Osteoarthritis deformans (DOA) of the shoulder is a chronic degenerative cartilage disease that causes pain and stiffness during movement. It is important that the doctor establishes the true causes of pain and discomfort at the diagnostic stage, because the treatment of this pathology has its own characteristics.
Let's figure out what pain in the shoulder means when raising the arm up.
Causes of disease
The causes of osteoarthritis are the natural wear of the joint, which, under the influence of various factors, occurs until old age. The shoulder joint is a complex structure. Representatives of a number of professions (for example, builders, workers, athletes, and so on) load their hands daily, which may sooner or later affect their he alth. Another cause that can lead to arthrosis is injury.
DOA of the shoulder joint is common and occurs in approximately 7% of the population. The most common areas of disease that can result in disability for a person are the knee, ankle and hip joints.
Symptoms of the disease
The first symptom that attracts the attention of the patient in the presence of this disease is pain in the shoulder when raising the arm up. It occurs after prolonged exertion at work, at home or in the gym. The next day, discomfort may recede, but in the future they appear more often.
In the event that you do not consult a doctor in time and do not start treatment, then stiffness will join the pain discomfort over time: the range of motion of the joint will decrease so much that it will be impossible to take your hands back or stretch them up. In this case, a person will hear a crunch with clicks in the shoulder.
Severity of disease
Severity in DOA of the shoulder joint does not always correspond to the severity of symptoms, since pain sensitivity in patients is different, and pathological processes can develop faster or, conversely, slower, depending on certain concomitant circumstances. Therefore, doctors without fail clarify the diagnosis using instrumental diagnostic methods, for example, through X-ray, magnetic resonance and computed tomography.
1st degree
When DOA 1 degree of the shoulder joint in the pictures, the doctor sees a small narrowing of the joint space along with single osteophytes. As a rule, at an early stage, patients complain onlyfor short-term pain after exercise and limitation of mobility. With proper therapy, arthrosis of the first degree can not only be stopped, but also reversed, returning the joints to their he althy state.
Next, consider deforming arthrosis of the 2nd degree.
2nd degree
In the event that the disease progresses due to the patient's inaction or due to an incorrect diagnosis, the articular cavity narrows to a minimum, and then they already speak of the second degree of this pathology. In this case, parts of the dead cartilage can fall into the gap between the bones, which causes severe pain along with inflammation. The joints swell, and the pain becomes continuous. As for movements, they are limited to such an extent that people are forced to give up their usual activities such as driving a car, cooking, working at a computer, and the like. With arthrosis of the second degree, the muscles of the hand can also atrophy, which will indicate a neglected pathological process. In such a situation, the doctor will be forced to assess the chances of success with conservative treatment. If the deformity of the joint is irreversible, then only surgery will help the patient.
List of glucocorticoid drugs effective for this disease, consider below.
Treatment of pathology
In the event that the doctor to whom the patient applied prescribes only painkillers ointments, then you should be wary. This disease does not tolerate a careless approach, without complex therapy there are few chances for positive results. of decisive importance in the treatment of this diseasehave methods of physiotherapy, gymnastics and massage. The treatment program in each situation is individual.
Medication Therapy
The main goals of shoulder OA therapy are:
- Elimination of pain syndrome.
- Restoration of blood circulation in the tissues of the joint.
During the drug therapy of this pathology, a conservative method is most often used, in which drugs are used in the form of pills, injections or ointments. In advanced cases, patients are prescribed surgery. Rapid healing of the patient is carried out only at the initial stage of the disease. Depending on the result of the patient's diagnosis, the doctor selects medications. The following medications are commonly prescribed:
- Taking non-steroidal anti-inflammatory drugs in the form of "Diclofenac", "Aceclofenac" and "Nimesulide" (instructions for use, price and reviews of the drug will be presented below).
- The use of muscle relaxants in the form of Sirdalud and Mydocalma.
- The list of chondroprotective drugs includes Glucosamine along with Chondroitin and hyaluronic acid.
Simultaneously with medications, doctors prescribe the use of glucocorticoid ointments to help relieve inflammation and reduce pain. Ointments such as Voltaren, Ibuprofen and indomethacin ointment have proven themselves as effective external agents.
Sometimesdoctors are forced to prescribe direct hormonal injections into the joint cavity, such as Hydrocortisone and Diprospan. The list of glucocorticoid drugs can be continued with Kenalog, Flosteron, Celeston
Hormonal injections, as a rule, do not treat the underlying disease, but only help alleviate the patient's serious condition, reduce inflammation and reduce the harmful effects of drugs on the body. The described method of therapy can only be used as part of complex treatment.
With the ineffectiveness of conservative methods of drug therapy, when drugs from the list of chondroprotectors or glucocorticoids do not work fully, the doctor may resort to surgical intervention, which consists in the complete replacement of the diseased shoulder joint. It should be emphasized that the level of medicine in this direction is constantly developing, in connection with this, high-tech operations significantly improve the quality of life for patients.
Instructions for the use of "Nimesulide"
According to reviews, the price of the drug is quite acceptable. It costs about 180-250 rubles. A large number of contraindications suggests that the instruction is very important for familiarization. An adult patient needs to consume 100 mg of powder 2 times a day after meals. The granules should be diluted in warm water. If this dose does not work, it can be doubled. The course of treatment lasts no more than 15 days.
Surgical treatment
In the event that it is not possible to stop the symptoms of the diseaseconservative method, then surgical treatment may be prescribed:
- Puncture of the shoulder joint is a minimally invasive method that allows you to remove the inflammatory fluid from the joint area and introduce a medical preparation there.
- Arthroscopy involves a mini-surgery, which is carried out under the control of a video camera through a puncture in the joint area. This treatment option relieves symptoms without requiring long-term rehabilitation.
- Arthroplasty is a relatively new type of surgical intervention, in which a pathologically altered articulation is replaced with a bioprosthesis. Such an operation allows you to finally cope with the disease, but, like any other surgical intervention, it has risks.
Physiotherapy
This method of therapy involves the following treatments:
- Shock wave treatment is a method based on the action of acoustic waves that are generated by a special apparatus. During the session, the doctor brings the applicator closer to the pathological area, through which the impulses act on the diseased tissue. This leads to improved metabolic processes and relieves pain by increasing shoulder mobility.
- Laser therapy at an early stage can be one of the main methods of treatment. This approach makes it possible to abandon the drug burden on the body, and in the future even avoid surgery.
- Myostimulation allows patients to restore strength in a diseased limb, thanks to this, after 2-3 sessions, patientsstart active physical education. This technique is especially indicated for the weakened and the elderly.
- Phonophoresis involves the use of ultrasound with the simultaneous application of a drug in the form of a gel to the skin over the joint. Due to this effect, the effectiveness of the drug is increased, since by means of ultrasonic rays it is facilitated by its penetration through the skin to the affected shoulder joint.
- Ozone therapy is usually prescribed as an aid. Like other physiotherapy techniques, it reduces pain and speeds up the recovery process.
Kinesitherapy
The following methods of treatment of DOA of the shoulder joint can be additionally used (according to ICD-10 code M19):
- Therapeutic exercises are prescribed between exacerbations of the disease, when the inflammatory processes subside and patients feel the strength for a gentle workout. A well-chosen exercise program will help strengthen your muscles and prevent future bouts of osteoarthritis.
- Massage and lymphatic drainage along with manual therapy lead to significant relief. True, as in the case of physiotherapy exercises, they are prescribed outside the period of exacerbation. Only professionals should carry out such effects on the body, since it is very easy to damage a diseased joint.
- Carrying out mechanotherapy involves exercises using special simulators available in professional gymsorthopedic clinics. Instructors explain to patients how to use each of these devices properly and profitably.
- Joint traction helps to slightly increase the space inside the joint, reduces bone friction during active or passive arm movement. In the presence of osteoarthritis of the shoulder joint, such a manipulation is carried out by experienced manual therapists.
Exercise
Especially with DOA of the right shoulder joint or the left, it is important to undergo treatment with physical education and gymnastics. Physical exercise effectively slows down the progression of the disease by improving blood circulation, so that nutrients enter the joint cavity very quickly. With the help of gymnastics, the shoulder girdle is strengthened, thereby reducing the load on the joint. In the event that physical education is carried out with the use of weight, then you need to know that with the presence of a diagnosis of "shoulder arthrosis" you can not lift more than 5 kg. The appearance of pain indicates that it is time to stop exercising with DOA of the shoulder joint, or at least switch to an easy complex.
It is mandatory to carry out a warm-up to warm up and to prepare for a more difficult physical set of exercises. The warm-up involves rotating the shoulders along with rotation, clasping hands behind the back and other types of stretches that are commonly known.
He alth and gymnastic exercises are carried out under the supervision of a physiotherapist or doctor in charge. One of them must be shown to be correct.implementation of the complex. It is best when exercises are developed specifically for a specific case. It must be remembered that gymnastics is also capable of destroying joints in the event that training will load them beyond the norm.
Physical education should not be performed if the patient has septic arthritis of the shoulder joint. After doing gymnastics, you must definitely take a contrast shower, lubricate the joints with anesthetic ointment. It is very useful to do a light self-massage of the shoulder and collar area. Gymnastics should be done every day at any convenient time. In the event that a person regularly performs the complex developed for him, then very soon he will notice the long-awaited result.
Conclusion
Thus, deforming arthrosis is a very serious disease. At stake is the ability to work the upper limbs. At the initial stage, the prognosis, as a rule, is always favorable. But with the passage of time, as degenerative and dystrophic changes develop, it can deteriorate significantly. In the case of ankylosis, even the threat of death from any cause increases, which is directly related to increased risks of injury and thromboembolic complications.
