Shoulder arthropathy is a widespread chronic disease associated with damage to joint structures. The pathological process is accompanied by degeneration and deformation of the articular surfaces. In this case, not only the cartilage tissue is damaged, but also the bone tissue. Pathological symptoms and treatments depend on the degree of joint damage.
The disease can develop for years without manifesting. At some point, under the influence of adverse factors (hypothermia, trauma, severe concomitant diseases), the first signs of disease appear. Consultation with a doctor is necessary at this point, as fighting chondrodystrophic changes is particularly effective at the onset of the disease.
Causes of Shoulder Arthropathy
The causes of degenerative dystrophic damage to joint tissue are varied. Of these, injury plays a major role, so posttraumatic arthropathy of the shoulder joint is considered to be the most common pathological form. Even minor but repeated damage to cartilage tissue can trigger this condition.
In addition, the disease can occur under the influence of the following pathological factors:
- Severe joint damage: synovitis, gout, acute or chronic arthritis, aseptic necrosis of the humerus.
- Joints are often overworked. Most commonly seen in volleyball, tennis, and basketball players.
- Congenital lesions of the shoulder joint.
- endocrine diseases.
- Elderly and old age.
- Overweight (obesity).
- Vitamin deficiency.
- Autoimmune lesions and weakened immune system.
- Genetic susceptibility.
Most of the patients are people who do monotonous manual labor. Therefore, arthropathy of the right shoulder is more often diagnosed than that of the left shoulder.
The disease usually develops under the influence of not one, but several unfavorable factors at the same time. On this basis, treatment should be comprehensive, not only to fight the disease, but also to eliminate all the causes of the disease.
characteristic signs of the disease
Shoulder joint disease begins unwittingly and develops gradually, appearing suddenly after injury, hypothermia, or severe physical exertion. In this case, symptoms of damage to the shoulder joint and nearby tissues occur:
- pain;
- creaking and clicking sounds during hand movement;
- Stiffness and reduced range of motion in the shoulders.
The disease most often occurs in a chronic form. Excessive stress or injury on the joints may cause the disease to worsen.
The intensity of symptoms depends largely on the severity of cartilage and bone tissue damage, so it is customary to distinguish several degrees of disease. This systematization significantly facilitates diagnosis and allows you to accurately predict disease outcomes.
Shoulder joint disease I degree
During this time, joint tissue is slightly affected. Pain is only observed after excessive physical exertion or prolonged monotonous work. Patients often don't notice these symptoms, attributing them to overwork or muscle strain. A 1-degree failure can only be dealt with conservatively.
In the early stage of the disease, there was no obvious change in the cartilage tissue on the X-ray film, and only an oval ring was seen around the joint cavity.
Shoulder joint disease Ⅱ degree
During this stage, the symptoms of the disease become more pronounced. The cartilage tissue becomes thin and deformed, and the ligaments in the joint are damaged. During the movement of the hand, a creaking sound is heard and the lining of the joint pocket becomes inflamed. The pain becomes constant over time. Morning stiffness and limited movement occur, which can lead to muscle wasting.
Shoulder joint disease Ⅲ degree
During this time, the joints have deformed significantly, with little to no movement. The patient had acute pain that radiated to the arm and shoulder blade. If you don't stop further damage to the tissue, the pathological process can lead to disability.
Third-degree disease is not amenable to conservative treatment and requires surgical intervention.
Shoulder and shoulder joint disease rarely reaches stage three. In most cases, the second stage is diagnosed as the transition to the chronic form.
which doctor to contact
Often, people facing joint pain don't know who to turn to for help. At the first symptoms of the disease, you should see a rheumatologist. The specialist will not only perform a comprehensive physical examination and make a diagnosis, but also, if necessary, administer an anesthetic into the joint to relieve severe pain.
With advanced forms of the disease, rheumatologists may be helpless. In this case, you will need a surgeon or an orthopedic surgeon. In big cities, you can make an appointment with an arthrologist who only deals with joint disease.
How to treat frozen shoulder
After a medical examination and diagnosis, your doctor will prescribe specific therapies that will give you long-term, stable remission of the disease. There is no cure for degenerative changes in the joints, but slowing the progression of the destructive process and relieving the patient's condition is an entirely feasible task.
The main goals of antiarthropathic treatment are pain relief and restoration of joint mobility.
modern drug therapy
In some patients, it is difficult to make an accurate diagnosis in the early stages of the disease. At this stage, pain is not noticeable and does not force the patient to seek specialist help. Mostly, they are treated independently with folk remedies. Some patients perform therapeutic exercises to reduce joint pain and stiffness. For the treatment of arthropathy, use the medicine prescribed by your doctor at the recommended dose and duration of administration. The most effective are the following groups of drugs:
- non-steroidal anti-inflammatory drugs;
- chondroprotective agent;
- corticosteroid drugs;
- non-narcotic analgesics;
- vasodilators;
- Muscle relaxant.
Many drugs for this pathology are sometimes prescribed for long periods of time. Depending on the severity of the disease, the drug can be given orally, topically, intramuscularly, or into the shoulder joint cavity.
Non-steroidal anti-inflammatory drugs (NSAIDs)
Due to gastrointestinal side effects, NSAIDs are long-term contraindicated.
The disease can be treated with drugs at an early stage in the development of the pathological process. The course is determined based on the severity of the patient's condition and symptoms. As a stand-alone treatment, the ointment included in this group is not prescribed. They are used in combination with similar drugs used intramuscularly or orally. Their mission is to reduce inflammation and ease the patient's condition.
chondroprotective agent
Nearly all patients included drugs aimed at improving metabolic processes in cartilage tissue in their regimen. In addition, they increase the elasticity of cartilage. Chondroprotective agents have such properties. These medicinal substances vary according to the main active ingredient from which they are made:
- hyaluronic acid;
- chondroitin sulfate;
- Glucosamine;
- Consolidated funds.
Glucosamine is a substance that plays an important role in the formation of healthy cartilage tissue. Chondroitin sulfate's job is to nourish and cushion the shoulders.
Monotherapy formulations are more proven on the market than combinations of substances.
The polysaccharide contained in the intercellular space is hyaluronic acid. It also reduces the sensitivity of receptors that respond to pain. Combination chondroprotectants containing multiple active ingredients have the greatest advantage.
Chondroprotective agents are most effectively used in the initial stages of the disease. The job of the drug is to synthesize new cells of healthy cartilage tissue to replace damaged tissue. This group of drugs is less effective in the presence of pain and swelling. Therefore, the first need to use anti-inflammatory drugs to relieve the patient's condition.
For maximum effect, injectable formulations are used for intra-articular or intramuscular administration. The course of treatment with chondroprotective agents lasted up to six months, with some patients noticing the first results after 3 months of treatment. It is important to follow some rules when treating this type of medication.
With the start of the treatment process, physical overload, stressful situations should be excluded. The patient will get the greatest effect if he starts taking chondroprotective agents, improves nutrition, and does physical therapy exercises. Dr. Bubnovsky's method is used by many patients with shoulder arthrosis, where they perform a set of exercises specifically designed to achieve gradual joint recovery or halt the progression of the disease.
corticosteroid drugs
When severe pain occurs, corticosteroids are prescribed if anti-inflammatory drugs have not had a positive effect. To relieve the patient's condition, ointments or injections are prescribed.
pain reliever
In the initial stages of the disease, pain relievers are prescribed to relieve pain.
Compared with non-steroidal anti-inflammatory drugs, this group of drugs has less negative effects on the digestive tract mucosa.
They have unexpressed anti-inflammatory effects and are effective against pain.
vasodilator
Mandatory means of treating arthropathy are vasodilators. They eliminate vasospasm and normalize blood flow in the affected area. Many patients complain of nighttime pain, which can be effectively managed with this group of drugs.
muscle relaxant
When osteoarthritis of the shoulder joint is affected, muscle spasms are considered common and can be relieved by muscle relaxants. When prescribing them, follow the principle of complexity and use them with pain relievers and anti-inflammatory drugs. If necessary, the initially prescribed minimum dose is gradually increased.
operation treatment
The main purpose of surgery is to restore the working ability of the joint and improve the quality of life of the patient. If conservative treatment fails, the persistent pain syndrome persists, the joint is progressively deformed, and the range of motion is severely limited, the patient requires surgical intervention.
The decision as to whether surgery is required is made by the orthopaedic or traumatologist together with the patient. The size of the endoprosthesis and the material from which it is made are then determined. Today, implants are made of titanium and high-strength polymers and weigh close to natural joints. The durability and reliability of endoprostheses are unquestionable.
recovery period
Surgery to replace the affected joint usually does not have complications. Immobilization with a support bandage is required for the first 14 days. Allows early passive performance of complex physical exercises on special equipment and equipment. Load power allowed after 45-60 days.
physiotherapy
Any complex anti-arthritis exercises are only useful during remission. Do not charge if you have elevated body temperature, soreness, and other symptoms of worsening illness.
Exercise therapy should not cause pain or discomfort. If you feel a little inconvenience, you should give up exercising.
It should be charged every day. After a load, it is useful to self-massage the affected joints and nearby muscle areas with a healing cream, which the attending physician will help you choose.
physiotherapy
Physical therapy can allow you to enhance the effects of your medications, reduce your doses and minimize your risk of complications. The type of physiotherapy is determined by the doctor, guided by the patient's condition, ignoring the course and possible contraindications of accompanying diseases.
In most cases, the following physical therapy procedures are used to treat:
- magnetic therapy;
- Ultrasound with hydrocortisone;
- Electrophoresis of anti-inflammatory and analgesic substances;
- UV exposure
- Treatment with lasers and infrared rays.
Physical therapy is performed several times a year, 10-15 times each time.
Healing with folk methods
Combining folk remedies with drug therapy, exercise therapy, proper nutrition, and physical therapy can achieve long-term stable remission.
One of the best recipes is a compress using birch leaves, which have anti-inflammatory and warming properties. Young leaves are best, as their beneficial properties are reduced towards autumn. A small massage of the affected limb is required before compressions are performed. The leaves are then applied to the skin, reinforced with plastic wrap and bandages. Apply the compress overnight. The treatment time is 10 days.
Salt baths are therapeutic. The crystals are pre-dissolved in hot water before this process. The resulting solution was then poured into the bath. The process will require about 3 kg of salt. Also, you can add a few drops of any essential oil. It is best to take a bath before going to bed, and the bath time should not exceed 30 minutes.
Hot oatmeal helps a lot. They should be poured with boiling water, adhered and used for their intended purpose. Such procedures are recommended in the evening.
Also useful herbal poultice. Soak anti-inflammatory crushed plants (yarrow, ginger, turmeric, clover, calamus) in boiling water, cover for 10 minutes, then apply to the sore spot. After surgery, a healing cream should be applied to the affected shoulder and bedtime.
It is recommended to inject corn stigma in it. 1 teaspoon of stock or 1 filter bag is brewed with 200ml of boiling water, cover for 30 minutes, consume 1 tablespoon. Use a spoon half an hour before meals.
Prevention of Shoulder Osteoarthritis
Disease prevention can be primary and secondary. Primary prevention includes the following activities:
- exercise regularly - jogging or brisk walking to develop shoulder girdle muscles;
- hot and cold shower;
- Eliminate overload and avoid traumatic situations.
- Prompt treatment of diseases that can cause shoulder joint disease;
Secondary prevention aims to diagnose and treat arthritis early.
in conclusion
Restoring joint function is a long and difficult process. Treatment of shoulder joint disease should mainly aim at eliminating the symptoms of the disease. Only a complex therapy combining medical and folk methods can bring relief and restore the ability to work.