Somatic cells of the human body are capable of a large number of mitotic divisions.Thanks to this characteristic of our body, it can exist independently for a long time in the external environment, restore damaged tissues or dead cells.
Unfortunately, the number of these divisions is strictly limited and individual for each person.In this regard, upon reaching old age, various diseases begin to appear.Arthrosis is considered one of the most common, as the pain syndrome that accompanies this pathology significantly reduces the patient's quality of life.
Omarthrosis or arthrosis of the shoulder joint becomes a serious problem that interferes with the normal performance of work and daily tasks.It is this disease that will be discussed below;we will analyze the causes of the disease arthrosis of the shoulder joint, the symptoms and the treatment of this unpleasant pathology.
what is it
Osteoarthritis of the shoulder is accompanied by a disruption of the normal blood supply to this important bone joint, as a result of which the thickness of the cartilage tissue decreases and the head of the bone is exposed.Due to the increased friction, a person notices the appearance of pain, which, depending on the degree, may appear only during physical activity or even at rest.
Due to injury to the surrounding anatomical structures, an inflammatory process is observed, aggravating the decrease in the amplitude of active and passive movements in the upper limb.The lack of appropriate treatment often leads to a complication of the process through deformation of the joints, which is called deforming osteoarthritis.
Anatomy of the shoulder joint
The shoulder joint is a ball and socket;it is this structure that allows a person to perform various movements with the upper limb.Three large bones come together in this anatomical area, including the scapula, the clavicle, and the humerus itself.The joint capsule is quite deep and reinforced by a whole complex of ligaments.
Due to some anatomical features of the structure of the shoulder joint, cases of spontaneous dislocations and subluxations in this area are often encountered during daily work at home.The ease and variety of movements is due not only to the spherical shape of the joint surfaces, but also to the presence of a large amount of special synovial fluid, which reduces friction between the surfaces.
Causes of arthrosis of the shoulder joint
The disease presented in the article develops as a result of the impact of a whole complex of provoking factors.Clinical studies conducted in a number of leading research institutes allowed to reliably establish the pathophysiological mechanism of the appearance of changes in bone and cartilage tissue during arthrosis.However, reliable "triggers" have never been identified.
In most cases, this degenerative disease develops secondary, that is, after some pathogenic impact on the shoulder joint.
A retrospective analysis of the medical histories of patients with this pathology in the area of the shoulder joint made it possible to identify influences that could significantly increase the probability of the occurrence of the disease.
These include:
- excessive physical activity leading to physical thinning of the joint surfaces;
- frequent falls on the hand and other injuries of the belt of the upper limb;
- occupational hazards;
- congenital pathologies of the connective tissue;
- disturbed mineral metabolism, accompanied by the appearance of crystalloid deposits on the head of the humerus;
- reduced production of synovial fluid;
- age-related changes in the structure of the vascular wall, causing dystrophic changes in bones;
- lack of proper drug therapy in the presence of an acute or chronic inflammatory process in the joint space;
- pathologies of the nervous system that cause insufficient trophism of the musculoskeletal system;
- the presence of excess weight, constant swelling of the upper limbs;
- diseases of the endocrine system.
Primary arthrosis of the shoulder
The modern medical classification of arthrosis of the shoulder joint, depending on the causes of development, distinguishes two forms - primary and secondary.In the case of a primary diagnosis, the diagnosis is established only after conducting a full set of diagnostic measures to completely exclude the presence of the above-described causes of the appearance of the disease.It is believed that the starting point in the pathogenesis is the deterioration of systemic blood flow against the background of a decrease in myocardial contractility or the permeability of the vascular wall.
Over time, a person begins to notice the appearance of unpleasant sensations during movements in the shoulder.Initially, the discomfort appears during exercise, and then stops disappearing even during rest.Another reason contributing to the rapid progression of the disease is the appearance of so-called osteophytes.These bone spurs form as a result of a compensatory increase in the activity of chondroclasts, which attempt to replace the loss of mature cartilage cells.They have the appearance of a spike, which, when moving, contributes to injury to the capsule and the occurrence of an aseptic inflammatory process.
Against the background of the described changes in the synovial fluid, fibrin threads appear, penetrating the ligament apparatus during prolonged rest.Due to the decrease in the elasticity of the white muscle fibers, a characteristic feeling of "stiffness" appears, which usually disappears after 20-30 minutes of the development of the limb.Shoulder arthrosis has pronounced symptoms, their intensity and treatment are directly proportional to the degree of development of the process.
Secondary arthrosis of the shoulder joint
The secondary form of this disease is a consequence of the presence of a basic pathology, complicated by disorders in the functioning of the musculoskeletal system.Among the causes in first place in frequency are traumatic injuries of an acute or chronic nature.This problem is especially relevant in the cold season, when a person often falls, stretching his hand forward to soften the fall.
Enzymopathies are congenital diseases accompanied by a decrease in the production of specific enzymes that build the ligament apparatus, and can also cause the development of secondary arthrosis of the shoulder joint.It is these patients who often develop luxations and subluxations while performing daily activities.The loosening of this bone joint contributes to increased trauma to the contact surfaces against which the disease occurs.
Symptoms and signs
Shoulder osteoarthritis has complex symptoms and treatment;due to some characteristics of the characteristic signs, its detection often occurs in the later stages of the development of the pathological process.Experts distinguish three degrees of destruction of cartilage tissue in the girdle of the upper limb.In accordance with them, the symptom complex found in the patient will also differ.
In the first stage of the disease, a person rarely notices pain in the shoulder;most often there is discomfort in the limb during heavy physical exertion or immediately after it.In such situations, the patient needs several days to recover and completely get rid of the discomfort in the joint.Precisely for the reason that a person tends to attribute pain to the manifestation of a simple, as it seems to him, dislocation of the ligamentous apparatus, the disease continues its development, reminding itself more and more often.
Arthrosis of the shoulder joint of the 2nd degree is accompanied by a brighter clinical picture.This is due to the fact that in addition to erosion and disruption of normal nutrition of the joint surfaces, secondary inflammation occurs, which spreads to the ligaments and surrounding muscle fibers.The disease leads to the fact that pain occurs even with minor physical exertion.Due to severe pain, the patient becomes unable to make circular movements, which indicates that the process of deforming arthrosis has begun and the amplitude of active movements of the arm in space is limited.
The development of grade 3 leads to almost complete loss of mobility in the shoulder joint.The patient noted significant muscle atrophy and loss of ability to care for himself.Another characteristic symptom is the appearance of bony protrusions above the surface of the skin.The probability of the disease reaching this far exists mainly in people who do not have the opportunity to minimize the load on their upper limbs due to professional activity or during professional sports.
Diagnosis of arthrosis of the shoulder joint
Establishing a diagnosis of arthrosis of the shoulder joint is a procedure that requires certain skills from a specialist.After the appearance of pain in the upper limb, it is recommended to consult an orthopedic traumatologist.Doctors of this profile possess the full range of necessary knowledge.
During the examination, the first thing you should pay attention to is the patient's complaints and medical history.The doctor finds out why the pain appeared, what its nature is, and after what it disappears.It is then necessary to identify occupational risks and the presence of risk factors.
The main diagnostic method for detecting deforming osteoarthritis of the shoulder joint is simple radiography.
The next stage is a physical examination, when a specialist uses palpation to identify painful areas and determine the full range of active and passive movements in the limb.In addition, the presence of local edema and increased skin temperature in the region of the projection of the bone joint is assessed.Based on the data obtained, the doctor can make a preliminary diagnosis, but a differential diagnosis is necessary to prescribe the most adequate therapy.
In order to establish the most correct diagnosis, the extent of the process and possibly identify the cause, various additional laboratory and instrumental diagnostic methods are performed on the patient.
The most informative include:
- clinical blood test;
- determination of biochemical parameters of blood serum;
- clinical urinalysis;
- x-ray of the affected joint;
- ultrasound diagnostics;
- arthroscopic examination;
- magnetic resonance and computed tomography;
- scintigraphy;
- joint puncture followed by biochemical analysis of synovial fluid.
Signs directly indicating the development of arthrosis include the appearance of a significant narrowing of the joint gap, sclerosis of subcartilaginous structures, thinning of the chondrocyte layer itself, the appearance of osteophytes and the deposition of salt crystals in the intra-articular fluid.
How to treat arthrosis of the shoulder joint
After establishing this diagnosis, the doctor is faced with a serious question of choosing the most appropriate therapeutic tactics.Modern medicine has reached a level where it is able to help patients with diseases of the musculoskeletal system to completely return to normal life.
The treatment of arthrosis of the shoulder joint is long-term and therefore often leads to the development of complications.
The chosen method for correcting arthrosis of the shoulder joint directly depends on the following factors:
- process degree;
- general condition of the patient;
- age;
- physiological characteristics.
As a rule, in the early stages, it is enough to prescribe drugs with general and local action.
In the presence of the second degree of arthrosis of the shoulder joint, the symptoms accompanying the disease are almost impossible to completely stop.A person is shown a significant reduction in physical activity to prevent further development of the pathological process;in parallel, a whole range of drugs is prescribed.
The third degree practically does not lend itself to conservative influence;in the presence of such an advanced disease, surgical treatment is indicated, the volume of which depends on many factors and is chosen directly by the attending physician.Next, we will talk in more detail about each of the existing methods for removing arthrosis.
medicines
The following groups of drugs are used as conservative therapy in the presence of this disease:
- glucocorticoids;
- non-steroidal anti-inflammatory drugs;
- analgesics;
- drugs with a chondroprotective effect.
Medicinal substances from this group have a significantly more pronounced anti-inflammatory effect than non-steroidal drugs.
Glucocorticoids are recognized as the most effective agents against inflammatory phenomena.These natural and synthetic adrenal hormone analogues can significantly affect the production of inflammatory neurotransmitters.This reduces local swelling, pain and temperature in the affected area of the musculoskeletal system.
The disadvantages of this treatment include a large number of side effects of glucocorticoids.The presented drugs can cause Cushing's syndrome, lead to disruption of the general metabolism and retention of water in the intercellular space.In this regard, it is recommended that treatment begin with the prescription of NSAIDs.
NSAIDs with anti-inflammatory effects have a direct effect on cyclooxygenase molecules that cause inflammation in damaged tissues.
Preference is given to selective drugs that do not have a harmful effect on the mucous membrane of the digestive tract.
Depending on the severity of the patient's condition and the severity of the pain syndrome, narcotic and non-narcotic pain relievers are used.
The first group is considered more effective, but the side effect of drug addiction leads to the need to strictly limit their use.
Non-opioid drugs have a less pronounced analgesic effect, but do not cause addiction, so they can be prescribed more widely.
It is extremely important not to use chondroprotective agents during the acute period of the disease, as this can lead to increased inflammatory processes.It is necessary to stop the attack and then prescribe a long course of drugs that restore the structure of the joint.
Surgical treatment
In some cases, surgical correction of the condition of a patient with shoulder arthrosis is indicated.This invasive method is used in the presence of a severe destructive process directly in the joint.Most often, patients undergoing surgical treatment are unable to perform daily tasks due to severe limitation of active and passive movements in the shoulder.
After establishing the final diagnosis, a whole set of measurements is performed, during which the optimal parameters for the future prosthesis are selected.Then, a custom-made transplant is made, consisting of high-strength polymers or titanium.
Surgery for arthrosis of the shoulder joint is performed in the final (last) stages of the disease.
The surgical intervention is quite extensive, so the patient goes through a long period of preparation.A total replacement of the affected bone joint is performed, followed by a period of physical therapy that allows full functionality of the girdle of the upper limb to be restored.
Physical therapy
These are physical exercises that allow the mobility of the shoulder to be restored in the shortest possible time, not only after surgical treatment, but also during the therapeutic effect on the disease.Specially developed complexes relieve morning stiffness, stimulate the normalization of blood supply, lymphatic drainage and restore the normal composition of synovial fluid.
It is extremely important that rotational and adductive movements in the upper limb are performed without additional loads, because otherwise there is a high probability of additional trauma and destruction of the cartilage.Rehabilitation specialists are engaged in the development of special complexes of physical therapy.
Each clinical case requires an individual approach, so if you have a disease or want to prevent its development, seek help from this doctor.
Recommendations for treatment at home
Any illness should be treated in a hospital setting under the supervision of highly qualified medical professionals.However, in some cases, the patient does not have the option of a long-term stay in the clinic.In such situations, you should independently monitor the recovery process.
Physical exercises for deforming arthrosis of the shoulder joint are extremely important, as they slow down the progression of the disease.
The following recommendations should be followed:
- strictly follow the instructions and prescriptions of the attending physician;
- maximally limit the affected arm from physical activity;
- get rid of excess body weight by creating a slight calorie deficit and walking in the fresh air;
- divide the daily amount of food into 5-6 meals;
- drink at least 2 liters of water a day;
- change the type of work activity to one that requires a minimum load on the upper limbs.
People's funds
Many elderly people know from their own experience what arthrosis of the shoulder joint is and how to treat it at home.In addition to the recommendations described above regarding changing the type of work activity and removing excess body weight, traditional medicine has a whole range of remedies that help reduce pain and swelling of the affected limb.Various ointments, decoctions, compresses and baths are used for this purpose.We will focus on these treatment methods in more detail.
Ointments
Alternative medicine has a large number of original and effective recipes for preparing anti-inflammatory ointments.The simplest method involves mixing one egg yolk with a teaspoon of turpentine and the same amount of apple cider vinegar.Applying the ointment to the affected joint at night will greatly reduce pain and inflammation.
Another good remedy for treating arthrosis of the shoulder joint is a mixture of fifty grams of agarwood and one hundred milliliters of vodka.After mixing the components and letting them brew for 12 days, you should rub the resulting ointment into the area of the projection of the inflamed bone joint every day.
Decoctions and tinctures
Decoctions and tinctures play a key role in folk medicine.The mixture of a tablespoon of ground agave leaves with 150 milliliters of 70% ethyl alcohol is considered one of the easiest to prepare and at the same time the most effective infusion for arthrosis.After infusing the medicine for two weeks, the liquid should be consumed orally, twenty drops with water for thirty days.
For potion devotees there is a good remedy.To make it, you will need two tablespoons of blueberry leaves and half a liter of boiling water.After mixing the ingredients, let them brew in a thermos overnight.Then take 150 ml of the product three times a day immediately before meals.The course of treatment is 30 days.
Compresses and friction
To reduce pain and inflammation in the area of the shoulder joint affected by arthrosis, various compresses are used.One of the most effective is considered to be a mixture of a liter of vodka and one hundred grams of gentian.The medicine should be infused for two weeks, then used every night before going to bed.
Another simple and effective remedy is a compress of finely grated horseradish mixed with a small amount of water to a puree.Put a handful of medicine in gauze and apply it to the inflamed joint for 20-30 minutes.
Bathrooms
Baths are widely used to treat various diseases of the musculoskeletal system.Thanks to the complex effect, a good anti-inflammatory and anti-edematous effect is achieved.
Preparing a bath is quite simple;to do this, follow these recommendations:
- fill the tub with hot water;
- add to it about a kilogram of sea or ordinary kitchen salt;
- throw in some pine boughs;
- pour a few tablespoons of candied honey;
- at the very end add a teaspoon of turpentine oil.
The course of treatment consists of twelve baths.The duration of one procedure should be about twenty minutes.From the very first use of a therapeutic bath, the patient notices a significant improvement in the general condition and a reduction in discomfort in the joints.
Prevention
Modern medicine does not yet have specific measures to prevent arthrosis.This is due to the polyetiological nature of the pathology.However, there are non-specific measures that can significantly reduce the risk of developing the disease.There is primary and secondary prevention.
The first includes:
- daily walks outside;
- the use of a contrast shower, which allows you to achieve increased vascular tone;
- gentle treatment of the joints, avoiding excessive physical activity;
- moderate exercise 2-3 times a week.
The second group includes the following:
- comprehensive and complex treatment of arthritic processes;
- regular intake of calcium supplements;
- prescription of chondroprotective drugs;
- physical therapy.