The degeneration of connective tissue and cartilage eventually leads to the development of a chronic disease characterized by an undulating course and is called osteoarthritis. It turns out that arthrosis of the shoulder joint is pathological changes in the tissues of the shoulder joint bag. A distinctive feature of this disease is considered to be extremely slow development. Due to this, the patient does not notice the development of the pathological process. The shoulder joint is one of the most mobile and has a wide range of motion. But this makes it one of the most traumatic, along with the forearm joint. Even minor mechanical damage can lead to the development of the disease.
Reasons for the development of arthrosis
The causes of the development of the disease are the natural wear of the connective tissue, inflammation of various etiologies, and salt deposits. In addition, there are a number of factors that can also lead to the development of a pathological process, during which the cartilage tissue becomes thinner and loses its smoothness.
Classification of osteoarthritis
There is a conditional classification of the disease: it is primary and secondary arthrosis.
Primary osteoarthritis develops over time in the course of natural changes in the joint with no apparent cause. Secondary - a consequence of limb injuries. Arthrosis of the second type is most often diagnosed in middle-aged and young people. In older people, a mixed type of the disease is most often determined. The development of a primary disease can lead to:
- genetic diseases that lead to the premature destruction of connective tissue and the development of the disease at a young age. Most often, osteoarthritis of the shoulder joint appears in women with dysfunctional genetics.
- Congenital defects of the joints, leading to their greatest trauma.
The root causes of the development of the disease of the second group include the following reasons.
- Mechanical damage and herbs of the hands. These include dislocations, fractures, severe bruises. Sprains can also cause the disease.
- Osteoarthritis can be called an occupational disease of builders and all those who have the main burden of work in their hands.
- The cause of osteoarthritis is considered to be advanced rheumatoid arthritis.
- Mechanical damage always affects the nerve fibers and the blood supply system, as a result of which the proper nutrition of the tissues decreases, which leads to post-traumatic arthrosis.
- Violations of the endocrine system, metabolic processes. Unstable work of the endocrine system leads to a decrease in the supply of organs and tissues with essential nutrients, which, in turn, negatively affects joint mobility and contributes to their deformation.
- At menopause, due to the decrease in the amount of female hormones, the gradual destruction of cartilage tissue begins. Autoimmune diseases such as gout or psoriasis are also considered a catalyst for the development of osteoarthritis.
- Diseases of the heart and the vascular system of the body greatly affect the active destruction of the shoulder joint bag. For example, varicose veins cause a decrease in blood flow through the vessels, which significantly affects the nutrition of the tissues, and as a result, degeneration of the joints develops.
Traumatologists always warn that unreduced dislocation over time or lack of proper treatment in the future will inevitably lead to the development of arthrosis. This is because the bones grow together and the joint loses its mobility.
The course of the disease
Osteoarthritis of the shoulder joint begins with a gradual change in the cartilage tissue. Due to injuries or other reasons, the blood supply to the connective tissue decreases, which leads to thinning of the cartilage, its external changes, the decrease in the synovial membrane and the appearance of salt deposits. This leads to decreased range of motion and discomfort in this area.
The clinical picture of arthrosis manifests itself gradually, so many do not notice the initial stage of the disease and miss the opportunity for quick relief of the injury.
Arthritis symptoms include:
- Pain in the shoulder, collarbone and shoulder blades. Pain can manifest itself both at rest and during active loads.
- First a quieter and then audible creak at the joint.
- Decreased motor activity of the limb.
- Painful reaction of the joint to changing weather conditions.
- A small swelling may appear in the area of the affected joint.
- Complete loss of mobility due to ossification of the joint, this symptom is observed in the most severe stage of the disease.
Degrees of arthrosis of the shoulder joint.
The stages of development of the disease have a clear classification. Four phases of osteoarthritis progression have been identified.
1st grade osteoarthritis
The beginning of the development of the pathology is characterized by slight pain in the shoulder area in the morning and at night. There is a decrease in motor activity in the morning, which disappears after a while. There is a slight stiffness of movement. After a long rest with an active load, a throbbing pain may appear. When working with one hand on the shoulder joint, a barely audible crunch can be noted without an attack of painful sensations. Constant pain occurs only during physical exertion, which disappears at rest. It is not always possible to diagnose the onset of the disease with the help of X-ray examination, since the image shows only the appearance of small salt deposits and a slight narrowing of the synovial membrane.
Osteoarthritis 2 degrees
At this stage of the development of the disease, there is a significant decrease in motor activity. The crunch in the joint during movement becomes significantly audible, the pain symptoms are sharp and permanent. The joint remains mobile, but the mechanics of the movement change significantly. During exercise, the pain becomes more intense and prolonged. During the development of arthrosis of the second degree, the patient does not leave the feeling of constant fatigue. Aching pains appear in the shoulder, associated with a significant change in the thickness of the interosseous membrane. The X-ray image shows that the synovial space is thinned several times compared to the norm. In addition, there is a significant deformation of the joint, which leads to the inability to perform heavy physical work. Salt deposits occupy an increasing area.
3 degree osteoarthritis
This stage of the disease is characterized by a significant loss of motor activity, even oscillatory movements of small amplitude. The pain becomes constant, its character changes from aching to sharp. This is due to spasms of the periarticular muscles. The bones in the joint become inflamed and sensitive to changing weather conditions. A sign of this degree of arthrosis is a crunch, audible to others, at the slightest movement of the hand. When conducting an X-ray examination, there is an almost complete disappearance of the interosseous membrane, significant salt deposits are located along the edges. The deformation of the tissues is so great that it creates significant difficulties in moving until they are completely lost. 3rd degree osteoarthritis is the cause of disability due to loss of limb capacity.
4 stage of development of arthrosis
In this phase of the disease, a complete loss of movement is recorded, the joint is completely deformed. Accompanied by constant and unbearable pain, which is not suppressed with medication. On the radiograph, fusion of the bones of the joint is observed - ankylosis or the appearance of a false joint - neoarthrosis. Disease in this form always leads to disability. The only treatment is to replace the joint with an artificial one through surgery.
Diagnosis and differential diagnosis of osteoarthritis
A preliminary diagnosis is made on the basis of joint mobility tests and descriptions of symptoms from the patient's words. For damage or refutation, an X-ray examination is prescribed. At the initial stage, slight salt deposits are noted, the deformation of the joint is not repaired. In complex phases of the disease, an X-ray image fully reflects the degree of destruction of connective tissue and the area of the affected joint.
For an accurate diagnosis at the initial stage, the doctor may prescribe additional examinations, for example, a CT scan or MRI with or without contrast.
Be sure to prescribe a biochemical blood test to determine the amount of uric acid salts.
Treatment of osteoarthritis of the shoulder joint
The golden rule that a disease is easier to prevent than to cure also applies here. But if the disease has begun to develop, the main thing is to start complex treatment in time. The nature of the disease is such that it cannot be cured, but the risk of its development can be significantly reduced.
Treatment in the early stages.
At the first stage of the development of the disease, chondoprotectors are prescribed, which accelerate the process of regeneration of cartilage tissue, and vitamin-mineral complexes, increase the amount of essential trace elements in the periarticular tissues.
To reduce symptoms, the patient is prescribed a diet, it is strictly forbidden to eat salty, pickled foods, various types of canned food and smoked meats. It is recommended to eat vegetables and fruits as much as possible.
The doctor should prescribe ointments and gels that not only relieve pain, but also help restore the connective tissue of the joint.
Great importance in the process of treating the first degree of arthrosis is given to physiotherapy exercises. It is recommended to apply medical patches to the affected joint.
Treatment of stage 2 osteoarthritis
At this stage, it is necessary to reduce the pain syndrome and fully or partially eliminate the focus of inflammation. In this case, nonsteroidal drugs that relieve pain and relieve inflammation are prescribed.
As in the first case, condoprotectors are mandatory. Hyaluronic acid, which is part of these drugs, accelerates the process of tissue repair. A strict diet is mandatory, excluding all foods that provoke the development of the disease.
In addition to drug treatment, regular physical education is necessary. Physiotherapy is an invaluable aid in the treatment of osteoarthritis. The simplest, but most effective methods of treatment are prescribed, such as ultrasonic treatment of the affected joint, electrophoresis, spot laser impact on the bones of the shoulder joint.
In addition, mud baths, massage visits and traditional medicine are recommended to activate the recovery process. These measures can significantly slow down the development of the disease.
Treatment of the third stage of the disease.
The treatment of this phase is a set of measures to relieve pain, for which an injection is applied in the joint with a corticosteroid. The number of lockouts should not exceed 4 times a year.
Therapeutic measures are aimed at activating tissue repair processes and slowing down the process of destruction. For this, chondoprotectors and drugs that improve blood circulation are prescribed.
Physiotherapy and physiotherapy exercises are also recommended. A strict diet is required, excluding foods or foods rich in acids.
Treatment of 4 degrees of osteoarthritis
Treatment of this form of the disease is possible only by a surgical method by replacing the joint with an artificial one. The most common are ceramic, titanium and plastic artificial prostheses. Medical methods, as well as physiotherapy, do not give any results.
Treatment with folk methods
Traditional medicine methods are actively used in the initial stages of the disease. Medicinal herbal tinctures, various compresses, rubbing, homemade ointments are widely used.
Folk remedies only provide additional pain relief, no healing effect is observed. Therapeutic measures are appointed only by a specialist, and he also controls their implementation.
Compresses from oatmeal, cabbage juice or honey are widely used. Alcohol tinctures are being prepared on the rhizomes of elecampane and golden mustache, lilac and angelica flowers.
Baths with medicinal herbs are recommended as a warming procedure. To do this, take hay powder, mint, burdock rhizomes, mustard seeds.
Ointments are prepared with herbs sweet clover, hops, St. John's wort based on cosmetic petroleum jelly.
What doctor treats arthritis?
An orthopedic surgeon deals with diseases of the joints, but by determining the root causes of the development of the disease, further examination by a trauma surgeon is possible. Since it is precisely the elucidation of the causes of the disease that allows us to prescribe the most correct treatment.