Shoulder osteochondrosis develops in people who unduly load the shoulder joint (athletes, loaders, etc.). The cause is untreated or undertreated joint injuries, sprained tendons and muscles, poor posture, a sedentary lifestyle, and is accompanied by osteochondrosis of the cervical spine. The first symptoms of shoulder osteochondrosis may appear in people after 30-35 years of age. At the age of 45 years and older, the symptoms are more pronounced, the aging process occurs, and signs of joint deformation appear.
Specialists from the Yusupov Hospital deal with problems of the human musculoskeletal system. Depending on the disease and the degree of damage, associated complications, the patient can be examined by a neurologist, cardiologist, therapist, orthopedic traumatologist, surgeon and other specialists. If the patient requires symptomatic treatment, then the first contact is with a general practitioner; osteochondrosis is treated by a neurologist, a surgeon, and an orthopedic doctor and a chiropractor may also be involved.
Causes of back and shoulder pain
More often, pain in the neck and shoulders is a sign of diseases of the musculoskeletal system, which are accompanied by damage to tendons, cartilage and joints, as well as inflammation and pinched nerve roots.
Mechanical damage to musculoskeletal, ligamentous, and nerve structures is the main cause of pain.
The neck-shoulder region is the most mobile. It bears significant loads, even when left in a static position for a long time. This part of the spine is susceptible to the following diseases:
- arthritis or arthrosis of the shoulder joint, glenohumeral periarthritis or periarthrosis, tendinitis;
- cervical osteochondrosis, spondylosis;
- osteoporosis;
- scoliosis;
- intervertebral hernia;
- myositis;
- plexitis;
- tumor neoplasms in the cervical-brachial region.
The shoulder often hurts due to damage to the rotator cuff muscles. The pain in this case is localized directly in the shoulder joint. It becomes aching or dull in nature, radiating to the arm above the elbow.
Predisposing factors for the occurrence of diseases of the musculoskeletal system, and, accordingly, back pain in the shoulder area include:
- Injuries to joints, bones, ligaments, muscles. “Fresh” injuries are accompanied by severe pain, but those suffered in the past, especially if they were not treated, make themselves felt as chronic pain. Athletes often experience back shoulder pain after a tendon sprain or rupture.
- Sedentary lifestyle. Physical inactivity leads to weakening of the muscle corset and problems with the spine, shoulders and neck.
- Excessive physical activity. Excessive loads, like physical inactivity, are harmful to the spine and muscles. They carry a high risk of injury. Swimmers, bodybuilders, and athletes involved in contact combat and weightlifting are at risk.
- Excess weight. The more extra pounds you carry, the greater the strain on your neck and shoulders. Fat does not hold the spine in the correct position, but rather acts as additional ballast. You need to build muscle mass.
- Incorrect posture or prolonged heavy load on one side. An uneven load on the spine is fraught not only with scoliosis, but also with deformation of the vertebrae and inflammation of the nerve fibers.
Back pain that radiates to the shoulder can occur not only in an athlete, but also in an ordinary person, since the glenohumeral region is vulnerable to damage to the ligamentous-muscular system. The pain syndrome can be one- or two-sided, sometimes radiating to the arm and chest.
Let's look at the main causes of pain in the neck and shoulder joint, which a doctor most often encounters.
Osteochondrosis or spondylosis
These diseases are accompanied by pathological changes in the spine, which disrupts the functioning of the nerves. The intensity of pain depends on the severity of degenerative processes. At first it is aching and moderate. Without treatment, it becomes acute, can spread to the hand, and cause numbness in the fingers.
Osteochondrosis and spondylosis have a similar cervical pain syndrome and may be accompanied by headache, dizziness, increased blood and intracranial pressure
Periarthritis
Humeral periarthritis is also called “frozen shoulder” syndrome, since the disease has severe symptoms:
- severe pain in the right or left shoulder, which radiates to the neck, intensifies when moving the head;
- increase in pain at night;
- stiffness and limited mobility in the cervical region and upper back.
Unlike arthritis, periarthritis causes inflammation of the soft tissues that surround the joint: the joint capsule, ligaments, tendons and muscles. As a result of the inflammatory process, pain occurs and shoulder mobility is impaired.
Subacute periarthritis is not always accompanied by pronounced symptoms. Sometimes its existence may be indicated by an occasional aching pain between the neck and shoulder.
Note! Humeral periarthritis occupies a leading place among the causes of pain in the neck and shoulder joint.
Neuroma (schwannoma) of the spine
This neoplasm is benign. It is located in the trunk of the brachial plexus, and as it increases in size, it causes pain between the neck and shoulder. Most often, the pain is acute and occurs when the tumor comes into contact with the vertebral body.
Neuroma develops from Schwann cells of nervous tissue
Plexit
It is a neurological disease of an inflammatory nature. With plexitis, various large nerve plexuses can be affected, but the shoulder girdle and cervical region are most often affected. The disease can be recognized by acute pain and muscle weakness.
With cervical plexitis, the phrenic nerve may become inflamed. As a result, accompanying symptoms appear in the form of breathing problems and hiccups. Brachial plexitis may be accompanied by a decrease in the sensitivity of the extremities; the hands often become numb and cold to the touch.
Myalgia (myositis)
Muscle pain in the shoulder and upper back area is often due to muscle spasm or inflammation. Hypothermia, infections, excessive physical exertion, sudden movements, osteochondrosis, intervertebral hernia and other diseases can contribute to the appearance of myositis.
Myositis of the neck or shoulder must be treated promptly, since other muscle groups may be involved in the inflammatory process
With myositis, the pain is acute and severe and does not go away even at rest. The affected area turns red and the local temperature rises. Headache, dizziness, and general deterioration of health are not uncommon.
Characteristic features of the disease
Osteochondrosis affects not only the cartilaginous structures of the spine, but also almost all joints in the human body. The hyaline cartilages of large joints, one of which is the shoulder, are especially susceptible to destruction. Trophic disorder leads to dehydration of tissues, losing about 30% of moisture. Cartilage loses its elasticity and firmness and is no longer able to perform its shock-absorbing function. Their surface dries out and a network of microcracks forms on it, the size of which constantly increases under any significant dynamic load.
Osteochondrotic processes can trigger various external and internal negative factors:
- lack of foods in the diet with vitamins and microelements necessary for the construction of hyaline cartilage;
- endocrine and metabolic disorders, hematopoietic and circulatory disorders;
- congenital anomalies of the structure of the shoulder joint;
- previous injuries - dislocations, intra-articular and extra-articular fractures, ligament ruptures, other injuries of the ligamentous-tendon apparatus;
- overweight.
Excess weight is one of the predisposing factors in the development of pathology.
In young people, osteochondrosis of the shoulder joint often develops against the background of increased physical activity. When lifting weights or intense sports training, cartilage tissue is micro-traumatized. Initially, this does not in any way affect the functional activity of the joint. But with repeated stress, the affected area increases, and soon the first signs of pathology appear.
Old people and elderly people are most susceptible to developing shoulder osteochondrosis for many reasons. This is a decrease in collagen production, the progression of destructive processes and a decrease in the rate of recovery, the inability of cartilage to retain moisture. The muscles that stabilize joint structures during flexion and extension also weaken. In grade 2 and 3 pathologies, this function begins to be performed by the thinned and overgrown edges of the bone plates.
Diagnosis of back and shoulder pain
To find the cause of the pain, a computer examination will be required. A doctor from the SmartMed clinic individually selects a set of diagnostic procedures, which may include:
- radiography;
- CT scan;
- Magnetic resonance imaging.
The most accurate and informative method for diagnosing pain in the back and shoulder is MRI. The SmartMed clinic has installed a new Siemens Symphony 1.5 Tesla tomograph, with which you can detect initial pathological changes in the joint and soft tissues, see neoplasms, disorders of innervation or blood circulation. The cost of tomography includes not only the examination itself, but also a consultation with a diagnostician.
Humeroscapular periarthritis
Osteochondrosis of the cervical spine can manifest itself as a neurological complication, in which the leading symptom is glenohumeral periarthritis (inflammation of the periarticular tissues and joints). Causes may include: trauma, physical activity, hypothermia, inflammation, disruption of the innervation of the shoulder caused by damage to nerve fibers and changes in the discs.
Symptoms of glenohumeral periarthritis: pain in the joint, mainly at night. They radiate to the neck and arm, intensify with movement, increase in intensity, and stiffness of the joint occurs when raising the arm above the horizontal level is problematic.
The muscles surrounding the joint become smaller and atrophy may occur. The volume of the muscles surrounding the joint decreases, they can atrophy, the hand becomes bluish and swells. Humeral periarthritis has symptoms similar to those of cervical osteochondrosis. The neck, shoulder girdle, shoulder, shoulder blade hurt. Tapping on the shoulder blade, shoulder or collarbone is painful. When palpating, it can be difficult to determine the exact location of the pain. More often it is expressed in the joint space.
In the subacute stage of the disease, pain usually intensifies with changes in posture. Subsequently, atrophy (thinning) of the muscles of the shoulder girdle may develop.
Treatment of back pain radiating to the shoulder
Based on the examination results, the doctor prescribes treatment. What it will be like depends on the cause of the pain. Therapy is aimed at both eliminating pain and treating the underlying disease. If the cause is not removed, the pain will return again, so a specialized specialist should be involved in drawing up a treatment protocol.
Therapy is predominantly conservative - a combination of medications and physiotherapeutic procedures. To treat shoulder pain, the following groups of drugs are prescribed:
- non-steroidal anti-inflammatory drugs;
- corticosteroids;
- analgesics.
Additionally, mineral-vitamin complexes and chondroprotectors can be used.
Important! For severe pain, a therapeutic blockade is indicated.
The effect of taking medications is enhanced by physiotherapeutic procedures: magnetotherapy, electrophoresis, ultrasound therapy. For diseases of the musculoskeletal system, massage and physical therapy are additionally prescribed.
The duration of therapy depends on the severity of the patient's condition. For example, with chronic osteochondrosis of the cervical spine, several courses are required.
Treatment tactics
Symptoms and treatment of osteochondrosis of the shoulder joint are interrelated. The pathology is not yet completely treatable. Therefore, treatment is aimed at eliminating painful symptoms, stopping destructive processes, and partially restoring damaged cartilage.
In case of acute pain, the patient is advised to wear rigid or semi-rigid orthoses that reliably fix the joint.
A bandage on the shoulder joint protects against excessive loads.
During the remission stage, it is recommended to use elastic bandages that do not limit the mobility of the joint, but prevent the occurrence of stress on it. Sleeping on orthopedic mattresses and pillows helps prevent relapse. This also helps improve blood circulation, microcirculation, and stimulates the regeneration of damaged connective tissue structures.
To accelerate blood circulation in the shoulder joint, eliminate nutritional deficiencies, and normalize trophism, physiotherapeutic procedures are carried out:
- magnetic therapy;
- laser therapy;
- UHF therapy.
UHF therapy of the shoulder joint.
To eliminate pain, non-steroidal anti-inflammatory drugs are used - Diclofenac, Ketoprofen, Ibuprofen, Meloxicam.
If they are ineffective, drug blockades with glucocorticosteroids Diprospan, Triamcinolone, Dexamethasone are carried out. During the remission stage, it is advisable to use ointments with a warming effect, for example, Capsicum or Finalgon, as painkillers.
Hirudotherapy, or therapy with medicinal leeches, has proven itself well in the treatment of osteochondrosis. From 3 to 5 annelids are installed on the shoulder area, which, together with saliva, inject biologically active substances into the blood with anti-inflammatory, anti-exudative, and analgesic effects.
Patients are also recommended massage of the collar area, manual therapy, and acupuncture.
Massage of the cervical-collar area.
But physical therapy has the highest clinical effectiveness. Daily exercise helps strengthen the muscle corset, which stabilizes the joint structure. During training, blood circulation accelerates, cartilage tissue is saturated with oxygen and nutrients.
First aid for back and shoulder pain
It doesn’t matter whether the pain in your shoulders and upper back is severe or tolerable, you need to seek qualified help. Since the nature of pain is often neurological, it is worth making an appointment with a neurologist. Doctors working in the medical field have extensive work experience and high ratings on the ProDoctors review site. They specialize in treating all neurological conditions that lead to shoulder and back pain.
In addition to a neurologist, you may need the help of an orthopedist-traumatologist
Before going to the clinic, in order to reduce the intensity of the pain syndrome, you should follow the recommendations:
- do not put stress on the sore shoulder: do not carry bags, refuse physical work, do not perform exercises, do not make sudden movements or turns;
- refrain from thermal procedures;
- minimize any movements, up to complete immobilization by fixing the shoulder to the body.
If the pain is severe and cannot be tolerated, you can take a painkiller. But it is better to apply ice to the sore spot through a cloth for 10-15 minutes. It will reduce swelling and pain caused by pinched nerve endings.
If the pain syndrome is moderate, before seeing a doctor you should refrain from using medications that can blur the clinical picture.
Severe stage of shoulder osteochondrosis: symptoms and treatment
Mild manifestations of shoulder osteochondrosis - pain that periodically occurs during exercise, discomfort is replaced by more pronounced symptoms. The pain occurs most often at night for no reason, radiates to the arm, neck, and when moving the arm to the side or behind the back, the pain intensifies. There appears a sharp limitation in the movement of the arm, stiffness of the joint, and a characteristic posture - the shoulder is pressed to the chest. The patient's hand swells on the side of the lesion of the shoulder joint, cyanosis of the skin and a decrease in the temperature of the limb appear, increased hand reflexes, and pain on palpation in the affected area. As the disease progresses, the symptoms intensify; the patient cannot move his arm due to severe pain, which becomes constant.
In severe cases, the disease is treated with surgery. The indication for surgery is the lack of effect from drug treatment; the operation is performed when the patient’s condition sharply deteriorates, with severe pain that cannot be relieved. At the Yusupov Hospital, doctors approach the treatment of osteochondrosis with great responsibility; drug treatment is carried out using innovative drugs. The hospital also performs surgical treatment of the disease and rehabilitation measures. You can make an appointment with a doctor by calling the Yusupov Hospital.