Humeroscapular periarthritis: features of diagnostic measures and treatment of the disease

is an inflammatory process that occurs in the joint tissues of the shoulder. The manifestation of the pathology is observed in aching pain, which significantly intensifies with movement, as well as tension in the periarticular muscles.

Clinical observations allow us to come to the conclusion that glenohumeral periarthritis occurs more often than other types of pathological processes, which is due to the constant functioning and tension of the shoulder tendon.

Humeroscapular periarthritis - inflammation in the joint tissues of the shoulder

What is glenohumeral periarthritis?

Humeroscapular periarthritis

is a disease localized in close proximity to the shoulder joint. The progression of the pathology leads to changes of a degenerative-dystrophic nature, causing reactive inflammation.

Women over 55 years of age are most at risk of developing pathological processes in the shoulder joint. However, despite this, the disease can also be diagnosed in men.

In practice, right-sided periarthritis is more common, which is explained by increased loads on the limb, but this does not at all exclude the development of other forms of periarthritis of the shoulder.

Inspection

When examined, there are usually no external changes. During palpation, painful points are determined along the anterior, lateral or posterior surface of the shoulder joint at the attachment points of the rotator cuff muscles. Movement in the shoulder joint is painful. Characterized by greater pain during active (which the patient himself makes) movements, while passive movements (which the doctor makes with the patient’s limb) are less painful. Simple functional tests can help determine which rotator cuff muscles are inflamed.

If the supraspinatus tendon is affected, abduction of the shoulder is painful. The appearance of pain only at the beginning and at the end of movement indicates inflammation of the serous bursa located under the acromial process of the scapula (subacromial bursitis). Nowadays this condition is more often called impingement syndrome.

Pain during external rotation of the shoulder (trying to comb one's hair) indicates damage to the tendons of the infraspinatus and teres minor muscles.

Placing the arm behind the back (internal rotation of the shoulder) indicates inflammation of the subscapularis tendon.

Flexion at the elbow joint and supination of the forearm, reminiscent of turning a key in a lock (the doctor resists this movement), indicates damage to the tendon of the head of the biceps.

With painful passive movements in the shoulder joint, as in the photo below, you can think about damage to the shoulder joint itself (arthrosis, arthritis).

Clarifying which muscle is affected can be useful when carrying out blockades.

The most likely causes of glenohumeral periarthritis

The clinical picture of the disease allows us to identify two most likely causes

, leading to the formation and development of degenerative processes in the shoulder joint:

1. Neurodystrophic changes

   , progressing in diseases of the musculoskeletal system.

2. Shoulder injuries

   received in the course of everyday life or professional activities.

Despite the existence of probable causes, there are cases when it is impossible to determine the prerequisites for the pathology.

In addition to probable causes, there are a number of risk factors

, increasing the likelihood of periarthritis of the glenohumeral region. These include:

• age characteristics;
• local or general hypothermia of the body;
• motor dysfunction;
• abnormal skeletal development;
• surgical intervention leading to impaired blood supply to the tissues of the shoulder.

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Forms of glenohumeral periarthritis

Today it is customary to distinguish three main forms of pathology:

• simple;
• acute;
• chronic.

In a situation where the disease occurs as a result of the consequences of an injury, several days or even a week may pass before the symptoms of glenohumeral periarthritis appear, which is the reason for the formation of prerequisites for the formation of the disease, for which only a small part of patients seek diagnosis.

Another form of glenohumeral periarthritis, which is quite rare, is considered to be algodystrophic “shoulder-hand” syndrome, which is characterized by severe pain, the presence of cold swelling, atrophy of joint tissue and loss of mobility.

The course of the disease, accompanied by the “shoulder-hand” syndrome, is characterized by protractedness and complexity of treatment.

What will be the effect of the classes?

Regular exercise will solve the following problems:

• Increase muscle tone.
• Strengthen muscles.
• Restore normal performance to ligaments and tendons.
• Improve blood supply to the affected area.
• Increase the range of motion in the joint.

An important condition for starting regular training is the transition of the disease from the acute stage to the remission stage, when the main symptoms of periarthritis are eliminated and inflammation is reduced.

Symptoms of glenohumeral periarthritis

Numerous studies and practice in treating patients have allowed specialists to identify the main symptoms of glenohumeral periarthritis, taking into account the form of development of pathological processes.

Symptoms of glenohumeral periarthritis in a simple form

• mild pain, concentrated in the shoulder area when performing movements;
• mild limitation of mobility;
• pain when resting at night on the back;
• point tenderness on palpation of the anterior outer surface of the shoulder.

Symptoms of glenohumeral periarthritis in acute form

• sudden, increasing pain;
• expansion of the area of ​​localization of pain from the shoulder to the neck, arm;
• increasing pain during night rest;
• relief when bending the elbow;
• slight swelling.

Symptoms of chronic humeroscapular periarthritis

• moderate pain;
• accompanying movements with discomfort;
• aches and pains during rest;
• periodic pain when performing hand movements.

In the advanced stage of chronic arthritis

also observed:

• density of periarticular tissues;
• loss of joint mobility;
• sharp pain.

Set of exercises

Several exercises to develop your shoulder:

• You can sit or stand. Doesn't really matter. Place your hands on your waist. At a slow pace, we perform circular movements with our shoulders, first forward, then back. The time to complete the exercise is approximately 1 minute in each direction.
• The starting position too. We place our hands on the waist. At a calm pace, we move our shoulders forward and backward. Number of repetitions 8–10 times.
• We stand straight. Hands are pressed to the body. Slowly, without sudden movements, we raise our shoulders up, without lifting our arms from our body. Then we lower it. If you feel pain or significant discomfort, you do not need to do the exercise. The optimal number of repetitions is 10–12 times.
• You can sit or stand. Bend the affected arm at the elbow. In this position, we try to move the elbow to the side until the sore shoulder is perpendicular to the body.
• Place the hand of the affected arm on the opposite shoulder joint. The elbow of the hand that is bothering you should touch the abdominal area. Using your healthy hand, grab the elbow of the sore upper limb. Smoothly, without sudden movements, we raise the elbow of the sore arm, which should not come off the front surface of the body. Raising your elbow as high as possible, hold the position for about 10 seconds, then lower your hand.

At home, to treat periarthritis of the shoulder joint, you can use special exercises to restore full mobility of the arm. Physical therapy can be recommended in all cases, but not in the acute period.

Diagnosis of glenohumeral periarthritis

You should seek medical help if symptoms of glenohumeral periarthritis appear, which include pain of varying strength and difficulty in motor function.

Diagnosis of glenohumeral periarthritis is carried out by a general practitioner - therapist

. Based on the results of studying the patient’s medical history and identifying key symptoms, the therapist can give a referral to such specialized specialists (surgeon, neurologist, orthopedist).

To clarify the diagnosis and determine the causes of the disease, diagnostic methods are used such as:

• radiography;
• ultrasound examination (ultrasound);
• MRI diagnostics;
• laboratory type research.

Exercises for ankle and foot periarthritis

This selection of exercises will help you quickly cope with inflammation in the muscles surrounding the joints of the foot and leg:

• Sitting on a chair, you need to bend your leg at the knee, take the ankle joint in your hand and gently rotate it. You should perform 5 rotations in one direction and 5 rotations in the other direction for each leg.
• While sitting on a chair, you should raise your legs until they are parallel to the floor and perform rotational movements with your feet in one direction and the other. You need to perform 7 rotations.
• While sitting on a chair, you need to put the fabric on the floor and try to crumple it with your toes, and then smooth it out.
• Sitting on a chair, you need to turn your feet with your toes in different directions and press your heels towards each other. From this position, you should try to raise your legs, stretching them onto your toes, and then slowly lower them back.
• While sitting on a chair, you should try to roll a water bottle or stick, using only your feet and fingers for this purpose.

If you perform these exercises every day, you will be able to achieve stable remission of the disease and prevent its progression. The good thing about the complex is that it can be performed even at the workplace.

Treatment of glenohumeral periarthritis

Due to the peculiarities of the clinical picture, treatment of glenohumeral periarthritis

is a complex process that requires patience. The first stages of treatment of pathological processes are aimed at removing the load from the diseased joint, which eliminates the possibility of tissue deterioration.

Treatment of glenohumeral periarthritis is a complex and long process

During the treatment process, various methods are used to eliminate symptoms and restore tissue of the damaged joint. Let's look at the most effective of them.

Drug treatment of glenohumeral periarthritis

Relief of pain and elimination of inflammation can be achieved through drug treatment of glenohumeral periarthritis, during which the following groups of drugs are used:

• NSAIDs are non-steroidal anti-inflammatory drugs that help soothe and eliminate pain attacks, relieving muscle lesions;
• painkillers that ease the course of the disease;
• muscle relaxants that reduce muscle tone and relieve spasms;
• chondroprotectors that accelerate regenerative processes.

It is important to note that taking chondroprotectors promotes the restoration of joint tissue, which helps accelerate the process of combating pathological processes. "Artracam" is considered to be the most effective.

.

IMPORTANT! Before taking medications of any group, consultation with a specialist is required.

Physiotherapeutic procedures as a method of treating glenohumeral periarthritis

Physiotherapeutic methods of treatment are a separate area of ​​treatment for degenerative diseases. Today the following treatment methods are used:

• electrical stimulation;
• laser exposure;
• phonophoresis;
• shock wave therapy;
• magnetic therapy;
• acupuncture;
• manual therapy.

Each method has its own advantages and disadvantages. Recommended procedures are determined by the attending physician, in accordance with the individual characteristics of the disease.

Physical therapy (physical therapy) for glenohumeral periarthritis

Physiotherapy

is one of the necessary conditions for complex treatment of the disease and a speedy recovery of the patient. It is recommended to perform therapeutic exercises under the strict supervision of the attending physician.

All therapeutic complexes for glenohumeral periarthritis contain swimming, which is due to a number of useful properties, including the ability to relieve excess tension.

The main goals of using a set of gymnastic exercises are:

• improving blood flow to affected tissues;
• getting rid of congestion;
• strengthening the muscle frame;
• normalization of metabolic processes.

It is important that performing exercises is not permissible during the acute stage of development of the pathology.

Surgery

In situations where conservative treatment methods do not produce adequate results, radical ones are used, in particular surgery.

Surgery is advisable in the following situations:

• violation of tissue integrity;
• cuff damage;
• inflammation of nerve endings;
• the occurrence of tunnel syndrome.

It is important to note that surgery requires certain conditions. Contraindications to surgery may include:

• persistent limitation of motor function;
• the presence of purulent inflammation;
• intolerance to anesthesia;
• refusal to intervene.

The operation is carried out either by an open method or using specialized equipment.

Postisometric relaxation

As a complement to all treatment methods, we recommend post-isometric relaxation (PIR). Doctors note that relaxation helps 9 out of 10 patients with glenohumeral periarthritis.

The essence of the method is as follows:

• With the help of special movements, the maximum possible tension in the shoulder muscles is achieved in the patient’s condition.
• Muscle tension is maintained at maximum for 7–10 seconds.
• After which the muscles relax as much as possible - the relaxation phase.

Postisometric relaxation is aimed at relieving muscle spasm in the sore shoulder. This allows you to reduce pain and restore almost full mobility to the joint.

Preventive measures for glenohumeral periarthritis

Preventive measures help minimize the risks of pathological processes in the tissues of the shoulder joint. Among the most effective among them are:

• limiting loads on the joint;
• timely treatment of infectious and inflammatory processes and disorders of the musculoskeletal system;
• eliminating the possibility of hypothermia;
• systematic performance of specialized gymnastic exercises;
• planning a diet enriched with vitamins and minerals necessary for recovery;
• improving posture, regardless of the type of activity.

Symptoms and diagnosis

The main sign of the onset of the disease is pain.
It affects the muscles attached to the joint. Typically, patients complain of pain that occurs during certain types of stress (at the onset of the disease), as well as at rest and even at night (with chronicity of the process). Quite often, the disease occurs in representatives of professions whose work involves constant stress on the shoulder joint, and people actively involved in sports. Many people with shoulder periarthritis have osteochondrosis of the cervical spine. Diagnosis is usually relatively simple; characteristic complaints and simple diagnostic tests indicate the presence of an inflammatory process. To get a complete picture, your doctor may prescribe an x-ray or tomogram. It is important to distinguish between pain that occurs during periarthritis and arthrosis of the shoulder joint (which is sometimes mistakenly called glenohumeral periarthrosis). In the second case, changes in articular tissues are degenerative in nature and cannot be completely cured.