. The analysis also helps to assess the general state of health.
- Urine analysis. Kidney pathologies often cause deforming secondary osteoarthritis. Analysis is necessary for an accurate diagnosis.
- Blood chemistry. The data help to determine the cause of inflammation. Biochemical tests are also performed to monitor complications and side effects during therapy.
Treatment of osteoarthritis of the shoulder joints
The therapy is long and difficult. The course of treatment includes medication, well-being procedures, a set of special exercises for osteoarthritis of the shoulder joint. In severe cases, surgical intervention is indicated.
Medications and doses are chosen individually. The doctor may prescribe:
- Non-steroidal anti-inflammatory drugs (NSAIDs). Medications reduce inflammation and pain.
- Glucocorticosteroid preparations. Hormone-based remedies have a more intense effect on the focus of pain. Medications not only alleviate the patient's condition, but also reduce inflammation, exhibit antihistamine and immunosuppressive properties. Glucocorticosteroids are prescribed in cases where NSAIDs are not effective.
- Painkillers. Medications of this group are prescribed for severe pain syndrome. Depending on the severity of the symptoms, the doctor chooses non-narcotic or narcotic analgesics (rarely).
- Chondroprotectors. The active ingredients of the drug are involved in the formation of new cartilage tissue. Diseased ankle regeneration is accelerated, trophism is improved. Chondroprotectors have a cumulative effect and have proven themselves in the treatment of osteoarthritis of varying severity.
Some drugs are injected directly into the wrist cavity. For example, blockade has a better analgesic effect than taking drugs in tablet form.
Courses are performed after removal of irritation. Physiotherapy as part of complex therapy helps to improve drug transport to the diseased joint, relieve swelling, and reduce pain.
For the treatment of osteoarthritis use:
- Shock wave therapy.
Physiotherapy can be combined with massage, exercise therapy, therapeutic baths. It is best to undergo a series of procedures based on a specialized clinic. The doctor will make a treatment plan taking into account the condition of a certain patient.
Moderate physical activity is important to slow down the degenerative processes. It is best to start exercise therapy for osteoarthritis of the shoulder joint at a medical center, under the supervision of a doctor. The specialist will select the exercises, teach them how to perform them correctly, and distribute the load so as not to cause a worsening of the disease. Gymnastics usually involves a workout for warm-up, stretching and strength. 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.
The operation is performed with grade 3 osteoarthritis, 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:
- Beer. A long needle is inserted into the ankle 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. Material obtained during puncture is sent for research to determine the infectious agent or other indicators.
- Arthroscopy. With the help of microsurgery instruments, the doctor examines the joint cavity, removes the scar tissue, performs a suture of the tendons of the rotating cuff or the capsule of the joint if they are damaged. Some piercings remain on the skin. The patient recovers quickly.
- Endoprosthetics. Endoprosthetics allow you to completely get rid of chronic pain, restore arm mobility. A long rehabilitation (from 3 to 6 months) is needed after the operation.