Somatic cells of the human body are capable of a large number of mitotic divisions.Thanks to this feature of our body, it can exist independently for a long time in the external environment, restore damaged tissues or dead cells.
Unfortunately, the number of these divisions is strictly limited and individual for each person.In this regard, upon reaching old age, various diseases begin to appear.Arthrosis is considered one of the most common, as it is the pain syndrome accompanying this pathology that significantly reduces the patient's quality of life.
Osteoarthritis, or arthrosis of the shoulder joint, becomes a serious problem that prevents the normal performance of work and daily tasks.It is this disease that will be discussed below;we will analyze the causes of shoulder joint arthrosis, symptoms and treatment of this unpleasant pathology.
What is it?
Osteoarthritis of the shoulder is associated with an interruption of the normal blood supply to this important bone joint, as a result of which the thickness of the cartilage tissue decreases and the head of the bone is exposed.Due to increased friction, a person notices the appearance of pain, which, depending on the degree, may appear only during physical activity or even at rest.
Due to the damage to the surrounding anatomical structures, an inflammatory process is observed, aggravating the decrease in the amplitude of active and passive movements in the upper limb.The lack of proper treatment often leads to a complication of the process from joint deformation, which is called osteoarthritis deformans.
Anatomy of the shoulder joint
The shoulder joint is a ball-and-socket joint;it is this structure that allows a person to perform a variety of movements with the upper limb.Three large bones converge in this anatomical region, including the scapula, the clavicle, and the humerus itself.The joint capsule is quite deep and reinforced by a whole complex of ligaments.
Due to some anatomical features of the structure of the shoulder joint, there are frequent cases of spontaneous dislocations and subluxations in this area during daily work at home.The ease and variety of movements is due not only to the spherical shape of the articular surfaces, but also to the presence of a large amount of special synovial fluid, which reduces the friction between the surfaces.
Causes of arthrosis of the shoulder joint
The disease presented in the article develops as a result of the influence of a whole complex of provoking factors.Clinical studies conducted in a number of leading research institutes have made it possible to reliably establish the pathophysiological mechanism of changes in bone and cartilage tissue during arthrosis.However, reliable "causers" have never been identified.
In most cases, this degenerative disease develops secondarily, that is, after a pathogenic effect on the shoulder joint.
A retrospective analysis of the medical histories of patients with this pathology in the shoulder joint area made it possible to identify influences that can significantly increase the likelihood of the disease occurring.
These include:
- excessive physical activity leading to physical thinning of articular surfaces;
- frequent falls on the arm and other injuries in the belt of the upper limbs;
- occupational hazards;
- congenital pathologies of the connective tissue;
- impaired mineral metabolism, associated with the appearance of crystalloid deposits on the head of the humerus;
- decrease in the production of synovial fluid;
- age-related changes in the structure of the vascular wall, causing dystrophic changes in the bone;
- lack of appropriate drug therapy in the presence of acute or chronic inflammatory process in the joint space;
- pathologies of the nervous system that cause insufficient trophism of the musculoskeletal system;
- the presence of excess weight, constant swelling of the upper extremities;
- diseases of the endocrine system.
Primary arthrosis of the shoulder
Modern medical classification of arthrosis of the shoulder joint, depending on the causes of development, distinguishes two forms - primary and secondary.In the primary case, the diagnosis is established only after a full range of diagnostic measures has been performed to completely exclude the presence of the causes described above for the occurrence of the disease.It is believed that the starting point in pathogenesis is the deterioration of blood flow throughout the system against the background of a decrease in myocardial contractility or the permeability of the vascular wall.
Over time, a person begins to notice the appearance of unpleasant sensations during shoulder movements.At first, discomfort is present during exercise, and then ceases to disappear even during rest.Another reason that contributes to the rapid progression of the disease is the appearance of so-called osteophytes.These bone spurs form as a result of a compensatory increase in the activity of chondroclasts that attempt to replenish the loss of mature cartilage cells.They have the appearance of a spike, which, when moving, contributes to damage to the capsule and the appearance of an aseptic inflammatory process.
Against the background of the described changes, fibrin threads appear in the synovial fluid, penetrating the ligamentous apparatus during long rest.Due to the decrease in the elasticity of the white muscle fibers, a characteristic feeling of "stiffness" appears, which usually disappears after 20-30 minutes of limb development.Shoulder arthrosis has pronounced symptoms, their intensity and treatment are directly proportional to the degree of the development process.
Secondary arthrosis of the shoulder joint
The secondary form of this disease is a consequence of the presence of a basic pathology, complicated by disorders in the functioning of the musculoskeletal system.Among the causes, traumatic injuries of an acute or chronic nature are the first in frequency.This problem is especially important in the cold season, when a person often falls, putting his hand forward to soften the fall.
Enzymopathies are congenital diseases associated with a decrease in the production of specific enzymes that make up the ligamentous apparatus and can also cause the development of secondary arthrosis of the shoulder joint.It is these patients who often experience dislocations and subluxations while performing daily activities.Looseness in this bone joint contributes to increased trauma to the contact surfaces against which the disease arises.
Symptoms and signs
Shoulder arthrosis has complex symptoms and treatment;due to some features of the characteristic signs, its detection often occurs in the later stages of the development of the pathological process.Experts distinguish three degrees of cartilage tissue destruction in the girdle of the upper limbs.In accordance with them, the symptom complex found in the patient will also change.
With stage 1 disease, a person rarely notices shoulder pain;more often there are discomforts in the limbs during heavy physical exercises or immediately after it.In such situations, the patient needs a few days to recover and completely get rid of the discomfort in the joint.Precisely for the reason that a person is inclined to attribute pain to the appearance of a simple sprain, as it seems to him, of the ligamentous apparatus, the disease continues its development, reminding itself more and more often.
Osteoarthritis of the shoulder joint of the 2nd degree is associated with a more vivid clinical picture.This is due to the fact that in addition to the erosion and disruption of the normal nutrition of the articular surfaces, secondary inflammation occurs, spreading to the surrounding ligaments and muscle fibers.The disease leads to the fact that pain is present even with slight physical strain.Due to severe pain, the patient becomes unable to make circular movements, which indicates that the process of deforming osteoarthritis has begun and the amplitude of active movements of the hand in space is limited.
Grade 3 development leads to an almost complete loss of mobility in the shoulder joint.The patient notices significant muscle atrophy and loss of ability to care for himself.Another characteristic symptom is the appearance of bony protrusions on the surface of the skin.The likelihood that the disease will go that far exists mainly in people who do not have the opportunity to minimize the load on the upper limbs due to professional activity or during professional sports.
Diagnosis of arthrosis of the shoulder joint
Establishing a diagnosis of arthrosis of the shoulder joint is a procedure that requires certain skills from a specialist.After the appearance of pain in the upper limb, it is advisable to consult an orthopedic traumatologist.It is the doctors of this profile who have the full range of necessary knowledge.
During the examination, the first thing you should pay attention to is the patient's complaints and medical history.The doctor finds out why the pain appeared, what is its nature and also after what disappears.Then, it is necessary to identify occupational hazards and the presence of risk factors.
The main diagnostic method for detecting deforming osteoarthritis of the shoulder joint is plain radiography.
The next stage is a physical examination, when a specialist uses palpation to identify painful areas and determine the full range of active and passive movements in the limb.In addition, the presence of local edema and increased skin temperature in the projection area of the bone joint is evaluated.Based on the data obtained, the doctor can make a preliminary diagnosis, but differential diagnosis is required to prescribe the most adequate therapy.
In order to establish the most accurate diagnosis, extent of the process and possible identification of the cause, various additional laboratory and instrumental diagnostic methods are performed on the patient.
The most informative include:
- clinical blood test;
- determination of biochemical parameters of blood serum;
- clinical analysis of urine;
- X-ray of the affected joint;
- ultrasound diagnostics;
- arthroscopic examination;
- magnetic resonance and computed tomography;
- scintigraphy;
- joint puncture followed by biochemical analysis of synovial fluid.
Signs that indicate the development of arthrosis directly include the appearance of a significant narrowing of the joint space, sclerosis of the subcartilaginous structures, thinning of the chondrocyte layer itself, the appearance of osteophytes and the deposition of salt crystals in the intra-articular fluid.
How to treat arthrosis of the shoulder joints
After establishing this diagnosis, the doctor is faced with a serious question regarding the choice of the most appropriate therapeutic tactics.Modern medicine has reached a level where it is able to help patients with diseases of the musculoskeletal system to fully return to normal life.
Treatment of arthrosis of the shoulder joint is long-term and therefore often leads to the development of complications.
The method chosen for the correction of arthrosis of the shoulder joint depends directly on the following factors:
- process rate;
- general condition of the patient;
- age;
- physiological characteristics.
As a rule, in the early stages, it is enough to prescribe medications of general and local action.
In the presence of arthrosis of the second degree of the shoulder joint, the symptoms accompanying the disease are almost impossible to stop completely.A person is shown a significant reduction in physical activity to prevent further development of the pathological process;in parallel, a whole range of medications is prescribed.
The third degree is practically not subject to conservative influence;in the presence of such an advanced disease, surgical treatment is indicated, the volume of which depends on many factors and is chosen directly by the attending physician.Next, we will talk in more detail about each of the existing methods to get rid of arthrosis.
MEDICINES
The following groups of drugs are used as conservative therapy in the presence of this disease:
- glucocorticoids;
- non-steroidal drugs with anti-inflammatory effects;
- analgesic;
- drugs with chondroprotective effects.
Medicinal substances belonging to this group have a significantly more pronounced anti-inflammatory effect than non-steroidal drugs.
Glucocorticoids are known as the most effective agents against inflammatory phenomena.These natural and synthetic adrenal hormone analogs can significantly affect the production of inflammatory neurotransmitters.This reduces local swelling, pain and temperature in the affected area of the musculoskeletal system.
The disadvantages of this treatment include a large number of side effects of glucocorticoids.The presented drugs can cause Cushing's syndrome, lead to disruption of the general metabolism and retention of water in the intercellular space.In this regard, it is recommended to start the treatment with the prescription of NSAIDs.
Nonsteroidal drugs with anti-inflammatory effects have a direct effect on cyclooxygenase molecules, which promote inflammation in damaged tissues.
Preference is given to selective drugs that do not have a harmful effect on the mucosa of the digestive tract.
Depending on the severity of the patient's condition and the severity of the pain syndrome, narcotic and non-narcotic sedatives are used.
The first group is considered more effective, but the side effect of drug addiction leads to the need to strictly limit their use.
Non-opioid drugs have a less pronounced analgesic effect, however, they do not cause addiction, so they can be prescribed more widely.
It is extremely important not to use chondroprotective agents during the acute period of the disease, as this can lead to increased inflammatory processes.It is necessary to stop the attack, and then prescribe a long course of drugs that restore the structure of the joint.
Surgical treatment
In some cases, surgical correction of the condition of a patient with shoulder arthrosis is indicated.This invasive method is used in the presence of a severe destructive process directly in the joint.Most often, patients undergoing surgical treatment are unable to perform daily tasks due to severe limitation of active and passive shoulder movements.
After the final diagnosis has been established, a series of measurements are taken, during which the optimal parameters for the future prosthesis are selected.Then, a graft made of high-strength polymers or titanium is custom made.
Surgery for arthrosis of the shoulder joint is performed in the terminal (last) stages of the disease.
The surgical intervention is quite extensive, so the patient undergoes a long preparation period.A complete replacement of the affected bone joint is performed, followed by a period of physical therapy, which allows full functionality of the upper limb girdle to be restored.
Therapeutic exercises
It is physical exercises that make it possible to restore mobility in the shoulder in the shortest possible time, not only after surgical treatment, but also during the course of medicinal influence on the disease.Specially developed complexes relieve a person from morning stiffness, stimulate the normalization of blood supply, lymphatic drainage and restore the normal composition of synovial fluid.
It is extremely important that rotation and adduction movements in the upper limb are performed without additional loads, as otherwise there is a high probability of additional trauma and cartilage destruction.Rehabilitation specialists are engaged in the development of special complexes of physical therapy.
Each clinical case requires an individual approach, so if you have a disease or if you want to prevent its development, seek help from this doctor.
Recommendations for home treatment
Any illness should be treated in a hospital setting under the supervision of qualified medical personnel.However, in some cases, the patient does not have the opportunity for a long-term stay in the clinic.In such situations, you should independently monitor your recovery process.
Physical exercises for deforming shoulder joint arthrosis are extremely important because they slow down the progression of the disease.
The following recommendations should be followed:
- strictly follow the instructions and prescriptions of the attending physician;
- limit the affected arm from physical activity as much as possible;
- get rid of excess body weight by creating a slight calorie deficit and walking in the fresh air;
- divide the daily amount of food into 5-6 meals;
- drink at least 2 liters of water a day;
- change the type of work activity to one that requires minimal load on the upper limbs.
Folk remedies
Many elderly people know from their own experience what arthrosis of the shoulder joint is and how to treat it at home.In addition to the recommendations described above regarding changing the type of work activity and removing excess body weight, traditional medicine has a whole range of healing agents that help reduce pain and swelling in the affected limb.Various ointments, decoctions, compresses and baths are used for this purpose.It is these treatment methods that we will dwell on in more detail.
ointment
Alternative medicine has a large number of original and effective recipes for the preparation of anti-inflammatory ointments.The simplest method involves mixing an egg yolk with a teaspoon of turpentine and the same amount of apple cider vinegar.Applying the oil to the affected joint at night will significantly reduce pain and inflammation.
Another good remedy for the treatment of arthrosis of the shoulder joint is a mixture of fifty grams of elecampane and one hundred milliliters of vodka.After mixing the ingredients and letting them brew for 12 days, the resulting oil should be rubbed daily into the projection area of the inflamed bone joint.
Decoctions and tinctures
Decoctions and tinctures play a key role in folk medicine.One of the easiest infusions to prepare, and at the same time the most effective infusion for arthrosis, is considered to be mixing a tablespoon of ground agave leaves with 150 milliliters of 70% ethyl alcohol.After injecting the medicine for two weeks, the liquid should be consumed orally, twenty drops with water for thirty days.
For supporters of boils there is a good remedy.To make it you will need two tablespoons of blackberry leaves and half a liter of boiling water.After mixing the ingredients, let them brew in a thermos overnight.Then take 150 ml of the product three times a day immediately before meals.The course of treatment is 30 days.
Compresses and friction
To reduce pain and inflammation in the area of the shoulder joint affected by arthrosis, various compresses are used.One of the most effective is considered to be a mixture of one liter of vodka and one hundred grams of cinquefoil.The drug should be injected for two weeks, after which it should be used every evening before going to bed.
Another simple and effective remedy is a compress consisting of finely ground horseradish, mixed with a small amount of water until it becomes puree.Put a handful of medicine on a gauze cloth and apply it to the inflamed joint for 20-30 minutes.
bathrooms
Baths are widely used for the treatment of various diseases of the musculoskeletal system.Thanks to the complex effect, a good anti-inflammatory and anti-edematous effect is achieved.
Preparing a bath is quite simple;to do this, follow these recommendations:
- fill the bathtub with hot water;
- add about a kilogram of sea or common kitchen salt to it;
- throw in some pine branches;
- pour a few teaspoons of sweetened honey;
- at the end, add a teaspoon of turpentine oil.
The treatment course consists of twelve baths.The duration of a procedure should be approximately twenty minutes.Already from the first use of a therapeutic bath, the patient notices a significant improvement in the general condition and a decrease in discomfort in the joints.
Preventing
Modern medicine still has no specific measures to prevent arthrosis.This is due to the polyetiological nature of the pathology.However, there are non-specific measures that can significantly reduce the risk of developing the disease.There is primary and secondary prevention.
The first includes:
- daily walks outside;
- the use of a contrast shower, which allows you to achieve increased tone of blood vessels;
- gentle treatment of the joints, avoiding excessive physical activity;
- moderate exercise 2-3 times a week.
The second group includes the following:
- complete and comprehensive treatment of arthritic processes;
- regular intake of calcium supplements;
- prescription of chondroprotective drugs;
- physical therapy.