Shoulder

Neck pain can appear gradually and significantly reduce the quality of life of the patient. To know the cause of neck and shoulder pain, you need to see a doctor and have a comprehensive examination. The most common cause of that pain is osteoarthritis of the shoulder.

The disease needs to be fully treated for a long time, only an experienced specialist can prescribe it.

What is it?

Shoulder arthropathy is a chronic, progressive metabolic dystrophy, leading to gradual destruction of articular cartilage, protective growth of bone tissue, and joint deformity and loss of function.

A wide range of arm movements is provided by the synchronous interaction of the joints of the shoulder complex:

• humeroscapular or simply humeral;
• acromioclav Acid - between the collarbone and the acromial process of the shoulder blades;
• sternum - between the sternum and collarbone.

The shoulder joint is highly mobile, provided by the convex head of the scapula and the relatively flat articular opening of the scapula. The joint is strengthened by tendons of the muscles of the upper extremities, above which are the coracoid-acromial ligaments. The not-so-reliable reinforcement allows the joint to move in different directions, but at the same time increases the risk of injury.

The code for shoulder arthropathy according to the International Classification of Diseases 10th Revision (ICD-10) is M19 (other arthropathy). Treatment of shoulder disease should begin as soon as possible. But even severe stages of the disease can be treated successfully.

Causes of shoulder osteoarthritis

The main causes of shoulder joint disease:

• consequences of acute trauma - dislocation, dislocation, fracture in the joint, bruise;
• permanent long-term injury related to occupation or sports loads;
• transfer of acute and chronic inflammatory and autoimmune processes in the shoulder joint - acute purulent arthritis, chronic rheumatism, psoriasis and other inflammatory diseases of the joints;
• against the background of a chronic inflammatory process in the peristaltic tissues - periarthritis, which leads to a decrease in blood circulation and nutrition of cartilage tissue;
• disorders of metabolism (exchange) joints - gouty arthritis;
• Hormonal disorder;
• birth defects (dysplasia) - eg, articular surfaces of the shoulder joints.

Under the influence of any of these reasons (sometimes many at once), the composition and volume of the synovial fluid feeding the cartilage tissue of the joint is disturbed. Cartilage gradually decreases in volume, cracks, and loses its cushioning properties. This leads to trauma to the bone, its growth along the edges of the joint surface, joint deformity, and reduced function. In the joint cavity, cyclic synovitis occurs - bursitis. Because of bursitis, joint disease is called osteoarthritis or osteoarthritis - depending on which process is taking place (inflammation or metabolic dystrophy). As a result of the inflammation and necrosis of the bone, small pieces of tissue were separated from it - the mice with joints or the mice with joints.

Have risk:

• for microtrauma - blacksmith, miner, tennis player, weightlifter, discus thrower;
• for acute injuries - gymnasts, athletes, circus performers;
• people with a genetic burden;
• people with any chronic joint disease.

Symptoms of shoulder osteoarthritis

The disease begins slowly, gradually. The rate at which it progresses depends on the cause, the general condition of the patient and his genetics.

First sign

The early symptoms of shoulder arthritis may go unnoticed, especially if they occur against the background of some existing joint disease. These are mild attacks, occurring in cycles, mainly after exercise, pain and discomfort when moving joints. Pain in the left joint can be confused with a heart attack. They pass quickly, but it's worth noting them.

If such symptoms recur, it is better to immediately consult a doctor, since any disease is easier to treat in the early stages.

Overt symptoms

Pain increases, after exertion does not go away immediately. Pain that occurs at night, as well as pain related to changes in weather. Hand movements become painful, they are accompanied by a characteristic crackle. In the morning or when you are in a certain position for a long time, the movement appears stiff, to get rid of it, you need to move. The pain syndrome can be localized not only to the shoulder area, but also to the arms, neck, and upper back.

Periodically, the joint swells, slightly red skin appears on it, the pain is more intense and becomes permanent. Body temperature may increase slightly. This is a sign of synovitis - aseptic (non-infectious) synovitis. If there is a foci of infection in the body (wisdom teeth, diseases of the ENT organs, etc. ), then it can enter the joint through blood and lymphatic vessels, causing a purulent inflammatory process. In this case, high fever, headache may appear, the general condition may be strongly disturbed.

The combination of degenerative-dystrophic and inflammatory processes in the joint gradually leads to permanent loss of limb function and constant pain.

But even such patients can be helped, you just need to go to the clinic.

Danger symptoms

There are a number of symptoms of shoulder osteoarthritis that signal an urgent need to see a doctor. This:

• the appearance of edema and redness of the tissues in the joint area, fever;
• soreness in the joint, accompanied by a change in its shape;
• joint pain that radiates to the arms, neck, or back;
• Unable to perform previous arm movements, even just raising it causes severe pain.

These symptoms indicate that your body needs help. Only a doctor can provide.

Is shoulder osteoarthritis dangerous?

Without medical attention, brachial arthropathy is very dangerous with a stable progression with the development of a permanent pain syndrome, decreased limb function, and various, sometimes life-threatening, complications.

Degree of shoulder osteoarthritis

There are three degrees of osteoarthritis of the shoulder joint:

• Shoulder Osteoarthritis Grade 1- early stage. All symptoms appeared mild and mainly after exercise. On the X-ray, some joint space narrowing can sometimes be seen, but usually not. It is possible to detect small violations in cartilage tissue at this stage only with the help of magnetic resonance imaging (MRI).
• Osteoarthritis of the shoulder 2 degrees- progression stage. The shoulder pain is constant, the pain is worse with movement of the arms, they go down (elbows, forearms, hands) or neck, back, below the shoulder blades. There are difficulties with the functioning of the limbs, signs of bursitis develop periodically. On X-ray, the joint space is significantly narrowed, bone grows (osteocytes) along the edge of the joint surface, bone tissue is compressed (osteoblasts).
• 3 degree shoulder osteoarthritis- advanced stage. Strong, persistent joint pain with a crunching sound when moving the arm. Range of motion is limited, sometimes the arm is completely immobilized due to pain. Joints are deformed, sometimes leading to compression of nerves and blood vessels. On X-ray: almost no visible joint cavity, significant bone growth accompanied by joint deformity, severe sclerosis and bone tissue necrosis, joint cramps.

Possible complications

Any localization and form of arthritis has serious complications, so you should not delay treatment.

If you do not treat the disease or arbitrarily treat it with folk remedies, the risk of complications such as:

• significant deformity and limitation of joint mobility;
• dislocation, subluxation and intra-articular fracture with minor trauma or sudden movement;
• rupture of the tendons that surround muscle and ligament joints - they atrophy and tear easily;
• aseptic necrosis of the ends of the bones with complete destruction of the joint and loss of its function;
• purulent-infective complications when the infection enters the joint cavity from other foci.

What to do with exacerbations?

Exacerbation of the pathological process is usually associated with an increase in stress on the extremities or with the development of inflammation - bursitis. In this case, the joint is more painful, there is a slight swelling, and the body temperature rises. In such cases, you should adhere to the following self-help algorithm:

• call home doctor;
• take a pain reliever inside;
• apply anesthetic to the skin in the affected joint area;
• tie a sore arm with a bandage - this will reduce the load;
• Lie on high - sit down with a pillow under your back - this will reduce tissue swelling.

Types of shoulder joint diseases

According to various criteria, the disease is divided into separate categories.

Due to illness

According to this criterion, primary and secondary osteoarthritis are distinguished. Primary shoulder arthropathy is primarily a result of age-related changes and develops after age 50. But sometimes the disease begins at a young age, but the cause cannot be determined. In this case, they were talking about primary idiopathic shoulder arthropathy. An important role in its development is due to genetic predisposition: the presence of a similar disease in one of the close relatives.

Secondary sclerosis of the shoulder joint develops after trauma and previous diseases, but genetic burden is also important here: in a person, even a minor injury or acute arthritis can lead todevelopment of joint disease, while in another person more serious damage ends without consequences.

According to the feature of flow

Distribution of shoulder deformity, characterized by rapid progression of skeletal deformities. Characteristic of this type of disease is a change in the shape of the joints and frequent invasion of nearby blood vessels and nerves. Vascular compression leads to impaired blood circulation and rapid progression of degenerative-dystrophic disorders, and compression of nerves leads to impaired limb sensitivity and severe pain along peripheral nerves. Because.

Origin

Post-traumatic shoulder arthritis - the symptoms and treatment of this disease have their own characteristics associated with traumatic damage of certain joint structures. Exchange dystrophic changes occur after intra-articular fractures, dislocations, dislocations, ruptures of ligaments and tendons, and simple bruises. The injury occurs from a blow to the joint or from a fall on one side with an arm attached. Capsular rupture with dislocation usually occurs with a fall on the abducted arm.

Often, after a minor injury, a person does not notice the first signs of joint disease for a long time and seeks medical help already in the second stage of the disease. Significant injuries require long-term rehabilitation, and joint diseases, as a rule, begin to be treated at an early stage.

Arthritis of the shoulder after inflammatory diseases - the symptoms and course of such a pathology depend on the underlying pathology. The shoulder joint is commonly involved in psoriatic arthritis, while the joint in one joint is slow-growing, but difficult to treat. With rheumatoid arthritis, both shoulders are affected, the arthropathy develops in waves with frequent alternation of metabolic-dystrophic and inflammatory processes.

Allotment

Only one joint on the left or right side can be affected and then they talk about sclerosis. The simultaneous failure of the two shoulder joints (left and right) is called oligoarthrosis.

Arthritis of other joints of the shoulder complex

Fungal arthritis - most often of post-traumatic origin. It developed on the basis of horizontal hand lifting. Accompanied by pain when raising the arm. With the growth of osteoblasts on the surface of the joint, an infiltrate syndrome may appear - invasion of the tendons and muscles of the shoulder between the ends of the bones and soreness of the shoulder blades during rotation and initiationshoulder. This accelerates the progression of joint disease and impaired hand function.

Diagnose

Without an accurate diagnosis, this disease cannot be treated. Full examination can only be done at the clinic. At the initial consultation, the physician asks the patient, examines the patient, prescribes additional research methods, and conducts specialized consultations:

• Laboratory tests of blood, synovial fluid - inflammatory, autoimmune and degenerative-dystrophic processes are detected.
• Musical instruments:
  1. X-ray of the shoulder joint - detects changes in bone tissue;
  2. computed tomography (CT) - changes in cartilage and bone tissue in the early stages;
  3. magnetic resonance imaging (MRI) - changes in the soft tissues and around the joints;
  4. diagnostic arthroscopy - is performed if necessary to clarify the nature of the pathological process.

Treatment of shoulder osteoarthritis

After establishing the final diagnosis, a complex conservative treatment of shoulder arthropathy is prescribed. If conservative treatment is not effective, surgical treatment is indicated.

Conservative therapy

It includes pharmacological and non-pharmacological methods.

Medical treatment

The goal of drug treatment is to eliminate pain and stop the progression of osteoarthritis. To alleviate the patient's condition, appoint:

1. Drugs of the groupnon-steroidal anti-inflammatory drugs (NSAIDs). The drug is administered intramuscularly, orally or rectally; At the same time, drugs of the NSAID group are prescribed externally in the form of ointments, gels or creams.
2. Drugs of the groupmuscle relaxant- relax the muscles around the joint; spasticity of these muscles increases pain;
3. Pain reliefwith local anesthetic.The drug solution is injected into the joint cavity or into the tissues around the joint - the pain relief effect is rapid.

The process of treating genetic disease (affecting disease mechanisms) as part of medical treatment for osteoarthritis of the shoulder includes:

1. ChondroprotectorsDrugs in their composition are biologically active substances that restore cartilage tissue. They are prescribed orally in the form of tablets and powder, in the form of intramuscular and intraocular injections, and can also be used externally in the form of ointments and creams.
2. Angioprotectors- Means of improving blood microcirculation. Indicated in tablets for oral administration and solutions for intravenous drip.
3. Hyaluronic acid preparations- inserted into the joint cavity to improve amortization properties and prevent bone tissue destruction.

Vitamin-mineral complex to improve metabolism in joint tissues and motility.

Non-drug treatment

The basis of non-drug treatment for shoulder osteoarthritis is a healthy active lifestyle and proper nutrition. It is very important to get rid of such bad habits as smoking and alcohol abuse - they contribute to circulatory disorders and have a toxic effect on joint tissues.

Nutrition, diet

There is no specific diet to treat osteoarthritis of the shoulder, but proper nutrition is very important in this disease. It is recommended to include in the daily diet: sea fish, seafood, lean poultry meat, dairy products, cheeses, cheeses, cereals (oatmeal, buckwheat), vegetables, fruits.

Exclude from the diet: easily digestible carbohydrates (sweets, muffins, sweetened carbonated drinks), fatty red meat, foods that stimulate tissue that cause swelling - salt (excessive amounts), spicy spices andmany spices.

Preference should be given to boiled, stewed, and steamed dishes.

Orthopedic treatment to distribute the load on the extremities

To prevent shoulder injury, it is recommended that you periodically wear an elastic protective vest in the form of a short sleeve that connects to the opposite arm. The device improves blood circulation, eliminates swelling. However, wearing it continuously is not recommended, as this leads to a rapid decrease in the range of motion of the shoulder.

Many specialists include duct tape in the complex treatment of shoulder arthropathy - fixation of tissues with adhesive elastic bandages. This eliminates pain, improves blood circulation and joint function.

Physical therapy

Exercise therapy - performing a daily set of exercises - with shoulder osteoarthritis is the main method of rehabilitation. Complex gymnastics prescribed by a doctor, mastered under the supervision of a gymnastics coach. Once the patient begins to correctly perform the entire exercise, it can be performed at home.

Physical therapy

Physiotherapy is included in complex therapy at any stage of the disease. This is an electrical and acoustic method with the use of analgesics, lasers and magnetic therapy - stimulation of regenerative processes in joint tissues, shock wave therapy (SWT) treatments - exposurewith sound, has a pronounced choroidal protection effect.

Folk remedies

Folk remedies only bring great benefits when prescribed by a doctor. Here are some of them:

• A decoction of honeysuckle branches to drink.Pour a glass of crushed ingredients before going to bed with 500 ml of water, bring to a boil, let it simmer for 5 minutes, keep it overnight, then filter and drink 100 ml 3 times a day. It is an anesthetic.
• An old recipe for anesthetic ointment from wild rosemary.Take vaseline or butter and minced hay. In an enameled dish, alternate layers of grease and grass on top, cover the dish, cover the cracks with flour, and place in the oven (preferably in the oven) over low heat for 2 hours. , Remove from the oven, filter through double gauze, store in the refrigerator and rub on the affected skin 2-3 times a day.

Surgical operation

With the ineffectiveness of conservative treatment for shoulder arthropathy, the following surgical interventions are performed:

• Arthroscopy operationallows to eliminate various defects in the joint cavity. They are done mainly for young people with post-traumatic joint disease. Arthroscopy allows you to tighten and attach the biceps tendon to the bone (tenodesis - this will remove the loosening of the joint), remove the growing bone - create bone (osteolysis), restore the joint cavity with implants, v. v.
• Endoscopic- replacement of damaged, dysfunctional joints with artificial joints.

Treatment methods in the clinic

Clinical experts have developed their own approach to the treatment of shoulder joint disease. First of all, each patient is carefully examined using the most modern diagnostic equipment (including MRI). After that, he completely relieves the pain with pharmacological and non-pharmacological methods. At the same time, an individual complex therapy is selected for him, which includes:

• the most modern drugs and non-drug methods, including transplant plasmolifting;
• Oriental Medicine's methods of treatment and rehabilitation of joints and the whole body in general; which is acupuncture, massage, chiropractic therapy, bandaging, etc. v.

This approach quickly helps the patient relieve pain and prevent the progression of the disease. And regular preventive courses allow the patient to forget about the disease and lead a normal life. Many patient reviews talk about how effective this treatment is.

Combines the proven techniques of the East and the innovative methods of Western medicine.

General clinical guidelines

For people with shoulder osteoarthritis should:

• practice a healthy lifestyle, be physically active, and alternately rest;
• eat right regularly;
• get rid of all bad habits;
• regularly perform therapeutic exercises, avoid sudden movements;
• sleeping on your back or side at night, placing a small pillow under your sore arm;
• give up strenuous activities, avoid injury, prolonged stress and colds;
• during exacerbations (development of bursitis), avoid any thermal procedures;
• Follow all recommendations of your attending physician.

Prevent

It is especially important for people with severe hereditary problems to follow certain rules to prevent shoulder joint disease. They should not do weightlifting, tennis, traumatic sports, blacksmithing, blacksmithing, miners. Everyone who wants a healthy joint should lead an active lifestyle and regularly eat right.

Frequently asked questions about the disease

1. Shoulder and neck pain take what medicine?

   Pain, aggravated by movement and lifting weights.

2. Why is the disease dangerous?

   Formation of permanent pain syndrome and loss of limb function.

3. Which doctor treats shoulder deformity?

   Post-traumatic - an orthopedic surgeon, against inflammatory diseases - a rheumatologist.

4. Is blockade performed for shoulder arthropathy?

   For severe pain, yes.

5. How effective are physical therapy methods for this disease?

   Effective as part of complex treatment.

6. Can osteoarthritis of the shoulder be completely cured?

   No, but doctors can stop its progression and save the patient from pain.

Shoulder joint disease requires long-term, systematic and rigorous treatment under the supervision of a doctor. Attempts to deal with the disease on their own are fraught with complications and disability. But a qualified therapist can stop this process at any stage of the disease, save patients from pain and significantly improve their quality of life.