Shoulder joint disease

Shoulder pain develops gradually and significantly reduces the patient's quality of life. To find out the cause of shoulder pain, you need to see a doctor and get a full examination. The most common cause of this pain is osteoarthritis of the shoulder.

This disorder requires adequate long-term treatment and can only be prescribed by experienced specialists.

what is this?

Shoulder arthropathy is a long-term, progressive metabolic malnutrition disorder that results in progressive destruction of articular cartilage, protective growth of bone tissue, joint deformity, and loss of function.

The synchronized interaction of the shoulder complex joints provides a wide range of arm motions:

• the scapula or simply the humerus;
• acromioclavicular - between the clavicle and the acromion of the scapula;
• Sternoclavicular - Between the sternum and the clavicle.

The shoulder joint is very mobile, which is provided by the convex head of the humerus and the relatively flat scapula socket. The joint is strengthened by the tendons of the muscles of the upper extremity, above which is the coracoacromial ligament. Less reliable reinforcement allows the joint to move in different directions, but at the same time increases the risk of injury.

The shoulder joint disease code according to the International Classification of Diseases, 10th edition (ICD-10) is M19 (other types of joint disease). Treatment of shoulder joint disease should begin as soon as possible. But even advanced stages of the disease can be successfully treated.

Causes of frozen shoulder

The main causes of shoulder joint disease:

• Consequences of acute injury - dislocation, subluxation, intra-articular fractures, bruising;
• Permanent long-term microtrauma related to occupational or exercise load;
• Metastasis of acute and chronic infectious-inflammatory and autoimmune processes in the shoulder joint - acute septic arthritis, chronic rheumatoid, psoriasis and other arthritis;
• Against the background of a chronic inflammatory process in the tissues around the joint - humerus scapulohumeral periarthritis, which leads to impaired blood circulation and nutrition of the cartilage tissue;
• Metabolic (exchange) joint diseases - gouty arthritis;
• hormone imbalance;
• Congenital malformations (dysplasia) - eg, the articular surfaces of the shoulder joint.

Under the influence of any one of these causes (sometimes several at the same time), the composition and volume of the synovial fluid supplying the articular cartilage tissue can be disturbed. The cartilage gradually decreases in volume, breaks down, and loses its cushioning properties. This can lead to bone damage, growth along the edges of the articular surfaces, joint deformities, and decreased function. In the joint cavity, inflammation of the synovium occurs periodically - synovitis. Due to synovitis, the joint disease is called osteoarthritis or osteoarthritis - depending on which process is predominant (inflammatory or metabolic dystrophy). Due to inflammation and necrosis of the bone, small pieces of tissue are isolated from it - isolator or joint mice.

risky:

• For microtrauma - blacksmiths, miners, tennis players, weight lifters, discus athletes;
• Acute injuries - gymnasts, athletes, circus artists;
• a person with a genetic burden;
• People with any chronic joint disease.

Frozen shoulder symptoms

The disease begins gradually, gradually. The rate of its progression depends on the etiology, the general condition of the patient, and its genetics.

first sign

The first symptoms of shoulder arthropathy may go unnoticed, especially if they occur in the context of some existing shoulder disease. These are mild and occur periodically, mainly after movement, pain, discomfort during joint movement. Left joint pain can be confused with heart pain. They pass quickly, but it's worth keeping an eye on them.

If such symptoms recur, it is best to consult a doctor immediately, as any disease is easier to treat in its early stages.

obvious symptoms

The pain gets worse and doesn't go away immediately after exertion. Nocturnal pain occurs, as well as pain associated with changes in the weather. Movements of the hand become painful, with characteristic tightening. Movement stiffness occurs in the morning or when you hold a certain position for a long time, and to remove the stiffness, you need to move. The pain syndrome can not only be confined to the shoulder area, but can also radiate to the arms, neck, and upper back.

Periodically, the joint swells, a slight redness of the skin appears over it, the pain increases, and it becomes permanent. Body temperature may rise slightly. This is a sign of synovitis - sterile (infectious) inflammation of the synovium. If there are foci of infection in the body (dental caries, diseases of the ENT organs, etc. ), it can enter the joints through the blood and lymphatic vessels, causing a purulent inflammatory process. In this case, there may be a high fever, headache, and the general condition may be severely disturbed.

The combination of degenerative dystrophic and inflammatory processes in the joints gradually leads to permanent loss of limb function and persistent pain.

But even such patients can get help, you just need to go to the clinic.

Dangerous symptoms

There are many symptoms of shoulder osteoarthritis that indicate that you need urgent medical help. This:

• Edema and tissue redness in the joint area, fever;
• joint pain, accompanied by changes in its shape;
• joint pain radiating to the arms, neck, or back;
• The amount of movement of the arm was impossible before, and even just lifting it caused severe pain.

These symptoms indicate that your body needs help. Only a doctor can provide.

What is the danger of frozen shoulder

In the absence of medical attention, brachial arthropathy is dangerous and progresses steadily with the development of permanent pain syndromes, decreased limb function, and the development of various sometimes life-threatening complications.

Degree of arthropathy of the shoulder joint

Arthropathy of the shoulder joint is divided into three degrees:

• Shoulder joint disease 1 degree- Early stage. All symptoms were mild, mainly after exercise. On an X-ray, a slight narrowing of the joint space can sometimes be seen, but more often this is not the case. Only with the help of Magnetic Resonance Imaging (MRI) is it possible to detect small lesions in the cartilage tissue at this stage.
• Shoulder joint 2 degrees- Progressive stage. The shoulders are often painful, exacerbated by movement of the arms, either down (elbows, forearms, hands) or on the neck, back, under the shoulder blades. Limb function is difficult and signs of synovitis appear periodically. On X-rays, the joint space is markedly narrowed, and bone growth (osteophytes) can be seen along the edges of the joint surface, and bone tissue is compacted (ossclerosis).
• Shoulder joint 3 degrees- Advanced stage. The joint pain is intense, constant, and there is a noticeable tightening when moving the arm. The range of motion is limited and sometimes the arm is completely immobile due to pain. Deformation of the joints, sometimes resulting in pinched nerves and blood vessels. X-ray film: joint space is almost invisible, there is obvious bone growth, joint deformity, bone tissue severe hardening and necrosis, joint mice.

possible complications

Arthropathy of any location and form has serious complications, so you should not delay treatment.

If you do not treat the disease or treat it yourself with folk remedies, you are at risk for complications, such as:

• Significant deformity and limited joint mobility;
• Dislocations, subluxations and intra-articular fractures from minor injuries or sudden movements;
• Rupture of tendons around muscle and ligament joints - they shrink and tear easily;
• Aseptic necrosis of the humeral head, complete destruction of the joint, loss of function;
• Suppurative septic complications occur when infection enters the joint cavity from other lesions.

What to do if the condition gets worse

Exacerbation of the pathological process is often associated with increased pressure on the extremities or the development of inflammation-synovitis. In this case, the joint is more painful, there is slight swelling, and the body temperature is raised. In this case, you should follow the self-help algorithm:

• call the doctor at home;
• Take a tablet of one of these pain relievers;
• Apply anesthetic ointment to the skin of the affected joint;
• Bandage the sore arm - this will reduce the load;
• Adopt an elevated position—sit down with a pillow under your back—to reduce tissue swelling.

Types of Shoulder Arthropathy

The disease is divided into different types based on various criteria.

due to disease

According to this criterion, primary and secondary osteoarthritis are differentiated. Primary shoulder arthropathy is primarily the result of age-related changes and develops after 50 years. But sometimes the disease starts at a young age and the cause of its onset cannot be determined. In this case, they talked about primary idiopathic shoulder. Genetic predisposition plays an important role in its development: a similar disease is present in one of the close relatives.

Secondary arthropathy of the shoulder develops after injury and pre-existing disease, but the genetic burden is also important here: In a person, even a minor injury or acute arthritis can lead to the development of arthropathy, whileIn another, the more serious injury ended with no consequences.

According to traffic characteristics

Assigned shoulder deforming arthropathy, characterized by rapid progression of skeletal deformities. A hallmark of this type of disease is changes in the shape of the joints, which often involve nearby blood vessels and nerves. Vascular compression leads to impaired circulation and rapid progression of degenerative dystrophic disease, and nerve compression leads to impaired limb sensitivity and severe pain in peripheral nerves.

origin

Posttraumatic Arthropathy of the Shoulder - The symptoms and treatment of this disorder have its own characteristics associated with traumatic lesions of certain joint structures. Exchange dystrophic changes occur after intra-articular fractures, dislocations, subluxations, ligament, tendon ruptures, and simple bruising. The cause of the injury is a blow to the joint or a fall on the side of the arm that is adducted. Rupture and dislocation of the joint capsule usually occurs when the arm is abducted and falls.

Often, after a minor injury, a person does not notice the first signs of joint disease for a long time and seeks medical help already in the second stage of the disease. Severe injuries require long-term rehabilitation, and arthropathy is often treated early.

Shoulder joint after inflammatory disease - the symptoms and course of this pathology depend on the underlying disease. Psoriatic arthritis often affects the shoulder joint, whereas arthropathy occurs in one joint and develops slowly but is difficult to treat. With rheumatoid arthritis, both shoulders are affected, the joint disease develops in waves, with frequent alternations of metabolic malnutrition and inflammatory processes.

distribute

Only one left or right joint will be affected and then they talk about monoarticular disease. Damage to both (left and right) scapular joints at the same time is called oligoarticular joints.

Arthropathy of other joints of the shoulder

Acromioclavicular Arthropathy - Most common after trauma. It was developed in the context of horizontal weightlifting. Pain when raising arm. With the growth of osteophytes on the articular surface, impingement syndrome - damage to the tendons and muscles of the shoulder between the humeral head and the acromion of the scapula during shoulder rotation and abduction can occur. This accelerates the progression of arthropathy and the decline of hand function.

diagnosis

Without a proper diagnosis, it is impossible to treat the disease. A full examination can only be done in a clinic. At the initial consultation, the doctor will ask the patient, examine him, prescribe other research methods and specialist consultation:

• Laboratory tests to detect blood, joint fluid - inflammatory, autoimmune and degenerative dystrophic processes.
• instrumental music:
  1. shoulder radiography - changes in bone tissue are detected;
  2. Computed tomography (CT) - changes in early cartilage and bone tissue;
  3. Magnetic Resonance Imaging (MRI) - changes in soft joints and tissues around them;
  4. Diagnostic arthroscopy - performed when necessary to elucidate the nature of the pathological process.

Treatment of Shoulder Osteoarthritis

After the final diagnosis is established, complex conservative treatment of the shoulder joint is performed. If conservative treatment fails, surgical treatment is prescribed.

Conservative treatment

It includes pharmacological and non-pharmacological methods.

medical treatement

The goal of drug therapy is to eliminate pain and inhibit the progression of osteoarthritis. To alleviate the patient's condition, specify:

1. Group medicineNon-steroidal anti-inflammatory drugs (NSAIDs). Drugs are administered intramuscularly, orally or rectally; meanwhile, drugs in the NSAID group are administered externally in the form of ointments, gels, or creams.
2. Group medicinemuscle relaxant- Relax the muscles around the joints; spasticity of these muscles increases pain;
3. pain blockwith local anesthetic.The drug solution is injected into the joint cavity or tissue around the joint - rapid pain relief.

Pathogenic (affecting disease mechanism) course of treatment as part of medical therapy for shoulder arthropathy includes:

1. chondroprotective agent- A drug with in its composition biologically active substances that restore cartilage tissue. They are available orally in the form of tablets and powders, as intramuscular and intra-articular injections, and externally in the form of ointments and creams.
2. Vascular protector- Means of improving blood microcirculation. Dispenses tablets for oral administration and solutions for intravenous drip.
3. Hyaluronic acid preparation- Introduced into the joint cavity to improve depreciation performance and prevent the destruction of bone tissue.

The vitamin-mineral complex improves the metabolic processes of the joints and tissues around them.

non-drug treatment

The basis of non-pharmacological treatment of shoulder joint disease is a healthy active lifestyle and proper nutrition. It's important to get rid of bad habits like smoking and alcohol - they can cause circulatory disturbances and have a toxic effect on joint tissue.

nutrition, diet

There is no special diet for the treatment of shoulder joint disease, but proper nutrition is very important for this disease. Recommended to include in your daily diet: marine fish, seafood, lean poultry, dairy products, cottage cheese, cheese, grains (oatmeal, buckwheat), vegetables, fruits.

Diet to exclude: digestible carbohydrates (sweet foods, muffins, sweet carbonated drinks), fatty red meat, foods that irritate tissues and cause swelling - salt (excess), spicy and spicy seasonings.

It is recommended to prioritize boiled, stewed and steamed dishes.

Orthopedic treatment to distribute limb load

To prevent shoulder injuries, it is recommended to regularly wear an elastic protective retainer in the form of a short sleeve attached to the opposite arm. The device improves blood circulation and eliminates swelling. However, it is not recommended to wear it frequently, as this can lead to a rapid reduction in the range of motion of the shoulders.

Many specialists include the use of duct tape in the complex treatment of the shoulder joint - fixing the tissue with viscoelastic tape. This eliminates pain and improves blood circulation and joint function.

physiotherapy

Exercise therapy - performing a set of exercises daily - the shoulder joint is the main method of rehabilitation. Gymnastics complex is prescribed by a doctor and mastered under the supervision of a sports therapy coach. Once the patient begins to perform the complete set of exercises correctly, it can be performed at home.

physiotherapy

Physical therapy is included in the complex treatment of any stage of the disease. These are electro and acoustophoresis using painkillers, lasers and magnetotherapy - a process that stimulates the regeneration of joint tissue, shock wave therapy (SWT) - a process of sound exposure with pronounced chondroprotective effects.

folk remedies

Folk remedies are only of great benefit when prescribed by a doctor. Here are some of them:

• Viburnum branch decoction orally.Before going to bed, pour a cup of crushed raw materials, add 500 ml of water, boil, simmer for 5 minutes, keep it overnight, and then filter 100 ml of water, 3 times a day. This is an anesthetic.
• An ancient recipe for anesthesia salve from the herb wild rosemary.Take petroleum jelly or butter and dry chopped grass. In an enameled plate, fold the fat bottom and grass layers alternately to the very top, cover, spread the dough on the cracks, and place in the oven (preferably in the oven) over low heat for 2 hours, from the ovenRemove, filter through double gauze, store in refrigerator, and apply to affected joint 2-3 times a day.

Surgery

Since conservative treatment of shoulder arthropathy was ineffective, the following surgical interventions were performed:

• Arthroscopic surgeryAllows to eliminate various defects in the joint cavity. They are primarily aimed at young people with post-traumatic arthropathy. Arthroscopy allows you to tighten the biceps tendon and attach it to the bone (tenodesis - this will remove loosening of the joint), remove bone growth - osteophytes (debridement), restore the joint cavity with a graft, etc. .
• endoprosthesis- Replace damaged, non-functioning joints with artificial joints.

Methods of clinical treatment of the disease

Clinical specialists have developed their own methods of treating shoulder arthropathy. First, each patient is carefully examined using state-of-the-art diagnostic equipment, including MRI. He then used medication and non-drug methods for complete pain relief. At the same time, a personalized comprehensive therapy was selected for him, including:

• The most modern medical and non-medical methods, including plasma lift;
• Traditional oriental methods treat and restore the function of joints and the whole organism; these are acupuncture, moxibustion, auricular therapy, patching, etc.

This approach can quickly relieve a person's pain and inhibit the progression of the disease. Regular prevention sessions allow patients to forget about the disease and live a normal life. Many patient reviews speak of the effectiveness of this treatment.

Combining proven Eastern techniques with innovative approaches to Western medicine.

General clinical guidelines

For people with shoulder osteoarthritis, it is recommended to:

• Live a healthy, mobile lifestyle that alternates physical activity with rest;
• regular diet;
• Get rid of all bad habits;
• Regular therapeutic exercises to avoid sudden movements;
• sleep on your back or healthy side at night with a small pillow under your sore arm;
• Give up strenuous physical exertion to avoid injuries, prolonged stress and colds;
• During exacerbations (development of synovitis), avoid any thermal procedures;
• Follow all advice of your attending physician.

prevention

It is especially important for people with genetic aggravation to follow certain rules to prevent shoulder joint disease. They should not do weightlifting, tennis, traumatic sports, work as hammers, blacksmiths, miners. Everyone who wants to have healthy joints should lead an active lifestyle and eat right on a regular basis.

Frequently Asked Questions about Disease

1. Frozen shoulder is how is it?

   Pain is exacerbated by exercise and weight lifting.

2. Why is this disease dangerous?

   Permanent pain syndrome and loss of limb function develop.

3. Which doctor treats shoulder deformities?

   Post-traumatic - an orthopaedic-traumatologist, with a background of inflammatory disease - a rheumatologist.

4. Is the shoulder joint blocked?

   For severe pain, yes.

5. How effective are physical therapy methods for this disorder?

   Effective as part of complex treatment.

6. Is it possible to completely cure shoulder deforming joint disease?

   No, but doctors can inhibit its progression and save the patient from suffering.

Shoulder joint disease should be under the guidance of a physician for long-term, systematic and strict treatment. Attempts to deal with the disease alone are fraught with complications and disabilities. But a qualified specialist can stop the process at any stage of the disease, saving the patient pain and significantly improving his quality of life.