Osteoarthritis (osteoarthritis) is a degenerative disease of the cartilage tissue in which the normal function of the joint is disturbed. In most cases the disease is chronic. Shoulder osteoarthritis is characterized by pain and a gradual loss of hand functionality. Most often, the pathology is noted in old age. The causes of osteoarthritis are changes in the age of the body, shoulder injuries, birth defects and constant stress on the shoulder girdle. If a person is faced with discomfort in the shoulder girdle, it is necessary to consult a doctor and undergo an examination. With the help of a complex action, it is possible to stop the development of degenerative changes.
What is shoulder osteoarthritis
Osteoarthritis of the shoulder - damage to the cartilage tissue of the joint, in which degenerative changes occur. The blood supply in cartilage tissue is disturbed, so that it is no longer adequately supplied with nutrients and oxygen.At risk are people who experience excessive stress on the shoulders every day and who have congenital defects in the joint tissue.In the early stages, the person feels aching pain, but the shoulder continues to function normally. If the provoking factors are not eliminated, the disease leads to serious damage to health.
Diagnostics play an important role in the treatment of osteoarthritis. With the help of X-rays, it is possible to accurately determine the cause of the disease and the degree of damage.
Anatomical background
Congenital disorders of the structure of joints and connective tissue can be the causes of the appearance of the disease. If a person has features in the structure of the shoulder girdle, even a normal load can provoke the appearance of osteoarthritis. To avoid problems, you need to take preventive measures and consult a doctor regularly. Congenital dysplasia can be controlled with massage and exercise therapy.
Causes and Risk Factors
All elderly people are at risk.According to WHO statistics, the likelihood of developing osteoarthritis increases significantly after 45 years.By the age of 65, more than 50% of people have this disease. The reasons that provoke the early onset of the disease include:
- damage to the rotator cuff of the shoulder;
- Shoulder injury;
- constant stress related to exercise or work;
- infectious and autoimmune diseases;
- Obesity;
- wrong metabolism.
The older a person gets, the higher the risk of developing degenerative joint damage.
Views
The defeat of cartilage tissue is divided into primary and secondary. The diagnosis of primary osteoarthritis is made if there are no comorbidities. It is usually noticed in old age. The reason for its occurrence is age-related changes. The secondary view is carried out due to injuries or against the background of another disease. In addition, the disease is classified by location.Degenerative changes in the shoulder can occur in the area of the shoulder joint itself or the acromioclavicular joint.
Developmental stages and symptoms
The symptoms depend on the stage of development of the shoulder osteoarthritis. The pathology is divided into three phases:
- The first. . . Aching pains occur, which intensify at night, the functionality of the shoulder girdle is retained.
- The second. . . When moving the hands, a crunch can be heard, the pain is constant, the mobility of the shoulder is limited.
- Third. . . Severe pain, the arm is fixed in one position, protrusions are visible in the affected area, a severe deformation of the joint can be seen on the X-ray.
The disease cannot develop for a long time. If a person continues to put pressure on the shoulder girdle, the condition worsens.
Which doctor should you contact?
Osteoarthritis of the shoulder joint is treated by different doctors. The initial examination is carried out by a therapist or rheumatologist. In addition, the following specialists can be involved in the treatment:
- The surgeon;
- Orthopedist;
- Neurologist.
In most cases, the treatment regimen will be drawn up by a rheumatologist.A surgeon's help is needed when the disease requires surgical treatment or intra-articular manipulations.Consultation with a neurologist is necessary if the nerve bundle has been compressed due to the disease.
Only after a diagnostic examination will the therapist or rheumatologist determine whether the help of other specialists is required.
diagnosis
Hardware and laboratory tests, as well as manual exams, are used to make an accurate diagnosis. First, an inspection with various tests is carried out. The person's history is examined. All of this will help make a preliminary diagnosis. In addition, MRIs and X-rays are used to determine the degree of narrowing of the joint space, the condition of the blood vessels, synovial membrane, and tendons.
Manual examination
Manual examination involves palpating the affected area and performing diagnostic tests. Pain usually occurs when palpating the acromioclavicular joint. If a person has trouble putting their hand behind their head, it may indicate osteoarthritis of the shoulder joint. A manual examination can help the doctor spot inflammation. The information obtained from the manual examination plays an important role in the diagnosis.The examination should be carried out by an experienced rheumatologist or therapist so as not to cause damage during tests and functional tests.
Instrumental methods
Using instrumental research methods, you can determine:
- the degree of narrowing of the joint space;
- uneven joint surface;
- Localize osteoarthritis.
After the use of instrumental diagnostic methods, the necessary therapy is selected. X-rays, CT or MRI are used for diagnosis. These methods provide the necessary information. The instrumental examination can be repeated during treatment.
laboratory
Laboratory tests allow you to assess the condition of your entire body and rule out inflammatory arthritis. First, blood is drawn for analysis. In the case of osteoarthritis, all clinical and biochemical blood tests are within the normal range. With arthritis, the rate of sedimentation, the amount of immunoglobulins and other markers of the inflammatory process in the body are significantly increased. Based on the results obtained, the doctor makes a final diagnosis and selects an effective treatment regimen.
For accurate results, donate blood on an empty stomach in the morning.
treatment
The treatment approach is complex. Medicines, physical therapy, physical therapy exercises are used. If the disease has progressed or doesn't respond to treatment, surgery will be done. Basic principles of therapy:
- Relieve pain;
- stop the development of the disease;
- Start the mechanisms of cartilage tissue recovery.
In the initial stage, the result is achieved through the use of medication.It is important to rule out provoking factors. A stable remission is achieved through physiotherapy and exercise therapy.
medication
The following groups of drugs can be used for treatment:
- nonsteroidal anti-inflammatory;
- Chondroprotectors;
- Corticosteroids;
- Vasodilators.
NSAIDs and corticosteroids are used to relieve pain. They are valid for a limited time. Chondroprotectors can accelerate the restoration of cartilage tissue. Vasodilators help improve blood flow and relieve small vessel cramps.
Before prescribing this or that remedy, you need to carefully study the contraindications. Only a doctor can correctly combine all drugs.
Surgical
Surgical intervention is performed only as a last resort when irreversible degenerative processes have occurred. The reasons for the operation are:
- lack of effect of conservative therapy;
- the appearance of complications;
- the appearance of severe degenerative changes.
If the joint has lost its original appearance, an endoprosthesis is performed.The diseased joint is replaced by an artificial one. The operation is complex and requires a high level of qualification on the part of the surgeon. Puncture and arthroscopy can also be done to treat osteoarthritis.
Puncture
The puncture is performed when a large amount of fluid has accumulated in the joint cavity. This procedure is also done for infectious inflammation to determine the type of infection. Eliminating excess fluid will help reduce pressure on the shoulder joint and increase its range of motion. The procedure is minimally invasive, so recovery will be as quick as possible once it is complete. Puncture has indications and contraindications. It is only used if there is accumulation of fluid in the joint capsule or if an infectious osteoarthritis complication is suspected.
Arthroscopy
Arthroscopy is a minimally invasive surgical technique in which damaged shoulder cartilage is removed. The operation is performed with endoscopic devices and a micro camera. The advantage of this method of treatment is rapid rehabilitation. By removing the destroyed cartilage, you can relieve stress and restore mobility to the joint. The disadvantage of the procedure is that access to the affected area is somewhat limited.
Endoprosthetics
Endoprosthetics is the complete replacement of a damaged joint with a biocompatible analog.Titanium construction is widely used. The operation can even get rid of stage 3 osteoarthritis. Long-term rehabilitation is carried out after the endoprosthetics. This makes it possible to completely eliminate the affected areas and chronic pain, as well as restore the mobility of the shoulder girdle.
The operation is not always possible. In the elderly, the rehabilitation phase is much more difficult. Other treatment options are used before the appointment to endoprosthetics.
physical therapy
Physiotherapy procedures play an important role in getting rid of osteoarthritis of the shoulder girdle. With their help, it is possible to restore normal joint mobility and reduce the severity of pain. The following procedures are carried out:
- Electrophoresis;
- local cryotherapy;
- Magnetic Therapy.
Physiotherapy can be used if there are no acute manifestations of the disease (severe pain, limited mobility). Regular exposure will completely eliminate discomfort. Each procedure must be performed by a qualified technician.Before visiting physical therapy rooms, it is important to consult your doctor.
Kinesitherapy
Kinesitherapy describes the use of active and passive methods to restore shoulder function. If the disease is mild, the person can use an active method of recovery through exercise. The passive method consists of external exposure through massage or mechanotherapy. Kinesitherapy helps to quickly get rid of the manifestations of osteoarthritis of the shoulder joint.
The passive method of recovery through mechanotherapy is available to people of all ages.
Exercise therapy
Physiotherapy exercises allow you to strain the muscles and restore mobility to the shoulder joint. Mostly static exercises are used. Dynamic loading in which active shoulder rotation is performed is undesirable. The following exercises can be performed:
- Shaking shoulders- It is necessary to take the starting position, sit in a chair and put your hands on your knees. Relax your shoulders, then start swinging your elbows. At the same time, your hands are on your knees.
- Slow rotation- You need to sit on a chair and put your hands on your knees, then slowly, with short pauses, start rotating your shoulders. Circular movements are carried out back and forth.
Physiotherapy can only be used during remission, when pain and movement restrictions are almost completely absent.
massage
By massaging the affected area, you can achieve the following effects:
- Improvement of tissue nutrition;
- Relieve swelling;
- tone the muscles;
- Remove pain.
It is recommended that all measures be carried out by a qualified specialist. When doing self-massage, strong pressure and sudden movements should be avoided.The result of the massage effect can be felt within a few weeks after regular use.
The massage should be accompanied by other activities. If a person does exercises from the movement therapy complex and visits a massage room, he will get great results.
Mechanotherapy
Mechanotherapy means a series of exercises that are performed on special mechanisms. This method will allow you to recover in no time. Mechanotherapy is ideal for rehabilitation after an operation. Special mechanisms allow you to adjust the load, which allows for faster recovery of muscles and ligaments. All actions are carried out under stationary conditions. Teaching about rehabilitation mechanisms should be conducted with an instructor. He will correctly choose the load and the required simulator.
Pulling force of the joints
Joints are stretched with a special device. The following effects can be achieved with this method:
- improve blood circulation;
- increase the joint space;
- relieve the ligaments.
The narrowing of the joint space is one of the main manifestations of osteoarthritis. You can use this procedure to improve the situation. The degree of stress is chosen individually. The traction is initially carried out with minimal weights.
Before prescribing the traction of the joints, it is necessary to conduct an examination for possible contraindications.
Folk methods
Traditional methods allow you to get rid of pain and accelerate the process of restoring cartilage tissue. The following remedies can be used:
- Burdock leaves- Fresh burdock leaves are crushed until soft and applied to the affected area for 30-60 minutes. Fixation is carried out with gauze.
- Salt compress- 50 g of salt are dissolved in 450 ml of water, after which gauze is added to the liquid. The gauze is removed, heated and applied to the shoulder for 45 minutes.
- gelatin- 2 teaspoons of gelatin must be diluted in 100 ml of warm water, after which the liquid is brought to a boil. Gelatin is taken orally once a day, before meals. It promotes the restoration of the cartilage tissue.
Traditional methods help to get a good result in therapy. It is advisable to use them during remission.
Diet for osteoarthritis
With any type of osteoarthritis (shoulder, wrist, ankle), you need to provide your body with all the nutrients for rapid restoration of the cartilage tissue. You must include the following foods in your diet:
- Nuts;
- Bran;
- gelatinous jelly;
- Buckwheat porridge;
- Eggs.
The diet should be balanced. Vitamin supplements can be taken to get essential vitamins and minerals. It is advisable to eat 4-5 times a day. During the treatment of osteoarthritis, alcoholic beverages and sweets are excluded. If a person is to achieve permanent remission, they must continuously adhere to the principles of proper nutrition.
Complications and prognosis
The prognosis depends on the age of the person, the degree of damage and the individual characteristics of the organism. Complete restoration of cartilage tissue and joint functionality is possible at a young age. In old age you have to adhere to certain rules in order to achieve a sustainable improvement in your condition. Osteoarthritis of the shoulder responds better to therapy than osteoarthritis of the foot, as the shoulder girdle is easy to isolate from stress. This allows for more effective conservative treatment.
Differences between shoulder osteoarthritis and arthritis
Osteoarthritis and arthritis have the same manifestations, but they differ in the clinical picture. The main difference is that osteoarthritis is a non-inflammatory disease.In the early stages, pain in osteoarthritis worries a person only after exercise, and in arthritis it is constant.Arthritis is an inflammatory degenerative disease. The treatment differs slightly from that of osteoarthritis.
In order not to confuse these diseases, methods of differential diagnosis are used. Laboratory and instrumental studies will help pinpoint the presence or absence of inflammation.
prophylaxis
Prevention of osteoarthritis consists in eliminating provoking factors and maintaining a healthy lifestyle. You need to do the following:
- give moderate physical activity;
- Avoid hypothermia;
- Use chondroprotectors;
- avoid hard physical labor;
- Reduce body weight to normal.
Preventive measures help keep the joints healthy into old age. Prevention should be carried out with particular care by people over the age of 45 or actively involved in sports.
Conclusions
- Osteoarthritis of the shoulder is a degenerative disease in which the cartilage tissue of the joint is gradually destroyed.As a result, the person is in pain and movement is restricted.
- Treatment for the disease includesthe use of drugs, the conduct of physical therapy and the implementation of exercises from the complex of physiotherapeutic exercises.
- At an early stage in the disease process, the prognosis for full recovery is favorable.
- Prevention can greatly reduce the chance of osteoarthritis of the shoulder joint.