Treatment of periarthritis of the shoulder joint. Periarthritis humeroscapular: treatment and symptoms
The musculoskeletal system of a person is as vulnerable as other organs. This article will deal with a disease such as periarthritis of the humeropathy: treatment and symptoms of the problem.
Initially, you need to understand the main terms that will be used in this article. So, periarthritis of the shoulder joint, the basic concepts:
- Periarthritis( "peri" - around, around, around) is a disease during which inflammation occurs in the tissues surrounding the shoulder joint( ligaments, muscles, tendons, joint capsules).The main difference from shoulder arthrosis is that there is no deep damage to the cartilage itself and other internal structures of the shoulder.
- Shoulder area. This is the area around the shoulder joint. It is there that symptomatology will be observed and the pathological condition will be localized.
What is important to know about a disease such as periarthritis of the humeroscapularis? Treatment and symptoms of the disease - this must be told in the first place. Here it is worthwhile to clarify that the severity of the indicators of the disease will depend on the very form of the disease. According to experts, there are three.
This is the easiest form of the disease. It begins with a slight pain in the shoulder joint. In this case, they arise only in the case when a person tries to throw a hand behind his back or raise it above his head. Movement in the joint is somewhat limited. Because of the pain, not all of them can be completed.
If the patient does not receive proper treatment with simple periarthritis, the problem will gradually develop into an acute form. At the same time, painful sensations increase. Pain gives in hand, neck. Symptomatic arises not only when the affected arm moves, but also at rest. Limitation of movement gradually increases. Painful even touch in the area of the affected shoulder joint. Other indicators, which can occur in this case: an increase in body temperature to 37-37.5 ° C;changes in blood tests( may increase ESR, often appears C-reactive protein).It should be noted that these are indicators of inflammatory processes that can occur in the body.
Chronic form of the disease
It was our turn to find out what chronic periarthritis of the shoulder joint is, symptoms and treatment for this type of problem. Thus, the indicators in this case are not so clearly expressed, but they persist for as long as possible. If the time does not cope with acute periarthritis, it will go into a chronic form. And her treatment is very, very difficult( in addition, more time is needed to recover).The pain is tolerable, but a sharp movement of the hand can lead to "lumbago" and other unpleasant sensations. At rest, pain occurs at night or in the morning, so that often the patient's sleep is disturbed. After a certain time, the illness can pass by itself, but the consequences will long be felt.
The main ways to get rid of the problem
What can be the treatment of periarthritis of the shoulder joint? So, experts identify several areas for getting rid of this problem.
- Conservative treatment. The patient is prescribed pills, injections.
- Therapeutic physical training( LFK).
- Physiotherapy treatment.
- Operative( surgical) intervention.
However, before I want to say that self-medication in this case is very dangerous. This can lead to irreversible consequences and deterioration of the patient's health. With this problem, you should always contact a doctor. After all, only an expert can make the correct diagnosis, and also prescribe adequate treatment.
Conservative treatment of
What is most important if a patient has periarthritis of the shoulder joint? Treatment. Drugs that can help, experts divide into several large groups:
- Non-steroidal anti-inflammatory drugs. These are painkillers such as Diclofenac, Ibuprofen. At the same time, they not only fight with pain, but also contribute to reducing inflammation in the affected area. Attention: these medications can be taken only in short courses and for a limited time. And all because they negatively affect the gastric mucosa, contributing to the formation of ulcers. They also have a fairly large list of side effects, which are better to be familiarized with in advance. Specialists say that recently the latest generation of drugs appeared on the market. These are such medications as "Nimesulide", "Movalis".They act selectively, and the list of side effects from their application is much shorter.
- Corticosteroids, i.e.hormonal anti-inflammatory drugs. These medications are prescribed if the medication described above does not have the desired effect on the affected joint. Most often in this case, doctors prescribe drugs such as "Diprospan" or "Flosteron"( the active substance in them is betamethasone).Most often they are injected into the body. And since they are extremely strong, it is enough that there are a couple of injections. However, the list of side effects is much larger.
- Treatment of periarthritis of the shoulder joint can be performed using the Novocain blockade method. However, this method is used after the exercise therapy and the prescribed drugs have not had the proper therapeutic effect on the aching joint. So, these are special procedures, during which time injections of Novokain antiseptic are periodically given to the affected joint( sometimes together with such preparations as Hydrocortisone or Kenalog).The main goal of this procedure is to remove a strong pain syndrome.
What else can I use if the patient has a periarthritis of the shoulder joint? Treatment - ointment "Dolobene", "Traumeel", etc. By these means, you can also remove pain syndrome, if it is not very pronounced.
It is also very important to use physiotherapeutic procedures. Often, their doctors are appointed almost from the first day of the problem. It is believed that only with the integrated approach: treatment with drugs, exercise therapy and physiotherapy - you can quickly cope with this disease.
- Laser therapy - the best way to get rid of the disease.
- Shockwave therapy may also be prescribed. This procedure perfectly restores the affected tissues during inflammation.
- Ultrasonic therapy heats inflammation sites, thereby increasing blood flow and relieving pain. This procedure also restores the affected tissue and reduces inflammation itself.
- Magnetotherapy helps tissues recover, relieves pain and increases the motor activity of the affected joint.
- Hirudotherapy, i.e.treatment with leeches. The only nuance: the patient may experience an allergic reaction. This is important to remember.
Medical gymnastics, or exercise therapy
So, the periarthritis of the shoulder joint. Treatment( patient feedback is the first confirmation) will be most effective if, together with the use of medicines, a person does special exercises of therapeutic gymnastics. However, in this case, you need to remember that everything must be done under the supervision of a specialist. It is important to follow a certain procedure:
- Lessons should be regular. They should be held at the same time.
- The load should increase gradually, the complex of exercises with time should expand.
- All the exercises are desirable after the course of physiotherapy.
Treatment of periarthritis of the shoulder joint can be performed by surgery. However, this extreme measure can be prescribed to the patient only if all of the above methods do not bring the desired results. The name of the operation is subacromial decompression. Its essence is: an acromion is removed( an outgrowth on the shoulder blade) and one bundle from the same area. After that, the tissues that are near, stop traumatizing each other, the inflammation passes, the mobility of the joint returns, the pain disappears. Indications for use of this procedure:
- Patients who have pain syndrome persisting even after using corticosteroids.
- Patients whose pain does not last for six months( with all possible medications).
- Patients of working age, whose work is associated with constant movement in the shoulder joint.
It is important to remember that after the operation the patient should undergo a course of exercise therapy to restore the motor activity of the shoulder joint.
Folk methods of treatment
Treatment of periarthritis of the shoulder joint can also be carried out with the help of traditional medicine. However, it is worth remembering that any method of getting rid of the problem should be coordinated with the attending physician.
- You can make a simple decoction of chamomile( a tablespoon of the ingredient, pour 250 ml of water).This rubs the aching shoulder, massaging the lesion a little.
- Compresses made from burdock leaves. So, they need to be heated a little and applied to the painful shoulder for about 10 minutes( until they cool down).
- Bought in the pharmacy tincture of calendula, you can rub the sore shoulder in the place of pain.
- Table horseradish. It should be rubbed on a small grater in a gruel and applied in the form of a compress, wrapped in gauze, to a painful shoulder. Do this twice a day for 15 minutes.
Simple conclusions and necessary advice
Shoulder and shoulder periarthritis: symptoms and its treatment - this has been said enough. As a small conclusion, I want to note that it is also important to immobilize the hand when the first symptoms appear. This is the only way to remove the extra burden on the joint and ease the pain. This effect can be obtained if you apply a wire tire or a suspending gauze dressing. However, with the humeroscapular periarthritis, this bandage should be periodically removed. Otherwise, the mobility of the joint will worsen, and the incapacity of the patient will last.
It is also important to say that in treating this problem, you need to use the entire set of methods. After all, this is the only way to cope with this disease in the shortest possible time. It should be remembered that self-medication can be dangerous to health. And if the pain has passed without proper help, the consequences will still remain, and from time to time will make themselves felt. So it is necessary, at the first symptoms, to seek medical help, without delaying the problem to acute or even chronic form of its course.
How to effectively treat periarthritis?
Periarthritis is a disease that manifests itself in a pronounced inflammatory process that occurs in the soft periarticular tissues. This disease affects the ligaments, cartilage, tendons and joint cavity, as well as muscle tissue around it. Most often, periarthritis affects the tissues of the shoulder, scapula and ulnar joints, but sometimes there is periarthritis of the knee and joints of the fingers. In the initial stages this ailment is quite easy to treat, but if the disease is started, then the cure of the patient will be a difficult task even for an experienced doctor. Therefore, in order that the inflammation of the periarticular tissues does not develop into serious complications, each person suffering from this disease needs to know how to treat the periarthritis.
Treatment of periarthritis
Modern medicine offers the following effective ways to treat periarthritis:
- conservative treatment( medications, ointments and injections);
- physiotherapy treatment( physiotherapy, shock wave therapy, magnetotherapy, ultrasound therapy, etc.);
- therapeutic gymnastics and massage;
- treatment by operation.
- Non-steroidal anti-inflammatory drugs. These drugs help to quickly cope with the severe pain syndrome, which is the main sign of joint periarthritis. In addition, these drugs contribute to a significant reduction in the inflammatory process and help prevent further damage to the periarticular tissues. Typically, doctors prescribe to their patients the most common non-steroidal anti-inflammatory drugs, such as ibuprofen, aspirin, diclofenac, voltaren and many others. However, it should be remembered that these drugs have quite serious side effects. They have a strong irritant effect on the walls of the stomach and promote the formation of gastritis and stomach ulcers. Therefore, people suffering from any diseases of the gastrointestinal tract, should take them with great care. But more recently in the market of medicines there appeared the newest nonsteroidal anesthetics, which do not exert such a serious negative influence on the human body. This is nimesulid, movalis and celecoxib.
- Hormonal( steroid) anti-inflammatory drugs. With neglected forms of periarthritis, nonsteroidal preparations lose their effectiveness and cease to have an anti-inflammatory and analgesic effect. In this situation, the treating physicians have to prescribe steroid( that is, hormonal) anti-inflammatory drugs to their patients in order to reduce the pain syndrome and relieve the inflammatory process. The most popular drugs from this group today are flosteron and diprospan. These medications have a powerful anti-inflammatory effect that can cope with virtually any pain and inflammation. However, at the same time they have much more serious side effects and can seriously damage the patient's body. To avoid this, treatment with hormonal anti-inflammatory drugs is not carried out in the form of tablets or capsules, but in the form of local injections, that is, injecting them directly into the diseased joint. As a rule, the entire course of treatment includes no more than 2-3 injections.
- Ointments. In addition, for the local treatment of the joint affected by periarthritis, it is also possible to use various medicinal ointments. Today, for this purpose, ointments of three different types are used: analgesic, warming and anabolic. Anabolic and analgesic ointments help to remove even a very strong pain syndrome, and a warming ointment contributes to getting rid of muscle spasm and effective relaxation of muscle fibers. In addition, an ointment with a pronounced warming effect helps to significantly reduce the swelling of the periarticular soft tissues, significantly improve the metabolic processes in the aching joint, thereby preventing its possible dystrophy.
Medical gymnastics with periarthritis
Treatment of periarthritis must necessarily include the implementation of a special set of exercises that help improve the condition of the affected joint and prevent the loss of its mobility. The following exercises help to get rid of the periarthritis of the shoulder and shoulder joints, which are the most common form of this disease.
Sit on a chair, straighten your shoulders and put your hands on your waist so that your elbows are spread apart. Now start slowly, without any sharp movements, rotate your shoulders first forward, and then back. To get the best result, do these exercises with circular movements of the shoulders for one minute in each side.
Take the same starting position - sitting on a chair and putting your palms on your waist. Begin very smoothly to move your shoulders forward to the limit, as far as the disease allows, and after - back and also to the maximum. These exercises should be repeated about 5-6 times.
Standing, lead a sick hand as far as possible behind the back. Now take her by the wrist with a healthy hand and start very gently pulling down in the direction of the leg on the healthy side. It is important to remember that this exercise should be done, not allowing the slightest feeling of pain. From this exercise you should experience only the tension of the muscles of the shoulder girdle. Repeat these exercises at least 5-6 times, trying to keep the voltage within 10-12 seconds.
Sit down again on the chair and place the palm of the affected hand on the healthy shoulder, and press the elbow close to your chest. After that, grip the elbow with your other hand and start gently pushing the sick limb upward. In carrying out these exercises, it is important to ensure that the hand is always in contact with the body and not tearing away from the chest. It should seem to smoothly go up and down your chest.
Folk remedies for periarthritis
- For the treatment of periarthritis it is very good to use an infusion prepared from such a valuable medicinal plant as St. John's wort. For this infusion, you will need 1 tbsp. Spoon the herb St. John's wort pour 1 glass of hot water and leave to infuse for about half an hour. Ready-made infusion should be filtered through cheesecloth and take 1 tbsp.spoon 3 times daily before meals.
- Another very useful drug for this disease is grass nettle. To cook from her infusion, take about 10 g of finely chopped dry grass and pour it with a glass of boiling water. Leave to soak for about a quarter of an hour, strain well and drink 3-4 times a day.
- Everyone knows the black currant is also considered an excellent natural remedy for this ailment. To prepare a tasty curative drink you will need 1 tsp of finely chopped dry leaves of black currant and a glass of steep boiling water. Pour the leaves with hot water and leave to stand for 20-25 minutes. This useful infusion should be taken in half a cup 2 times a day.
- Horseradish acts in much the same way as a warming ointment, helping to reduce inflammation and providing blood flow to the aching joint. To prepare a pack of horseradish, take the root of this plant and grate it on a fine grater, then add the finished slurry into aluminum dishes and put on the fire. Then warmed shredded horseradish wrap in cheesecloth or clean cotton cloth, make lotions on the most painful areas of the shoulder and back.
- Do not forget about such a wonderful tool, as tincture of calendula. To make it, pour 50 g of dried calendula flowers with one bottle of quality vodka or medical alcohol and leave to infuse in a place inaccessible to the sun. Ready tincture regularly rub the sick joint until the disease passes.
- There are many useful fees that help to effectively combat periarthritis. To prepare one of them you will need birch buds, dandelion root, peppermint leaves and coriander grass. Take everything in equal parts and pour very hot water. From the ready-made infusion it is possible to make compresses or simply rub them a sore spot.
In addition to the above recipes, simple, but at the same time, effective methods of traditional medicine, which contribute to the early disposal of periarthritis.
Treatment of brachyopathy periarthritis
Non-medicinal people, brachyopathy periarthritis, also called adhesive shoulder capsulitis, often appears to be a joint disease. But actually it is not. Only the surrounding tissues are affected, including the joint capsule, ligaments and tendons around the joint. It is this feature that distinguishes periarthritis from ordinary arthritis.
Sometimes the sign of periarthritis is the stiffness of movements that does not cause pain. By analogy with the natural phenomenon, this manifestation of the disease is called a "frozen shoulder".
Forms of humeroparous periarthritis
- The forms in which the disease is on humans can vary: normal periarthritis is characterized by a mild rare shoulder pain that occurs in specific circumstances - for example, when the arm moves upward or sideways. Sometimes, and with the usual course of the disease, there are limitations in the movement of the shoulder - the pain becomes intolerable in the case of sudden throws or a hand over the head.
- If you do not pay attention to periarthritis, the probability of getting an acute form of this disease is great - it is up to 60 percent. Most often, this is facilitated by suddenly increased loads, additional trauma, etc. However, it happens that acute periarthritis occurs, unexpectedly, bypassing the phase of simple flow. There are such cases with severe damage to the hands. Picture of the course of the disease: sharp pain in the shoulder, pain in the neck and arm, night attacks of pain. Raise your hands up or make a circular motion - it is impossible because of the sharp pain, but here the arm goes calmly.
- The lack of adequate treatment leads to the fact that the brachial artery disease becomes chronic. This period is characterized by periodic mild pains, but rotational movements of the hand, sharp jerks, lead to "lumbago".Sleep may be disturbed, as aching pains or aches are not ruled out.
- The chronic stage can be prolonged. After it, the disease either recedes, sometimes, by itself, or progresses, passing into ankylosing periarthritis. This is a severe form of the disease, its signs: dull pain in the shoulder, decreased mobility, "frozen" shoulder, sudden pain with hand movements, blocking movements, inability to extend your arm above shoulder level or make a circular motion.
- Inflammation of the long biceps head is another form of the disease. More common in men. The inability to bend-unbend the arm, the pain in the front surface of the shoulder, the forearm, the attachment point of the biceps - these are the signs of this form of periarthritis.
Why and how periarthritis appears. Symptoms
The shoulder is a complex joint associated with a large number of muscles, tendons, ligaments, vessels, nerves. Loads on tendon fibers lead to microtraumas - the so-called "incisions", which are subsequently torn. The most serious disorders occur in the region of the shoulder tendon fibers, which attach the tendon to the bones.
The shoulder joint has a lot of nerve endings, due to which the sensitivity of the entire arm is provided. As a result of the inflammatory process, the muscles around the affected area come into tension, swell, mechanically squeezing the nerve endings. The patient feels this as a "numbness" of the hand or pain, the inability to perform a series of movements.
Inflammation of the shoulder tendons is among the causes of brachyopathy periarthritis. Approximately every fourth inhabitant of the planet is familiar with the symptoms of this disease, women among the sick - more. Also, the disease often makes itself felt after excessive exercise. To the periarthritis on the left leads to myocardial infarction, which disrupts the blood vessels. Having lost normal blood supply, tendons easily break, become inflamed and swell. A right-sided periarthritis may indicate a sick liver. Women who underwent surgical interventions in the chest area may also get sick, because during the operation the blood supply scheme of this part of the body changes. Diseases of the cervical spine, displacement of vertebrae, osteochondrosis, various infringements can also provoke periarthritis.
How to understand that this is a humeropathy periarthritis?
The doctor makes a diagnosis based on the patient's examination data, previously revealing the pain points, finding the positions and movements in which the pain is intensified. Can be appointed X-ray of the shoulder. On the analysis of blood it is impossible to determine the presence of the humeroparous periarthritis, excluding its acute form. In this case, the level of ESR and C-reactive protein is increased.
After a long treatment on the roentgenogram, microcalcations of calcium crystals are visible, where the affected tendon is attached to the bone. With ankylosing periarthritis, a snapshot can help in detecting a loss in the density of the head of the humerus.
How to treat humeroparous periarthritis?
This disease is treated! And in any form, so do not delay the trip to the doctor. In the initial stages, trigger points are affected. The doctor prescribes compresses with dimexid medication. Sometimes they use laserotherapy and cryotherapy. Such manipulations help to normalize the blood flow, improve the plasticity of the ligaments. In acute cases, you should first remove the inflammation with medicines. The course of periarticular injections of hormonal corticosteroid drugs can relieve pain and quickly begin treatment.
Of non-traditional methods for eliminating periarthritis, opt for leech treatment, eliminating allergy to girudoprocedures. Five sessions help reduce puffiness and tenderness of the shoulder.
Therapeutic massage, PIR, manual practices, cryotherapy, help in 90 percent of the cases. It will take 10 to 15 sessions.
"People's" treatment of periarthritis
- Folk treatment is possible with mild or chronic stage. Apply:
- 5 g. Currants chop and brew a glass of boiling water, insist half an hour, then use half a glass twice a day.
- Welding two tsp.dry leaves of nettle, heated on a water bath, 1 tbsp each.three to four times a day.
- 50 g. Calendula insist in half a liter of vodka for 15 days, then rub the sore spot.
- 1 tbsp. St. John's wort insist half an hour and drink on st.l 4 times a day.
- Shredded root horseradish is heated and gauze is applied to the sore shoulder.
How to prevent adherent periarthritis
To prevent the development of periarthritis, you should periodically visit a doctor, monitor the condition of the body, with the slightest suspicion to visit a neurologist or therapist.
If the episode of the disease has already been, then the prevention consists of such items as: restriction of loads, extremely important for the restoration of tissues;regularity of joint exercises;observance of doctor's recommendations.
What is it?↑
The shoulder joint is a single unit consisting of three true joints and two joints. The bone elements of the joint are represented by the clavicle, scapula and upper humerus, the muscular elements - the anterior dentate, the subscapular, the triceps, the deltoid, the biceps, the small thoracic, trapezoid, and other muscles.
Fig.: structure of the shoulder joint
Because of its super-mobility, the humeroscapular joint is the least stable joint in the human body and needs increased protection and fixation.
Accordingly, there are three ligaments( upper, middle and lower) for this, which ensure joint stability and active stabilization, and to increase the area of contact between the humerus and the scapula on the articular surface of the joint, there is a cartilaginous lip.
The entire joint is covered with a capsule. The complexity of the structure of the shoulder joint ensures the smoothness of its movements.
Due to the synchronous interaction of the small joints of the shoulder girdle, the movements in the shoulder are carried out in four degrees of freedom: withdrawal and reduction, extension and bending, external and internal rotation, rotation.
In the development of humeropathy periarthritis, the main role is assigned to the state of the rotator cuff of the shoulder, consisting of the supraspinatus, subacute, small round and subscapular muscles.
These muscles begin at the scapula and attach to the humerus, thereby stabilizing the joint and ensuring coordination of movements of the upper limb.
Fig.: Inflammation in the shoulder joint
In cases of injuries and disorders of the joint function due to changes in the vessels, formation of calcifications, etc.his mobility is lost, as well as pain that significantly reduces the quality of life of the ill.
Main Causes ↑
The main role in the onset of the disease in patients under 40 years of age is assigned to prolonged microtraumatism or a single injury( fracture of the scapula or clavicle, damage at the junction of the clavicle and scapula).
In patients older than 40 years, as a rule, develops a humeropathy periarthritis on the background of osteochondrosis due to degenerative changes in the body, manifested tissues with significant load.
There are many theories of the onset of humeroparous periarthritis. The statement about the nature of the disease appeared as early as the middle of the 19th century: vascular disorders, calcification, trauma, and much more were assumed.
In general, all causes of rotational cuff pathologies can be divided into several main groups:
Shoulder joint tissue may be damaged due to various reasons:
- Traumatic: is more often a single injury with a fall on the arm or a direct blow to the shoulder. Possible multiple microtraumatism in sports, the presence of harmful working conditions, etc.more often observed in individuals at a young age.
- Degenerative: occurs due to blood flow disturbance against a background of low load.
By the nature of the pathology coverage:
- partial damage to the part of the tendon of the supraspinatus;
- local tendon damage through its entire thickness;
- extensive damage together with a small round muscle;
- periosteal detachment of humerus.
To diseases that promote the development of periarthritis, include:
- tendonosis - calcium deposition in the tendons;
- external compression of the supraspinatus.
Symptoms, Symptoms and Localization ↑
Always damage to the rotator cuff of the shoulder is accompanied by a different intensity of pain, wavy or persistent.
Pain localizes in the shoulder region and radiates to the shoulder.
Pain intensification occurs during movement, especially when the arm is extended to 60-120 degrees.taking pain medication has only a slight positive effect.
The second characteristic feature of periarthritis is the restriction of movements in the joint.
With the progression of the disease, the volume of active movements gradually decreases, and later the passive movements are limited( active movements are performed by the person himself, passive movements are performed by the researcher, the patient can not move the limb independently).
Periarthritis can occur on the left, on the right, or be bilateral.
The localization of the pathological process depends more on the physiological load on the joint. In those cases, if a large load falls on the right hand( javelin throwers, etc.), the right shoulder joint, respectively, is damaged. Left-sided periarthritis often occurs as a result of trauma, a fall on the left arm.There was a sharp pain in the back? Perhaps one of the nerves is pinched. Read more about the problem in our article about what to do if the nerve in the back is pinched.
How to relieve pain in the joint? Perhaps you will get an ointment with an anti-inflammatory effect. On one of these drugs, read here.
Forms and possible consequences ↑
Periarthritis of the shoulder joint may be acute or chronic.
- Acute periarthritis: occurs after trauma. Characterized by the sudden appearance of pain in the shoulder, which intensify at night. Because of this, a person can not move his hand. Externally, there is swelling in the joint area. The disease lasts for several weeks, after which the pains become less intense, and the movements are restored.
- Chronic periarthritis : characterized by blunt, aching pain in the shoulder region, which intensify at night and in the morning. If the process progresses, ankylosing periarthritis may occur.
Clinical forms of manifestations of the disease
Symptomocomplex is a complete absence or sharp restriction of active movements in the shoulder while maintaining passive.
The duration of the disease is no more than 1 month, otherwise the contracture of the joint develops.
Pathology is due to stabilization of the head of the shoulder in the joint capsule due to damage to the rotator cuff.
Characterized by pain in the joint in various positions. It develops with the transverse mechanism of damage to the cuff.
Pain in the shoulder region in the absence of smooth movements. It develops with external compression of the supraspinous muscle by neighboring tissues, often with clavicles.
Syndrome "frozen shoulder" Dypley's syndrome
It is characterized by a pronounced restriction of passive and active movements in the joint. It develops with degenerative changes in the rotator cuff, which last 4-6 months and lead to tenderness of the tendon of the supraspinatus.
In the future, inflammation in joint capsules and reduction of intraarticular fluid in the joint cavity occurs.
The changes are a compensatory mechanism that prevents complete damage to the cuff.
Paralytic Shoulder Joint Syndrome
Absence of active movements in the joint with damage to the cuff and brachial plexus.
As traumatic damage occurs simultaneously in several structures, the course of the disease is significantly aggravated.
Upon examination, the physician draws attention to:
- symmetry of the shoulder and shoulder joints;
- muscle strength of the shoulder girdle;
- presence of bone protrusions.
As a rule, muscle atrophy is observed in the suprascapular region from the pathology side.
When probing, soreness is noted in the area of the patient joint, above the scapula, along the outer surface of the shoulder. The painfulness of both bony protuberances and articulations and muscles is noted.
The next step is to determine the amount of motion .
The estimation of data is based on the volume of movements in the norm :
- lead 180 °;
- extension 50-60 °;
- rotation inside 110 °;
- rotation to the outside 70-80 °.
Initially assess the active movement.
With extensive damage to the rotator cuff, restriction of the lead and rotation inside is observed within 5-10 degrees, for the isolated damage of the supraspinar abdomen, painful abduction is within 60-120 degrees, with more and less lead there is no soreness.
The second stage is the study of passive movements.
A sharp decrease in the volume of active and passive movements is characteristic of the "frozen" shoulder.
As a rule, in case of a traumatic nature of pathology, the disease occurs in people under the age of 40, so when a patient is questioned, the doctor also finds out the circumstances of the injury.
If the patient is more than 40 years old, the disease appeared against the background of degenerative changes. Constant microtraumatization is facilitated by harmful working conditions: a risk factor is a profession that requires constant physical exertion on the hands.
The cause of periarthritis can be a single injury of the shoulder joint, a fall on the elbow, a sharp wave.
X-ray examination of the shoulder joint is of great diagnostic value in various projections. The picture is performed in a state of rest, when the arm rotates inward or outward, when the shoulder is withdrawn.
To determine the radiological signs of humeroparous periarthritis, it is necessary to clarify:
- the position of the humerus with respect to the scapula;The contour of the humerus and scapula;
- homogeneity of bone structures;
- availability of existing defects;
- presence of additional bone formations( microcrystals);
- the presence of an inflammatory process.
Most often, an X-ray image shows a bone defect and a lack of uniform structure in the region of the head of the humerus.
The study can be supplemented by the introduction of a contrast agent into the joint cavity. In the case of damage to the cuff, the contrast agent goes beyond the joint.
CT is performed in the case of bone pathology, detected during X-rays. Modern technology allows you to get a 3D image of the joint.
The received data allow to estimate a spatial position of elements of a joint, presence of any additional formations, damage of muscles and their tendons.
Ultrasound is an informative and inexpensive method for diagnosing shoulder pathology. Advantages of the method:
- short study duration;
- no special training.
Magnetic resonance imaging
The method allows you to simultaneously consider the bones, muscles, tendons, ligaments, articular capsule, cartilaginous lip.
This technique allows you to diagnose any pathological condition of the shoulder-shoulder joint, even those that can not be recognized using the above methods: impingement syndrome, muscle retraction, etc.
Arthroscopy is a minimally invasive surgical procedure that allows finding the cause of the disease and, if necessary, removing it.
Indications for diagnostic arthroscopy:
- pain in the shoulder joint of an unclear etiology;
- limitation of active motions of unclear etiology.
Indications for medical arthroscopy:
- cuff pathology, which is revealed in diagnostic oratroscopy;
- impingement syndrome;
- free-standing body in the joint cavity;
- local cuff damage;
- extensive cuff damage in the event that an open intervention is contraindicated.
Contraindications to arthroscopy:
- severe general condition of the patient;
- purulent-inflammatory diseases of the hand, shoulder joint;
- contracture of the joint;
- categorical refusal of the patient from the operation.
Why do joints hurt?then it may be due to the deposition of salts. More information about the disease can be found here.
Do you have an intervertebral hernia? About the symptoms and methods of treatment of a hernia can be read here.
Treatment of humeroparous periarthritis ↑
Drug treatment and ointments
Even experienced specialists are wondering: how and what to treat a humeroscapular periarthritis?
Non-operative treatment is effective in patients with tendonosis, partial damage to the cuff of the shoulder in the initial stages, the "frozen" shoulder.
In such cases, the cuff muscles can contract, and the pain is caused by the reactive inflammation of the periarticular tissues.
Treatment is carried out in a specialized department under the supervision of an orthopedic physician and a physiotherapist. Inflammation and pain are stopped by medication and physiotherapy.
- analgesics( baralgin, analgin, tramal, etc.);
- non-steroidal anti-inflammatory drugs( ketorol, diclobber, nimesil, etc.);
- muscle relaxants of central action( midocals, etc.);
- chondroprotectors( structum, etc.).
Photo: drug structum
Non-steroidal preparations have a pronounced anti-inflammatory and analgesic effect.
By their strength of action, they resemble narcotic substances, but do not cause addiction.
However, they have a number of contraindications: gastric or duodenal ulcers, impaired liver and kidney function.
The effective way to treat spasticity( abnormal muscle contraction) is to reduce the increased muscle tone with the intake of muscle relaxants.
The use of midolma allows to reduce the dosage of anti-inflammatory drugs, and the structure suppresses the degradation of articular cartilage and helps to reduce pain.
Due to its effect, the drug improves the physiological function of the joint, reduces the amount of intra-articular fluid and reduces the need for anti-inflammatory drugs.
Blockade - injections diprospan to the sore point
Photo: injection drug Dispropan
To reduce the intensity of the pain syndrome helps block the suprascapal nerve, in the podkromialnoe space.
Diprospan is assigned no more than 2 times. The interval between injections should be at least 20 days.
A good effect is observed from the use of injections with a mixture of drugs: diprospan, flosteron, metipred.
The use of blockades can cause side effects: necrosis or atrophy of the skin at the injection site, loss of skin pigmentation, inflammation of the shoulder joint, accumulation of blood in the joint cavity, degeneration of the articular surfaces, degeneration of the tendons.
How to relieve pain effectively?
If the tablets are ineffective, you can try a Novocain blockade in the shoulder joint area. A positive effect is observed already in the first procedure.
Photo: Novocain in Injections
If necessary, the injection is repeated in combination with glucocorticoid preparations. Separately, novocaine is devoid of steroid medications and does not cause side effects. For a month it is permissible to use a blockade 2-3 times.
- The correction of the muscle tone of the cuff of the shoulder is achieved by the use of electrostimulation of groups of muscles of the shoulder, shoulder joint, and forearm.
- Laser therapy( parameters: power 0.1-300 mW / cm2, duration 5 minutes, treatment course 15 procedures).
- Ultrasound therapy with phonophoresis( 10-15 procedures for 10-15 minutes) - improves blood flow and promotes recovery and regeneration of periarticular tissues.
- Shockwave therapy - accelerates the restoration of damaged tissues, improves blood flow and relieves inflammation.
- Hydrotherapy( shower-massage for 15 minutes at a temperature of 37o C, treatment course 10 procedures).
- Muscle hypotrophy is eliminated by mechanotherapy and physiotherapy, mud therapy.
Restoration of normal joint function by magnet treatment. The duration of the promedura is 20-30 minutes, induction from 10 to 40 mT, the course of treatment is 20 procedures.
- eliminates pain syndrome;
- accelerates the regeneration of diseased tissues;
- increases immunity.
After conducting a course of conservative treatment it is recommended to exclude monotonous movements, which are associated with the removal of the arm to 60-70 degrees and flexion in the shoulder joint to 30-45 degrees.
It is necessary to repeat the course of physiotherapy every month.
In the case of degenerative changes and the absence of a positive effect of conservative treatment within 3 months, an operation is indicated.
Conservative treatment can not be effective if the anatomical integrity of muscles, tendons, or ligaments is compromised.
Therefore, in order to ensure the restoration of the function of the shoulder joint, it is necessary to conduct surgical treatment that allows restoring the continuity of the joint structures and eliminating the cause of the disease.
Indications for operation:
- inefficiency of conservative therapy for 3 months;
- partial damage of tendons with violation of the function of the supraspinatus;
- local and extensive damage to the tendon cuff;
- periosteal cuff damage;
- lesions, complicated inflammation of the main nervous structures( subscapular and radial nerves);
- tunnel syndrome.
Contraindications to operation:
- Presence of resistant joint contracture;
- pyoinflammatory diseases of any localization;
- severe general condition of the patient, which is a contraindication to anesthesia;
- refusal of operation;
- inability of the patient to carry out rehabilitation measures.
How to do a massage with scoliosis? You can find out about this here.
Alternative Therapies ↑
When treatment is not required to follow a special diet.
The main condition in proper nutrition is the intake of sufficient amounts of proteins and vitamins, which are necessary for the normal healing of diseased body tissues.
Is one of the effective methods of treating periarthritis. In 90% of cases, the disease can be cured after 15 sessions.
An even greater result can be obtained with a combination of this method with laser treatment, manual therapy, massage.
Treatment should be started after a 2-3 day break after blockade.
Treatment with folk remedies and at home
At home, a positive result can be achieved using folk methods:
- Decoction from an equal amount of chamomile, plantain leaves, peppermint and burdock root. The obtained medicine rubs the area of the patient's joint with light movements.
- Apply heated burdock leaves to the aching joint as a compress twice a day.
- Rub the joint area with tincture of calendula.
- Grate the root of the horseradish and preheat. The resulting gruel should be applied to the affected area twice a day.
- Prepare a saline solution by taking 100 grams of salt and a liter of water. Stir the salt until completely dissolved. The solution is heated and moistened with gauze. Obtain the bandage attached to the patient's joint for 2-3 hours.
- Prepare a collection of leaves of black currant, dog rose, raspberry and cowberry, taken in the proportions of 2: 1: 1: 1.Take 2 tablespoons of the mixture per liter of water, boil for 10 minutes and leave to infuse for 4 hours. The received drink should be taken 100 ml 4 times a day on an empty stomach.
- & lt; Honey apply a thin layer in the area of the affected joint. Then warm this area with a plastic wrap and a warm kerchief.
- Pour 40 g of dried nettle with a liter of boiling water and leave to infuse for 15 minutes. After filter and take three times a day.
Massage and self-massage
When periarthritis massage the area of the affected joint, back, collar zone, chest.
Massage allows you to eliminate pain, normalize muscle tone, restore joint mobility and prevent further development of the disease.
Contraindicated method during acute inflammation.
Swimming and gymnastics in the water
Swimming and hydrocolonotherapy are included in the list of desirable exercises during the rehabilitation period. It allows to normalize the muscle tone and increase the amplitude of movements in the affected joint.
Hirudotherapy and acupuncture
Therapeutic effect is possessed by hirudotherapy.
The only contraindication to its use is an allergic reaction in response to a leech bite.
Improvement is observed after 5-6 sessions.
An experienced specialist puts leeches on acupuncture points. This causes irritation of the sensory nerve, which contributes to the improvement of blood flow in the diseased organ, and the saliva of the medical leech pains pain, inflammation and relieves swelling.
Thanks to acupuncture and acupressure there is pain syndrome, the motor activity of the shoulder is restored, stiffness is eliminated, working capacity and quality of life is improved.
The difficulty in treating periarthritis in pregnant women is that the use of most drugs is contraindicated, as well as the use of physiotherapy procedures.
In this case, you need to consult with a specialist and choose the best course of non-drug treatment, folk methods, therapeutic gymnastics.
Rehabilitation after the main course of treatment should be carried out in a comprehensive manner and includes:
- use of medicines;
- phonophoresis, electrophoresis, UHF, paraffin applications;
- bath, etc.
Measures for disease prevention ↑
Prevention of periarthritis consists in the timely application of medical care in case of injury to the shoulder joint, if possible, remove from the daily life the monotonous movements in the joint( especially aside).
After the course of treatment it is necessary to periodically undergo a course of rehabilitation.
Frequently Asked Questions ↑
Which doctor should I contact?
Violation of the function of the shoulder joint is the reason for turning to an orthopedic traumatologist. In a number of cases, consultation with other specialists is required: a neurologist, a rheumatologist, a physiotherapist.
Is disability given?
In case of permanent irreversible violation of the function of the shoulder joint, when the operative treatment did not give a positive result, or during the operation there were complications that can not be treated, a disability group is formed.
Is it permissible for patients to visit the sauna?
Bath helps to normalize muscle tone, improves blood circulation in muscles. However, you can go to the bath only if there are no signs of acute inflammation. Strictly contraindicated bath immediately after getting injured.
Is it possible to warm the affected joint?
Thermal procedures help to improve blood circulation, normalize muscle tone and relieve pain syndrome. These properties are important in the treatment of humeroparous periarthritis. However, it must be remembered that during acute inflammation, the patient area is strictly prohibited from heating.
Does the disease occur in children?
In childhood, periarthritis is extremely rare, due to the good restorative capacity of the body and the absence of degeneration processes. The cause of the disease can serve as a serious injury to the shoulder joint.
Video: symptoms and treatment
douard, 38 years old:I have treated bilateral periarthritis for 4 months already: a course of treatment for a neurologist, surgeon. Complex treatment: ointments, massage, physiotherapy. No positive results. Have appointed or nominated blockade diprospanom. There is a fear of injecting because of the side effects of the drug. But, probably, it is necessary to risk - pains do not pass.
Inna, 40 years:This disease is very serious. Do not help ointments, pills. All to no avail. Even after the appointment of injections with dexamethasone it did not become easier. The motor ability of the hand has been lost: it is almost impossible to raise a hand or move it to the side. Physioprocedures are contraindicated because of some reasons. Almost I do not believe that I will be cured one day.
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- 04.03.2014 at 22:28
From ointments traumatologist orthopedist appointed ketonal cream! Voltaren called emulgel weak. . the effect was really not tried himself, in general, I have this disease passes through some stages, first it hurt a little to raise my hand, smeared Indovazin( good ointment! !) helps to relieve inflammation, in general the doctor advised ketonal cream, injections of diclofenac2ml 7 times, nicotinic acid 2ml 20 times!milgama 10 times, actovegin 20 times! !nanoplaster( well, I once bought it really shikotit but I do not know how it helps the current for a while)!well, and magnetotherapy did not help, it helps uniquely only ULTRASOUND WITH HYDROCARTISON, and most importantly LASER THERAPY! !!the most important thing is not to earn the ulcer while you are treating this periarthritis. .(
Treatment of periarthritis of the shoulder joint - Medical portal EUROLAB
Reasons for periarthritis of the shoulder joint
By periarthritis of the shoulder joint is understood a pain syndrome with increasing limitation of movements and development of drive contracture of the shoulder if there is no timely treatment. The disease is very common and covers about 3% of the population of males and females aged 40-60 years, among men it happens more often. Among chronic diseases of the shoulder girdle is about 60% of cases. The disease has a long course( one or two years) and in 20% of cases leads to loss of efficiency. The causes of periarthritis of the shoulder joint are still unknown. There are primary and secondary periarthritis. Occurrence of secondary periarthritis is often associated with trauma, such as bruise of the shoulder joint. The pathogenesis of the disease is also not completely established.
Three phases are conditionally distinguished during the course of the disease:
- , the first is the appearance of causeless pain on the anterior surface of the shoulder joint, in the zone of the large tubercle, without restriction of movements in the joint;
- in the second formed a leading contracture with restriction of rotational movements of the shoulder;
- the third phase, residual, is characterized by a reduction in pain and movement.
Duration of the disease from 12 to 18 months.
At this time patients complain of the appearance of spontaneous or post-traumatic pain on the front surface of the shoulder joint. Painful, can irradiate under the scapula, into the thoracic spine, especially with the retraction of the arm back with internal rotation.
How to treat the periarthritis of the shoulder joint?
In the early stages of periarthritis, non-steroidal anti-inflammatory drugs are prescribed to stop pain and eliminate jet inflammation, B vitamins, E and biostimulants.
Conduct reflexotherapy, recommend therapeutic exercise, compresses with 30% dimexide solution, previously lubricating the skin with heparin and hydrocortisone ointments and sprinkling it with powdered furazolidone. Assign physiotherapy methods of treatment - magnetotherapy, hydrocortisone folophoresis, amplipulse.
In the later stages, with the development of drive contracture of the shoulder, in addition to the therapeutic measures described above, a local blockade is performed with careful replication and placing the limb on the branch line with a gradual increase in the angle of retraction.
Assign a massage of the neck, shoulder, shoulder, shoulder.
At the stage of neglected pathology, surgical treatment is shown - selective capsulotomy. The capsule of the joint is crossed directly along the edge of the joint lip. After again, the treatment is performed with complete elimination of the actuating contracture of the shoulder. After the operation, the limb is placed on the bypass tire and physiotherapy methods are prescribed, physiotherapy methods.
With what diseases may be associated
Certain common diseases in the development of periarthritis are diabetes, tuberculosis, osteochondrosis of the cervical spine, chest pathology, and the like.
Treatment of periarthritis of the shoulder joint at home
Treatment of periarthritis is based on the conclusion of a profile physician. Treatment can be performed at home, only for physiotherapy procedures it is necessary to visit a specialized institution. If the doctor sees the meaning in the surgical intervention, the patient is hospitalized.
What are the treatments for periarthritis of the shoulder joint?
Drug therapy can be represented by:
- local blockade - novocaine or lidocaine;
- with dimexide, furazolidone, heparin ointment within the framework of physiotherapy;
- hydrocortisone - in the podkromialnuyu or in the fake region of 50-100 mg, the injection is repeated 5-10 days before the pain decreases;
Periarthritis of the shoulder joint: symptoms and treatment of the disease
Most often, the cervical brachial periarthritis occurs due to various injuries. But there are cases when the disease can develop after a myocardial infarction. It causes a spasm or die off of a group of vessels. Because of poor blood flow, tendons in the shoulder lose elasticity, become brittle, become inflamed and swell. Diseases of the liver also contribute to the development of the disease.
In women, shoulder-scapular periarthritis can develop after an operation to remove the breast. This also occurs due to deterioration of blood circulation and due to damage to blood vessels and nerves during surgery. Another reason is, of course, spine disease, mainly - the displacement of the intervertebral joints in the cervical vertebra.
Each disease, depending on the stage of development, has its own specific symptoms: periarthritis of the shoulder joints is an exception. Specialists distinguish 4 types of ailment with certain signs. The main indicator, suitable for all types of malaise, is shoulder pain. To determine exactly at what stage the humerous periarthritis is located, it is necessary to consult a specialist.
To clarify the diagnosis, the doctor will need an X-ray of the shoulder joint , with which you can also track the healing process. The blood test for this disease is always normal and without abnormalities. Only in the acute course of the disease there is an increased level of inflammatory factor of ESR and C-reactive protein.
Simple periarthritis of the shoulder
Simple periarthritis of the shoulder is the easiest form of the disease. Begins the ailment with a weak pain in the shoulder. It manifests itself mainly when you raise your hand or try to get your hand behind your back and touch the spine. Limited mobility of the joint, perform the action is completely difficult. If you do not disturb the affected area, then unpleasant feelings recede.
To clarify the diagnosis, your doctor may suggest the following experiment: you will raise a sore arm, and he will "stop" you from performing this action. If this pain is significantly increased with this resistance, then you have a simple periarthritis of the shoulder.
If the treatment fails on time, the periarthritis becomes acute. Mobility of the hand is limited even more. Attempts to raise a hand or to take it aside are accompanied by pain, which only increases with time. But at the same time a man easily raises his hand up, but only ahead of himself. According to this indicator, a doctor can quickly diagnose.
Also, shoulder periarthritis has the following symptoms:
- exacerbation of pain in the morning and evening hours;
- increase in temperature to 37 degrees and above;
- inflammation factors determined by blood analysis.
Symptoms: shoulder bladder periarthritis causes the patient to press a bent arm to the trunk. Thus, unpleasant sensations become minimal . If the disease is left untreated, it can last several weeks, causing discomfort to the person. And after the illness goes into a heavier form.
Chronic periarthritis of the shoulder
Almost every disease has its chronic stage, not an exception and a shoulder periarthritis. Without proper medical care, the disease progresses and in the future is very difficult to treat. The main signs of the transition of the disease to the chronic stage are:
- reduction of pain;
- discomfort in the shoulder in the morning and evening;
- rare "lumbago" with an awkward shoulder movement.
At this stage, a person has a worsening of sleep due to night and morning pain. Internal tissues in the shoulder joint are depleted as much as possible, which is why a "chamber" occurs. At this stage, the ailment can stop itself, then there is no need for medical intervention and treatment: the periarthritis of the shoulder joint retreats, and the person quickly goes on to recover. Remission occurs in 70% of cases, but there is a possibility of ankylosis.
Ankylosing periarthritis of the shoulder( adhesive capsulitis)
In 30% of cases, the disease can pass into ankylosing periarthritis. In this case, treatment of shoulder periarthritis is impossible. This is due to all the processes that all this time influenced the shoulder. Gradually, the bones in the joint begin to coalesce. As a result of the process, ankylosis is formed, which completely blocks movement.
Unpleasant feelings are dull and tolerant, but the ailment practically makes a person disabled, depriving him of working capacity. In people, ankylosis is called a "frozen shoulder". In some cases, any movement of the joint can cause severe pain.
Gradually, the following actions become impossible for the patient:
- lifting arms to shoulder level;
- lifting hands to the side more than 20 degrees;
- putting your hand behind your back;
- rotation of the shoulder joint.
Undoubtedly, all these violations strongly affect the ordinary way of life of a person. Do not give to do not only your favorite things, but also work trivially. Therefore, in no case should the treatment of the shoulder of the scapular periarthritis be initiated.
There are two approaches to how to treat the periarthritis of the shoulder joint: traditional medicine or folk remedies. First of all, it is necessary to understand that it is impossible to completely exclude the help of a doctor. It is he who must correctly diagnose and prescribe the treatment: shoulder blade periarthritis can be stopped with folk remedies, but only in conjunction with medicines.
Many people are afraid to go to the doctor or do not pay enough attention to their ailments. As a result, this ailment is only aggravated. Usually, specialists prescribe hormonal drugs to their patients or recommend special compresses to eradicate the periarthritis of the face: the treatment depends mainly on the stage of the disease and the patient's capabilities.
Treatment of periarthritis with shoulder joint should be monitored by the attending physician. You can hurt yourself without knowing the dosage and dosage regimen.
Today there are dozens of recipes for folk medicine that can help with almost all diseases, not an exception and periarthritis of the shoulder joint: treatment with folk remedies can take place both with tinctures, and with the help of a special bath or bandage. Everyone can find their own recipe, which corrects the shaken health.
One of the most popular and effective methods is the use of a special herbal compress. Prepare it will not be particularly difficult for anyone, but at the same time it will cope well with the disease. For the recipe, you will need:
- 1 part medicinal marshmallow( grass);
- 2 parts of chamomile pharmacy;
- 2 parts of the sweet clover.
All the herbs well chop and add boiling water so much to make a messy mixture. After placing the mixture on a clean folded several times a bandage or a napkin, place another hot compress on the shoulder. Try to keep the heat as long as possible. To do this, use food film and woolen shawl.
Very popular in the people are compresses based on honey. They are a universal medicine for all kinds of periarthritis. Take a little honey and apply a thin layer in the shoulder area, as well as around the diseased area: clavicle, scapula and forearm. After cover all the film and insulate. The compress should be left overnight.
Before you treat compresses, check to see if you are allergic to the ingredients. To do this, first cover a small area of the skin, and if you see irritation and redness, then you should abandon this method.
The bath with the use of natural ingredients not only relax after a hard day, but also help to carry out the necessary treatment: the shoulder of the scapular periarthritis also lends itself to this effect. Especially interesting is the recipe using hay. Experts say that it has healing properties and helps with various diseases, and the bath with it is prepared very easily.
You will need about 600 grams of trash per 10 liters of water. Then follow the recipe:
- take the right amount of medication and fill it with water;
- put on medium heat and bring to a boil;
- remove from the plate and put to infuse for 45 minutes;
- strain the infusion and add it to the prepared bath.
The water temperature should be within 38 degrees. Take such a bath should not more than 20 minutes.
Various bandages are popular. They are well fixed on the shoulder and are easy to use. But it is far from always possible to find the necessary grass and start treatment with folk remedies: then the humerous periarthritis can be cured and improvised by means that are in the house of each person. For this you only need: salt, water and gauze.
First of all, prepare a saline solution: take 100 g of salt per 1 liter of water, stir until complete dissolution. Put the gauze folded into eight layers( you can flax cloth) and heat the solution so that the gauze can be extracted without burning. Apply a hot bandage to the shoulder joint and fix it with a handkerchief. The bandage is recommended to be applied for two weeks before bedtime.
Medical gymnastics with shoulder blade periarthritis can be performed even at work and exercises will not take you much time. When you have free time, sitting on a chair, perform the following movements:
- raise and lower your shoulders;
- , put your hands in the "lock" and lift them forward and up;
- hands are closed again, bend them ahead of themselves to each shoulder;
- hands in the "lock", pull their palms outward first forward and up, then forward and down;
- shake a relaxed hand along the body.
Already at home you can do other exercises aimed at restoring the mobility of the shoulder, but it is better to attend special classes. So you do not hurt yourself and do not overdo it. Shoulder periarthritis is better to begin to treat with gymnastics as early as possible , so that the disease does not worsen. It is also recommended to attend massage and manual therapy, especially after exercise therapy.
Pleuralopathy periarthritis - treatment with various methods
Pleuralopathy periarthritis is an inflammation of the capsule and tendons of the shoulder joint. This disease, along with arthritis and arthrosis, is often the cause of shoulder pain. When the diagnosis of humeropathy periarthritis should begin treatment as early as possible, until the disease is not started. Only if this condition is met can you expect a good result.
Therapy should primarily be directed to the cause of the
- disease of the shoulder joint( shoulder-blow, fall on the shoulder or outstretched arm);
- excessive physical stress on the shoulder joint;
- long uncommon activity with shoulder strain;
- diseases of the cardiovascular system( myocardial infarction, for example, leads to a violation of microcirculation in the joint, micro-obstructions of the tendons of the shoulder and their inflammation);
- liver disease( can cause humeroscapular periarthritis on the right);
- pathology of the cervical spine( displacement of the intervertebral cervical discs, radiculitis, intervertebral hernia);
- radical mastectomy, or removal of the mammary gland( possibly damaging the blood vessels and nerve trunks, as well as changing microcirculation).
When establishing the diagnosis, it is important to relieve the load on the shoulder joint by immobilizing the affected limb. This is achieved by applying a suspending gauze bandage or a wire bar. Immobilization is necessary until the elimination of bright signs of inflammation. Longer immobilization can lead to the development of stiffness in the joint, which will significantly prolong disability.
In case of periarthritis of the shoulder joint, medical treatment is required: the medications necessary in a specific case are prescribed by a doctor traumatologist or orthopedist. Almost always prescribed painkillers and anti-inflammatory drugs - non-steroidal analgesics. These drugs can be taken not only inside, but also used for local treatment in the form of ointments or gels. With severe pain, the periarticular tissues of the humeroscapular region are treated with a solution of anesthetic( blockade) and glucocorticoid hormones, which have a strong anti-inflammatory property. The anesthetic, by which the joint region is cut, prevents the development of pain contracture, when movements in the joint become impossible due to severe pain. Injections are repeated every 5-10 days until the pain subsides. As a rule, hormones have a fast and good result, so the treatment course is only 2-3 injections, and sometimes only a single injection is required. Hormonal drugs in some cases are prescribed for oral administration. If the cause of the disease is the violation of the blood supply to the joint, then angioprotectors and drugs that improve blood microcirculation in tissues are used.
Physiotherapy takes an important place in the therapy of humeroparous periarthritis. The following methods are used:
- Shockwave therapy - accelerates the regeneration of damaged tissues, strengthens local blood flow, which leads to a reduction in inflammatory phenomena.
- Ultrasound - relieves pain when using ultrasound waves of high or low frequency. Ultrasonic vibrations are transmitted to inflamed tissues and vessels, causing their relaxation. Local heating improves blood flow and promotes the restoration of periarticular tissues.
- Percutaneous electrostimulation - reduces inflammation and pain. The properties of this method are based on the interruption of pain impulses from the capsule of the shoulder joint to nerve fibers.
- Magnetotherapy, laser therapy - reduce pain, increase immune defense, accelerate the regeneration of tissues.
During the rehabilitation period, spa treatment with radon and hydrosulphuric baths
is shown. In addition to the above methods, acupuncture, acupressure, electrophoresis, mud applications, and quartz lamp irradiation can be used. A good effect is possessed by hot compresses on the area of the shoulder joint. Physiotherapy methods are never prescribed as monotherapy. They are always combined with medicinal treatment and therapeutic gymnastics. To decide how to treat periarthritis, by what methods of physiotherapy and in what combination are they, the doctor should know the form and stage of the disease.
In the treatment of shoulder periarthritis, exercise therapy often plays a key role. With the help of special exercises you can achieve a reduction in pain, improve the elasticity of the joint capsule of the shoulder, increase mobility in the joint and strengthen the surrounding muscles. The complex of exercises for periarthritis of the shoulder the doctor makes individually for each patient. To achieve the best result when performing exercises, you must follow certain rules:
- gymnastics should be practiced after the end of the course of physiotherapy;
- exercises must be performed in the same order;
- classes should be regular and conducted approximately at the same time;
- should gradually increase the load on the joint and eventually expand the set of exercises.
Physiotherapy exercises with shoulder periarthritis include the following exercises:
- Squeezing and unclenching of hands in the hands.
- Flexion and extensor movements of the arms in the wrist joint, circular movements around it.
- Turns your hands palm up and down.
- Touching the fingers of the opposite shoulder.
- Hand movement to the sides with simultaneous rotation of the hands.
- Alternately raising hands up.
- Pressing the palms on a hard surface( cabinet, wall).
- Little jerks by hand.
- Rotational movements of the arms around the elbow joints alternately in both directions.
- Circular rotation of the arms in the shoulder region back and forth alternately.
- Place an arm behind the back and touch it with the fingers of the opposite shoulder blade.
- With the torso tilted with one hand, try to reach the fingers of the opposite leg, the second hand is at the same time maximally raised.
- Moves to the standing position from the sitting position with the simultaneous dilution of the hands to the sides. Then return to a sitting position with the movement of the palms on the knees.
- Consecutive movements by hands: pulling forward, lifting up, diluting them to the sides and lowering "at the seams".
- Tilt forward with free dangling of hands to the floor( gravity is relaxed by the capsule of the shoulder joint).
- Tilt forward with the emphasis of a healthy hand on the back of the chair. The back should be relaxed while the lowered affected hand performs pendulum movements.
Each exercise should be performed 6-10 times. Daily should be allocated for therapeutic gymnastics for about half an hour. It is advisable to conduct classes in the morning or in the daytime. Even the lightest exercises can significantly improve mobility in the joint and reduce discomfort during movement. More complex exercises can recommend a doctor. Of particular importance is the method of so-called post-isometric relaxation. Its essence lies in the short-term isometric operation of the shoulder muscles with minimal effort( 5-10 s) and subsequent passive stretching during the same time. This combination is repeated 3 to 6 times, after which there is a steady decrease in muscle tone( hypotension) and pain disappears. To obtain a noticeable effect, you must strictly observe the minimum intensity of muscular work and the time of execution. The isometric work of the musculature of the shoulder can be achieved with the help of elementary movements.
Tip: With periarthritis of the shoulder joint, do not exercise anything without the advice of a doctor.
Inadequate loading can worsen the condition of the periarticular tissues and lead to increased pain and progression of inflammation.
Traditional methods of treatment
With the diagnosis of periarthritis of the shoulder joint, you can try folk remedies. Traditional medicine suggests using for this purpose different plants for grinding, compresses and lotions on the joint area. Here are a few ways:
- Prepare a decoction of chamomile, peppermint, psyllium leaves and burdock root taken in equal amounts. Cooked broth triturate the shoulder joint area with light massaging movements.
- Heated leaves of burdock are applied to the painful shoulder in the form of a compress 2 times a day.
- For grinding the joint area use the calendula tincture. It can be purchased at the pharmacy or cooked at home: 50 g of flowers should take 500 ml of vodka and infuse the liquid for two weeks.
- For a compress, you can use a heated mash prepared from the root of the horseradish. Before use, the ground mass should be heated, wrapped in gauze and applied to the affected shoulder 2 times a day.
From non-traditional methods of medicine it is possible to note hirudotherapy - treatment by leeches, which are placed on the shoulder in the area of the lesion. There are almost no contraindications for this method, except for the onset of an allergic reaction.
Important: Before using a humerous periarthritis to start a folk remedy, consult a doctor. Some drugs may be contraindicated in various forms of periarthritis.
Surgical intervention is necessary for long-term maintenance of pain, frequent relapses and severe limitation of mobility in the shoulder joint, until the loss of its motor function is completely lost. The operation with this disease is in subacromial decompression. The surgeon removes a small part of the scapula( acromion) and one of the ligaments. Due to this interference, surrounding tissues cease to injure each other during movements, and the painful contracture disappears. If fibrotic contracture develops, then an arthrotomy is performed - dissection of the joint capsule.
The operation is recommended in cases when conservative therapy is ineffective
As a result of the operation, the patient is able to again perform free movements in the shoulder, the function of the joint is restored completely or in a significant amount. After surgery, the patient is given a restorative treatment, the basis of which is exercise therapy. With a successful operation and no complications, the work capacity is restored in about 3 months. Treatment of periarthritis of the shoulder joint should be complex, that is, include various methods. Usually, drug therapy is combined with physiotherapy procedures. After the abatement of the inflammatory process, conservative treatment is complemented by therapeutic gymnastics, which restores the functions of the shoulder joint. If necessary, surgical intervention should be performed.
Important: if you suspect a humeropathy periarthritis, you should not take the medicine before consulting a specialist.
Painkillers obscure the clinical picture of the disease, which can lead to diagnostic errors. In addition, most non-steroidal analgesics have a lot of side effects that must be taken into account when using them.
With timely access to medical care, humerus periarthritis is well suited for conservative therapy. In this case, the functions of the shoulder joint are quickly restored, and the person returns to a full life. Late treatment to the doctor and self-medication lead to progression of the disease and worsening of the long-term results of treatment. The duration of therapy increases, and conservative treatment becomes less effective. In severe cases, surgical intervention is required. Despite this, the prognosis of the humeroparous periarthritis remains favorable in most cases.