The somatic cells of 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 sense, various diseases begin to appear upon reaching old age.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 the disease osteoarthritis of the shoulder joint, the symptoms and the treatment of this unpleasant pathology.
What is it?
Osteoarthritis of the shoulder 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 becomes exposed.Due to increased friction, a person notices the appearance of pain, which, depending on the degree, can only manifest itself during physical activity or even at rest.
Due to the injury to the surrounding anatomical structures, an inflammatory process is observed that aggravates the decrease in the amplitude of active and passive movements in the upper limb.The lack of adequate treatment often leads to a complication of the process due to deformation of the joint, 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 is reinforced by a whole complex of ligaments.
Due to some anatomical characteristics of the structure of the shoulder joint, cases of spontaneous dislocations and subluxations in this area are common 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 friction between the surfaces.
Causes of osteoarthritis 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 several leading research institutes have made it possible to reliably establish the pathophysiological mechanism of the emergence of changes in bone and cartilage tissue during osteoarthritis.However, reliable “triggers” have never been identified.
In most cases, this degenerative disease develops secondary, that is, after some pathogenic effect on the shoulder joint.
A retrospective analysis of the medical records of patients with this pathology in the shoulder joint made it possible to identify influences that could significantly increase the probability of the onset of the disease.
These include:
- excessive physical activity leading to physical thinning of the joint surfaces;
- frequent falls on the arm and other injuries to the upper limb belt;
- occupational risks;
- congenital connective tissue pathologies;
- disturbance of mineral metabolism, accompanied by the appearance of crystalloid deposits in 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 an acute or chronic inflammatory process in the joint space;
- pathologies of the nervous system 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 osteoarthritis of the shoulder.
The modern medical classification of osteoarthritis of the shoulder joint, depending on the causes of its development, distinguishes two forms: primary and secondary.In the case of primary disease, the diagnosis is established only after a full range of diagnostic measures have been carried out to completely exclude the presence of the above-described causes for the occurrence of the disease.It is believed that the starting point of pathogenesis is the deterioration of systemic 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, the discomfort is present during exercise and then stops disappearing 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 replace the loss of mature cartilage cells.They have the appearance of a spike that, when moved, 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, which permeate the ligamentous apparatus during prolonged rest.Due to a decrease in the elasticity of the white muscle fibers, a characteristic feeling of “stiffness” appears, which usually disappears within 20-30 minutes of the development of the limb.Osteoarthritis of the shoulder has pronounced symptoms, its intensity and treatment are directly proportional to the degree of the developing 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 alterations in the functioning of the musculoskeletal system.Among the causes, traumatic injuries of an acute or chronic nature occupy the first place in frequency.This problem is especially relevant in the cold season, when a person often falls and puts his hand forward to soften the fall.
Enzymopathies are congenital diseases accompanied by a decrease in the production of specific enzymes that form the ligamentous apparatus and can also lead to the development of secondary osteoarthritis of the shoulder joint.It is these patients who often experience dislocations and subluxations when performing everyday activities.Looseness in this bone joint contributes to further trauma to the contact surfaces, against which the disease arises.
Symptoms and signs
Osteoarthritis of the shoulder has complex symptoms and treatment;Due to some features of the characteristic signs, their detection often occurs in the late stages of the development of the pathological process.Experts distinguish three degrees of destruction of cartilage tissue in the waist of the upper limb.According to them, the symptom complex found in the patient will also be different.
In stage 1 disease, a person rarely notices shoulder pain;Most of the time there is discomfort in the limb when performing intense physical exercise or immediately after.In such situations, the patient needs several days to recover and completely eliminate discomfort in the joint.Precisely for the reason that a person tends to attribute pain to the manifestation of a simple, as it seems to him, sprain of the ligamentous apparatus, the disease continues to develop, remembering itself more and more often.
Osteoarthritis of the shoulder joint of the second 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 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 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 amplitude of active hand movements in space is limited.
The development of grade 3 leads to an almost complete loss of mobility in the shoulder joint.The patient notices significant muscle atrophy and loss of the ability to care for himself.Another characteristic symptom is the appearance of bony protuberances on the surface of the skin.The likelihood of the disease going so far exists mainly in people who do not have the opportunity to minimize the load on their upper extremities due to professional activity or playing 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 possess the entire range of necessary knowledge.
During the examination, the first thing to 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 when it disappears.Next, it is necessary to identify occupational risks and the presence of risk factors.
The main diagnostic method to detect 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 of the limb.Additionally, the presence of local edema and increased skin temperature in the projection area of the bone joint is assessed.From the data obtained, the doctor can make a preliminary diagnosis, but a differential diagnosis is necessary to prescribe the most appropriate therapy.
To establish the most correct diagnosis, the extent of the process and the possible identification of the cause, several additional instrumental and laboratory diagnostic methods are performed on the patient.
The most informative ones include:
- clinical blood test;
- determination of biochemical parameters of blood serum;
- clinical urine analysis;
- X-ray of the affected joint;
- ultrasound diagnosis;
- arthroscopic examination;
- MRI and CT scan;
- scintigraphy;
- Joint puncture followed by biochemical analysis of the synovial fluid.
Signs that directly indicate the development of osteoarthritis include the appearance of a significant narrowing of the joint space, sclerosis of 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 osteoarthritis of the shoulder joint.
After establishing this diagnosis, the doctor faces the serious question of 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 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 depends directly on the following factors:
- process degree;
- general condition of the patient;
- age;
- physiological characteristics.
As a rule, in the early stages it is sufficient to prescribe drugs of 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;In parallel, a wide 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 treating doctor.Below we will talk in more detail about each of the existing methods of getting rid of osteoarthritis.
Medications
The following groups of drugs are used as conservative therapy in the presence of this disease:
- glucocorticoids;
- non-steroidal drugs with anti-inflammatory effects;
- pain relievers;
- Drugs with chondroprotective effects.
Medicinal substances belonging to this group have a much 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 glucocorticoid side effects.The presented drugs can cause Cushing's syndrome, provoke disturbances in general metabolism and water retention in the intercellular space.In this sense, it is recommended to start treatment with the prescription of NSAIDs.
Non-steroidal 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 harmful effects 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 effect of drug addiction leads to the need to strictly limit its use.
Non-opioid drugs have a less pronounced analgesic effect, but 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 long-term treatment with 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 severe destructive process directly in the joint.Very often, patients undergoing surgical treatment are unable to perform everyday tasks due to severe limitation of active and passive movements of the shoulder.
After the final diagnosis is established, a wide range of measurements is carried out, during which the optimal parameters for the future prosthesis are selected.A transplant consisting of high-strength polymers or titanium is then carried out to order.
Surgery for osteoarthritis of the shoulder joint is performed in the terminal (late) stages of the disease.
The surgical intervention is quite extensive, so the patient goes through a long period of preparation.A complete replacement of the affected bone joint is performed, followed by a period of physiotherapy, which allows full functionality of the waist of the upper limb to be restored.
therapeutic exercise
It is physical exercises that make it possible 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's morning stiffness, stimulate the normalization of blood supply, lymphatic drainage, and restore the normal composition of the 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 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 any disease or if you want to prevent its development, seek help from this doctor.
Recommendations for treatment at home.
Any illness must be treated in a hospital under the supervision of highly qualified medical workers.However, in some cases, the patient does not have the opportunity to stay in the clinic for a long period of time.In such situations, you must 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 treating 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 loading on the upper extremities.
Folk remedies
Many older people know from their own experience what osteoarthritis of the shoulder joint is and how to treat it at home.In addition to the recommendations described above about changing the type of work activity and getting rid of excess body weight, traditional medicine has a whole range of healing agents that help reduce pain and swelling in the affected limb.For this, various ointments, decoctions, compresses and baths are used.It is these treatment methods 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 is to mix 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 osteoarthritis 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 sit 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 infusions to prepare, and at the same time most effective for osteoarthritis, is considered a mixture of a tablespoon of ground agave leaves with 150 milliliters of 70% ethyl alcohol.After infusing the medication 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 prepare it you will need two tablespoons of cranberry leaves and half a liter of boiling water.After mixing the ingredients, let them sit in a thermos overnight.Subsequently take 150 ml of the product three times a day immediately before meals.The course of treatment is 30 days.
Compresses and rubbing.
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 medication should be infused for two weeks, after which it should be used every night before bedtime.
Another simple and effective remedy is a compress consisting of finely grated horseradish, mixed with a small amount of water until a puree is obtained.Place a handful of medicine on a piece of gauze and apply it to the swollen 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 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 candied 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 the therapeutic bath, the patient notices a significant improvement in general condition and a decrease in joint discomfort.
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 in the fresh air;
- the use of a contrast shower, which allows achieving 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:
- complete and comprehensive treatment of arthritic processes;
- regular intake of calcium supplements;
- prescription of chondroprotective drugs;
- physiotherapy.