Osteoarthritis of the shoulder joint

Among the many non-infectious pathologies of the musculoskeletal system, osteoarthritis of the shoulder joint is often encountered - a disease associated with the destruction of cartilage tissues covering the articular surface. Inflammation in this case is absent, or proceeds in a weak form. Otherwise, the pathology is called deforming arthrosis. Patients suffering from rheumatoid diseases are more often affected.

Epidemiology

Osteoarthritis of the shoulder joint is a fairly common pathology. According to statistics, it affects more than 6% of the population. Women and men have approximately equal chances of getting sick, but at a younger age men suffer from osteoarthritis more often, and after 40-50 years - women.

With increasing age changes, the incidence of the disease increases dramatically, which has been confirmed by numerous studies. According to some data, the pathology is found in about 2% of patients up to 45 years of age, but after 45 and up to 65 years of age, the incidence rate increases sharply to about 8-10%.

The most common clinically significant factors in the development of osteoarthritis are considered to be occupational activity, physical activity, and the presence of other diseases (including metabolic disorders).

Osteoarthritis more often affects the knee and hip joints. Shoulder joint pathology ranks only third in terms of prevalence. [1]

Causes of the osteoarthritis of the shoulder joint

Osteoarthritis of the shoulder joint may result from an inflammatory process, dysplasia (congenital disorder of joint development), impaired blood supply. Significant factors in the development of the disease can be occupational injuries and microtraumas with damage to the ligamentous apparatus. Shoulder joints are often affected in loaders, construction workers, painters, acrobats, weightlifters. Pathological changes are often caused by intensive loads on the joint, insufficient nutrient intake. [2]

A special role is played by genetic features, hereditary predisposition, age, excessive body weight, sedentary lifestyle, unsatisfactory conditions of professional activity, concomitant diseases, etc.

In general, the following reasons for the development of the disease can be named:

• endocrine pathologies (diabetes mellitus, hyper and hypothyroidism, obesity);
• Injuries of varying degrees (both fractures and microtraumas);
• inflammatory pathologies (arthritis, gout, rheumatoid pathologies);
• metabolic disorders (Wilson-Conovalov disease, Paget's disease);
• Congenital defects (e.g., different arm lengths);
• genetic collagen abnormalities;
• neuropathy (toxic, diabetic origin);
• regular hemorrhages in the joint cavity (e.g., in hemophilia).

Risk factors

The development of osteoarthritis of the shoulder joint is closely associated with risk factors such as:

• Systemic factors:
  • Age - the pathology is more common after 30-40 years of age;
  • gender - at a younger age, men are more often affected, and after 40 years - women;
  • hormonal status - women go through menopause;
  • genetic predisposition;
  • reduced bone mineral density, vitamin D deficiency.
• Local factors:
  • Prior trauma and injury to the shoulder joint;
  • muscle weakness;
  • abnormal joint axis;
  • hypermobility.
• External factors:
  • Obesity of any degree;
  • excessive strain on the shoulder joint;
  • sports, occupational stress.

Pathogenesis

An important function of cartilage is considered to be adapting the shoulder to mechanical loading and providing motor capabilities. In a healthy state, cartilage tissue consists of connective tissue matrix and chondrocytes that maintain a balance between anabolism and catabolism (destructive processes). With the formation of osteoarthritis, the healthy balance is disturbed: the phenomena of destruction begin to prevail. Proinflammatory cytokines (interleukin-1) are of great importance in this mechanism, under the influence of which the production of proteolytic enzymes (matrix metalloproteinases) by chondrocytes is activated, provoking degenerative changes in collagen fibers and proteoglycans. Among other things, in the process of osteoarthritis there is an excessive production of cyclooxygenase-2 by chondrocytes. This is an enzyme that triggers the production of prostaglandins involved in the start of the inflammatory response.

The underlying causes of osteoarthritis formation are trauma (the most common factors), dysplasia processes (congenital disorders combined with insufficient joint biomechanics) and inflammatory pathologies (often a consequence of autoimmune diseases).

Symptoms of the osteoarthritis of the shoulder joint

The symptomatology of osteoarthritis of the shoulder joint consists of basic signs such as pain, crepitation and stiffness, deformity (increase in joint volume).

The leading clinical symptom is pain that lasts for many days. The pain syndrome is caused by changes in the synovial membrane, muscle spasm, inflammation, and capsule stretching. The nature of the pain may vary, but a common feature is that it increases with physical activity and decreases at rest.

Inflammatory signs are manifested by a sudden increase in pain, the appearance of pronounced discomfort during night rest, morning stiffness and swelling of the shoulder joint. Pain is prone to change under the influence of weather conditions, temperature changes.

Crepitation is another symptom typical of osteoarthritis of the shoulder joint. It is manifested by a crunching, crackling or creaking sensation during active movement. Crepitation is caused by a lack of alignment between the articular surfaces, limited mobility in the shoulder joint, or blockage by an element of articular cartilage.

Increased volume of the shoulder joint is often due to proliferative changes or swelling of the periarticular tissue. As secondary synovitis develops, there may be severe swelling and localized fever.

The first painful sign with which patients most often go to the doctor is pain. Although it is usually preceded by discomfort in the shoulder joint, to which few people pay attention in time. The first pain appears during physical exertion and passes at rest (in particular, against the background of night rest).

Osteoarthritis of the left, right shoulder joint is accompanied by a heterogeneous nature of pain. Pain syndrome is usually not associated with a direct lesion of cartilage, because cartilage tissue does not contain nerve endings. The causes in this case are:

• Subchondral bone (inflammatory process, microdamage, medullary hypertension);
• osteophytes (irritation of nerve endings in the periostium);
• ligamentous apparatus (sprain);
• the site of attachment of the ligament-tendon component of the joint to the bone (inflammatory reaction);
• articular bag (inflammatory reaction, sprain);
• periarticular muscles (spasms);
• synovial membrane (inflammatory response).

Osteoarthritis of the shoulder and acromial-clavicular joint can present with several types of pain:

• pain resulting from daily physical activity and disappearing at night rest (the symptom is provoked by decreased cushioning of cartilage and subcartilaginous bone elements);
• continuous, dull pain at night (the symptom is due to venous stasis in the subchondral spongiosa segment of the bone and increased intraosseous pressure);
• short-lasting, transient pain (periods of 15-20 minutes), which appears after rest and passes during motor activity (the symptom is associated with friction of joint surfaces covered by elements of bone and cartilage destruction);
• constant pain (the symptom is explained by reflex spasm of the musculature and the start of reactive synovitis).

Stages

To date, it is customary to distinguish three degrees of the course of the disease.

• Osteoarthritis of the shoulder joint of the 1st degree is not accompanied by any pronounced morphological changes in the articular tissues. Violations are noted only in the functionality of the synovial membrane and the biochemical composition of synovial fluid that nourishes cartilage and menisci. As a result of these changes, the shoulder joint loses the ability to adequately resist normal loads, overloads occur, accompanied by pain and inflammation.
• Osteoarthritis of the shoulder joint of the 2nd degree is characterized by the start of destructive processes in the cartilage and menisci. On the bone side, osteophytes are formed as a result of the load.
• Osteoarthritis of the shoulder joint of the 3rd degree is manifested by a pronounced deformation of the bone - the supporting articular site, which changes the axis of the limb. The articular ligaments shorten, pathologic mobility of the shoulder joint develops. In the case of simultaneous appearance of stiffness of the articular bursa, natural movements are sharply limited - contractures develop.

Forms

There are two basic types of osteoarthritis. These are primary, or idiopathic, and secondary - that is, developing against the background of other pathologies.

• Primary osteoarthritis, in turn, can be localized (when fewer than three joints are affected at the same time) and generalized (3 joint groups or more are affected).
• Secondary osteoarthritis can be:
  • Post-traumatic (as a result of shoulder injuries);
  • congenital, acquired, endemic (e.g. Hypermobility syndrome);
  • a consequence of metabolic pathologies (ochronosis, Gaucher's disease, hemochromatosis, etc.);
  • endocrinopathies (acromegaly, hyperparathyroidism, hypothyroidism, diabetes mellitus);
  • as a consequence of calcium deposition disorders (hydroxyapatite, calcium pyrophosphate);
  • a consequence of neuropathies (Charcot's disease);
  • as a consequence of other pathologies (e.g. Osteonecrosis).

Complications and consequences

Osteoarthritis of the shoulder joint develops gradually, the symptomatology manifests itself slowly, at first - imperceptibly. At first, the patient begins to be bothered by a weak, short-lasting pain that does not have a clear location. The pain tends to intensify during physical activity.

In some patients, the first sign is crunching, joint discomfort, and temporary stiffness. Further, the symptomatology expands: pain begins to bother even at rest, with changes in weather, etc. Over time, the pain syndrome becomes more pronounced, motor capabilities are limited. The shoulder begins to hurt from all sides.

Periods of exacerbation of osteoarthritis are followed by short remissions, which become increasingly shorter. As a result of intense pain, the muscles of the affected arm reflexively spasm, and muscle contracture may form. Crunching becomes constant, joint deformity increases, cramps occur.

After a while, the shoulder region becomes significantly curved, motor capabilities are practically lost, and the ability to work suffers. In severe cases, disability occurs.

Diagnostics of the osteoarthritis of the shoulder joint

The diagnosis of osteoarthritis is confirmed by a typical radiological picture, which is characterized by a specific asymmetric narrowing of the joint gap, the presence of subchondral cysts and marginal growths, subchondral sclerosis, and in advanced cases - deformation of bone epiphyses.

Laboratory tests do not show any signs that are special and typical for osteoarthritis of the shoulder joint. However, laboratory diagnostics are still performed:

• in order to distinguish osteoarthritis from other similar pathologies (in osteoarthritis, there are no inflammatory changes in the general blood count, no rheumatoid factor, and serum uric acid levels are within normal limits);
• before starting therapy in order to clarify the likely contraindications to prescribing certain medications;
• in order to detect inflammatory process (examine COE and C-reactive protein).

Synovial fluid is analyzed only in synovitis for differential diagnosis. Osteoarthritis of the shoulder joint is not reflected in the inflammatory character of synovial fluid: usually the fluid is clear or slightly cloudy, viscous, with a concentration of leukocytes not more than 2000/mm³.

Instrumental diagnostics, first of all, is represented by X-ray examination - the most informative method of detecting osteoarthritis of the shoulder joint. X-rays show narrowing of the joint gap, the presence of marginal osteophytes, phenomena of subchondral sclerosis. Sometimes radiography in several projections may be required, for example, in the anteroposterior and lateral projection, with the arm raised or pulled to the side.

Computerized resonance imaging is less frequently prescribed. The use of magnetic resonance imaging is necessary to assess the condition of cartilage, which is especially important at an early stage of the pathology, when radiological signs are not yet detected, but pain syndrome is already present.

Arthroscopy is considered the most accurate diagnostic procedure for osteoarthritis of the shoulder. Using probe microscopy, the doctor accurately determines the extent of cartilage damage:

• in the first degree, the cartilage is softened (by touching it with a probe);
• in the second degree, small cracks and micro-damage on the cartilage surface become visible;
• in the third degree, there is sagging of cartilage elements by about 2.5 mm;
• In the fourth degree, the cartilage is completely absent and the bone tissue is unprotected.

Differential diagnosis

The diagnosis of osteoarthritis of the shoulder joint is usually not difficult. However, each specific clinical situation should be analyzed by the doctor within the framework of the theoretical probability of secondary origin of the disease. In this regard, it is recommended to differentiate this disorder with the following pathologies:

• post-traumatic synovitis;
• Ankylosing spondylitis (Bechterew's disease);
• reactive arthritis;
• rheumatic polymyalgia;
• gout, pseudogout;
• infectious arthritis;
• psoriatic arthritis;
• rheumatoid arthritis;
• paraneoplastic, diabetic arthropathy;
• fibromyalgia.

Treatment of the osteoarthritis of the shoulder joint

Therapeutic measures for this disease should be combined with lifestyle changes, physical activity correction, and joint protection. The first therapeutic step is to reduce pain, improve joint function, prevent shoulder deformity and prevent the development of disability. The prescribed therapeutic measures should optimize the patient's quality of life and prevent further destruction of cartilage. [3]

Therapy is complex, including non-pharmacologic, pharmacologic, and surgical methods. Drug treatment is often based on the use of non-steroidal anti-inflammatory drugs, glucocorticosteroids, vitamins of the B-group, as well as the use of therapeutic blockades. Physiotherapy can be represented by myostimulation, phonophoresis, shock-wave and laser procedures, ozone therapy. In addition, therapeutic exercise and manual therapy are also included.

Therapeutic exercises are usually prescribed at the stage of pain reduction: exercises should be gentle, with a gradual increase in load. As the musculature strengthens, episodes of exacerbation of osteoarthritis of the shoulder joint occur less frequently. A suitable set of exercises can be obtained from a specialist in physical therapy.

It is recommended to adjust the diet by including in the diet products containing collagen compounds. It is about lean meat, gelatin, seafood, bananas, dried fruits. [4]

Medications

As symptomatic medications for osteoarthritis of the shoulder joint, the use of analgesics, nonsteroidal anti-inflammatory drugs is appropriate. If necessary, opioid analgesics, intra-articular injection of glucocorticoids are prescribed. As long-acting drugs, preference is given to medicines based on hyaluronic acid, strontium ranelate, Piascledine, Diacerein, glucosamine and chondroitin sulfate.

Paracetamol is prescribed to patients with mild to moderate pain intensity, in the absence of signs of inflammation. A dosage of 3 g per day can be used for a long time. Higher doses can cause the development of side effects from the digestive system and kidneys. Paracetamol is not prescribed to patients with hepatic pathologies and alcohol abusers.	The maximum allowable amount of Paracetamol in one administration should not exceed 350 mg. Continuous administration should not exceed 3 g per day.
Nonsteroidal anti-inflammatory drugs are indicated only for the period of worsening pain syndrome. Use the minimum effective amount of them, as large doses and prolonged use (more than 3-5 days) is a risk factor for the development of side effects from the digestive system. Dose dependence is also possible. It is recommended to take non-steroidal anti-inflammatory drugs simultaneously with proton pump inhibitors - to protect the GI organs.	Non-steroidal anti-inflammatory drugs are prescribed if the safer Paracetamol has no effect, or if there are signs of inflammation. Severe pain is another indication for the use of such drugs, but in the least effective amount and for the shortest possible time. Example: taking Orthofen whole, without chewing, with water, preferably before meals, 100-150 mg per day (if possible, the dosage is reduced to 70-100 mg per day).
Ointments containing non-steroidal anti-inflammatory components demonstrate sufficient analgesic effect in osteoarthritis of the shoulder. They are well tolerated, but should not be used for more than 2 weeks without a break, as they become less effective over time.	Ointments for osteoarthritis of the shoulder joint are shown to patients to accelerate the relief of pain syndrome against the background of taking Paracetamol, or when patients are unable to take non-steroidal drugs orally. Possible variants of ointments: Diclofenac 1-2% (ointment, gel), Diclac-gel, Artiflex, Ultrafastin gel 2.5%, Dolgit cream, Dicloseif forte, Fanigan Fast gel, Nobi gel, Voltaren emulgel, Arthrokol, Diclofen, Valusal, Olfen gel and so on. Ointments or gel are applied 3-4 times a day, rubbing into the area of the affected shoulder. The duration is determined by the nature of osteoarthritis and the effectiveness of treatment (but not more than 14 consecutive days).
Painkillers in the form of opioid analgesics are prescribed for a short period of time, for severe pain, if Paracetamol and non-steroidal anti-inflammatory drugs were ineffective (or there were contraindications to prescribing the optimal amount of these medications).	Opioid analgesic Tramadol is prescribed in the first days of severe pain syndrome at 50 mg per day with a gradual increase in dosage up to 200-300 mg per day. Retard tablets are taken 100-200 mg every 12 hours. Overdose of the drug may cause signs typical for all centrally acting opioid analgesics: vomiting, impaired consciousness, miosis, convulsions, respiratory center depression.
Intra-articular injections in osteoarthritis of the shoulder joint are performed to reduce pain and inflammation. The duration of the effect of glucocorticoids is usually 1-4 weeks.	A single intra-articular injection of methylprednisolone 40 mg or triamcinolone 20-40 mg is recommended. It is undesirable to perform more than 2-3 intra-articular injections per year in the same shoulder.
Glucosamine and chondroitin sulfate are characterized by moderate analgesic ability and increased safety. There is information about their possible structural-modifying effect (inhibition of joint gap narrowing). The effect of the drugs is long-lasting and can be observed for several months after discontinuation of treatment.	In osteoarthritis of the shoulder, chondroitin sulfate is almost always indicated for long-term use, 500 mg twice a day. Glucosamine is taken at 1500 mg per day for 1-3 months. Treatment courses can be repeated 2-3 times a year.
Diacerein can be used for primary or secondary osteoarthritis of the shoulder. It reduces pain, and the effect can last for several months after the end of use.	Diacerein capsule is taken whole, without chewing, after a meal. The daily amount of the drug is 1 capsule (50 mg), the frequency of administration - every 12 hours. The course of treatment cannot be less than 4 months. Tolerability of the drug is good.
Piascledine, a preparation based on unsaponifiable compounds of avocado and soybean, is prescribed for long-term reduction of pain, improvement of shoulder joint function, and inhibition of osteoarthritis progression.	Piascledine is taken 300 mg daily for a long time. Possible side effects: diarrhea, abdominal pain, belching with fat taste. Since the drug contains soybean oil, it should not be used in patients prone to allergies to soy and peanut products.
Hyaluronic acid-based medications help to reduce pain, and the effect of use lasts from 2 months to a year.	Hyaluronic acid preparations are injected into the joint cavity. The number of such injections may be 3-5, with possible repetition after 6-12 months. After the injection, a small swelling may appear in the shoulder area, which is formed due to the volume of the injected solution. The swelling disappears within 1-2 days.
Strontium ranelate (Bivalos) helps to reduce pain and improve joint function, stimulates osteogenesis.	For oral administration, pour the contents of one sachet into a glass, add 50 ml of water, stir to form a suspension and drink. The optimal daily amount of the drug - 2 g of strontium ranelate per day, before bedtime. Application - prolonged, recommended by the doctor.

Physiotherapeutic treatment

Local application of superficial cold or heat is indicated for shoulder osteoarthritis. Such procedures produce an analgesic effect.

A vivid but short-lasting analgesic effect is provided by percutaneous electrical nerve stimulation. Acupuncture may also be used.

Meanwhile, the basis of physiotherapy is often shockwave treatment, which has a rapid analgesic, anti-edema and anti-inflammatory effect. Each patient is prescribed an individual therapeutic course, depending on the mechanism of development of osteoarthritis of the shoulder joint, the presence of concomitant pathologies, characteristics and duration of clinical manifestations. Such an individual approach helps to achieve the fastest and most lasting result:

• to relieve the patient of pain, swelling in the shoulder area;
• to restore motor volume;
• prevent further development of osteoarthritis and its complications;
• Improve the ability to work and quality of life.

The technique of shockwave therapy is the application of a focused stream of infrasound vibrations, which pass unimpeded through the muscle tissue and affect the immediate pathological focus, in the zone "tendon-muscle", "ligament-bone". The procedure increases blood circulation in the shoulder joint, optimizes blood supply to the joint and periarticular tissues, activates the natural process of tissue repair and renewal, promotes the destruction of calcium deposits and their removal.

Surgical treatment

Surgical treatment may consist of joint endoprosthesis, which can reduce pain, improve motor function and quality of life of a patient with shoulder osteoarthritis. The duration of the effect of surgical intervention is approximately 10 years, with an incidence of infectious complications and the need for reinterventions ranging from 0.2 to 2% annually. The most optimal rates of endoprosthesis are noted in patients 45-74 years old, with body weight less than 70 kg.

Surgical treatment may be recommended for patients with severe shoulder osteoarthritis, which is accompanied by intense pain syndrome that does not respond to conservative therapy, in the presence of marked impairment of joint function (development of severe deformity, instability of the joint, the appearance of contractures and atrophic changes in the musculature). [5]

Exercises and gymnastics for osteoarthritis of the shoulder joint

Regular therapeutic exercises help to strengthen the muscles surrounding the shoulder area, improve the tone of tendon ligaments and eliminate pain syndrome. In addition, a special set of exercises restores joint performance, but they must be done daily for a long time.

Begin by warming up and relaxing the muscles, followed by movement and stretching approaches. Each exercise is performed 10 times, or until the pain limits.

1. Raise and lower the shoulders, perform circular movements back and forth.
2. Lower the affected limb so that it relaxes and hangs freely. Swing the affected limb back and forth and to the sides.
3. Hold the affected arm with the other hand by the forearm, slowly raise it to chest level and lower it to the starting position. Keeping the arm at chest level, perform movements to the sides, in a circle.
4. Hold a gymnastic stick with arms wide apart. Move the stick left and right, up and down.
5. Hold a gymnastic stick on outstretched arms with the opposite end resting on the floor. Bend and straighten arms at the elbows, perform circular movements.
6. Rotate the ball around the torso, move it from the left hand to the right hand and vice versa.
7. Hold a gymnastic stick with both hands behind the back. Perform upward and downward movements.
8. Lay on their backs, raise their hands above their heads, joining their fingers in a lock, then lower them.
9. Lying on the back, slide up and down with arms straightened out to the sides. Repeat the exercise also sitting and standing.
10. Keep arms bent at the elbows, pressed against the torso. Spread arms to the sides, return to the starting position.
11. Lie on your back, wrap your hands around your forearms, perform circular movements.

Exercises for osteoarthritis of the shoulder joint are aimed at reducing pain and preserving motor function. Exercises that help strengthen the relevant muscle groups are recommended. Strength exercises (isometric, counteracting) are indicated, which also help to eliminate pain syndrome.

Before you start exercising, it is necessary to make sure that there are no contraindications to physical therapy. These are considered to be:

• uncontrolled cardiac rhythm disturbances, third-degree blockade;
• "fresh" pathologic changes on the electrocardiogram;
• unstable angina;
• cardiomyopathy;
• heart defects;
• uncontrolled arterial hypertension.

Folk treatment of osteoarthritis of the shoulder joint

Osteoarthritis of the shoulders requires a comprehensive therapeutic approach. Therefore, folk remedies are often added to traditional treatment, which helps to speed up the recovery process.

The following recipes may be used:

• Rinse and dry freshly plucked burdock leaves, pass them through a meat grinder. The resulting pulp is distributed over the skin above the affected joint, overlay a gauze bandage, leave overnight. This treatment can be repeated several nights in a row, until the condition improves.
• Collect fern leaves, apply to the affected shoulder joint and tie with a gauze bandage. It is left overnight. Treatment is repeated for several days.
• Apply fresh mugwort leaves or compresses of cabbage leaves (especially helps with swelling).
• Dry gelatin is eaten in the morning before breakfast, 1 tbsp, drinking 200-300 ml of water, for a long time.
• Steep fresh burdock leaves in boiling water, then take them out and mix them with honey. The resulting remedy is applied to the affected shoulder joint, overlay a gauze bandage and tie a woolen scarf. Leave overnight. The procedure can be repeated several times, until a steady improvement in the condition.

In addition, it is recommended to take warm baths with mustard powder, or with herbal infusions (mint, calendula, St. John's wort, oregano), decoction of topinambour.

Diet in osteoarthritis of the shoulder joint

Dietary correction complements the treatment and helps to accelerate the recovery of performance of the shoulder affected by osteoarthritis. Dietary nutrition implies compliance with certain rules:

• The diet should be as varied, complete and balanced as possible.
• It is important to limit salt intake to 5 g per day. Smoked, canned, salted products are excluded from the menu.
• It is recommended to increase the consumption of plain clean water without gas, at least to 2-2.5 liters per day.
• It is necessary to introduce foods containing vegetable oils and unsaturated fatty acids omega-3 and omega-6 into the menu.
• Specially useful in osteoarthritis are cold meats, poured fish, jelly, kisel. Such dishes contain mucopolysaccharides that help improve cartilage structure, stimulating collagen synthesis.

A prerequisite for patients with osteoarthritis of the shoulder joint is weight control. It is useful to regularly organize unloading days. Fractional, frequent portioned meals are indicated.

Recommended Products:

• weak broths (preferably fish or vegetable broths);
• lean meats, cold meats and pouring dishes;
• dairy products (kefir, ryazhenka, hard cheese, cottage cheese, natural yogurt);
• fish (preferably sea fish);
• whole grain bread, bran;
• vegetables in any form;
• nuts, seeds;
• any fruit;
• compotes, tea, kisel, morsels, water without gas.

You should limit the consumption of rich broths, fatty meat and lard, smoked meat and convenience foods, offal and sausages, red meat, baked goods, alcohol and strong coffee, spicy spices and seasonings.

Prevention

Any load should be moderate, but its presence is necessary: to normalize weight, optimize blood circulation, strengthen the muscle corset. A sedentary lifestyle, as well as excessive physical activity, can be a trigger in the development of shoulder osteoarthritis.

It is important to be careful both at home and at work, avoid joint overload, injury or improper hand positioning while working or exercising.

Beginners should always do their first workouts under the supervision of an instructor or doctor.

In addition, it is necessary to review and adjust your dietary habits. In order to prevent osteoarthritis, it is advisable to exclude red meat and animal fats from the diet. It is good if the menu will regularly include seafood, dairy products, fish, herbs, nuts, fruits and vegetables, as well as gelatin (in the form of jelly, cold cuts, etc.). Specialists also advise to increase the daily volume of fluid intake - up to 2-2.5 liters per day.

It is mandatory to refuse alcoholic beverages.

Other recommendations for osteoarthritis prevention include:

• Protect the shoulder joints from hypothermia;
• to control your body weight;
• lead a healthy lifestyle, follow a rest and sleep schedule, avoid stress.

Forecast

Osteoarthritis of the shoulder joint usually has a long course, with gradual irreversible aggravation of the clinical picture. Due to the slow dynamics of the disease, the ability to work is present for a long time.

Severe cases of pathology are accompanied by complete destruction of the joint: articular ankylosis or neoarthrosis with non-natural mobility is formed.

In general, osteoarthritis of the shoulder joint can cause disability of the patient. With the early connection of chondroprotectors, it is often possible to improve the condition of patients, which is mainly due to the slowing of the progression of the disease response. Drugs in different forms of application contribute to the effectiveness of treatment even in generalized forms of osteoarthritis.