The risk of developing shoulder arthrosis increases with age. But an injury, such as a dislocated shoulder, can trigger osteoarthritis in young people. With arthrosis, the cartilage that connects the tops of bones wears out and breaks down. This causes swelling, pain, further development of osteophytes and bones begin to rub against each other.
The shoulder consists of two joints: the acromioclavicular joint and the humeral joint. Osteoarthritis in these joints usually appears in people over 50 years of age. At a younger age, it may appear as a result of injury, such as a fracture or dislocation of the shoulder. This type is called post-traumatic arthrosis. The disease can also be hereditary.
How it develops
The cervical region includes 7 vertebrae, the most mobile of the entire spinal column. If certain pathological processes occur in the body, the cervical vertebrae, protected by an elastic cartilage “plate” (disc), become covered with osteophytes (bone growths). The cartilage, in turn, becomes thinner and destroyed, and the adjacent soft tissue atrophies.
The intervertebral disc can bulge and put pressure on nearby tissue or nerves. The vertebrae change their shape, which leads to spinal deformities. If they are pronounced, the patient develops deforming cervical arthrosis.
Sometimes the cause of neck arthrosis is... flat feet!
Development mechanism
The mechanism of formation of deforming arthrosis is as follows: under the influence of negative factors, cartilage tissue loses moisture, becomes less elastic and ceases to fully perform its functions. Further, metabolic processes are disrupted in them, lymph stagnation occurs, which leads to the loss of salt deposits - the places where salts are deposited become a platform for the formation of false joints.
Over time, the disease progresses, the cartilage tissue dries out, the distance between the edge of the nearby vertebra and the hook-shaped growths decreases, and they themselves become deformed and flattened. Bone tissue grows to the sides, compresses the nerve roots and leads to stenosis of the spinal canal, which causes disorders of the musculoskeletal, nervous and autonomic systems.
What happens with uncovertebral arthrosis
Important: arthrosis at the level of the third or fourth cervical vertebra is especially dangerous, as it can cause serious damage to the spinal cord.
Causes of arthrosis of the cervical vertebrae
- Genetic pathologies of the development of the musculoskeletal system as a whole, for example dysplasia, flat feet, scoliosis (if a certain link in the spine is damaged, the entire biomechanical chain suffers).
- Dystrophic changes in joints associated with age-related changes.
- Cervical spine injuries.
- Excessive strain, for example due to excess weight, associated with professional activities or sports.
- Herniated or protruded discs.
- Inflammatory diseases (arthritis, rheumatism).
- Malfunctions of the endocrine system.
- Metabolic disorders, etc.
Most often, arthrosis of the cervical vertebrae develops after an injury or due to excessive strain on the neck.
Pathogenesis
Changes occur in the facet joints: the amount of joint fluid decreases, the cartilage becomes thinner and becomes less smooth. Often, the articular surfaces are excessively displaced relative to each other, which is due to both changes in the properties of the articular capsule and excessive or non-physiological load on the articular processes, the cause of which is a change in the relationships between various structures in case of abnormalities in the development of the spine, redistribution of the load in case of postural disorders, or an increase in the vertical load in case of decreasing the height of intervertebral discs.
Due to the displacement of the articular surfaces, the capsule of the facet joint is stretched. Nerve receptors located in the thickness of the capsule send a signal to the brain about excessive stretching. The surrounding muscles, having received the “command” to eliminate the disorder that has arisen, become excessively tense and spasm. Moreover, since the normal relationships between the elements of the spine are disrupted, the joints are fixed in a vicious position, which further aggravates cervical spondyloarthrosis and leads to further progression of degenerative changes.
The range of motion in the joints decreases, and ankylosis may develop over time. A complex of pathological changes with simultaneous damage to the facet joints and discs leads to pinched nerve roots. Neurological disorders occur. Direct compression of blood vessels and pain, causing spasm of the vertebral arteries, negatively affect the blood supply to the brain, which is manifested by dizziness, headaches and flashing spots before the eyes. There may be disturbances in the venous outflow, leading to an increase in intracranial pressure, resulting in heaviness in the head, impaired coordination of movements and tinnitus.
How to recognize
Arthrosis of the cervical vertebrae is accompanied by dull, aching pain, usually one-sided, which intensifies with movement. Patients complain of morning pain. Unpleasant sensations originate in the neck area, and then move to the shoulder blades and arms, the syndrome intensifies with palpation.
Other characteristic symptoms of the disease are:
- paroxysmal dizziness or migraine;
- decreased range of head movement due to pain (for example, a person can tilt their head 45-50°);
- crunching when moving the neck;
- specific sounds in the ears;
- visual impairment;
- pain in the chest area;
- numbness in the lower part of the face.
At later stages, against the background of a total lack of synovial fluid in the joints, deformities of the spinal column appear, and systemic hypertension can also develop - an unexplained increase in blood pressure. If the disease is complicated by radicular symptoms, such as a pinched nerve, its form is diagnosed - uncovertebral arthrosis. It is not easy to recognize the disease on your own: based on its symptoms, it can easily be confused with a pathology of the cardiovascular system or brain.
Symptoms of arthrosis of the cervical vertebrae are not at all typical for diseases of the musculoskeletal system
Classification
Taking into account the severity of pathomorphological and clinical manifestations in traumatology and orthopedics, 4 stages of cervical spondyloarthrosis are distinguished:
- Stage 1 – is asymptomatic. Initial changes occur in the joints.
- Stage 2 – the first signs of spondyloarthrosis appear: discomfort, pain, slight decrease in mobility.
- Stage 3 – changes become clearly visible on radiographs: facet joints are deformed, bone growths appear along the edges of the articular surfaces.
- Stage 4 – pronounced impairments in the mobility of the affected area occur; ankylosis, disturbances in the blood supply to the brain, and neurological symptoms may be observed.
Difficulties in diagnosis
Before prescribing a complex treatment regimen or prescribing intra-articular injection of synovial fluid prostheses, the rheumatologist must ensure that the diagnosis is correct, since the symptoms of the disease duplicate a number of other pathologies. After collecting an anamnesis and studying a blood test to determine the absence of other diseases (with arthrosis, blood counts do not change), one of the following studies is carried out:
- radiography in several projections;
- CT or MRI;
- vascular angiography.
As a result of examinations, the doctor determines changes in the structure of the cartilage of the intervertebral discs, the joint space, the amount of synovial fluid and its deficiency in the joints, the nature of bone growths - osteophytes.
Arthrosis of the shoulder joint - symptoms
As with most types of osteoarthritis, pain is the main symptom. Pain usually occurs when moving the joint. Sometimes a person may experience pain while sleeping. Another symptom is limited movement. It can be easily noticed when attempting maximum flexion/extension of the shoulder. A doctor can diagnose shoulder arthrosis based on this particular symptom. He or she may hold your hand and use movements to check the joint for restriction of movement. Sometimes clicking and cracking noises may occur when moving. Another sign that your doctor will look for first is atrophy of the muscle around the shoulder due to lack of use and weakening. For diagnosis you may need:
- X-ray
- Blood test (to detect rheumatoid arthritis and rule out other diseases)
- Joint synovial fluid analysis
- MRI
Why arthrosis of the cervical vertebrae needs to be treated
If the treatment of osteoarthritis of the cervical vertebrae is delayed, the disease can lead to the following complications:
- compression of nerve endings and, as a result, severe pain;
- pinching of the spinal canals;
- stroke.
Rare, but accurate: arthrosis of the cervical vertebrae can lead to stroke
What type of doctor performs the operation?
A very important element for the employees of the Gelenk Klinik orthopedic medical center in Germany is the close connection between doctors and patients. This means that your attending physician will take care of you from the day you take your medical history until the operation itself. This way, you will have a contact person who understands your situation and can answer all your questions at any time. The Gelenk Clinic's specialist in the treatment of back pain and spinal surgery is the experienced neurosurgeon Dr. Bian Ganepo.
Treatment of arthrosis of the cervical spine
As a rule, people turn to a rheumatologist with an acute form of the disease, so the primary goals of therapy are as follows:
- eliminate pain syndrome;
- stop inflammation;
- eliminate pinching of the nerve endings of the spinal trunk.
In addition, for the normal functioning of the vertebrae, it is necessary to restore the destroyed cartilage fibers of the discs, and for this, increase blood circulation in the damaged tissues.
Therapeutic methods
1. Medication.
NSAIDs are used to relieve pain and inflammation, and chondroprotectors are used to regenerate cartilage tissue. Blood circulation and nutrition of affected tissues can be normalized with the help of vasodilator drugs. Muscle relaxants are used to relieve muscle spasms.
2. Physiotherapeutic.
Physiotherapeutic treatment is auxiliary in nature and is aimed at accelerating metabolism in tissues. Most often, with this diagnosis, manual therapy, magnetic and acupuncture therapy, phonophoresis, and infrared radiation are prescribed.
Without exercise therapy or yoga, treatment for neck arthrosis will not be complete
If medications do not help and there is a possibility of vertebral artery syndrome, surgery is prescribed for uncoarthrosis of the cervical vertebrae. It involves removing and replacing the damaged joint with an endoprosthesis.
In order not to harm your neck with arthrosis and help it, practice, for example, the following morning exercises:
Symptoms of cervical spondyloarthrosis
The main manifestations of the disease in the initial stages are pain and discomfort in the neck. The pain is usually aching, constant, and worsens with movement. If you stay in an uncomfortable position for a long time or undergo intense stress at one time, the pain can become more acute, sometimes burning. In the morning, patients often feel stiffness in the neck, which usually disappears within 30-40 minutes. Irradiation to the shoulder and arm is uncharacteristic, and there are no neurological abnormalities.
With the progression of cervical spondyloarthrosis and the addition of osteochondrosis, the symptoms become more vivid and varied. The pain periodically intensifies and begins to radiate to the shoulder girdle and upper back. Dizziness, headaches, a feeling of fog and heaviness in the head appear. Paresthesia and numbness of certain parts of the body occur, and sensitivity disorders are possible. When the joints of the I-II vertebrae are affected (uncovertebral spondyloarthrosis), imbalances, cervical and brachial neuritis, and hyporeflexia are noted.
What is an orthopedic regimen for neck arthrosis?
Patients with arthrosis of any joint, including those using synovial fluid prosthetic preparations or other medications, are shown a special orthopedic regimen that will help avoid complications:
- It is necessary to carefully control your posture, avoiding curvature.
- During sedentary work, short breaks for physical activity are required.
- Orthopedic collars from Shants help relieve stress from the cervical region - according to the doctor’s indications.
- An orthopedic mattress and pillow will not be superfluous.
How to choose and wear a Shants collar?
Complex treatment of arthrosis of the cervical vertebrae also includes special gymnastics and professional massage. With the help of turns and rotations, bending and throwing back the head under the supervision of an instructor, it is possible to develop the motor capabilities of this part of the spine.
Intra-articular injections of the synovial fluid substitute “Noltrex” are not practiced for this type of arthrosis due to the specific localization. Instead, the patient may be offered professional massage or hardware methods for local and safe development of the deep and superficial back muscles. The main thing is to find a good specialist, trust him and not let the course of the disease run its course.
Prevention
The main preventive measure is to create a regime of moderate stress in the cervical region. It is necessary to avoid prolonged stays in a forced position and uncomfortable position while working and using a computer, and introduce regular breaks into the work schedule to change positions, rest and warm up muscles. Patients with developmental disorders and a history of spinal injuries should be observed by a spine specialist.
You can share your medical history, what helped you in the treatment of cervical spondyloarthrosis.
Possible complications
A disease such as uncovertebral arthrosis of the cervical spine is dangerous because without timely treatment it leads to undesirable consequences and disability. Possible complications of this pathology include:
- Synovial cyst.
- Intervertebral hernia.
- Paralysis of limbs.
- Compression of the vertebral artery.
- Cerebrovascular accident.
- Persistent loss of ability to work, assignment of a disability group.
Therefore, it is extremely important to prevent the development of degenerative processes, and to do small neck exercises every day as a preventative measure. In addition, maintaining an active lifestyle, wearing comfortable shoes, and proper nutrition will protect you from pathology. When the first signs of a disorder appear, you should immediately consult a doctor to receive full treatment. This will prevent the progression of the pathology and prevent the occurrence of complications.
Uncovertebral arthrosis of the cervical spine is a dangerous pathology that can lead to serious consequences. To prevent this, you should eat right, exercise, and consult a doctor when the first unpleasant symptoms appear. Timely therapy allows you to maintain normal neck mobility and a person’s ability to work.
What should you pay attention to after surgery?
After surgery, the spine should be at rest. Avoid sudden movements. Within 2-3 days, a Shants collar splint is placed on the neck - a soft and elastic anatomically shaped retainer that limits head rotation to 30°. Depending on the medical indications, you will be prescribed manual therapy to eliminate functional disorders of the musculoskeletal system, which will be carried out by an experienced physiotherapist. There is no need to remove sutures, as special absorbable threads are used during the operation. Therefore, you are allowed to take a shower already on the 7th day after the intervention.
- Inpatient treatment: 4 days
- Recommended time of stay in the clinic: 10-14 days
- Possible return home: after 7 days
- Recommended return flight: after 14 days
- When is it permissible to shower: after 7 days
- When sutures are removed: not necessary (absorbable sutures)
- When can you drive again: in 2 weeks
- Outpatient physical therapy: 2 weeks