Arthropathy of shoulder joint

One-third of people over the age of sixty report shoulder pain. In most cases, the cause of pain in this area is the development of arthropathy. The disease also affects young people who are engaged in sustained strenuous physical activity, such as miners, construction workers, loaders, etc.

This disease brings great inconvenience to daily life and sharply reduces work ability. In severe cases, the shoulder joint can cause disability. It is important to identify the disease in its earliest stages. There are treatments now available that can slow down the progression of the disease when treatment is started promptly.

what is pathology

Shoulder arthritis is a chronic disease in which degenerative processes destroy and thin the cartilage. Shoulder osteoarthritis is classified as a group of pathologies that are non-infectious in nature. First, the cartilage tissue covering the joint surface is destroyed.Cartilage loses strength and elasticity. It gradually thins and flattens. Due to changes in the cartilage layer, it loses its shock-absorbing properties. It reduces the ability to reduce impact loads that occur during arm flexion or extension.Osteoarthritis also affects all structures, such as the joint capsule, its shell, the bone surfaces adjacent to the cartilage layer, ligaments, and adjacent muscles. This is accompanied by pathological changes in other soft tissues near the joint. As a result of this disease, bony growths develop on the joint surfaces.The pathology manifests itself as pain and crunching in the affected shoulder area. In the later stages of the disease, the range of motion of the shoulder joint is drastically reduced. Inflammation of the nature of this process is either absent or weakly expressed. The pathology has a chronic, gradually progressive course.

reason

A series of pathological changes in osteoarthritis are caused by the natural aging of tissues. Cartilage damage caused by strong mechanical stress may lead to cartilage destruction. Various pathological processes also contribute to this.Primary shoulder arthritis is usually diagnosed in older adults. Secondary joint damage occurs in the context of previous disease. It happens at any age. The main causes of the disease are thought to be:

1. developmental abnormalities. The pathology is commonly found in patients with humeral head or glenoid dysplasia and other defects in the upper extremity.
2. Injuried. Traumatic arthropathy usually occurs after an intra-articular fracture. Sometimes the pathological cause is shoulder dislocation, most commonly habitual dislocation. Sometimes, severe bruising can lead to the development of pathology.
3. inflammation. The joint often develops when a patient has long-term glenohumeral periarthritis. Preexisting nonspecific septic arthritis, as well as specific joint pathology due to tuberculosis, syphilis, and other diseases, also contributes to this.

There is a group of risk factors that contribute to the development of this multi-causal disease. The following phenomena increase the likelihood of joint disease:

• genetic susceptibility. Many patients have close relatives who also suffer from joint disease. They also have lesions elsewhere. Often the knees, ankles, and other joints are affected.
• Overvoltage. It often occurs in athletes who play volleyball, tennis, basketball, and throwing sports equipment. This can also happen to people if their occupation is characterized by constant high loads on the upper limbs (loaders, miners, etc. ).
• disease. Osteoarthritis usually occurs in patients with autoimmune joint diseases. Some endocrine diseases, metabolic disorders, and connective tissue insufficiency (characterized by joint hypermobility) also contribute to cartilage degenerative processes.

The incidence of degenerative joint disease in patients increases dramatically with age. Frequent episodes of hypothermia can also have a negative impact on joints.

symptom

At onset, people with arthrosis experience shoulder discomfort and moderate pain. The pain is weather related. They become more intense after physical activity. The pain is worse in certain body positions. The pain will go away after you rest or change your position.A crunching sensation occurs when the patient moves the hand. There are no changes or swelling outside the joint. Over time, the pain may become more severe. It continues to bother patients regardless of their position. The pain has a pulling or aching quality.Shoulder joint pain becomes habitual and constant. Pain occurs with movement and at rest. They may disturb patients at night. Characteristics of joint osteoarthritis pain syndrome are as follows:

• Soreness over time and severe pain during physical activity;
• Unpleasant sensations appear only in the joint area, then radiate to the elbow area and then spread to the entire surface of the arm;
• The pain may spread to the back and neck on the affected side.

Soon after, the patient will develop symptoms of morning stiffness in the shoulder. The active range of motion of the joint is reduced. Mild swelling of the soft tissues of the shoulder can be detected after physical activity as well as hypothermia.As joint damage progresses, an increase in range of motion limitations is observed. Patients develop contractures (stiffness) that severely impair limb function. If osteoarthritis occurs on the right side, patients are unable to care for themselves.

development stage

For this disease, the pathological process of the joints is divided into three stages. They reflect the severity of damage to the joint structures and the presence of certain symptoms of shoulder joint injuries. Experts distinguish the following stages of the pathological process:

1. first. No significant structural changes in cartilage tissue thickness were noted. The composition of intra-articular fluid changes. The nutrition of cartilage is destroyed. He doesn't handle pressure well, which causes periodic pain.
2. second. During this stage, the cartilage tissue becomes thinner. Its structure is changing. The surface becomes rough. Cysts form within the thickness of the cartilage layer, and calcifications appear. The areas of bone adjacent to the joints are moderately deformed. The edges of the joint platform are covered with bone growth. The discomfort becomes constant.
3. third. Significant thinning of the cartilage layer and its structural destruction was noted. Extensive areas of cartilage destruction were identified. The joint platform was found to be significantly deformed. Limitations in range of motion are exposed. The ligaments are weak and the muscles around the joints are reduced in size and loose.

This method of classifying shoulder joint pathologies enables physicians to select appropriate treatment strategies based on the severity of the pathological process.

diagnosis

The appearance of symptoms of arthrosis forces the patient to see a doctor. He needs to see a therapist. An expert will make a preliminary diagnosis. After determining the cause of the joint injury, he will refer the patient to a rheumatologist, endocrinologist, surgeon, or orthopedic traumatologist.Doctors base their diagnosis on the typical clinical and X-ray signs of arthropathy. During the initial examination, the joint tissue is felt to determine the level of pain.The possibility of active and passive movement in the affected area is being studied. Doctors detect joint deformation or increase in size. To confirm the presence of arthrosis, the following studies are recommended:

1. radiography. Dystrophic changes in the cartilage layer were detected in the joints. Characteristic bone growth can be identified along the edges of the joint space. In later stages, they found a narrowing of the joint space. Determine changes in the shape and structure of bones adjacent to cartilage. The shape of the joint space becomes wedge-shaped. In the thickness of the bone, signs of rarefaction and the presence of cyst-like structures can be seen.
2. CT scan. This study in the initial stages of the disease provides the opportunity to evaluate the condition of bone and cartilage using layer-by-layer images.
3. Magnetic resonance imaging. This method evaluates the condition of soft tissue structures (cartilage, ligaments, joint capsules, etc. ). Clear, layer-by-layer images help determine the extent of damage to joints and periarticular structures.
4. Ultrasonography. Use ultrasound to detect changes in joints. This method is safe for the body as there is no harmful radiation.
5. Arthroscopy. It is performed using an endoscope. A robotic hand with a camera is inserted into the joint. The doctor can clearly see the damaged area. Determine the softened area of cartilage thickness. It reveals the presence of deep cracks penetrating into the subchondral plate of the bone. Deep ulcerations, erosions, and superficial cracks of the cartilage were detected.

Diagnosing shoulder arthritis in its later stages does not present any difficulty for doctors. When assessing the nature of joint damage, it is necessary to consider possible secondary origins of joint pathology in the context of other diseases.

treat

Treatment of osteoarthritis is performed by an orthopedic traumatologist or rheumatologist. During the motor function recovery phase, rehabilitation experts are actively involved in the treatment process.To relieve pain and restore function in your limb joints, it is important to receive prompt medical care and follow all doctor's instructions. It is necessary to limit the load on the joints and avoid sudden movements of the hands. It is important to avoid lifting or carrying heavy objects for long periods of time.Joints need to be loaded quantitatively under expert supervision, since complete inactivity can have a negative impact on the affected limb. Treatment options include conservative management and surgical intervention. The choice of method depends on the incidence of certain symptoms and the stage of the disease.

medical treatement

An important goal in treating arthrosis is to eliminate pain. To eliminate discomfort and reduce the severity of inflammation, doctors prescribe the following drugs:

1. Preparation for general anesthesia. During exacerbations, patients are given short-term nonsteroidal medications. If used uncontrolled for a long time, they can irritate the stomach lining and slow down the recovery process of the joints.
2. local remedies. When symptoms worsen, use gels and ointments containing nonsteroidal anti-inflammatory compounds. Hormone-containing drugs with local action are used less frequently. They can relieve inflammation and swelling.
3. intra-articular injection device. For persistent, severe pain that cannot be relieved by other means, corticosteroid medications may be injected into the joint. Lockdowns may not occur more than four times a year.

In phases one and two, chondroprotectants are used to restore and strengthen the joints. These products contain chondroitin sulfate, hyaluronic acid, and glucosamine. They are used for long-term courses of six months or more. The therapeutic effects become apparent after three months of continuous use of the drug.Additionally, vasodilators may be used to treat shoulder arthropathy. They increase blood flow and relieve capillary spasm. When spasm is detected, muscle relaxants can be used to relax the muscles in the shoulder area.

Surgical methods

In the third stage of arthrosis, when the joints are severely damaged, limited in mobility and unable to work, endoprosthetic surgery is required. Age, physical activity level and general health are considered before deciding whether to intervene. Installation of modern endoprostheses made of ceramics, plastics and metals can completely restore the function of the joint. The equipment is guaranteed to have a service life of more than fifteen years.

non-pharmacological treatment

Physiotherapy techniques are actively used in the remission and exacerbation stages of joint osteoarthritis. Their course use produces good results when included in complex treatment plans. For joint disease, the following physical therapy methods are used:

1. amplify pulse. This treatment uses alternating current to locally affect the joints. It relieves pain and has vasodilatory effects. This surgery improves tissue nutrition.
2. UHF. The connector is exposed to UHF waves. This method can relieve pain, reduce inflammation and swelling.
3. Magnet therapy. The joint structure is affected by pulsed magnetic fields. It improves blood flow. Cartilage is full of nutrients. Magnets remove decay products from cells. It suppresses autoimmune responses.
4. electrophoresis. This technology promotes the penetration of the drug into the affected joint, which is ensured by the action of electrical current on the tissue. During treatment, blood flow in the joint structures increases. This procedure reduces inflammation and swelling. Unpleasant sensations in hands are relieved. Muscle spasms are eliminated.
5. Balneotherapy. Therapeutic baths using radon gas, salt water and other beneficial solutions are actively used to treat shoulder arthritis. Blood flow improves, thereby enhancing nutrition and accelerating cell recovery. Inflammation is relieved.
6. electrical stimulation. With this treatment method, nerve trunks and muscles are electrically stimulated using electrodes, which deliver an electric current with specific parameters.

After remission, perform therapeutic massage. It restores blood flow and increases the elasticity of ligaments. Joint muscle spasms are reduced. The range of motion increases. For joint disease, exercise therapy is useful.Perform calisthenics when the pain calms down. During mechanical therapy, a special simulator is used for rehabilitation. Perform active-passive movements on them. They restore function to the affected joints.

How to treat it at home?

Laser therapy is considered an effective treatment for shoulder joint disease. The laser beam has a beneficial effect on the affected joint tissue. Devices that produce low-intensity infrared laser beams are used for treatment. Laser therapy is used to speed up cell metabolism.All physicochemical reactions are stimulated in tissues. Chondrocyte function is activated. Laser treatment has analgesic properties. Blood flow improves and swelling resolves. Local immunity is enhanced. Reserve telangiectasia. Laser therapy has anti-inflammatory properties.

To undergo surgery, you do not have to visit a medical facility frequently. Treatment of the shoulder joint at home is performed using a portable laser therapy device. With regular use, the pain will lessen. At-home joint laser treatment can improve the function of your shoulder joint.

prognosis and prevention

Shoulder joint disease cannot be completely cured. But it is possible to slow the progression of pathological joint changes. With regular treatment, the ability to work can be maintained. It's important to follow your doctor's advice.It is necessary to prevent hand injuries. It is important to avoid excessive impact on the shoulder joint during the performance of professional duties and during sports. It is necessary to promptly treat the diseases that cause joint disease.