How to treat arthrosis of the shoulder joint

Shoulder joint arthrosis is a degenerative disease associated with loss of cartilage, formation of osteophytes (bone spikes) and deformation. Hyaline cartilage is a layer of a few millimeters, specialized to absorb (mitigate) the mechanical stresses and contribute to the movement of the bones moving together with connective tissue.

arthrosis of the shoulder joint

Arthritis is a General term that means "inflammation". There are dozens types of arthritis, the most common form known as osteoarthritis. Arthrosis of the shoulder joint causes factors accelerating the progression, instability and mechanical overload of the affected joint parts. There is also a genetic predisposition to this disease.

The progression of arthrosis of the shoulder joint and wear is difficult to stop, as the proportion of elderly patients with osteoarthritis increased.

Anatomy

The shoulder is formed from three parts:

  1. the bone of the upper arm;
  2. shoulder bones (scapula);
  3. of the clavicle.

The head of the arm bone fits into a rounded cavity of the scapula called the glenoid. The combination of muscles and tendons keep the arm bone, located in the center of the socket of the shoulder. These tissues are called the rotary cuff.

The two shoulder joints and both can be affected by osteoarthritis. For effective treatment, the specialist determines which joint subject to pain and to determine the type of inflammation.

Arthritis and osteoarthritis are similar, they both affect the bones, ligaments, and joint capsule. Similar symptoms include stiffness and pain.

The joint connects the head of the humerus with the scapular and articulation system of the shoulder girdle. Making more movement, with displacement in the flexion and extension of the arm, dividing into external and internal rotation and combined circular motion. In this area the disease develops as a result of previous injuries, arthrosis of the shoulder joint entails instability or stiffness of rotation cuff injury, rheumatic disease, osteonecrosis or deformation.
The development of osteoarthritis, the patient suffers from pain and loss of movement. The humeral head loses its normal spherical shape. Tendons can be involved in the inflammatory process. External rotation is limited, the amplitude often reaches 90 degrees – developing arthrosis of the shoulder joint.

For the first time years the pain bearable, decrease in motor activity makes it less obvious symptoms. In case of arthrosis of the shoulder joint pain can be alleviated by acetaminophen or ibuprofen in the early stages of the disease.

Pain is most common symptom of osteoarthritis of the shoulder joint, aggravated by activity and progressively enhanced.

  • The shoulder joint pain concentrated in the back of the shoulder and is enhanced with climate change. Patients complain of deep pain within the joint.
  • Painful sensations arise in the acromial-clavicular joint (AC) focusing in the upper part of the shoulder. Sometimes extends to the side of the neck.
  • People with rheumatoid arthritis are experiencing pain around the shoulder, if two joints, the shoulder and the acromion-clavicular amazed.

Limited range of motion

Limited motion is another common symptom. Inability to raise the arm to comb your hair or take a book off the shelf. Heard squeaks, clicks or crackles (articular crepitus) when moving the hands.

As the progression of the disease osteoarthritis of glenohumeral joint, any movement causes pain in the shoulder. Appears in night sleep time and can be difficult portable.

treatment of osteoarthritis

Anamnesis and medical examination

After discussing symptoms and medical history of arthrosis of the shoulder joint, the doctor will examine your shoulder.

During the medical examination diagnosed:

  • Weakness (atrophy) of muscles
  • Pain
  • Degree of passive range of motion – assist, active – self directed
  • Any sign of damage to muscles, tendons and ligaments surrounding the joint
  • Signs of past injuries
  • Involvement of other joints (an indication of rheumatoid arthritis)
  • The feeling of noise and irritation in the joint with movement
  • Pain with pressure in the joint

Radiography

X-ray examination with the use of detailed images, creating a dense structure that will help to identify and treat osteoarthritis. To detect narrowing of the joint space, changes in bone tissue and the formation of bone spurs (osteophytes).
For approval of the diagnosis, injected local anesthetic into the joint. If you temporarily relieves pain – confirmed diagnosis of arthritis.

Non-surgical treatment

Initial treatment of osteoarthritis of the shoulder joint will be non-surgical. Your doctor may recommend the following options:

  • Activities or changes in activities to prevent causing pain. You may need to change the way of moving hands.
  • Exercises that improve range of motion in the shoulder.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen will reduce the inflammation and pain. Helps to treat arthritis of the shoulder joint. These drugs irritate the stomach lining and can cause internal bleeding.
  • Corticosteroid injections in the shoulder will greatly reduce the inflammatory syndrome accompanied by pain. This effect is often temporary.
  • Moist heat. Applying ice for 20-30 minutes two or three times a day will decrease this inflammation and relieve pain.
  • If diagnosed with rheumatoid arthritis, your doctor may prescribe modification of the drug – methotrexate.
  • Dietary supplements reduce inflammation
  • Physical therapy is useful in the treatment of osteoarthritis of the shoulder joint, periarticular contractures, frequent neck and back pain, and pain in the shoulder. It also helps to maintain mobility of the joints.

Surgery

how to treat arthritis

Considered if the arthrosis of the shoulder joint causes disability, no help of non-surgical options to treat traditional drugs no longer makes sense.

Shoulder arthroscopy is used to remove osteophytes and regularize the irregular cartilage surface. This minimally invasive procedure is performed on an outpatient basis, helping to treat such diseases as arthritis.

Arthroscopy. The time of arthroscopy will insert a small camera called an arthroscope in the shoulder joint. The camera allows you to take pictures that are displayed on the TV screen, the surgeon is guided by images, using surgical instruments small size. The arthroscope and surgical instruments are thin, your surgeon uses small incisions (cuts) are needed for standard open surgery.

During the procedure, the surgeon performs cleaning inside the capsule. The procedure relieves pain, but does not eliminate osteoarthritis. If the disease progresses, you may need another surgery in the future. Treatment of osteoarthritis of the shoulder joint comes in several courses.

Replacement of the shoulder joint. Advanced arthritis (arthrosis) of the shoulder joint can be treated by replacement surgery the Damaged parts are removed and replaced with artificial components called prostheses.

Surgical options include:

  • A hemiarthroplasty. Only the head of the humerus is replaced with an artificial component.
  • A total hip replacement. Replaced head humerus and glenoid bones. Plastic cavity ("Cup") fits into the articular part of the hemisphere of metal connects the upper humerus.
  • TNA Back shoulder. Semi spherical cavity and the metal opposed to the endoprosthesis. Hemispherical metal is attached to the glenoid cavity, and a cavity (Cup) of plastic is mounted in the upper part of the humerus. In total, the full replacement is recommended for people with arthropathy and based on the action of various muscles of the hands, helping to move the arm.
shoulder osteoarthritis treatment

Resection of the endoprosthesis. The most common surgical procedure used to treat acromioclavicular joints – resection arthroplasty. In this procedure, a small amount of bone collarbone is removed, leaving a space gradually fills with scar tissue.

Recovery. Surgical treatment of osteoarthritis effectively reduced pain, restored movement. Rehabilitation time depends on the type of surgery performed.

Complications. As in any surgery there are some risks and possible side effects. Potential problems after surgery include infection, excessive bleeding, blood clots, damage to blood vessels or nerves.

The surgeon will discuss acceptable ways to treat and possible complications before surgery.

26.09.2019