Somatic cells in the human body are capable of carrying out a large number of mitotic divisions.It is thanks to this feature of our body that 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.Osteoarthritis is considered one of the most common, since it is the pain syndrome that accompanies this pathology that significantly reduces the patient's quality of life.
Omarthrosis, or osteoarthritis of the shoulder joint, becomes a serious problem that interferes with the normal performance of work and daily tasks.It is this disease that will be discussed below;we will analyze the causes of shoulder osteoarthritis, symptoms and treatment of this unpleasant pathology.
What is this?
Osteoarthritis of the shoulder is accompanied by a disruption of the normal blood supply to this important bone joint, which leads to a decrease in the thickness of the cartilage tissue and exposure of the head of the bone.Due to increased friction, a person notices the appearance of pain, which, depending on the degree, can manifest itself only during physical activity or even at rest.
Due to damage to the surrounding anatomical structures, an inflammatory process is observed, aggravating the decrease in the range of active and passive movements of the upper limb.The absence of appropriate treatment often leads to a complication of the process by deformation of the joints, 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, clavicle and the humerus itself.The joint capsule is quite deep and reinforced by a whole complex of ligaments.
Due to certain 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 joint surfaces, but also to the presence of a large amount of special synovial fluid, which reduces friction between the surfaces.
Causes of osteoarthritis of the shoulder joint
The disease presented in the article develops under the influence of a whole complex of provoking factors.Clinical studies carried out 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 osteoarthritis.However, no reliable “trigger” has ever 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 history of patients with this pathology in the shoulder joint made it possible to identify influences that could significantly increase the likelihood of the disease developing.
These include:
- excessive physical activity leading to physical thinning of the joint surfaces;
- frequent falls to the arm and other injuries to the girdle of the upper limb;
- occupational risks;
- congenital connective tissue pathologies;
- 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 appropriate drug treatment in the presence of an acute or chronic inflammatory process in the joint space;
- pathologies of the nervous system leading to insufficient trophism of the musculoskeletal system;
- the presence of excess weight, constant swelling of the upper limbs;
- diseases of the endocrine system.
Primary osteoarthritis of the shoulder
The modern medical classification of osteoarthritis 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 full course of diagnostic measures has been carried out to completely exclude the presence of the above-described causes for the appearance of the disease.It is believed that the starting point of pathogenesis is the deterioration of system-wide 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.At first, discomfort is present during exercise, then stops disappearing even when resting.Another reason contributing 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 trying 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 into the ligamentous apparatus during prolonged rest.Due to a decrease in the elasticity of white muscle fibers, a characteristic feeling of "stiffness" appears, which usually disappears after 20-30 minutes of limb development.Osteoarthritis of the shoulder has pronounced symptoms, their intensity and treatment are directly proportional to the degree of development of the process.
Secondary osteoarthritis of the shoulder joint
The secondary form of this disease is a consequence of the presence of an underlying pathology, complicated by disturbances in the functioning of the musculoskeletal system.Among the causes, traumatic injuries of an acute or chronic nature come first in terms of frequency.This problem is especially relevant in the cold season, when a person often falls, putting his hand forward to soften the fall.
Enzymopathies are congenital diseases accompanied by 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 suffer from dislocations and subluxations during daily activities.The relaxation of this bone joint contributes to increasing the trauma of the surfaces in contact, against which the disease appears.
Symptoms and signs
Shoulder osteoarthritis has complex symptoms and treatment;due to certain features of characteristic signs, its detection often occurs at later stages of the development of the pathological process.Experts distinguish three degrees of destruction of the cartilaginous tissue of the girdle of the upper limb.In accordance with them, the symptom complex noted in the patient will also be different.
With stage 1 disease, a person rarely notices shoulder pain;most often there is discomfort in the limb during intense physical exercise or immediately after it.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, sprain of the ligamentous apparatus, that the disease continues its development, remembering 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 normal nutrition of the joint surfaces, secondary inflammation occurs, spreading 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 becomes unable to perform circular movements, which indicates that the deformation process of osteoarthritis has begun and the range of active movements of the hand in space is limited.
The development of grade 3 leads to an almost complete loss of mobility in the shoulder joint.The patient experiences significant muscle atrophy and loss of ability to care for himself.Another characteristic symptom is the appearance of bony protrusions above the surface of the skin.The likelihood of the disease going this far exists mainly in people who do not have the opportunity to minimize the load on their upper limbs due to professional activity or professional sports.
Diagnosis of osteoarthritis of the shoulder joint
Establishing a diagnosis of osteoarthritis 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 doctors of this profile who have all the 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 after which it disappears.Next, it is necessary to identify occupational risks and the presence of risk factors.
The main diagnostic method for detecting deforming osteoarthritis of the shoulder joint is simple radiography.
The next step is a physical examination, when a specialist uses palpation to identify painful areas and determine the entire active and passive movements of the limb.Additionally, the presence of local edema and increased skin temperature in the projection zone of the bone joint is assessed.Based on the data obtained, the doctor can make a preliminary diagnosis, but a differential diagnosis is necessary to prescribe the most adequate treatment.
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 carried out on the patient.
The most informative include:
- clinical blood test;
- determination of biochemical parameters of blood serum;
- clinical urine analysis;
- X-ray of the affected joint;
- ultrasound diagnostics;
- arthroscopic examination;
- magnetic resonance and computed tomography;
- scintigraphy;
- joint puncture followed by biochemical analysis of the synovial fluid.
Signs indicating the development of osteoarthritis directly include the appearance of significant narrowing of the joint space, sclerosis of subcartilaginous structures, thinning of the chondrocyte layer itself, the appearance of osteophytes and deposition of salt crystals in the intra-articular fluid.
How to treat osteoarthritis of the shoulder joint
After establishing this diagnosis, the doctor seriously asks the question of choosing the most appropriate therapeutic tactic.Modern medicine has reached a level where it is able to help patients with diseases of the musculoskeletal system completely return to normal life.
Treatment of osteoarthritis of the shoulder joint is long-term and therefore often leads to the development of complications.
The method chosen to correct osteoarthritis 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 early stages it is enough to prescribe drugs of general and local action.
In the presence of second degree osteoarthritis 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 the further development of the pathological process;at the same time, a whole range of medications is prescribed.
The third degree practically does not lend itself 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 getting rid of osteoarthritis.
Drugs
The following groups of drugs are used as conservative treatment in the presence of this disease:
- glucocorticoids;
- non-steroidal drugs with anti-inflammatory effects;
- painkillers;
- 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 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 injured tissues.
Preference is given to selective drugs that do not have a harmful effect on the mucous membrane of the digestive tract.
Depending on the severity of the patient's condition and the severity of the pain syndrome, narcotic and non-narcotic analgesics are used.
The first group is considered more effective, but the side effects of addiction to the drug lead to the need to strictly limit their use.
Non-opioid drugs have a less pronounced analgesic effect, but they are not addictive and therefore can be prescribed more widely.
It is extremely important not to use chondroprotective agents during the acute period of the disease, as this may 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 suffering from shoulder osteoarthritis 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 is established, a whole series of measurements are carried out, during which the optimal parameters for the future prosthesis are selected.Then, a graft made of high-strength polymers or titanium is made to order.
Surgery for osteoarthritis of the shoulder joint is carried out in the terminal (last) stages of the disease.
As the surgical procedure is quite extensive, the patient undergoes a long preparation period.A complete replacement of the affected bone joint is carried out, followed by a period of physiotherapy, which allows full functionality of the upper limb girdle to be restored.
Therapeutic exercise
These are physical exercises that allow shoulder mobility to be restored as quickly as possible, not only after surgical treatment, but also during drug treatment for the disease.Specially developed complexes relieve a person of morning stiffness, stimulate the normalization of blood supply, lymphatic drainage and restore the normal composition of synovial fluid.
It is extremely important that rotational and adduction movements in the upper limb are performed without additional loads, otherwise there is a high probability of additional trauma and cartilage destruction.Rehabilitation specialists are engaged in the development of special physiotherapy complexes.
Each clinical case requires an individual approach, so if you suffer from a disease or 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 highly qualified medical personnel.However, in some cases the patient does not have the opportunity to stay in the clinic for a long time.In such situations, you need to independently monitor your recovery process.
Physical exercises for deforming osteoarthritis of the shoulder joint 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 to physical activity as much as possible;
- get rid of excess 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 per day;
- change the type of work activity to one that requires minimal load on the upper limbs.
Folk remedies
Many older people know from experience what shoulder osteoarthritis is and how to treat it at home.In addition to the recommendations described above regarding changing the type of professional activity and getting rid of excess weight, traditional medicine has a whole range of healing agents that help reduce pain and swelling in the affected limb.For this purpose, various ointments, decoctions, compresses and baths are used.These are the treatment methods that we will return to in more detail.
Ointments
Alternative medicine offers a large number of original and effective recipes for the preparation of anti-inflammatory ointments.The simplest method is to mix an 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 osteoarthritis of the shoulder is a mixture of fifty grams of elecampane and one hundred milliliters of vodka.After mixing the components and letting them infuse for 12 days, you need to rub the resulting ointment into the projection area of the inflamed bone joint daily.
Decoctions and tinctures
Decoctions and tinctures play a key role in traditional medicine.One of the easiest to prepare and at the same time the most effective infusions for osteoarthritis is considered to be a mixture of one tablespoon of ground agave leaves with 150 milliliters 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 fans of decoctions, there is a good remedy.To prepare it, you will need two tablespoons of lingonberry leaves and half a liter of boiling water.After mixing the ingredients, let them steep in a thermos overnight.Then take 150 ml of the product three times a day just before meals.The duration of treatment is 30 days.
Compresses and frictions
In order to reduce pain and inflammation in the area of the shoulder joint affected by osteoarthritis, 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 should be infused for two weeks, after which it should be used every evening before bedtime.
Another simple and effective remedy is a compress made from finely grated horseradish, mixed with a small amount of water until you obtain a puree.Put a handful of medicine in gauze and apply it to the inflamed joint for 20 to 30 minutes.
Baths
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 a bath is quite simple;To do this, follow these recommendations:
- fill the bathtub with hot water;
- add about a kilogram of sea salt or regular kitchen salt there;
- throw in a few pine branches;
- pour a few teaspoons of candied honey;
- at the very end, add a teaspoon of turpentine oil.
The treatment course includes twelve baths.The duration of a procedure should be approximately twenty minutes.From the first use of a therapeutic bath, the patient notices a significant improvement in general condition and a reduction in discomfort in the joints.
Prevention
Modern medicine still does not 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 outside;
- the use of a contrast shower, which allows you to achieve increased vascular tone;
- gentle treatment of joints, avoidance of excessive physical activity;
- moderate exercise 2 to 3 times per week.
The second group includes the following:
- comprehensive and comprehensive treatment of arthritic processes;
- regular intake of calcium supplements;
- prescription of chondroprotective drugs;
- physiotherapy.