Arthrosis of the shoulder joint (oarthrosis) is a chronic disease in which irreversible degenerative-dystrophic processes occur in the tissues of the joint. The pathology disrupts the normal functioning of the limb. The range of motion of the shoulder gradually decreases until complete immobility. Osteoarthritis of the shoulder joint causes severe pain and reduces quality of life. If left untreated, disability occurs.
To stop the process of joint destruction and maintain mobility of the shoulder joint, you need to contact an orthopedic traumatologist after the first symptoms appear.
Causes of arthrosis of the shoulder joint
The disease is polyetiological. The development of deforming arthrosis of the shoulder joint can be associated with various factors:
- Professional sports or intense training.
- Endocrine diseases.
- Hormonal imbalances.
- Congenital pathologies of the development of the musculoskeletal system.
- Hereditary predisposition, etc.
In most cases, secondary arthrosis is diagnosed: pathology occurs after exposure to a particular factor on the joint. Less commonly, the primary or idiopathic form of the disease is recorded. It is impossible to determine the exact cause of tissue degeneration in this case.
Prospects.
Today we have extensive experience in shoulder replacements, and we can confidently say that this procedure has a high chance of success. As a rule, in everyday life without stress loads, artificial joints function for a long time without complaints. However, unfortunately, you cannot count on full activity as in a healthy arm.
If your artificial joint is worn out or unstable after many years of use, we advise you to consider a replacement procedure.
Symptoms of arthrosis of the shoulder joint
Changes in cartilage and bone tissue begin long before the first signs of arthrosis appear. Joint structures have a great potential for self-healing, so pathologies are rarely diagnosed at a young age, when all metabolic processes are quite active. As the body ages, recovery processes give way to degeneration. The first signs of destruction may appear after 40-50 years, and with the deforming type of the disease, patients notice changes as early as 16-18 years.
Symptoms of arthrosis of the shoulder joint:
- Crunching of the joint during movement.
- Pain, especially severe after physical activity.
- Stiffness of movement, expressed after sleep or long rest.
- Increased pain during weather changes.
Mechanism of disease development
Arthrosis begins with impaired blood circulation in the subcartilaginous layer of the periosteum.
Because of this, the nutrition of the cartilage deteriorates, it loses its elasticity, becomes thinner, and cracks appear on it. The amount of synovial fluid decreases, due to strong friction, the joints become inflamed. Progressive arthrosis is very dangerous. If treatment for arthrosis of the hand or foot is not started in time, the joints begin to take on unnatural, ugly shapes and may lose mobility.
The disease often occurs in women during menopause. Hormonal levels change in the female body and less estrogen is produced. Because of this, the body loses a lot of moisture, which makes cartilage and joints more brittle.
Degrees of arthrosis
Clinical classification defines three degrees of arthrosis of the shoulder joint:
- 1st degree. The patient complains of a slight crunching sound that appears when moving. There is no pain syndrome. Discomfort is felt when moving the arm to the extreme position.
- 2nd degree. Pain occurs when raising the limb above shoulder level. The range of motion is reduced. After significant exertion, the patient feels pain even at rest.
- 3rd degree. Mobility in the joint is severely limited. The pain syndrome is almost constant.
Is there an alternative to surgery?
In difficult cases, when conservative treatment of arthrosis of the foot has not helped and there is no mobility, surgery is indicated. Like any surgical intervention, endoprosthetics (replacing a joint with an implant) has contraindications and carries certain risks. Today, fortunately, this is not the only way to restore joint health - this can be done at the second or third stage of the disease, with the help of a synovial fluid endoprosthesis.
For example, the biopolymer with silver ions “Noltrex” is intended for intra-articular administration in a sterile dressing room. Its task is to restore the viscosity of the synovial fluid in the affected ankle joint. The drug reduces friction in the joint, which relieves pain and improves mobility. However, Noltrex does not affect the metabolism of cartilage. A feature of the Noltrex endoprosthesis is its very slow biodegradation, which explains its long-term effect (at least six months).
The synovial fluid endoprosthesis is inserted under local anesthesia in a dressing room or operating room. Here's how it works in the case of the ankle joint:
After inserting a synovial fluid implant, it will not be superfluous to prevent complications. Orthopedic doctors recommend that physical activity be dosed correctly, monitor nutrition and body weight, and that athletes respond to injuries and microtraumas in a timely manner. Movement is life, and ankle health is the key to an active lifestyle!
Diagnosis of arthrosis of the shoulder joint
The doctor must not only make a correct diagnosis, but also determine the cause of the pathology. Treatment of the underlying disease significantly improves the patient's well-being and slows down cartilage degeneration.
Manual examination
The first stage of diagnosis is a consultation with an orthopedic traumatologist. The doctor examines the diseased joint for swelling and severe deformation. As arthrosis develops, the muscles may partially atrophy - this is visible to the naked eye.
During a manual examination, the doctor evaluates the function of the joint according to several criteria:
- Ability to make voluntary hand movements.
- Thickening of the edges of the articular surfaces (large osteophytes can be detected by palpation).
- The presence of a crunching, “clicking” sound that can be heard or felt by the hand during shoulder movement.
- Joint jamming in the presence of free chondromic bodies.
- Pathological movements in the shoulder.
Radiography
To detect signs of arthrosis of the shoulder joint, radiography is performed in two projections, which allows you to assess the degree of narrowing of the joint space, the condition of the bone surfaces, the size and number of osteophytes, the presence of fluid, and inflammation of surrounding tissues.
Ultrasound examination (ultrasound)
A non-invasive method that allows you to examine joints in pregnant women and young children. Using a sonogram, the doctor determines the thickness of the cartilage and the condition of the synovial membrane. The method well visualizes osteophytes and enlarged lymph nodes in the periarticular space.
Magnetic resonance imaging (MRI)
The MRI machine takes images in successive slices. The images clearly show not only the joint, but also the adjacent tissues. Today, magnetic resonance imaging is one of the most informative methods in the diagnosis of arthrosis.
Lab tests
As part of a comprehensive examination, the following is prescribed:
- General blood analysis. Based on the results, the doctor can judge the presence and severity of the inflammatory process. The test also helps assess your overall health.
- Analysis of urine. Kidney pathologies often cause secondary arthrosis deformans. Analysis is necessary for accurate diagnosis.
- Blood chemistry. The data helps determine the cause of inflammation. Biochemical tests are also performed to monitor complications and side effects during therapy.
Disease recognition process
Diagnostics is carried out comprehensively. To determine the extent of damage, experts use the following methods:
- collecting medical history: recording complaints, determining the circumstances of occurrence, clarifying information about past pathologies and injuries, heredity;
- external assessment of the joint: determination of range of motion and zone of maximum pain;
- X-ray and CT: allow you to see the main visual symptoms (narrowing of the gap, growth, deformation);
- ultrasound examination: assessing the condition of cartilage, ligaments, bones, joints and muscles;
- magnetic resonance imaging: obtaining a visual image of the structures of the affected area;
- laboratory blood test: identification of the inflammatory process;
- arthroscopy: examining the inside of a joint using a camera inserted through a small puncture.
If the request is not primary, an appointment with specialized specialists is scheduled.
Treatment of arthrosis of the shoulder joint
Therapy is long and complex. The course of treatment includes medication, health procedures, and a set of special exercises for arthrosis of the shoulder joint. In difficult cases, surgical intervention is indicated.
Drug therapy
Medicines and dosage are selected individually. The doctor may prescribe:
- Non-steroidal anti-inflammatory drugs (NSAIDs). Medicines reduce inflammation and pain.
- Glucocorticosteroid drugs. Hormone-based products have a more intense effect on the source of pain. Medicines not only alleviate the patient’s condition, but also reduce inflammation and exhibit antihistamine and immunosuppressive properties. Glucocorticosteroids are prescribed in cases where NSAIDs are not effective.
- Painkillers. Medicines of this group are prescribed for severe pain syndrome. Depending on the severity of the symptoms, the doctor selects non-narcotic or narcotic (rarely) analgesics.
- Chondroprotectors. The active ingredients of the drugs are involved in the process of formation of new cartilage tissue. Regeneration of the diseased joint is accelerated, trophism is improved. Chondroprotectors have a cumulative effect and have proven themselves in the treatment of arthrosis of varying severity.
Some drugs are injected directly into the joint cavity. For example, a blockade has a better pain-relieving effect than taking medications in pill form.
Physiotherapy
Courses are carried out after the exacerbation is relieved. Physiotherapy as part of complex therapy helps improve the transport of medicinal substances to the diseased joint, relieve swelling, and reduce pain.
For the treatment of arthrosis the following is used:
- Electrophoresis.
- Phonophoresis.
- Shock wave therapy.
Physiotherapy can be combined with massage, exercise therapy, and medicinal baths. It is best to undergo a set of procedures at a specialized clinic. The doctor will draw up a treatment plan based on the condition of the individual patient.
Physiotherapy
Moderate physical activity is important to slow down degenerative processes. It is better to start exercise therapy for arthrosis of the shoulder joint in a medical center, under the supervision of a doctor. The specialist will select exercises, teach you how to perform them correctly and distribute the load so as not to cause an exacerbation of the disease. Gymnastics usually includes warm-up, stretching and strength training. Exercises are performed at least 3 times a week.
After a course with a specialist, patients can perform therapeutic exercises for arthrosis of the shoulder joint at home.
Surgery
The operation is performed for grade 3 arthrosis, when the disease no longer allows the patient to move normally, causes severe pain, and the prescribed therapy does not help.
There are several methods of surgical treatment:
- Puncture. A long needle is inserted into the joint cavity and the accumulated fluid is pumped out. Puncture reduces pressure, reduces swelling, and increases joint mobility. The procedure is minimally invasive and is therefore performed on an outpatient basis. The material obtained during puncture is sent for research to determine the infectious agent or other indicators.
- Arthroscopy. Using microsurgery instruments, the doctor examines the joint cavity, removes scar tissue, and sutures the rotator cuff tendons or joint capsule if damage is detected. Several punctures remain on the skin. The patient recovers quickly.
- Endoprosthetics. Endoprosthetics allows you to completely get rid of chronic pain and restore hand mobility. After the operation, long-term (3 to 6 months) rehabilitation is required.
Preventive measures
Like all other pathologies, shoulder arthrosis is easier to prevent than to treat. For prevention purposes, the following recommendations should be followed:
- minimize, or better yet eliminate, the main risk factors: lifting large loads, vibrations;
- choose moderate loads so as not to overdo it and prevent physical inactivity;
- avoid gaining excess weight.
If unpleasant symptoms are detected, you should immediately undergo examination by a specialist.
Author of the article:
Vyacheslav Samoilov