Osteoarthritis of the shoulder joint (omarthrosis) is a chronic disease in which irreversible degenerative-dystrophic processes occur in the tissues of the joint. Disrupts the normal functioning of the pathological joint. The range of motion of the shoulder is gradually reduced to complete immobility. Osteoarthritis of the shoulder joint causes severe pain and reduces quality of life. In the absence of treatment, disability occurs.
To stop the process of joint destruction and 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 joint
The disease is polyetiological. The development of deforming arthrosis 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 predisposition, etc.
In most cases, the diagnosis of secondary osteoarthritis is made: the pathology occurs after exposure to a combination of one or another factor. In rare cases, note the initial 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 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 sufficiently active. As the body ages, recovery processes give way to degeneration. The first signs of destruction may appear after 40-50 years, and patients with a type of deforming disease feel the changes at the age of 16-18 years.
Symptoms of shoulder osteoarthritis:
- Cracking of the joint during movement.
- Severe pain, especially after exercise.
- Stiffness of movement expressed after sleep or long rest.
- Increased pain during weather changes.
Degrees of osteoarthritis
The clinical classification identifies three degrees of osteoarthritis of the shoulder joint:
- 1 degree. The patient complains of a slight crisis seen during movement. There is no pain syndrome. Anxiety is felt when the hand is taken to an extreme position.
- 2 degrees. Pain occurs when the limb is raised above shoulder level. The range of motion is reduced. After significant exertion, the patient feels pain even at rest.
- 3 degrees. Joint mobility is severely limited. Pain syndrome is almost permanent.
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 patient well-being and slows cartilage degeneration.
The first stage of diagnosis is a consultation with an orthopedic traumatologist. The doctor examines the patient joint for swelling, severe deformity. The development of osteoarthritis can be accompanied by partial atrophy of the muscles - this can be seen with the naked eye.
With a manual examination, the doctor assesses the function of the joint according to several criteria:
- Ability to perform voluntary hand movements.
- Thickening of the edges of the articular surfaces (palpation can reveal large osteophytes).
- The presence of a crisis, "clicks" that can be heard or felt by hand during shoulder movement.
- Joint obstruction in the presence of free chondromatic bodies.
- Pathological movements in the shoulders.
To detect signs of osteoarthritis of the shoulder joint, radiography is performed in two projections, which allows to assess the degree of narrowing of the joint space, 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)
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 visualizes osteophytes, enlarged lymph nodes in the periarticular space.
Magnetic resonance imaging (MRI)
The MRI machine takes pictures of successive cuts. The images are not only playful, but also clearly show the adjacent tissues. To date, magnetic resonance imaging is one of the most informative methods in the diagnosis of osteoarthritis.
As part of a thorough examination, they determine:
- 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. Renal pathologies often cause osteoarthritis with secondary deformity. Analysis is needed for an accurate diagnosis.
- Blood chemistry. The data help determine the cause of inflammation. Biochemical tests are also performed to monitor complications and side effects during therapy.
Treatment of osteoarthritis of the shoulder joint
Treatment is long and difficult. The course of treatment includes medication, health procedures, special exercises for osteoarthritis of the shoulder joint. In difficult cases, surgery is indicated.
Medications and dosages are selected individually. The doctor may prescribe:
- Non-steroidal anti-inflammatory drugs (NSAIDs). Medications reduce inflammation and pain.
- Glucocorticosteroids. Hormone-based remedies have a stronger effect on the focus of pain. The drugs not only alleviate the patient's condition, but also reduce inflammation, have antihistamine and immunosuppressive properties. Glucocorticosteroids are prescribed when NSAIDs are ineffective.
- Painkillers. Medications of this group are prescribed for severe pain syndrome. Depending on the severity of the symptoms, the doctor may choose non-narcotic or narcotic (rarely) analgesics.
- Chondroprotectors. The active ingredients of the drugs are involved in the formation of new cartilage tissue. The recovery of the diseased joint is accelerated, trophism improves. Chondroprotectors have a cumulative effect and have proven themselves in the treatment of osteoarthritis of varying severity.
Some medications are injected directly into the joint cavity. For example, blockade has a better analgesic effect than taking the drug in tablet form.
Courses are held after the exacerbation is eliminated. As part of a complex therapy, physiotherapy helps to improve the transport of drugs to the diseased joints, eliminate swelling and reduce pain.
Use to treat osteoarthritis:
- Shock wave therapy.
Physiotherapy can be combined with massage, exercise therapy, therapeutic baths. It is good to go through a series of procedures based on a specific clinic. The doctor will develop a treatment plan based on the condition of a particular patient.
Moderate physical activity is important to slow down degenerative processes. In a medical center, it is better to start exercise therapy for osteoarthritis of the shoulder joint under the supervision of a doctor. The specialist will select the exercises, teach you how to perform them correctly, and distribute the load so as not to aggravate the disease. Gymnastics usually involves warm-ups, stretching, and strength training. Exercises are performed at least 3 times a week.
After a course with a specialist, patients can do therapeutic exercises for osteoarthritis of the shoulder joint at home.
Surgery is performed with grade 3 osteoarthritis when the disease no longer allows the patient to move normally, causes severe pain, and 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. Puncture reduces pressure, reduces swelling, increases joint mobility. The procedure is minimally invasive, so it is performed in an outpatient setting. 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 the scar tissue, and in case of damage, sutures the tendons of the rotator cuff or joint capsule. Several punctures remain on the skin. The patient recovers quickly.
- Endoprostheses. Endoprosthetics allow you to completely get rid of chronic pain and restore arm mobility. Long-term (3 to 6 months) rehabilitation is required after surgery.