28.11.2020

Scapulohumeral periarthritis

Scapulohumeral periarthritis is an inflammatory process, causing degenerative changes in the areas that surround the shoulder (the periosteum, tendons, joint capsule). They are deposited lime salts. The joint cannot function normally, as any movement when the disease accompanied by aching.

Pathology develops in stages. If time does not begin effective therapy, the inflammation can lead to disability. Therefore, it is important to detect the disease and begin immediate treatment to save the joint.

Pathogenesis

The opinions of experts in the reason why frozen shoulder develops, diverge. There are two assumptions:

  1. Frozen shoulder is formed due to prolonged microtemperature muscle tissue and tendons that occurs as a result of cyclic stress. For example, when the monotonous work, the blow to the shoulder, falling on a hand and so on. Consequently, the tissue is disrupted the exchange process, which leads to dystrophic changes.
  2. Frozen shoulder develops as a result of neurodystrophic changes of the tendon fibers, which arise due to accompanying pathological conditions (degenerative disc disease of the cervical spine, cervical spondylosis, displacement of the intervertebral joints). This leads to pinched nerves, a reflex spasm of the vessels (leading to poor circulation of blood fluid), dystrophy and reactive inflammatory condition of the tendon fibers of the joint.

Most doctors adhere to both points of view. Under the influence of both these factors in the tissue begin to accumulate metabolic products, which provoke the inflammatory process. Bad fall or blow to the shoulder only to reveal a hidden pathology which did not previously felt.

Symptoms

There are 2 symptoms that are observed in the disease: pain and limited movement. But in various forms of shoulder periarthritis they manifest themselves in different ways. There are the following types of inflammation:

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  • simple;
  • sharp;
  • chronic;
  • ankylosing.

Syndrome frozen shoulder periarthritis can affect one side of the shoulder, and both.

Simple form

This inflammatory process is considered to be the beginning of the development of pathology. It is characterized by the following clinical picture:

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  • in the region of the shoulder occurs mild pain;
  • the limited movement observed in the abduction of the extended limb to the side, the school folded his hands behind his back;
  • under rotations of the arm around its axis, overcoming the resistance, pain becomes stronger. Rotational motion without opposition does not cause discomfort.

The patient may not even be aware of the inflammatory process, as the symptoms are quite mild. A simple form of disease lasts 2-4 weeks. At complete rest and no load on the shoulder can pass on their own. If this does not occur, the disease takes acute.

The acute form

This kind of shoulder periarthritis can occur in the absence of treatment in simple type, or as an independent disease.

It is characterized by the following clinical picture:

  • the pain becomes sharp and strong;
  • discomfort spread in the cervical, across the hand;
  • pain syndrome increases with the attempts of rotation of the outstretched hand in the abduction of the limb is straightened up through the side, while raising your arms forward causes pain;
  • pain syndrome increases in night-time, which is sleep disorder;
  • the pain recedes if to bend the limb and pressed to the chest;
  • on palpation the swelling is observed in the front of the shoulder;
  • may increase the body temperature to 37-37,5 degrees.

This condition can last for several weeks. If you do not take any action, scapulohumeral periarthritis becomes chronic.

The chronic form

The disease is chronic type is characterised by the following:

  • the pain is minor and is aching in nature;
  • pain syndrome increases with the rotation or the wrong movement to predict its occurrence is impossible, it becomes a sharp, shooting;
  • during a night of rest (especially in the morning) there is an ache in the shoulder that does not sleep.

Chronic pathological condition may last for several months or even years. As a rule, without medical intervention, it switches to the ankylosing form.

Ankylosing form

Is the end stage of humeroscapular periarthritis. But in some cases it may occur as a primary disease. For it is peculiar:

  • dull, aching, not severe pain, but when I try to perform the movement, it is enhanced;
  • movements become restricted (hand does not rise above the horizontal position to the side);
  • fabrics are compacted, it is evident on palpation;
  • in some cases this form may take place without pain, but limitation of movement is present.

If you don’t get time to treat the frozen shoulder can cause severe complications. They can lead to disability for life.

Diagnosis of humeroscapular periarthritis

In the primary treatment in a medical institution, the doctor collects the history of the disease. With palpation it determines the character of the pain, presence of swelling.

To confirm the diagnosis assigned to the following diagnostics:

  • radiography;
  • computed tomography;
  • ultrasound examination;
  • magnetic resonance imaging;
  • arthrogram.
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If necessary, can be assigned to arthrocentesis with synovial fluid study. If you are experiencing symptoms of a neurological nature, conduct electromyographic study. Only after all the necessary diagnostic procedures, the specialist can make an accurate diagnosis and to appoint adequate treatment.

Treatment of humeroscapular periarthritis

For the treatment of a pathological condition are used as methods of traditional medicine and folk remedies. Therapeutic activities usually conducted on an outpatient basis and do not require hospitalization. Treatment is aimed at addressing the symptoms of humeroscapular periarthritis and the reasons of its origin.

To traditional methods of treatment include the following:

  • the use of medications;
  • chiropractic;
  • relaxation exercises;
  • surgery.
Drugs

For the treatment of adult patients with different forms of medicines:

  • pills and capsules;
  • vials of solution for injection for intramuscular, intraarticular;
  • gels and ointments for external use.

Conservative treatment is carried out only under the supervision of a qualified professional. To take any medication without his or her purpose is strictly prohibited. Self you can only worsen the pathological condition and cause severe complications.With timely treatment in a medical institution for qualified help, a good therapeutic outcome is the use of non-steroidal anti-inflammatory drugs. When severe pain and the acute inflammatory process is the blockade of the shoulder joint with the help of hormonal medications, Novocaine, Lidocaine.

Often with scapulohumeral periarthritis is assigned to the following nonsteroidal anti-inflammatory drugs:

  • Ketorol;
  • Dikloberl;
  • Nimesil and other.

These drugs in the short term eliminate the pain, but corrosive effect on the gastrointestinal tract. Therefore, the therapy of humeroscapular periarthritis does not exceed two weeks.

Medicines have contraindications:

  • ulcers disease stomach and duodenal ulcers;
  • the pathological state of the liver and kidneys;
  • gastritis and hyperacidity.

If treatment with nonsteroidal anti-inflammatory drugs did not give a proper result, appointed corticosteroids (hormonal drugs). As these medicines have side effects, taken orally, is not recommended. Therefore, they were appointed by intramuscular, intra-articular injection that can only be done by a qualified medical professional.

80% of patients after these injections disappears the unpleasant symptoms of humeroscapular periarthritis, inflammatory process stops. For this purpose it is enough only 1-3 injections with a small amount of time. The use of such medicines as Flosteron, Diprospan.

If treatment anti-inflammatory drugs and corticosteroid injections to no avail, it is blockade of Novocaine or Lidocaine. The shot is injected into the shoulder joint. The course of treatment is 1-3 treatments per month with an equal amount of time. The doctor looks after the first shot as quickly eliminates pain and returns the joint flexibility. If the action of Procaine and Lidocaine is not satisfactory, the injections add corticosteroids (Hydrocortisone, Kenalog).

A range of health exercises for scapulohumeral periarthritis

Before running you need to warm up the ligaments and muscles. To do massage on the neck, arm, shoulder. In addition to heating, the procedure also helps to eliminate the reflex contracture (immobility). Technique will show any massage therapist.

Before therapeutic exercises needed relaxation. Take a warm bath or just lie dormant. Then take a short five-minute warm-up.

Exercise with scapulohumeral periarthritis in the position lying on the back:

  • to compress and unclench her hands, to shake the fingers;
  • flexion and extension of the wrist;
  • put your hands parallel to the torso and rotate the palms up and down;
  • to lower the upper limb along the body, on the breath to bring the brush to the shoulders, the lower the exhalation;
  • to put tassels on the shoulders (elbows should be in front of him), on the inhale raise the elbows, exhale return to the starting position;
  • arms straight, twist your palms and raise the limbs out to the sides until, until you feel discomfort;
  • raise the arms turns up;
  • raise your hands to the ceiling and shake them well.

Basic relaxation exercises in scapulohumeral periarthritis are done sitting on a chair, resting the spine on the back. If the complex is effected on the one hand, all manipulations must first perform a healthy limb to view their range of motion and then copy it.

Done the following exercises:

  • put hands on waist, hands to dissolve in hand, start to slowly reduce them;
  • hands at waist, rotate shoulders in both directions;
  • press the elbow of the patient hands to the chest (while holding the brush on the shoulder), pull it up a healthy limb so that it slid over her Breasts, until my muscles will tense up (this should not cause pain);
  • on the inhale bend your arms, exhale to waggle them;
  • inhale to lower and raise the limb, expiratory wave;
  • to have his hand behind his back, raise his hand to the blade;
  • to do the tilt and rotation of the head.

Standing exercises with scapulohumeral periarthritis:

  • slowly rotate the hands back to the horizontal position in front of you;
  • relaxed and waving at the bottom (one extremity of the back, other in front);
  • walk about the room leisurely pace while waving his arms.

The complex of gymnastic exercises for scapulohumeral periarthritis starts in a lying position. Only then can you move into position, sitting and standing.

Surgery

It is used if medication and physical therapy did not help. Indications for surgery are:

  • continuous pain even after the blockade;
  • the development of purulent process in the joint and deformation of the tissue;
  • the desire of patient not to change the usual lifestyle, which required constant movement in the shoulder joint (for chronic and ankylosing periartroz he loses).

Surgery performed by arthroscope – through micro incisions with the use of optics and instruments, the surgeon removes the deformed tissue, restores damaged structure.

Non-traditional methods of treatment

Can only be applied in the complex therapy and in the early stages of development of the pathological state.

To eliminate the symptoms of periarthritis you can use the following recipes:

  1. Mix equal quantities of yarrow, St. John’s wort, rosehips, lingonberry leaves and currants. Take 1 tbsp. l. collection and pour 200 ml of boiling water. Allow the tea to cool. To drink it every day.
  2. At home you can make compresses, rubbing that warm up the joint.
  3. Spread on a given area of the med. Shoulder wrap with cellophane and wrap with a warm cloth. Leave the compress on the night.
  4. Applied to the diseased area of the leaves of burdock or cabbage. Keep them as long as possible (while registering).

There are plenty of recipes alternative medicine to treat the symptoms of humeroscapular periarthritis. Any of them must be approved by the doctor.

Preventive measures

To prevent the risk of developing the disease is necessary to observe following recommendations:

  • not to overload the spine and the shoulders uneven exercise;
  • to avoid injury of shoulder area;
  • daily to make a complex of exercises for development of mobility of humeral joints;
  • to go on a healthy diet with vitamins, minerals, fiber, calcium;
  • sleep on orthopedic pillows and mattresses;
  • keep your back straight when working at the computer, driving, etc.;
  • to comply with the order of the day.

The disease is always easier to prevent than to spend a lot of time and money for his treatment.

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