Arthrosis of the shoulder joint (Deforming arthrosis of the shoulder joint, Deforming osteoarthritis of the shoulder joint, Osteoarthritis of the shoulder joint)

Arthrosis of the shoulder joint is a lifelong degenerative disease that primarily affects the articular cartilage, and subsequently the heads of the bones that form the shoulder joint. Causing severe pain and impaired mobility in the joint, arthrosis can lead to loss of ability to work and significant difficulties in everyday self-care. It is also fraught with the transition of a degenerative process to the spine, especially to the cervical region.

Although symptoms of shoulder arthrosis

usually occur in people over 45 years of age, the disease can also develop in very young patients - due to injury, infections, carrying heavy loads with improper load distribution, and poor posture.
The symptoms of arthrosis of the shoulder joint
be left untreated - after a few years or decades this can lead to fusion of the bones and complete blocking of the shoulder. This condition is especially painful because the pathology usually affects the main hand (right in right-handed people, left in left-handed people).

General information

Cartilage tissue is a smooth layer between the adjacent areas of bones. It ensures their easy sliding relative to each other, ensuring free and painless operation of the joint. Excessive stress, inflammation or injury can trigger a degenerative process that gradually spreads over the entire surface.

As a result, the smoothness of the articular surfaces is disrupted, and movements begin to cause pain. At the same time, bone growths begin to appear along the edges of the joint, replacing the affected cartilage. As the degenerative process progresses, it involves not only bones, but also surrounding tissues. The limb becomes deformed, the muscles spasm, and the ligaments become weak and lose elasticity. Without treatment, a person loses the ability to move his arm.

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Detection of pathology

The most informative method for osteoarthritis of the shoulder joint is radiography. Based on characteristic radiographic signs, it is possible to identify not only the disease itself, but also its stage and features of the course. If tissue inflammation is suspected, as well as for a more detailed study of the condition of the joint, MRI and CT are performed. Performing arthroscopy allows for targeted collection of biological samples:

• cartilage;
• synovial membrane;
• joint fluid.

Carrying out biochemical studies and morphological study of biopsy samples helps to assess degenerative changes in the structures of the shoulder joint.

Causes

Unlike the knee, ankle and hip joints, the shoulder does not experience significant stress when walking, which is why this form of arthrosis occurs much less frequently. Pathology can be caused by:

• regular excessive physical activity: heavy lifting, professional sports, vibration;
• congenital pathologies of the structure of the shoulder joint and adjacent structures;
• rheumatoid arthritis, systemic lupus erythematosus and other autoimmune diseases;
• congenital weakness of connective tissue, accompanied by joint hypermobility;
• injuries: dislocations, sprains and ruptures of ligaments, intra-articular bone fractures;
• hormonal changes and disruptions (including pregnancy, menopause);
• inflammatory diseases of the joint and periarticular structures (arthritis, bursitis, etc.);
• metabolic disorders, including gout, diabetes.

Heredity plays an important role in predisposition to arthrosis.

How and why does deforming osteoarthritis of the shoulder joint appear?

All joints, including the shoulders, are subject to age-related changes. Over the years, joints become more fragile and vulnerable, and metabolism deteriorates. Nutrients reach the capsule in small portions and with a delay; cartilage lacks building elements such as glucosamine, chondroitin and hyaluronic acid. Little lubricating synovial fluid is secreted, the cartilaginous cover begins to deteriorate, which leads first to minor and later to acute painful sensations.

However, all this can happen not only to elderly patients, but also to young people. If their professional and amateur activities involve serious loads on the shoulder area, then the shoulder joints quickly undergo degenerative changes and “become unusable.” For example, this applies to swimmers, painters or active summer residents, on whose shoulders a significant physical load falls. In this case, more intensive nutrition of the joint capsule is necessary. The human body is simply not able to take care of itself - not enough glucosamine and chondroitin are synthesized to promptly and fully restore cartilage covers and prevent the development of osteoarthritis. With age, destruction accelerates, and natural healing processes, on the contrary, slow down.

The result is that the cartilage is destroyed, the bones rub against each other, and bone growths grow. If the process is not stopped and reversed in a timely manner, the range of movements is reduced so much that the patient completely stops moving his arms.

In addition to aging, factors that provoke osteoarthritis are:

• Injuries.

  For example, fractures or dislocations. Even an unfortunate fall on the shoulder can result in microcracks, which in turn will become prerequisites for early osteoarthritis.

• Sports or heavy physical activity.

  Volleyball, basketball, gymnastics and even gym classes may not go unnoticed and trigger OPS.

• Genetic predisposition.
• Endocrine or hormonal disorders.
• Past infectious or viral diseases.
• Congenital skeletal anomalies.
• Lack of load on the shoulder joint.
• Excess weight.
• Inflammation.
• Accompanying illnesses.

  For example, pathologies of the biliary tract and liver or spinal disease.

• Hypothermia.

OPS often develops for several reasons at once, which is why treatment of osteoarthritis of the shoulder joint can be complex. For example, you will need to change your diet, regulate hormone levels and do gymnastics.

Degrees

Doctors distinguish 3 degrees of deforming arthrosis of the shoulder joint, determining its symptoms and the choice of treatment tactics:

• Grade 1 is characterized by minimal manifestations: pain occurs only during intense or prolonged exercise and quickly goes away after rest, and x-rays reveal subchondral sclerosis of the articular surfaces;
• with arthrosis of the 2nd degree, the pain becomes much stronger, the person has to use painkillers to feel better; The x-ray shows a pronounced narrowing of the joint space, extensive areas of cartilage destruction, as well as bone growths (osteophytes);
• Stage 3 of the disease is accompanied by constant intense pain, joint mobility is significantly limited, and the image shows complete destruction of cartilage tissue, deformation of bone structures and a large number of osteophytes.

Mechanism of action of intra-articular injections "Noltrex"

To restore the viscosity of synovial fluid, a special artificial endoprosthesis Noltrex with the addition of silver ions has been developed. The gel is injected into the joint cavity in a medical office at intervals several times. The composition is completely biocompatible with tissues and therefore does not cause allergic or other reactions.

By introducing the drug into the joint cavity, the following results can be achieved:

• protect cartilage - the gel covers the synovial membrane and articular surfaces with an even layer, softens mechanical stress and stops further destruction;
• restore the viscosity of the synovial fluid - a drug with viscosity characteristics close to natural normalizes the properties of the joint environment;
• dilute the rubbing surfaces - the product restores the normal viscosity of the synovial fluid, as a result of which the joint spaces widen and friction stops.

Noltrex relieves pain in the shoulder joint for a year and a half

Symptoms

The main symptoms of shoulder arthrosis include:

• pain: occurs due to decreased smoothness of articular surfaces, proliferation of osteophytes and bone deformation; the intensity, duration and nature of the sensations depend on the degree of damage;
• crunch: one of the characteristic symptoms of the disease that appears in the early stages; differs from the physiological one in a coarser tone, and is also often accompanied by pain;
• limitation of mobility: associated with the appearance of pathological growths and particles of destroyed cartilage inside the joint; in the first stages it is represented by slight morning stiffness, which later increases until complete immobility (ankylosis);
• deformation: a change in the contours of first only the joint, and then the arm, occurs in the later stages of the disease and indicates complete destruction of the cartilage and involvement of bones, muscles and ligaments in the pathological process.

The progression of symptoms can occur over years or even decades, but eventually arthrosis of the shoulder joint leads to the inability to move the arm and severe pain.

Causes of osteoarthritis of the elbow and shoulder joints

Osteoarthritis of the shoulder and elbow joints develops when the cartilage and subchondral bone are unable to adequately withstand mechanical stress. This is due to the limitation of the restoration capabilities of these tissues. The main springboard for the development of pathological changes is hyaline cartilage. It not only reduces the number of chondrocytes, but also reduces their metabolic activity. This leads to a decrease in the production of collagen in the cartilage matrix and sulfated proteoglycans (high molecular weight compounds consisting of protein).

Under the influence of chronic overload of the joint, an increase in the synthesis and release of enzymes occurs. They contribute to the destruction of proteoglycans and collagen network. This determines the progressive degeneration of cartilage.

In osteoarthritis of the shoulder and elbow joints, degenerative changes predominate, but inflammation is no less important in the development of the disease. It is localized in the synovial membrane, cartilage, subchondral bone and soft tissues located around the joint.

Osteoarthritis is a multifactorial disease. Its development is facilitated by mechanical, hormonal and genetic risk factors. There are primary and secondary variants of osteoarthritis of the shoulder and elbow joints. Primary osteoarthritis develops in previously unchanged joints under the influence of various factors that contribute to the primary disruption of the metabolism of cartilage tissue, and secondary osteoarthritis is a consequence of previously existing diseases of the musculoskeletal system. The following reasons for the development of secondary osteoarthritis are known:

• Metabolic diseases (gout and pyrophosphate arthropathy, hemochromatosis, acromegaly, ochronosis, Wilson's disease);
• Anatomical abnormalities;
• Inflammatory diseases (septic arthritis, any inflammatory arthropathy);
• Acute or chronic trauma, bone fractures within the joint or in the surrounding area;
• Necrosis of bone tissue;
• Surgery to remove the meniscus or other joint interventions;
• Occupational injuries.

In primary osteoarthritis, the elbow and shoulder joints are not involved in the pathological process, but they can be affected in secondary osteoarthritis.

Diagnostics

Diagnosis of arthrosis of the shoulder joint requires an integrated approach. To accurately make a diagnosis and determine the extent of damage, the doctor uses the following methods:

• interview and history taking: the patient’s complaints are recorded, the circumstances of the occurrence of certain symptoms are determined; It is mandatory to clarify information about previous diseases and injuries, and the presence of joint damage in parents;
• examination: the doctor evaluates the joint visually, determines the range of movements, the area of ​​greatest pain, etc.;
• X-ray and CT: the main diagnostic method that allows you to see the characteristic symptoms of osteoarthritis (narrowing of the joint space, cartilage degeneration, bone growths and deformities);
• Ultrasound: makes it possible to assess the condition of cartilage, bones, ligaments, joint capsule and muscles;
• MRI: allows you to obtain virtual sections of all structures of the affected area;
• laboratory diagnostics: a blood test reveals an active inflammatory process, often accompanying arthrosis;
• arthroscopy: examining the inside of a joint using a camera inserted through a small puncture.

If the disease is secondary in nature, examinations and consultations with narrow specialists on the underlying pathology are mandatory.

Symptoms

Osteoarthritis of the shoulder at the initial stage of development manifests itself only as mild discomfort. Since they occur after hard physical work or being in one body position for a long time, a person attributes them to fatigue. Moreover, the discomfort quickly disappears after rest. But as the shoulder joint is destroyed and deformed, other, pronounced symptoms of osteoarthritis arise:

• in the morning the shoulder swells, swells, looks somewhat larger than healthy;
• after waking up, mobility is limited for 30-40 minutes;
• pain occurs at rest, always intensifies with sudden movement of the shoulder or arm;
• crunching, clicking, and crackling sounds become commonplace, accompanying almost every flexion or extension of the joint.

If soft tissues are injured by osteophytes, an inflammatory process develops. The pain intensifies and stiffness increases. The course of the disease is often complicated by synovitis - acute and then chronic inflammation of the synovial membrane. It is indicated by severe swelling of the shoulder, redness of the skin, and increased local temperature.

Treatment of arthrosis of the shoulder joint

Treatment of arthrosis of the shoulder joint depends on the degree of damage: at stages 1 and 2, the disease can be successfully stopped or slowed down by the correct selection of drugs. In case of extensive destruction, the only way to restore mobility and completely stop pain is surgery - arthroscopy with “cleaning” of the joint.

Drug treatment

Drug treatment for shoulder arthrosis is aimed at reducing symptoms and restoring cartilage tissue. The following groups of drugs are used for this:

• non-steroidal anti-inflammatory drugs (diclofenac, ibuprofen, nimesulide, meloxicam and their derivatives): block inflammatory reactions and reduce pain; are available in the form of tablets, ointments, suppositories and in injection form;
• hormonal agents (corticosteroids): used when NSAIDs are ineffective, have a similar effect; long-acting drugs injected directly into the joint cavity have a good effect;
• antispasmodics, B vitamins: used to reduce muscle spasms that inevitably accompany advanced arthrosis;
• chondroprotectors (chondroitin, glucosamine and their combinations): intended for long-term use, aimed at restoring cartilage tissue;
• drugs that improve microcirculation (nicotinic acid, pentoxifylline and others): indirectly stimulate regeneration processes by improving blood supply to the affected area;
• Enzyme blockers (contrical, gordox): partially slow down the destruction of cartilage tissue.

The selection of specific drugs, their dose, frequency of administration and course duration is carried out only by a doctor! It is important to remember that self-medication can accelerate joint degeneration and cause other side effects.

Physiotherapy

Physiotherapeutic techniques and exercise therapy significantly alleviate the course of the disease and enhance the effect of medications. The following procedures have proven good results:

• magnetic therapy: relieves pain, relieves inflammation, improves microcirculation and stimulates the regeneration of cartilage tissue;
• shock wave therapy: exposure to acoustic waves of a certain frequency helps destroy osteophytes, which facilitates movement in the affected joint;
• electrophoresis, phonophoresis: introduction of medications (painkillers, chondroprotectors) into tissues using electrical impulses or ultrasound; promotes better absorption of drugs;
• massage and physical therapy: dosed loads on the joint and intense manual stimulation stimulate blood circulation in the tissues.

Like medications, physiotherapy, massage and exercise therapy should be prescribed and carried out under the supervision of a specialist. If they are beneficial during a calm period, then exposure against the background of an acute inflammatory process can cause increased pain.

Surgery

The last stage of shoulder arthrosis is accompanied by severe symptoms and requires surgical treatment. Most of the changes that occur as a result of degeneration are irreversible, which is why the only way to restore mobility to a person is endoprosthetics. The affected joint is replaced with a modern prosthesis, which completely takes over its functions. This operation is especially effective in young and middle age, as it allows you to live without pain for years.

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How often to take a course of injections

Unlike drugs with hyaluronic acid, Noltrex has a much more prolonged effect. It is recommended to administer it at intervals of 9 months to 2 years, depending on the degree of damage to the shoulder joint. The medicine is of synthetic origin, therefore it is not detected and is not rejected by phagocytes - the immune cells of the body. This explains the long-term therapeutic effect.

Of course, any treatment for arthrosis will be effective only if the load on the joint is reduced. In the case of a shoulder, the prognosis is always favorable, especially if you seek help in a timely manner, without waiting for critical symptoms. “It will hurt and stop” - with this diagnosis, such an option, unfortunately, is excluded.

Shoulder pain does not always indicate the onset of arthrosis. Sometimes the reason is, indeed, a joint overwork, an uncomfortable position during sleep, or being in a draft. But much more often, pain is caused by other serious diseases, such as cervical osteochondrosis or glenohumeral periarthritis. Do you feel discomfort? Consult a specialist!

Diet

For shoulder arthrosis of any degree, it is important to monitor your diet:

• avoid overeating and excess weight;
• minimize harmful foods: fatty, spicy, salty, alcohol, canned food, smoked foods;
• consume a sufficient amount of foods high in collagen (jelly, aspic) and omega-3 (fatty fish, olive oils);
• give preference to boiled, steamed or stewed food rather than fried foods;
• reduce the amount of quickly digestible carbohydrates.

The diet should be complete and include the required amount of vitamins, minerals and nutrients.

Consequences and complications

Even a slight pain and crunch in the shoulder can result in unpleasant consequences. Without treatment, arthrosis leads to:

• significant restriction of mobility up to ankylosis (fusion of bones with each other);
• severe pain even at rest;
• severe deformation of the shoulder and entire arm.

To avoid these problems, it is important not to search on the Internet for how to treat arthrosis of the shoulder joint with folk remedies, but simply contact an orthopedist to select therapy.

Which doctor treats arthrosis

At the very first manifestation of symptoms, you can consult a rheumatologist.
Already after 30 years, pulling or aching pain may be felt in the joints after physical activity. Sometimes after sleep you may feel tension in your joints for some time. This is already a reason to see a doctor. Unfortunately, in most cases, such symptoms are not paid attention to, and people think about visiting a doctor and treating arthrosis when the pain begins to seriously interfere with movement. At this stage of the disease, you should consult an orthopedic doctor for treatment of arthrosis.

In case of joint injury, follow-up with an orthopedic surgeon is necessary to prevent and timely treatment of post-traumatic arthrosis.

Make an appointment Do not self-medicate. Contact our specialists who will correctly diagnose and prescribe treatment.

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Treatment at the Energy of Health clinic

Orthopedists at the Energy of Health clinic offer patients comprehensive treatment methods for shoulder arthrosis:

• modern drug therapy regimens that combine high efficiency and minimal side effects;
• time-tested and new physiotherapeutic techniques;
• PRP therapy;
• physical therapy and massage to relieve restrictions on joint movements.

If necessary, therapeutic punctures of the joint are performed with the administration of painkillers or artificial synovial fluid to facilitate movement.

We monitor the patient throughout the treatment to keep the disease under control.

Advantages of the clinic

The Health Energy Clinic offers its patients:

• comprehensive health screening programs;
• extensive examinations for an accurate diagnosis;
• consultations with narrow specialists of various profiles;
• modern treatment regimens, including not only medications, but also physiotherapy, massage and exercise therapy;
• affordable prices for all services.

Arthrosis of the shoulder joint is a problem that can completely change a person’s life. Don’t let the disease reach an irreversible stage, come for a consultation with an orthopedist at Energy of Health.

Latarjet operation as a method of treating osteoarthritis

This type of surgery is used to treat instability of the shoulder joint. The essence of the method is to move the coracoid process of the scapula and its attachment to the defective area of ​​the glenoid cavity.

Many specialists have carried out such interventions in different ways. The most modern one is using an arthroscope. An arthroscope is a device that will help not only to perform surgery on the shoulder joint, but also to see the joint from the inside due to the built-in camera.

The advantages of this method of treating osteoarthritis include rapid recovery and minimal intervention in the body. Also a low rate of complications and eliminating the possibility of dislocations in the future.

Experienced doctors at the Elena Malysheva Medical Center use only the latest and proven methods in their methods of diagnosing and treating osteoarthritis. Sign up for a consultation!