Humeroscapular periarthrosis. Causes, symptoms and treatment

Symptoms and diagnosis

The main sign of the onset of the disease is pain.
It affects the muscles attached to the joint. Typically, patients complain of pain that occurs during certain types of stress (at the onset of the disease), as well as at rest and even at night (with chronicity of the process). Quite often, the disease occurs in representatives of professions whose work involves constant stress on the shoulder joint, and people actively involved in sports. Many people with shoulder periarthritis have osteochondrosis of the cervical spine. Diagnosis is usually relatively simple; characteristic complaints and simple diagnostic tests indicate the presence of an inflammatory process. To get a complete picture, your doctor may prescribe an x-ray or tomogram. It is important to distinguish between pain that occurs during periarthritis and arthrosis of the shoulder joint (which is sometimes mistakenly called glenohumeral periarthrosis). In the second case, changes in articular tissues are degenerative in nature and cannot be completely cured.

3.Classification

The classification of this disease covers the symmetry of its manifestations. There are: right-sided, left-sided and bilateral glenohumeral periarthrosis. If the disease has developed as a result of constant external influence on one shoulder, then the remaining joints can remain healthy and not cause concern. In the case of the presence of any underlying disease associated with dystrophic changes in the musculoskeletal and connective tissue apparatus, at a certain age, disorders of joint mobility are likely to manifest themselves in multiple ways. The symmetrical type of glenohumeral periarthrosis, however, often leads to different pain and functional manifestations on the left and right shoulder.

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Types of treatment for glenohumeral periarthritis

The effectiveness of therapy largely depends on how correctly the cause of the disease has been identified. For example, if the inflammatory process started as a result of osteochondrosis of the cervical spine, then in addition to standard anti-inflammatory therapy, agents are used that improve the nutrition of nerve fibers and relieve muscle spasms.

The main task in the treatment of glenohumeral periarthritis is to relieve inflammation of the periarticular tissues and improve mobility in the joint.

They usually start with non-steroidal anti-inflammatory drugs orally and locally, in the form of ointments. Most often prescribed:

• diclofenac;
• piroxicam;
• ketoprofen;
• meloxicam;
• Celebrex.

For a mild form of the disease, this may be sufficient.

Blockades with diprospan have a good effect. They have a powerful anti-inflammatory effect and are applied to painful points near the joint.

The effectiveness of injections in the treatment of glenohumeral periarthritis can be increased by using other therapeutic measures in parallel with them - in particular, kinesiotaping, special exercises aimed at improving joint mobility, and physiotherapy.

Limiting the load on the affected joint is also an important step towards recovery.

Diagnostics

During the examination, the doctor pays attention to: the symmetry of the shoulder girdle and shoulder joints; expressiveness of the muscles of the shoulder girdle; presence of bony protrusions. When palpated, there is pain in the area of ​​the affected joint, above the shoulder blade, along the outer surface of the shoulder. There is pain in both bone protrusions and joints and muscles. X-ray examination of the shoulder joint in various projections is of great diagnostic importance. The picture is taken at rest, with the arm rotated inward or outward, and with the shoulder abducted. A CT scan is performed in case of bone pathology detected during radiography. Modern technologies make it possible to obtain a 3D image of the joint. Ultrasound is an informative and inexpensive method for diagnosing pathologies of the shoulder joint. MRI allows you to simultaneously examine bones, muscles, tendons, ligaments, joint capsule, and cartilaginous lip.

Inspection

When examined, there are usually no external changes. During palpation, painful points are determined along the anterior, lateral or posterior surface of the shoulder joint at the attachment points of the rotator cuff muscles. Movement in the shoulder joint is painful. Characterized by greater pain during active (which the patient himself makes) movements, while passive movements (which the doctor makes with the patient’s limb) are less painful. Simple functional tests can help determine which rotator cuff muscles are inflamed.

If the supraspinatus tendon is affected, abduction of the shoulder is painful. The appearance of pain only at the beginning and at the end of movement indicates inflammation of the serous bursa located under the acromial process of the scapula (subacromial bursitis). Nowadays this condition is more often called impingement syndrome.

Pain during external rotation of the shoulder (trying to comb one's hair) indicates damage to the tendons of the infraspinatus and teres minor muscles.

Placing the arm behind the back (internal rotation of the shoulder) indicates inflammation of the subscapularis tendon.

Flexion at the elbow joint and supination of the forearm, reminiscent of turning a key in a lock (the doctor resists this movement), indicates damage to the tendon of the head of the biceps.

With painful passive movements in the shoulder joint, as in the photo below, you can think about damage to the shoulder joint itself (arthrosis, arthritis).

Clarifying which muscle is affected can be useful when carrying out blockades.

Disease prevention

The best methods for preventing glenohumeral periarthritis are massage and special physical exercises. Let's give a few examples of the latter.

1. In a sitting position, bend your arms at the elbows, place them on your waist and move your shoulders back and forth.
2. In the same position, make circular movements with the stoves - smoothly and slowly.
3. In a sitting position, they put their hands behind their backs, trying to reach the fingers of one hand with the other and clasp them into a “lock”.

If you still experience pain in the shoulder girdle, make an appointment at the shock wave therapy clinic “Medical Center Health”. Express diagnostics, experienced specialists, individual treatment regimens, UVT course - by contacting this clinic, you will receive an effective solution to your problem.

Prevention methods

The main preventive method is reasonable physical activity. If professional duties require stress, you need to remember about rest and relaxation. It is also important to monitor the condition of the spine, because incorrect position of the neck and back for a long time can also cause the disease. Excessive sports loads can lead to sprains, torn ligaments and muscles, and other types of injuries - so it is better to conduct training under the guidance of experienced trainers.

Remember: with glenohumeral periarthritis of the shoulder joint, the pain can be so severe that it will prevent you from doing your usual activities. It is better to prevent a disease than to treat it.

If the disease does affect you, and you are bothered by pain when raising your arms or putting your hand behind your back, do not put off visiting a doctor. The sooner therapy is started, the greater the chance that you will be able to get rid of unpleasant symptoms quickly and completely.

Registration for treatment of glenohumeral periarthritis in our clinic in Moscow is made by calling the numbers listed on the website. Waiting for you!

Periarthritis humeroscapular

Humeral periarthritis is an inflammation of the periarticular structures of the shoulder, muscles, ligaments, which can occur due to injuries, excessive stress or unbalanced work of the shoulder girdle due to physical inactivity. The disease is accompanied by swelling and pain when moving. The pain intensifies when trying to raise the arm or move it back, and can radiate to the neck and shoulder blade. In chronic periarthritis, shoulder pain provokes headaches. Most often, people whose activities involve long periods of sitting at a desk or monotonous workload suffer from periarthritis.

When treating periarthritis, doctors recommend rest, immobilization of the limb, painkillers in the form of tablets and blockades. These conservative methods relieve pain, but are not a cure for periarthritis. In this case, symptomatic treatment is carried out, influencing the consequences, but the cause of the disease remains unresolved. And as a rule, the range of motion in the joint remains limited.

A sedentary lifestyle, sedentary work, and incorrect posture contribute to the development of muscle spasms in the shoulder girdle - deep muscles are forced to compensate for the load that occurs when the body is in an unnatural position. In spasmed muscles, nutrition is disrupted, tissue trophism suffers, the body loses the ability to cope with inflammation on its own, and pain appears.

After the onset of pain, a person tries even more to minimize physical activity. But such tactics further aggravate the situation; a vicious circle results, inflammation progresses, and the disease can develop into a chronic form.

Therefore, after relief of acute pain, it is necessary to immediately begin the process of treatment and rehabilitation so that the joint does not lose mobility.

Dr. Bubnovsky’s Center has accumulated vast experience in treating periarthritis of the shoulder joint with the help of properly selected physical activity.

Kinesitherapy helps get rid of muscle spasms, restores joint mobility and relieves pain.

Treatment begins with the kinesitherapist conducting myofascial diagnostics and testing shoulder mobility on a Bubnovsky multifunctional simulator (MTB). Then, based on the examination, an exercise program is developed taking into account the individual characteristics of the patient.

Classes are held in the kinesitherapy room on a special anti-gravity Bubnovsky simulator, the block mechanism of which is designed to perform exercises in decompression mode.

Therapeutic exercises activate the muscles of the shoulder girdle, normalize blood and lymph flow, helping the body cope with inflammation using its internal reserves without medications.

The center's instructors help you master the biomechanics of performing exercises and also teach patients the technique of diaphragmatic breathing. The kinesiotherapist conducts repeated examinations and adds new exercises to the training program.

The specialists at Dr. Bubnovsky’s center have been successfully treating various joint diseases for more than 20 years.

Treatment

Treatment should begin at the earliest stages of the disease - only in this case is it possible to preserve the function of the affected upper limb. In the treatment of the disease, physical therapy and physiotherapy become important. Exercise therapy for glenohumeral periarthrosis helps reduce pain, increase the elasticity of the joint capsule, increase joint mobility, improve the strength of the muscles that form a kind of rotator cuff - the condition of the joint itself depends on its condition. A set of exercises for each patient should be selected individually and classes should begin under the guidance of an experienced physical therapy specialist. Physiotherapeutic treatment helps restore full range of motion (using hardware techniques) or slow down the progression of changes, involving the use of “home” procedures. In the event that treatment with folk remedies begins, it is recommended to carry out warming, compresses with decoctions of medicinal herbs, taking infusions of medicinal herbs that have anti-inflammatory and analgesic effects, orally - calendula, eucalyptus, coltsfoot, St. John's wort, cornflower, aspen, alder. Conservative treatment includes medications that relieve pain, non-steroidal anti-inflammatory drugs, and intra-articular injections of hormonal anti-inflammatory drugs. Surgery will be recommended by the doctor in cases where conservative therapy is ineffective. In this case, the doctor will remove a small piece of tissue. The procedure is usually performed using arthroscopic techniques. The patient can be discharged on the same day.

Approximate gymnastics complex

During the period of subsiding exacerbation, Codman’s exercises are effective, they put a slight load on the shoulder joint and do not cause pain:

1. Standing, feet shoulder-width apart. Lean forward. Freely lower your arms down. Relax your shoulder girdle as much as possible. Remain in this position for 10-15 seconds.
2. Lean forward slightly, resting your healthy hand on the edge of the stool. Swing your affected arm left and right.

After the onset of remission, you can move on to more active gymnastics. The first few classes are carried out in a lying position. Subsequent training can be performed standing or sitting:

1. For a minute, clench and unclench your fingers into a fist.
2. Flex and straighten your wrists. Then rotate them in a circle.
3. Lower your arms along your body. As you inhale, raise your palms to your shoulders, and as you exhale, lower them.
4. Press your palms towards your body. Raise your hands up. Return to starting position.
5. Press your palms to your shoulders, elbows to your torso. As you inhale, raise your elbows, as you exhale, lower them.
6. Take the sore hand with your healthy hand and, as far as possible, move it behind your head. Lightly stretch the affected limb until you feel moderate pain.
7. Press your palms to your shoulders. Spread your elbows to the sides. Return to starting position.
8. Lying on the floor. Spread your arms. Lightly press your palms onto the floor.
9. Lying on the floor. Raise and lower your hands.
10. Lying on the floor. Raise your arms and shake your hands. Return to starting position. Relax your hands as much as possible.

Each exercise must be repeated from 3 to 8 times.

If there is complete absence of pain, the complex can be expanded:

Starting position - sitting on a chair:

1. Hands along the body. Rock them back and forth.
2. Raise both arms up. Maintain the position for 2-3 seconds. Lower your arms down and swing them back and forth 3-4 times.
3. Place your healthy hand behind your back and touch your shoulder blade with your fingertips. Try to repeat the same with the sore limb.
4. Place your arms along your body. Move your healthy arm to the side at an angle of 90º. Pull it. Maintain the position for 3-5 seconds. Repeat the exercise with the sore arm.
5. Place your hands on your shoulders. Raise your left leg and reach for it with the elbow of your right hand. Repeat the same with your left arm and right leg.
6. Lower your arms along your body. Slowly rotate in a circle, first with the healthy hand, then with the sick one.
7. Put your hands down. Bend your head back and forth and to the sides.
8. Rotate your head first clockwise, then counterclockwise. If this exercise causes dizziness, then it should be temporarily excluded from the complex.
9. Place your palms on your knees. Stand up with your arms spread wide to the sides. Sit down.

Starting position - standing:

1. Swing both arms back and forth.
2. Leaning forward slightly, do the same simultaneous swings of your arms, but left and right.
3. Walk in place, swinging your arms widely.

After completing the complex, it is recommended to treat the affected limb with position. The patient needs to lie on the floor, moving the straight sore arm to the side to the maximum possible angle.

To prevent the hand from “slipping” down, weights weighing about 0.5 kg are placed under the hand, elbow and forearm. The patient should remain in this position for the first time for 3-5 minutes. With each subsequent time, this time is increased by another 2-3 minutes. The maximum allowable duration of therapy is 30 minutes. Finally, stand on your feet and shake both arms for 30 seconds.

In the first 2 weeks, positioning treatment is sufficient to carry out once a day, then the procedure can be repeated 2 times a day (morning and evening).

Having mastered the technique of performing exercises for patients with glenohumeral periarthritis, you can not only alleviate your condition at home, but also significantly speed up recovery.

Humeroscapular periarthritis. A set of exercises according to Dr. Popov’s system:

httpv://www.youtube.com/watch?v=embed/Qnk6LeNHRpE

TV channel "Russia-1", program "About the Most Important Thing" with Sergei Bubnovsky on the topic "Humeroscapular periarthritis":

httpv://www.youtube.com/watch?v=embed/W9PtdE0ux3c

How to stay healthy?

Any problem can be solved.
However, when it comes to health, the best approach is one that prevents the problem from occurring. Regarding glenohumeral periarthritis, if a problem has arisen, be determined and complete the treatment, and then do your usual fifteen-minute morning exercises every day. It will take a little time, but it will give you strength and vigor both for this day and for the future. And remember, your body is a universal, well-coordinated mechanism that will serve faithfully with careful use and proper care for many years. Be healthy!

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Doing exercises

Despite the undeniable benefits and effectiveness, performing the exercises has a number of contraindications:

• Exacerbation of chronic diseases.
• Increased body temperature.
• Acute disorders in the cardiovascular system.
• High blood pressure.
• A disorder in the blood coagulation system with a high risk of bleeding.

If there are no contraindications to its implementation, then you should consult a rehabilitation doctor to choose a treatment method and select an individual set of exercises. If you follow all the doctor’s recommendations, physical therapy for glenohumeral periarthritis will help relieve pain and restore mobility to the joint. Performing such exercises is also an excellent method of preventing many diseases of the joints and spine.

How to perform Popov's exercises? Only a doctor can prescribe physical therapy so as not to provoke complications of the disease. To select the correct exercises, the patient must complete the entire set of Popov’s classes with an instructor once. This will help you choose movements that will not cause discomfort.

This relieves tension from the spine and shoulders faster. Popov’s set of exercises for glenohumeral periarthritis consists of the following elements:

1. Warm up the ligaments.
2. Tendon stretching.

Muscle warm-up involves the following exercises:

Sit on the edge of a chair, straighten your back, hands on your knees. Gradually lift part of your foot off the floor, taking small steps, without getting up from the chair. You need to move smoothly, stroking your lower limbs with your hands in the direction from the hips to the knee. Gradually you need to go lower to create a load on your shoulders. Slight tilts, like a pendulum, left and right. The shoulders make a figure of eight, first in one direction and then in the other. In this case, you need to observe your breathing, relax the muscles of the back and shoulder girdle. Grab one hand with the other and pull up to straighten your back. Sometimes upward movements are replaced by stretching your arms down to stretch the shoulder girdle

It is important that the back takes a round shape, leans back, and the lower back and thoracic region arch back. These movements are repeated 2-3 times

Again you need to do exercise No. 1 - walk in place. Pendulum-like movements should be performed in a relaxed state, the arms should move, as well as the back.

When moving backwards, the shoulder blades need to be brought together. Raise your arms up one by one, lower your hands to the floor. The back should follow the arms. Turn your head and neck in the direction in which you raise your arm. Place the thumb of each hand on the collarbone and begin to slowly rotate your elbows, first forward, then back, increasing the amplitude.

httpv://www.youtube.com/watch?v=embed/IK9a_PR8p7I

Turn your feet on your heels so that your toes and knees are facing each other. The patient should gradually lean forward. Hands slide along the thigh and shin, which will help stretch the ligaments of the back. The feet turn in the other direction. Then the person stands up, the shoulder blades come together, the chest straightens

All movements are performed smoothly, with caution, sudden movements should be avoided

Do exercise 1 again, i.e. walk without getting up. The thumbs are again on the collarbones, the arms are bent at the elbow, move them forward and up, back and down in turn.

Raise your arms, relax your hands, bend your wrists slightly, then lower your arms. Raise your arms and bend your elbows to tighten the biceps brachii muscle. This exercise ends with your arms bent at the elbows and pointing upward.

Next, according to Popov’s method, to treat glenohumeral periarthritis, you need to stretch the muscles:

1. Interlock your fingers and stretch your arms in front of you, which will allow you to make waves with your hands. Move from the elbow of one upper limb to the elbow of the other.
2. Perform rotations, adding shoulder rotations.
3. Feet shoulder width apart. Both hands are on your knees. You need to reach with one shoulder to the opposite knee, and then vice versa.
4. Place your hand on the opposite shoulder and support your elbow with the other hand. You need to lean forward, stretch up, bringing your elbow closer to your torso. When bending down, you need to inhale, and when lifting up, exhale. Changing hands, the movements are repeated.
5. Spread your legs as wide as possible, place your hands on your knees, and lean forward. It is forbidden to move your back; move your shoulders in turn to opposite knees. Only the shoulders should be involved in the work. Raise your body and move your shoulders.

Bubnovsky's technique

Dr. Sergei Bubnovsky has developed a set of gymnastic exercises that increases the mobility of the vertebrae, thereby restoring the patient’s motor activity.

The essence of the technique is the long-term preservation of the elasticity of muscle fibers, even some time after the end of treatment. Several options for conducting therapeutic sessions have been developed, the implementation of which will require a minimum of time.

The main difference from Popov’s gymnastics is that Bubnovsky does not focus on relaxing and stretching the ligamentous apparatus for periarthritis of the shoulder. With the help of various equipment, he tries to strengthen the spinal column and muscle frame.

From the available weights, you can use dumbbells of varying weights. It is recommended to start classes with the smallest weight, for example, 500 g or 1 kg. Gymnastics consists of lifting apparatus with outstretched arms in front of you, to the sides with straight and bent elbows.

Gradually it is necessary to increase not only the weight load, but the duration of classes. The appearance of pain at first is a good sign, says Bubnovsky. It is recommended to relieve pain with sea salt baths or contrast showers, as well as massage