Bursitis of the shoulder joint: how to get rid of the disease

Inflammation of the shoulder joint

Inflammation of the shoulder joint
Inflammation of the tissues of the shoulder joint area is a common pathology that can occur equally often in men and women, regardless of age. It develops due to the influence of a significant number of different causes. If inflammation of the shoulder joints has been established, treatment is prescribed by a medical specialist taking into account an integrated approach. It necessarily includes measures aimed at reducing the severity of the inflammatory reaction.

Symptoms at different stages of shoulder tendinitis

Initially, signs of the disease appear exclusively when the load on the shoulder joint increases. A person develops a pronounced pain syndrome, which goes away on its own after relaxation.

As the disease progresses, discomfort increases even with the simplest movements of the limb. This stage is characterized by difficulty raising the affected arm, taking a shower, combing hair, and putting on clothes.

In advanced stages of the disease, even slight movements of the hand are difficult for the patient.

If at the initial stages pain occurs in paroxysms, then over time they can become more prolonged (up to 8 hours in a row) and radiate to other organs - to the elbow or forearm.

We described in detail the characteristic symptoms of tendinitis above. In case of a chronic process, the following signs are added to the indicated symptoms:

• The appearance of multiple scars under the skin;
• The appearance of a crunching sound when making movements;
• Feeling of stiffness in the joint area.

It should be noted that if a patient is diagnosed with tendonitis, then bursitis of the shoulder joint may be detected at the same time. As a rule, these pathologies appear during the same period. In case of tendon rupture, the patient is given a more serious diagnosis - tendinosis.

Structural features

The shoulder joint has a round shape. The structure makes it possible to achieve a significant range of hand movements performed in 3 planes. The joint is strengthened by the ligaments and tendons of the muscles that form the cuff (supraspinatus, infraspinatus, rotator cuff).

The articular surfaces of the bones contain a cartilaginous canal that provides sufficient gliding, and the joint itself is covered with a connective tissue capsule. The complex structure is a factor that often provokes the development of inflammatory reactions in various structures.

Prevention methods

The main preventive method is reasonable physical activity. If professional duties require stress, you need to remember about rest and relaxation. It is also important to monitor the condition of the spine, because incorrect position of the neck and back for a long time can also cause the disease. Excessive sports loads can lead to sprains, torn ligaments and muscles, and other types of injuries - so it is better to conduct training under the guidance of experienced trainers.

Remember: with glenohumeral periarthritis of the shoulder joint, the pain can be so severe that it will prevent you from doing your usual activities. It is better to prevent a disease than to treat it.

If the disease does affect you, and you are bothered by pain when raising your arms or putting your hand behind your back, do not put off visiting a doctor. The sooner therapy is started, the greater the chance that you will be able to get rid of unpleasant symptoms quickly and completely.

Registration for treatment of glenohumeral periarthritis in our clinic in Moscow is made by calling the numbers listed on the website. Waiting for you!

Etiology

The trigger for the inflammatory response is damage to the tissues of the shoulder, which develops as a result of several common causes:

• An infectious process that often develops in soft tissues and is caused by the activity of pathogenic (disease-causing) or opportunistic microorganisms.
• Suffered injuries, which include dislocation of the joint with complete or partial release of the head of the humerus, rupture or sprain of ligaments, tendons, capsules, fracture of the bone base, damage to cartilage.
• Systematic long-term and significant physical activity, leading to the appearance of small tears in connective tissue fibers.
• Autoimmune inflammation, which is the result of an impaired functional state of the immune system. It is accompanied by the production of antibodies to one’s own connective tissue with damage and inflammation of the structures of the musculoskeletal system.
• Local hypothermia of the shoulder area, leading to an aseptic inflammatory process.
• Degenerative-dystrophic processes, primarily associated with impaired nutrition of cartilaginous structures, their gradual destruction and the development of an inflammatory reaction.

Often, under the influence of etiological factors, inflammation develops not only in the joint, but also in the surrounding nearby tissues. This disease is called periarteritis.

About the reasons

To understand how to treat bursitis of the shoulder joint (or any other joints), which should become the basis of prevention, you need to understand the cause of the inflammation. There are several of them (main ones) and most often their complex action leads to inflammation.

The main causes of shoulder bursitis:

• Shoulder injuries - fractures, dislocations, or simply bruises and wounds with or without a violation of the integrity of the joint. They lead to post-traumatic bursitis, the main principle of treatment of which is rest and immobility. Of particular danger are open joint injuries, in which harmful microflora (staphylococcus and other microorganisms) can easily penetrate inside.
• Constant overexertion and heavy physical stress on the shoulders.
• Diseases of the musculoskeletal system - arthritis, rheumatism and others.
• Autoimmune diseases – scleroderma, lupus and others.
• Allergy.
• Metabolic disorders in which joint nutrition deteriorates or salt deposits occur - gout and others.

There is a group of risk factors - reasons that lead to an increased chance of joint inflammation:

• Profession, work associated with constant or heavy load on the joint - loader, athlete.
• Intoxication of the body from smoking, alcohol abuse.
• Weak immunity.
• Patients taking certain medications for a long time and after corticosteroid therapy.

Signs and diagnosis

The main clinical manifestation of the inflammatory process is shoulder pain. It can hurt for quite a long time. The intensity of discomfort sensations can vary, usually higher during active movements. With significant inflammation affecting a large volume of tissue, redness of the skin (hyperemia) and swelling appear.

Determining the cause of the disease is carried out using various diagnostic methods, which include visualization of structures, various laboratory and functional studies. Based on the results, the doctor determines that the shoulder joint is inflamed. Treatment is selected in accordance with the causes of development and severity of the inflammatory reaction.

About diagnostics

For treatment of shoulder bursitis to be effective, it is necessary to confirm and clarify the diagnosis. This will help:

• Examination by a doctor with collection of anamnesis of the disease.
• Laboratory tests - blood, synovial fluid from the inflamed joint.
• Instrumental diagnostics to assess the location, degree and nature of inflammation, periarticular tissues - ultrasound, MRI, x-ray.

Bursitis can be unilateral (occur in only one of the paired joints) or bilateral (for example, bursitis of the right shoulder joint and at the same time bursitis of the left shoulder joint). Unilateral - usually the result of injury, bilateral - more often occurs for other reasons. Taking this into account, the doctor examines and prescribes studies of only one or both paired joints at once.

Diagnostics and therapy

Diagnosis and therapy
Treatment of inflammation of the shoulder joint is complex. It includes several areas, the choice of which depends on the cause, nature, localization and severity of the inflammatory process:

• Inflammation of the joint capsule of the shoulder joint - treatment is aimed at drug reduction of the severity of the inflammatory reaction, as well as eliminating the impact of the cause, for which non-steroidal anti-inflammatory, antibacterial agents, and immunosuppressants are used.
• Inflammation of the tendons of the shoulder joint - treatment includes resting the shoulder, anti-inflammatory drugs, and surgical manipulation if necessary.
• Inflammation of the shoulder joint ligaments - treatment includes achieving goals in terms of reducing the severity of inflammation, as well as restoring fiber strength using modern techniques for performing plastic invasive manipulations.

The main therapeutic areas include conservative tactics, surgery and rehabilitation measures.

Diagnosis of shoulder tendonitis

If tendinitis of the shoulder joint occurs, the success of treatment largely depends on the accuracy and timeliness of diagnosis of this pathological process. At the same time, in order to establish the specific form of the disease, it is imperative to undergo laboratory tests and perform a thorough examination of the patient. The disease can also be detected using the following diagnostic methods:

• Ultrasound of the shoulder joint;
• Magnetic resonance imaging;
• X-ray.

A prerequisite for identifying metabolic pathologies and rapid recovery of the patient is a biochemical blood test.

All the above studies are carried out in honey. In this case, innovative technology is used, and highly qualified specialists are involved in deciphering the test results. This allows you to quickly diagnose the disease, correctly draw up a treatment plan and eliminate the occurrence of complications.

Non-surgical tactics

Non-surgical treatment for inflammation in the tissues of the shoulder is prescribed in most cases. Non-steroidal anti-inflammatory drugs and glucocorticosteroids (hormonal agents with a pronounced anti-inflammatory therapeutic effect) are used as medications. For chronic inflammation, physiotherapy is used, the essence of which is the therapeutic effect of certain physical factors.

An alternative treatment option is intra-articular administration of platelet mass (a concentrated suspension of platelets), which has a stimulating effect on regeneration processes. Some folk remedies in the form of medicinal plants also have an anti-inflammatory effect, but their use is possible only after consultation with a doctor.

Causes of pain in the right shoulder joint

The structure of the shoulder joint is quite complex. It consists of an articular capsule and ligaments: coracohumeral, coracoacromial, acromioclavicular. Disturbances in the neurotrophic control of the joint capsule, traumatic injuries, and inflammation of the tendons/muscles are a source of stiffness and develop degenerative processes.

Symptoms of the disease

In patients with shoulder pain, the following symptoms are observed with a primary history: small swelling, mild fever, lethargy, intermittent/constant joint pain, mood swings, stiffness in which it is impossible to lift/abduct the upper limb to the side. With degenerative changes in the joint capsule, hand movements cause pain, which can be reflected in the neck, shoulder blade, and disrupt sleep.

Causes of right shoulder pain

As a rule, the source of pain is a variety of diseases with inflammatory/infectious processes and allergic reactions, injuries, weakening of muscle activity due to a sedentary lifestyle, etc., for example:

1. Inflammation of the synovial bursa (bursitis), which occurs due to shoulder injuries, osteomyelitis, and furunculosis. And also due to alcoholism, excess weight, intense stress on joints, ligaments, tendons.
2. An inflammatory process in the tendons (tendonitis), caused by scoliosis, padagra, rheumatoid arthritis, arthrosis and other joint diseases, sometimes as a side effect of medications.
3. Diffuse damage to the capsule and synovial membrane of the shoulder joint (capsulitis) appears due to a neurotrophic disorder in the capsule and inner layer of the joint capsule (osseous fibrous canal), from cardiovascular diseases in patients with oncology.
4. All types of arthritis, gout, as well as osteoarthritis, Still's disease, affect the joints. Arthritis can be a secondary disease after infection.
5. Injury/ contusion of the
   shoulder joint most often occurs during intense sports or significant physical activity. The resulting microtraumas and sprains contribute to the development of the inflammatory process.
6. Inflammation in the articular elements (periarthrosis) leads to the formation of sclerosing capsulitis.
7. Dystrophic pathologies of the articular cartilage of the cervical spine give rise to severe pain in the shoulder joint, and sometimes disorders spread to its cartilage.

Treatment of the right shoulder joint

The quality of life is greatly reduced due to pain in the mobile joint of the right shoulder. The patient cannot perform usual self-care activities at home or at work (for example, getting dressed, washing dishes, laying bricks, writing on a blackboard, etc.). When the shoulder joint hurts, treatment

prescribed after collecting anamnesis/diagnosis.

For arthritis/arthrosis, the rheumatologist prescribes a course of treatment: chondroprotectors, NSAIDs, hormonal therapy, painkillers. Instructions are given to eliminate inflammation in the synovial bursa using massage, physiotherapy, and analgesics. Physiotherapeutic procedures, drug therapy, exercise therapy, and massage are prescribed for glenohumeral periarthrosis.

Capsulitis is characterized by severe pain in the inflamed shoulder, so doctors prescribe treatment with non-steroidal anti-inflammatory drugs, and older people are mainly prescribed aceclofenac, which does not cause complications in the gastrointestinal tract, heart and kidneys. Additionally, hormonal drugs are injected into the diseased joint.

For tendonitis, first of all, the arm of the affected shoulder joint is fixed, cold compresses are applied and a course of NSAIDs is prescribed.
Such procedures help well with bruises, as well as injuries that occur due to dislocations, tendon sprains, muscle tears, and damage to the rotator cuff. Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr

Treatment of shoulder ligament lesions

First of all, it is necessary to exclude any movement of the shoulder joint. It is advisable to apply a fixing bandage for a while so that the shoulder, tendons and ligaments are in a state of calm.

As for medications, the doctor usually prescribes painkillers to reduce pain and swelling, as well as vitamins. The diet must be balanced - the treatment process will speed up if you add hyaluronic acid, chondroitin and glucosamine to the diet.

In more severe cases, they resort to procedures such as:

• cold compress on the damaged area;
• limb fixation;
• electrophoresis with anti-inflammatory drugs;
• magnetotherapy – a procedure using a magnetic field;
• balneotherapy – treatment with mineral waters;
• paraffin therapy is a method of heat treatment using paraffin.

Surgery is usually not performed for sprained or torn shoulder ligaments. They are indicated only in rare cases, for injuries with complications.

As the final stage of treatment, the patient needs to undergo a massage session in order to fully recover from the injury. Health-improving physical education with control of moderate loads is also recommended.

To prevent injuries to the ligaments of the shoulder joint, it is necessary to exercise regularly, control nutrition and weight, observe the necessary technique during training, etc.

Diagnostics

The doctor may be interested in the history of the disease (presence of injuries or characteristics of activity). A physical examination is often most helpful in diagnosing biceps tendonitis. The examination allows you to detect the presence of painful movements or muscle weakness, changes in the amplitude of movements. In addition, there are specific functional tests that suggest the presence of rotator cuff injuries or the presence of shoulder instability.

Radiography allows you to diagnose the presence of osteophytes in the tendon. X-rays do not visualize the tendons and, if treatment is not effective, an MRI examination is prescribed. MRI can detect changes not only in the tendons, but also the presence of damage to the rotator cuff or labrum.

Diagnostic arthroscopy is an invasive diagnostic method and is used not so much to diagnose biceps tendinitis, but to diagnose other shoulder problems that could not be diagnosed using X-rays or MRI. Using arthroscopy, the surgeon can visually assess the condition of the rotator cuff, labrum, or part of the biceps tendon located inside the joint.

Treatment

Conservative treatment

The main goal of conservative treatment is to reduce inflammation and pain. Therefore, at the first stage, conservative treatment includes rest and taking NSAIDs (ibuprofen). Anti-inflammatory drugs can reduce the inflammatory process and reduce pain. If severe pain is present, corticosteroid injections may be prescribed. The use of steroids can effectively relieve swelling and inflammation for some time.

During the period of time when calcium deposits begin to be reabsorbed, pain can be especially severe. In such cases, it is possible to remove part of the calcium deposits using saline rinsing. solution through two punctures in the area of ​​calcium deposits. This procedure is called lavage. Sometimes with this procedure it is possible to break the calcifications into pieces (they are removed with a needle). Removing deposits allows you to quickly reduce pain and achieve faster tendon recovery. Even when lavage does not remove calcium deposits, it can relieve pressure in the tendons, resulting in less pain.

Physiotherapy . Physiotherapy is one of the main components of the conservative treatment of calcific tendinitis. The use of a technique such as ultrasound helps reduce pain and inflammation. But the effect of using ultrasound is achieved only with a course of treatment (up to 24 procedures over 6 weeks). Shock wave therapy is currently the most modern method of conservative treatment of such diseases. The shock wave breaks down large calcium deposits, allowing the body to absorb them more quickly.

Exercise therapy is indicated at the stage of completion of reabsorption and allows you to restore muscle tone and improve blood supply to the structures of the shoulder. As a rule, an individual selection of exercises is carried out and exercise therapy is carried out for 4-6 weeks. Exercise is important to strengthen the rotator cuff muscles, as these muscles help control the stability of the shoulder joint. Strengthening these muscles can actually reduce the pressure on the calcium deposits in the tendon.

Signs and main symptoms of arthrosis of the shoulder joint

Considering the clinical picture of the disease, it is worth noting that the symptoms of the initial stages of development of pathological processes are weakly expressed. This is often the reason for late diagnosis of osteoarthritis of the shoulder joint.

Symptoms of arthrosis of the shoulder joint include:

• pain (when pressing/abducting a limb);
• accompaniment of movements with a characteristic crunch;
• inactivity;
• local redness and swelling.

Any of the symptoms of osteoarthritis of the shoulder joint requires the attention of a specialist.

As pathological processes develop, symptoms intensify. The earlier the disease is detected, the easier it is to prevent destructive processes, preserving the functionality of the joint as much as possible.

Causes

No one knows what exactly causes calcific tendinitis. Physical stress, aging or a combination of both leads to degenerative calcification. Some researchers suggest that calcium deposits are formed due to tissue hypoxia and insufficient oxygen supply to the tendon tissues. Others believe that pressure on the tendons can lead to their damage, resulting in the deposition of calcium deposits.

The mechanism of formation of reactive calcification has not been completely studied. Typically, this type of calcific tendinitis occurs in younger patients and occurs without any apparent cause.

Dietary nutrition as part of complex treatment of arthrosis of the shoulder joint

Medicines for arthrosis of the shoulder joint, physiotherapy and various types of exercises are not all that are included in the complex treatment of the disease. Another important component is nutrition.

Diet and adherence to the principles of proper nutrition are an integral part of the complex treatment of arthrosis of any type.

The principles of nutrition for shoulder arthrosis include:

1. Limiting or avoiding foods that negatively affect joint function (milk, fatty meat, potatoes, eggplants).
2. Inclusion in the diet of components that have a beneficial effect on the elasticity of joints (olive/linseed oil).
3. Fill your daily diet with antioxidants found in foods such as olives, bananas and cucumbers.
4. Complete cessation of bad habits (drinking alcohol, smoking).
5. Minimizing fried, pickled, and highly salty and sweet foods.