The somatic cells of the human body are capable of a large number of mitotic divisions.It is thanks to this feature of our body that it can independently exist 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.Osteoarthritis is considered one of the most common, since it is the painful syndrome that accompanies this pathology and significantly reduces the patient's quality of life.
Homarthrosis, or arthrosis of the shoulder joint, becomes a serious problem that interferes with the normal performance of work and daily activities.It is this disease that will be discussed below;we will analyze the causes of arthritic disease of the shoulder joint, the symptoms and treatment of this unpleasant pathology.
What is it?
Shoulder arthrosis is accompanied by a disruption of the normal blood supply to this important bone joint, as a result of which the thickness of the cartilaginous 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 severity, can occur only during physical activity or even at rest.
Due to the lesion of the surrounding anatomical structures, an inflammatory process is observed, which aggravates the decrease in the amplitude of active and passive movements of the upper limb.Lack of adequate treatment often leads to a complication of the process due to joint deformation, 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, cases of spontaneous dislocations and subluxations in this area during daily work at home are frequent.The ease and variety of movements are due not only to the spherical shape of the joint surfaces, but also to the presence of a large amount of special synovial fluid, which reduces 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 the appearance of changes in bone and cartilage tissue during arthrosis.However, no reliable “triggers” have ever been identified.
In most cases, this degenerative disease develops secondarily, that is, after some pathogenic effect on the shoulder joint.
A retrospective analysis of the medical histories of patients suffering from this pathology in the area of the shoulder joint made it possible to identify effects that could significantly increase the likelihood of the disease occurring.
These include:
- excessive physical activity leading to physical thinning of the joint surfaces;
- frequent falls to the arm and other injuries to the belt of the upper extremities;
- professional risks;
- congenital pathologies of the connective tissue;
- impaired mineral metabolism, accompanied by the appearance of crystalloid deposits on the head of the humerus;
- decreased production of synovial fluid;
- age-related changes in the structure of the vascular wall, causing dystrophic changes in the bone;
- lack of adequate drug therapy in the presence of acute or chronic inflammatory process in the joint space;
- nervous system pathologies that induce insufficient trophism of the musculoskeletal system;
- the presence of excess weight, constant swelling of the upper extremities;
- diseases of the endocrine system.
Primary shoulder arthritis
The modern medical classification of arthrosis of the shoulder joint, depending on the causes of development, distinguishes two forms: primary and secondary.In the case of primary, the diagnosis is established only after a complete set of diagnostic measures has been carried out to completely exclude the presence of the above-described causes for the onset of the disease.It is believed that the starting point of pathogenesis is the system-wide deterioration of blood flow against the background of a decrease in myocardial contractility or permeability of the vascular wall.
Over time, a person begins to notice the appearance of unpleasant sensations during shoulder movements.Initially, discomfort is present during exercise, then it 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 injury to the capsule and the occurrence of an aseptic inflammatory process.
Against the background of the described changes, fibrin threads appear in the synovial fluid, which permeate the ligament apparatus during a long rest.Due to the decrease in the elasticity of the white muscle fibers, a characteristic sensation of "stiffness" appears, which usually disappears 20-30 minutes after the development of the limb.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 an underlying pathology, complicated by disorders in the functioning of the musculoskeletal system.Among the causes, traumatic injuries of an acute or chronic nature are in first place in terms of frequency.This problem is especially relevant in the cold season, when a person often falls, reaching out to soften the fall.
Enzymopathies are congenital diseases accompanied by a decrease in the production of specific enzymes that make up the ligament system 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.The looseness of this bony joint contributes to increasing trauma to the contact surfaces, against which the disease manifests itself.
Symptoms and signs
Shoulder osteoarthritis has complex symptoms and treatments;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 destruction of cartilaginous tissue in the girdle of the upper extremities.According to them, the symptom complex encountered in the patient will also be different.
With stage 1 disease, a person rarely notices shoulder pain;very often discomfort is felt in the limb during intense physical exercise or immediately after.In such situations, the patient needs several days to recover and completely get rid of joint discomfort.It is precisely for the reason that a person is inclined to attribute pain to the manifestation of a simple, as it seems to him, distortion of the ligament system, the disease continues its development, reminding itself more and more often.
Osteoarthritis of the shoulder joint of the 2nd degree is accompanied by a more vivid clinical picture.This is due to the fact that in addition to erosion and disruption of the normal nutrition of the joint surfaces, secondary inflammation occurs that spreads to the surrounding ligaments and muscle fibers.The disease leads to the fact that pain is present even with minor physical exertion.Due to severe pain, the patient is no longer able to perform circular movements, which indicates that the process of deformation of arthrosis has begun and the amplitude of active movements of the hand in space is limited.
The development of grade 3 leads to an almost complete loss of mobility of the shoulder joint.The patient notes significant muscle atrophy and a loss of the ability to care for himself.Another characteristic symptom is the appearance of bony protrusions above the surface of the skin.The probability that the disease will extend to this extent exists especially in people who do not have the opportunity to minimize the load on the upper extremities 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 onset of pain in the upper limb it is advisable to consult an orthopedic traumatologist.It is doctors of this profile who possess the entire 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 its nature is, and also after what it disappears.Next, it is necessary to identify occupational risks and the presence of risk factors.
The main diagnostic method for detecting deforming arthrosis of the shoulder joint is simple x-ray.
The next stage is a physical examination, during which a specialist uses palpation to identify painful areas and determine the full range of active and passive movements of the limb.Furthermore, the presence of local edema and increased skin temperature in the area of the projection of the bone joint is evaluated.Based on the data obtained, the doctor can formulate a preliminary diagnosis, but the differential diagnosis is necessary to prescribe the most appropriate therapy.
In order to establish the most correct diagnosis, the 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 urinalysis;
- X-ray of the affected joint;
- ultrasound diagnostics;
- arthroscopic examination;
- magnetic resonance imaging and computed tomography;
- scintigraphy;
- joint puncture followed by biochemical analysis of synovial fluid.
Signs indicating the development of arthrosis directly include the appearance of 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 joint
After establishing this diagnosis, the doctor is faced with a serious question about choosing 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 completely 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 to correct arthrosis of the shoulder joint directly depends on the following factors:
- degree of process;
- general condition of the patient;
- age;
- physiological characteristics.
As a rule, in the initial stages, it is sufficient to prescribe drugs with general and local action.
In the presence of second-degree arthrosis of the shoulder joint, the symptoms accompanying the disease are almost impossible to completely stop.A person is shown a significant reduction in physical activity in order to prevent further development of the pathological process;at the same time a whole series of drugs is prescribed.
The third degree is practically not susceptible 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 of eliminating 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;
- analgesics;
- drugs with chondroprotective effects.
Medicinal substances belonging to this group have a significantly more pronounced anti-inflammatory effect than non-steroidal drugs.
Glucocorticoids are recognized as the most effective agents against inflammatory phenomena.These natural and synthetic analogues of adrenal hormones can significantly influence 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 water retention in the intercellular space.In this regard it is recommended to start treatment with the prescription of NSAIDs.
Nonsteroidal drugs with anti-inflammatory effects have a direct effect on cyclooxygenase molecules, which induce 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 painkillers are used.
The first group is considered more effective, but the side effect of dependence on the medicine leads to the need to strictly limit its 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 an increase in 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 osteoarthritis is indicated.This invasive method is used in the presence of a serious destructive process directly in the joint.Very often, patients undergoing surgical treatment are unable to perform daily activities due to severe limitation of active and passive movements of the shoulder.
After establishing the final diagnosis, a whole series of measurements is carried out, during which the optimal parameters for the future prosthesis are selected.Subsequently, a transplant consisting of high-strength polymers or titanium is made to order.
Surgery for arthrosis of the shoulder joint is performed in the terminal (last) stages of the disease.
The surgery is quite extensive, so the patient undergoes a long period of preparation.A complete replacement of the affected bony joint is performed, followed by a period of physical therapy, which allows full functionality of the upper limb girdle to be restored.
Therapeutic exercise
It is physical exercises that allow you to restore shoulder mobility in the shortest possible time, not only after surgical treatment, but also during the course of the medicinal effect 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 of the upper limb are performed without additional loads, since otherwise there is a high probability of further 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, ask this doctor for help.
Recommendations for treatment at home
Any disease must be treated in a hospital setting under the supervision of highly qualified healthcare workers.However, in some cases, the patient does not have the possibility of a long-term stay in the clinic.In such situations, you need to independently monitor the recovery process.
Physical exercises for deforming arthrosis of the shoulder joint are extremely important because they slow down the progression of the disease.
The following recommendations should be followed:
- scrupulously follow the instructions and prescriptions of your doctor;
- limit physical activity of the affected arm 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 older people know from personal 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 working activity and eliminating excess body weight, traditional medicine has a whole range of healing agents that help reduce pain and swelling of the affected limb.For this purpose, various ointments, decoctions, compresses and baths are used.It is these methods of treatment that we will dwell on in more detail.
Ointments
Alternative medicine has a large number of original and effective recipes for the preparation of anti-inflammatory ointments.The simplest method involves mixing one egg yolk with a teaspoon of turpentine and the same amount of apple cider vinegar.Applying the ointment 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 components and letting them brew for 12 days, you need to rub the resulting ointment into the projection area of the inflamed bone joint every day.
Decoctions and tinctures
Decoctions and tinctures play a key role in folk medicine.One of the easiest to prepare, and at the same time the most effective infusion for arthrosis, is considered to be a mixture of a spoonful of ground agave leaves with 150 ml of 70% ethyl alcohol.After infusing the medicine for two weeks, the liquid should be consumed orally, twenty drops with water for thirty days.
For supporters of decoctions there is a good remedy.To make it you will need two tablespoons of cranberry leaves and half a liter of boiling water.After mixing the ingredients, let them ferment in a thermos overnight.Then take 150 ml of product three times a day immediately before meals.The course of treatment is 30 days.
Compresses and rubs
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 medicine must be infused for two weeks, after which it must be used every evening before bedtime.
Another simple and effective remedy is a compress made of finely grated horseradish, mixed with a small amount of water until it becomes a puree.Place a handful of medicine in gauze and apply it to the inflamed joint for 20 to 30 minutes.
Bathrooms
Baths are widely used to treat various diseases of the musculoskeletal system.Thanks to the complex effect, a good anti-inflammatory and anti-edematous effect is achieved.
Preparing the bathroom is quite simple;to do this, follow these tips:
- fill the tub with hot water;
- add about a kilogram of sea or regular table salt;
- throw a few pine branches;
- pour a few teaspoons of candied honey;
- at the end add a teaspoon of turpentine oil.
The treatment path consists of twelve baths.The duration of one procedure should be approximately twenty minutes.Already from the first use of the therapeutic bath, the patient notices a significant improvement in the general condition and a decrease in joint discomfort.
Prevention
Modern medicine does not yet have specific measures to prevent osteoarthritis.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 outdoors;
- the use of a contrast shower, which allows you to achieve greater vascular tone;
- gentle treatment of joints, avoidance of excessive physical activity;
- moderate exercise 2-3 times a week.
The second group includes the following:
- comprehensive and comprehensive treatment of arthritic processes;
- regular intake of calcium supplements;
- prescription of chondroprotective drugs;
- physical therapy.