Somatic cells of the human body are capable of a large number of mitotic divisions.Thanks to this feature of our body, it can independently exist for a long time in the external environment, restore damaged tissues or dead cells.
Unfortunately, the number of these departments is strictly limited and individual for each person.In this regard, after reaching old age, various diseases begin to appear.Arthrosis is considered one of the most common, as it is a pain syndrome that accompanies this pathology and significantly reduces the patient's quality of life.
Osteoarthritis, or arthrosis of the shoulder joint, becomes a serious problem that interferes with the normal performance of work and everyday tasks.This disease will be discussed below;we will analyze the causes of arthrosis of the shoulder joint, symptoms and treatment of this unpleasant pathology.
what is that
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 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, can manifest itself only during physical activity or even at rest.
Due to injury to the surrounding anatomical structures, an inflammatory process is observed, which worsens the decrease in the amplitude of active and passive movements in the upper extremity.The lack of appropriate treatment often leads to the complication of the joint deformation process, 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 various movements with the upper limb.Three large bones come together in this anatomical region, including the scapula, the clavicle, and the humerus itself.The articular capsule is quite deep and strengthened by the entire complex of ligaments.
Due to some anatomical characteristics 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 a consequence not only of the spherical shape of the joint surfaces, but also of 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 carried out in a number of leading research institutes enabled reliable determination of the pathophysiological mechanism of changes in bone and cartilage tissue during arthrosis.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.
Retrospective analysis of the medical history of patients with this pathology in the area of the shoulder joint made it possible to identify influences that can significantly increase the probability of the occurrence of the disease.
This includes:
- excessive physical activity that leads to physical thinning of joint surfaces;
- frequent falls on the arm and other injuries of the upper limb belt;
- occupational hazards;
- congenital pathologies of connective tissue;
- disturbed mineral metabolism, accompanied by the appearance of crystalloid deposits on the head of the humerus;
- reduced 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 an 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 case of primary, the diagnosis is made only after a whole series of diagnostic measures have been carried out in order to completely exclude the presence of the causes of the disease described above.It is believed that the starting point in the pathogenesis is the deterioration of blood flow in the entire 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, 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 are formed as a result of a compensatory increase in the activity of chondroclasts trying to compensate for the loss of mature cartilage cells.They have the appearance of spikes, which, when moved, contribute to the injury of the capsule and the emergence of an aseptic inflammatory process.
Against the background of the described changes, fibrin threads appear in the synovial fluid, permeating the ligament apparatus during a 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 development of the process.
Secondary arthrosis of the shoulder joint
The secondary form of this disease is a consequence of the presence of the underlying pathology, complicated by disorders in the functioning of the musculoskeletal system.Among the causes, traumatic injuries of an acute or chronic nature take first place 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 ligament apparatus, and can also cause the development of secondary arthrosis of the shoulder joint.It is these patients who often experience dislocations and subluxations when performing daily activities.The looseness of this bone joint contributes to an increase in the traumatization of the contact surfaces, where the disease occurs.
Symptoms and signs
Shoulder osteoarthritis has complex symptoms and treatment;due to some characteristics 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 upper limb belt.In accordance with them, the complex of symptoms found in the patient will also differ.
With stage 1 of the disease, a person rarely notices shoulder pain;Discomfort in the extremity most often occurs when performing heavy physical exercise or immediately after it.In such situations, the patient needs several days to recover and completely resolve the discomfort in the joint.Precisely because a person is inclined to attribute pain to the manifestation of a simple, as it seems to him, sprain of the ligament apparatus, the disease continues its development, reminding itself more and more often.
Arthrosis 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 joint surfaces, secondary inflammation occurs that spreads to the ligaments and surrounding muscle fibers.The disease causes pain to be present even with minor physical exertion.Due to severe pain, the patient becomes incapable of circular movements, which indicates that the process of deforming osteoarthritis has begun and the amplitude of active arm movements in space is limited.
The development of the 3rd degree leads to an almost complete loss of mobility in the shoulder joint.The patient notices significant muscle atrophy and loss of ability to take care of himself.Another characteristic symptom is the appearance of bony protrusions above the surface of the skin.The probability that the disease will go that far exists mainly in people who do not have the ability 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 expert skills.After the onset of pain in the upper extremity, it is advisable to consult an orthopedic traumatologist.Doctors of this profile possess a whole range of necessary knowledge.
During the examination, the first thing to pay attention to is the patient's complaints and history.The doctor finds out why the pain appeared, what is its nature, and after which it disappears.Furthermore, 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 a simple radiograph.
The next stage is the physical examination, when the specialist identifies the painful areas by palpation and determines the whole series of active and passive movements in the limb.In addition, the presence of local edema and elevated skin temperature in the area of projection of the bone joint is assessed.Based on the obtained data, the doctor can make a preliminary diagnosis, but a differential diagnosis is necessary to prescribe the most adequate therapy.
In order to establish the most accurate diagnosis, scope 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 and computer 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 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 making 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 chosen method for the correction of arthrosis of the shoulder joint directly depends on the following factors:
- degree of process;
- general condition of the patient;
- old 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 arthrosis of the shoulder joint of the second degree, the symptoms accompanying the disease are almost impossible to completely stop.Persons are shown a significant reduction in physical activity in order to prevent further development of the pathological process;a whole series of drugs is prescribed in parallel.
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 doctor.Then we will talk in more detail about each of the existing methods of solving arthrosis.
Medicines
The following groups of drugs are used as conservative therapy in the presence of this disease:
- glucocorticoids;
- non-steroidal anti-inflammatory drugs;
- analgesics;
- drugs with chondroprotective action.
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 anti-inflammatory agents.These natural and synthetic adrenal hormone analogues can significantly affect the production of inflammatory neurotransmitters.This reduces local swelling, pain and temperature in the affected area of the musculoskeletal system.
Disadvantages of this treatment include a large number of side effects of glucocorticoids.The presented drugs can cause Cushing's syndrome, lead to disturbances in general metabolism and retention of water in the intercellular space.In this regard, it is recommended to start treatment by prescribing NSAIDs.
Nonsteroidal anti-inflammatory drugs have a direct effect on cyclooxygenase molecules, which cause 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 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 chondroprotectors in 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 patients with shoulder arthrosis is indicated.This invasive method is used in the presence of a severe destructive process directly in the joint.Patients who undergo surgical treatment are often unable to perform daily tasks due to severe limitation of active and passive movements in the shoulder.
After the final diagnosis is made, a whole series of measurements are taken during which the optimal parameters for the future prosthesis are selected.Then, a custom-made graft is made, consisting of high-strength polymers or titanium.
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 goes through a long preparatory period.A complete replacement of the affected bone joint is performed, followed by a period of physical therapy, which allows the full functionality of the upper limb girdle 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 medical treatment of the disease.Specially developed complexes relieve a person of morning stiffness, promote 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 extremity are performed without additional loads, because otherwise there is a high probability of additional trauma and cartilage destruction.Rehabilitators deal with the development of special complexes of physical therapy.
Each clinical case requires an individual approach, so if you have a disease or want to prevent its development, seek the help of this doctor.
Recommendations for home treatment
Any illness must be treated in a hospital environment under the supervision of highly qualified medical professionals.However, in some cases the patient does not have the possibility of a long-term stay in the clinic.In such situations, you have to monitor the recovery process on your own.
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:
- strictly adhere to the instructions and instructions of the attending physician;
- restrict the affected arm from physical activity as much as possible;
- get rid of excess body weight by creating a slight caloric 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 strain on the upper limbs.
Folk remedies
Many older people know from their own experience what arthrosis of the shoulder joint is and how to treat it at home.In addition to the above-described recommendations regarding changing the type of work activity and getting rid of excess body weight, traditional medicine has a whole range of remedies that help reduce pain and swelling in the affected limb.Various ointments, decoctions, poultices and baths are used for this purpose.We will dwell on these treatment methods in more detail.
Fats
Alternative medicine has a large number of original and effective recipes for the preparation of anti-inflammatory ointments.The simplest way is to mix one egg yolk with a teaspoon of turpentine and the same amount of apple cider vinegar.Applying 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 elecampan and one hundred milliliters of vodka.After mixing the components and letting them cook for 12 days, rub the resulting ointment every day in the area of the projection of the inflamed joint of the bone.
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 tablespoon of ground agave leaf with 150 milliliters of 70% ethyl alcohol.After two weeks of infusion, the liquid should be taken orally, twenty drops with water for thirty days.
For supporters of decoctions there is a good remedy.For preparation, you will need two tablespoons of cranberry leaves and half a liter of boiling water.After mixing the ingredients, leave them to cook 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 rubbing
In order to reduce pain and inflammation in the area of the shoulder joint affected by arthrosis, various dressings are used.A mixture of one liter of vodka and one hundred grams of kerosene is considered one of the most effective.The medicine should be infused for two weeks, after which it should be used every night before going to bed.
Another simple and effective remedy is a poultice made of finely grated horseradish, mixed with a small amount of water to make a puree.Place a handful of the medicine in gauze and apply to the inflamed joint for 20-30 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 so, follow these recommendations:
- fill the bathtub with warm water;
- add about a kilogram of sea or common table salt;
- throw a few pine branches;
- pour a few teaspoons of candied honey;
- at the very end, add a teaspoon of turpentine oil.
The treatment course consists of twelve baths.The duration of one procedure should be about twenty minutes.From the very first use of the therapeutic bath, the patient notices a significant improvement in the general condition and a reduction in discomfort in the joints.
Prevention
Modern medicine still does not have specific measures for the prevention of 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 are primary and secondary prevention.
The first includes:
- daily walks outside;
- using a contrast shower, which allows you to achieve increased vascular tone;
- gentle treatment of joints, avoiding excessive physical activity;
- moderate exercise 2-3 times a week.
The second group includes:
- complete and comprehensive treatment of arthritic processes;
- regular intake of calcium supplements;
- prescribing chondroprotective drugs;
- physical therapy.