Osteoarthritis of the shoulder joint (omarthrosis) is a chronic disease in which irreversible degenerative-dystrophic processes take place in the tissues of the joint. The pathology disrupts the normal functioning 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 destruction of the joint and maintain the mobility of the shoulder joint, it is necessary to contact an orthopedist-traumatologist after the first symptoms.
Causes of osteoarthritis of the shoulder joint
The disease is polyetiological. The development of deforming arthrosis of the shoulder joint can be associated with various factors:
- Professional sports or intensive training.
- Endocrine diseases.
- Hormonal disorders.
- Congenital pathologies of the development of the musculoskeletal system.
- Hereditary predisposition, etc.
In most cases, secondary osteoarthritis is diagnosed: the pathology occurs after exposure of the joint to one or another factor. The primary or idiopathic form of the disease is rarely registered. In this case, it is impossible to determine the exact cause of tissue degeneration.
Symptoms of osteoarthritis of the shoulder
Changes in cartilage and bone tissue begin long before the first signs of osteoarthritis appear. Joint structures have 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 may appear after 40-50 years, and in the deforming type of disease, patients notice changes as early as 16-18 years.
Symptoms of osteoarthritis of the shoulder:
- Cracking of the joint during movement.
- Pain, especially strong after training.
- Stiffness of movements, expressed after sleep or prolonged rest.
- Increased pain with changes in weather.
Degrees of osteoarthritis
The clinical classification determines three degrees of osteoarthritis of the shoulder joint:
- 1 degree. The patient complains of a slight crunch that occurs during movement. The pain syndrome is absent. There is discomfort when the arm is brought to the extreme position.
- 2nd degree. The pain occurs when the limb is raised above shoulder level. The range of motion is reduced. After a significant load, the patient feels pain even at rest.
- 3rd degree. Joint mobility is severely limited. The pain syndrome is almost constant.
Diagnosis of osteoarthritis of the shoulder joint
The doctor must not only correctly diagnose, 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 inspection
The first stage of the diagnosis is a consultation with an orthopedic traumatologist. The doctor examines the diseased joint for swelling, severe deformity. With the development of osteoarthritis, the muscles may partially atrophy - 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 perform random movements of the hands.
- Thickening of the edges of the joint surfaces (large osteophytes can be found on palpation).
- The presence of crunch, "clicks" that are heard or felt by the hand during the movement of the shoulder.
- Joint congestion in the presence of free chondromic bodies.
- Pathological movements in the shoulder.
Radiography
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 surrounding tissues.
Ultrasound examination (ultrasound)
A non-invasive method that allows you to examine the joints in pregnant women 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 the adjacent tissues. To date, magnetic resonance imaging is one of the most informative methods for diagnosing osteoarthritis.
Laboratory tests
As part of the overall review, they appoint:
- 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 general health.
- Urine analysis. Renal pathologies often cause secondary deforming arthrosis. The analysis is necessary for an accurate diagnosis.
- Blood chemistry. The data help to determine the cause of inflammation. Biochemical analyzes are also performed to monitor complications and side effects during therapy.
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
Medicines and dosage are chosen individually. The doctor may prescribe:
- Non-steroidal anti-inflammatory drugs (NSAIDs). Medications reduce inflammation and pain.
- Glucocorticosteroids. Hormone-based products have a more intense effect on the focus of pain. The drugs 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. Drugs from this group are prescribed for severe pain syndrome. Depending on the severity of the symptoms, the doctor chooses non-narcotic or narcotic (rarely) analgesics.
- Chondroprotectors. The active ingredients of the drugs are involved in the formation of new cartilage tissue. The regeneration of the diseased joint is accelerated, the trophism is improved. Chondroprotectors have a cumulative effect and have been proven in the treatment of osteoarthritis of varying severity.
Some medicines are injected directly into the joint cavity. For example, blockade has a better analgesic effect than taking drugs in tablet form.
Physiotherapy
The courses are held after the exacerbation is removed. Physiotherapy as part of complex therapy helps to improve the transport of drugs to the diseased joint, relieve swelling and reduce pain.
To treat osteoarthritis use:
- Electrophoresis.
- Phonophoresis.
- Shock wave therapy.
Physiotherapy can be combined with massage, physical 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 for slowing down degenerative processes. It is better to start training 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 how to perform them properly and distribute the load so as not to exacerbate 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 osteoarthritis of the shoulder joint at home.
Surgery
The operation is performed for 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. The puncture reduces the 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 examination to determine the infectious agent or other indicators.
- Arthroscopy. With the help of microsurgical instruments, the doctor examines the joint cavity, removes scars, sutures the tendons of the rotator cuff or the joint capsule if they are damaged. Several punctures remain on the skin. The patient recovers quickly.
- Endoprosthesis. Endoprosthesis allows you to completely get rid of chronic pain, to restore the mobility of the arm. Prolonged (3 to 6 months) rehabilitation is required after the operation.