Shoulder tendinitis

Mostly, inflammation in the shoulder area begins with the tendon bursa (tendobursitis) or the shoulder joint sheath (tenosynovitis, tendovaginitis) and only then spreads to the tendon itself - this pathology is diagnosed as tendinitis of the shoulder joint.

Not only people are susceptible to this disease, animals also suffer from it. Modern medicine distinguishes two forms of its manifestation: acute and chronic.

Causes of Shoulder Tendinitis

There are many sources that can provoke the emergence and progression of the inflammatory process in the human body. And to prevent the disease, it is necessary to remove the cause that provokes it, and for this, you need to know the "enemy". Let's find out the most common causes of shoulder tendinitis:

• There is a fairly high risk of acquiring this disease in people whose professional activities are associated with heavy physical exertion. The risk zone includes athletes of such sports as tennis, basketball, volleyball, hammer throwing (shot, javelin), handball, artistic gymnastics. The following professions are also “dangerous”: almost all construction workers (painter-plasterer, bricklayer), drivers of motor vehicles and many others.
• Numerous microtraumas associated with increased motor activity.
• The presence in the person's medical history of diseases related to the skeletal and muscular system:
  • Reactive arthritis.
  • Osteochondrosis.
  • Gout is a disease associated with a failure in metabolic processes. It has a negative impact on bone, connective and muscle tissue.
  • Osteoporosis is a pathology in which bones lose their strength, become more fragile and can easily break.
  • Rheumatoid arthritis.
  • And others.
• Congenital or acquired pathology of tendons, loss of elasticity and resilience.
• Problems with posture.
• Infectious diseases caused by pathogenic flora. Pathogenic bacteria spread quite quickly through the blood throughout the body and primarily affect its weakest point.
• Stressful and depressive states of a person can provoke muscle spasms, which entails increased stress on connective tissues.
• An allergic reaction of the body to taking medications can also provoke tendinitis of the shoulder joint.
• Inherited or acquired during life joint dysplasia.
• Diseases of the endocrine system: diabetes mellitus, thyroid disease.
• Deterioration of the body's defenses.
• The need to use a plaster cast or tight bandage for a long time.
• An error in the prescribed therapy and in the process of rehabilitation after surgery related to the shoulder joint area.
• Peculiarities in the anatomical structural configuration of the patient - if the disorders are associated with a deviation in the normal structure of the shoulder joint, then its degradation can cause the formation of a focus of inflammation, and hence the development of tendinitis of the shoulder joint.
• Osteochondrosis of the cervical vertebrae can also provoke this pathology.
• This development of events can also be caused by prolonged exposure to a draft or climatic cataclysms (being caught in a cold pouring rain).

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Symptoms of Shoulder Tendinitis

In principle, any inflammatory process, symptoms of tendinitis of the shoulder joint begin to manifest themselves with pain symptoms.

• At first, a person feels pain in the shoulder only during movement, but gradually it begins to bother him even when he is at rest.
• The skin of the shoulder area begins to show hyperemia: the epidermis becomes reddish, and when touched, its greater density and increased temperature are felt.
• When moving, even without using a phonendoscope, you can hear light clicking sounds.
• In some cases, minor swelling may be observed, which slightly limits movement in the joint. It may be difficult for a person to take an object from a shelf or put it back, and problems with clothing may arise.
• Over time, the pain may appear during sleep, and after some time, it may spread to the elbow joint.
• The pain can be monotonous or sharp and prolonged.
• Long-term ignoring of the problem can lead to complete or partial atrophy of the muscle tissue of the shoulder area. Such pathology is much more difficult to cure, and sometimes simply impossible.

Calcific tendinitis of the shoulder joint

If, in the course of some disease or lifestyle, salt deposits are observed on the tendons of the shoulder area, then specialists diagnose calcifying tendinitis of the shoulder joint. In the tissues adjacent to the salt accumulations, an inflammatory focus begins to form (this pathology often bothers people after 40 years). There are no thoroughly studied explanations for the cause of this pathology to date, but doctors suggest that such a scenario can be facilitated by multiple micro tears, injuries, age-related wear of connective tissues. Not the least role in this process is played by the lack of oxygen in the cellular and intercellular layers of the tendons.

Calcifying tendinitis of the shoulder joint is characterized by pain sensations that appear when moving the upper limb (it is very difficult to raise the arm). Due to such a change in position, discomfort begins to increase, the increase in pain symptoms occurs mainly at night. The protocol of therapeutic therapy prescribed by the attending physician largely depends on the X-ray data.

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Supraspinatus tendinitis of the shoulder joint

The human joint is a rather complex, one might say, unique structure, the adequate functioning of the "mechanism" as a whole depends on the joint work of all its elements. One of these components is the supraspinatus muscle, which completely fills the supraspinatus fossa of the scapula. Its main function is to abduct the shoulder and stretch the joint capsule in order to protect it from pinching. Tendinitis of the supraspinatus muscle of the shoulder joint can develop in case of injury to the muscle capsule by the acromioclavicular joint, the acromioclavicular ligament or the acromion itself. Such damage is fraught with subsequent deterioration of the physiological characteristics of the joint complex, the origin, sluggish or rapid inflammatory process and thinning of the tendon, which leads to complete degradation of the shoulder joint. And as a result, a person can get tendinitis of the supraspinatus muscle of the shoulder joint.

Diagnosis of shoulder tendinitis

Time passes and any mechanism begins to wear out, the human body is no exception. Joints, muscles and connective tissues also have their limits, so frequent microcracks, bruises, and other negative effects lead to pathological changes in the human body. Diagnosis of shoulder tendinitis includes:

• Identification and analysis of patient complaints.
• A specialist examination aimed at determining the location of the pathology, pain symptoms upon palpation of the area, determining joint mobility, establishing the presence of edema and hyperemia.
• It is worth differentiating this disease from other pathologies. For example, arthritis is characterized by constant pain even at rest, while tendinitis of the shoulder joint is pain associated with motor activity.
• Laboratory tests usually show no changes. The exception is tendinitis that developed due to bacterial damage to the patient's connective tissue (infection or rheumatoid processes).
• The X-ray method will be informative only if calcifying tendinitis of the shoulder joint is diagnosed. In this case, the film can show a cluster of calcifications (crystals of calcium salts) - this is already a fairly late stage of the disease.
• Computer and magnetic resonance imaging make it possible to determine degenerative changes in the structure of the shoulder joint: tendon ruptures, structural defects. Such a survey result may indicate the need for surgical intervention.
• Sometimes ultrasound examination is used as an additional diagnostic. This method allows to establish changes that have affected the structure of connective tissue, its contractile abilities.

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Treatment of shoulder tendinitis

First of all, it is necessary to say that the treatment of tendinitis of the shoulder joint largely depends on the stage and severity of the disease. In case of diagnosis of the disease at the early stages of its manifestation, the treatment protocol is quite gentle and includes:

• Maximum limitation of mobility and load on the diseased joint, and, consequently, on the affected tendon.
• Cold is used as an adjuvant therapy.
• To fix the joint and bring it to a state of rest, splints, bandages, and elastic bandages are used.
• Physical procedures are actively used:
  • Laser therapy.
  • Shock wave therapy
  • Magnetic therapy.
  • Exposure to ultraviolet and ultrasound rays.
  • In case of chronic manifestation of the disease, mud and paraffin applications, electrophoresis based on lidase are practiced.
• Medicinal treatment plays an important role – these are antibiotics, painkillers and anti-inflammatory drugs, and antimicrobial drugs.
• After the acute form of the disease has been relieved and the therapy has been effective, the doctor will start the patient on a set of therapeutic physical exercises.
• If there is no exacerbation, massage of the affected area is also indicated.

In case of more severe forms of damage, treatment of shoulder tendinitis begins with conservative therapy using anti-inflammatory drugs. If calcifying tendinitis is diagnosed, then a procedure is performed to remove salt deposits. To do this, two needles with a large hole are inserted into the joint and the salt is washed out using a saline solution. Then cold therapy, massages, physical therapy, and therapeutic exercises are added. If such measures do not lead to a positive result, then it is necessary to resort to surgical methods of treatment. In this case, it will be appropriate to use an arthroscope - a medical device equipped with a video camera. It is inserted into the lumen of the joint and the necessary manipulations are carried out. But a classic strip surgery can also be performed. The postoperative rehabilitation period usually reaches two to three months, but it will be possible to return to your usual active life no earlier than three to four months later.

Drug therapy may include multidirectional drugs. They are referred to as non-steroidal drugs.

Nimesil

This anti-inflammatory and analgesic drug is not prescribed to patients under 12 years of age. The drug is prescribed orally immediately after meals. The average daily dosage of the drug is 0.2 g, divided into two doses. Nimesil is prepared immediately before administration. To do this, pour the contents of the packet into a glass of warm water and mix well. The duration of treatment is no more than two weeks.

It is not recommended to take the drug if a person has a history of: ulcerative lesions of the stomach or duodenum, arterial hypertension, internal bleeding, congestive heart failure, severe renal dysfunction, hypersensitivity to the components of the drug. The drug nimesil is contraindicated during pregnancy and breastfeeding.

Nise

This medicine is used externally. Before the procedure, the skin area in the area of inflammation must be washed and dried with a towel. Apply a thin layer of gel to the skin (length of the path up to 3 cm). Do not rub hard. The number of daily procedures is from three to four. It is not recommended to use for more than ten days.

Contraindications to the drug include: acute phase of erosive and ulcerative gastrointestinal tract lesions, internal bleeding, dermatoses of various natures, tendency to allergic reactions, renal and hepatic insufficiency, bronchial spasm. Nise is not prescribed to women during pregnancy and lactation, as well as to children under seven years of age.

Ketorol

It has pronounced analgesic properties, while the active substance (ketorolac tromethamine) is an excellent anti-inflammatory agent with a moderate antipyretic effect. In tablet form, the drug is prescribed once at 10 mg. In case of severe pathology, the same dosage can be taken up to four times a day. The need for repeated administration is determined only by the attending physician.

Ketorol is not recommended for people suffering from individual intolerance to the components of the drug, acute erosive and ulcerative lesions of the digestive system, problems with blood clotting, stroke, problems in the respiratory system. The drug is not prescribed to women during pregnancy and breastfeeding, as well as to children under 16 years of age.

Nurofen

This excellent painkiller and antipyretic is taken with plenty of liquid. For patients over 12 years old, the starting dose of the drug is 0.2 g, taken three to four times a day. If necessary, a single dose can be increased to 0.4 g, while the maximum amount of the drug allowed per day is 1.2 g. For children from 6 to 12, the drug is prescribed in an amount of 0.2 g four times a day. Do not forget that Nurofen can be given to children whose weight has already reached 20 kg. The interval between administrations of the drug should not be less than six hours.

The drug is strictly contraindicated if the patient's medical history includes: cardiovascular insufficiency, severe arterial hypertension, ulcerative pathology of the gastrointestinal tract, hypersensitivity to the components of the drug, as well as in case of pregnancy (its third trimester), lactation and in children under six years of age.

Physical therapy for shoulder tendinitis

When treating tendonitis, therapeutic exercise exercises are quite simple and are aimed not at pressing the sore joint, but at “developing” it, gradually increasing the magnitude of the deviation. The doctor may suggest the following exercises:

• To do this, you will need a towel (it should be long). Throw it over some horizontal pole, holding each end separately with your hands. Begin to smoothly lower the healthy upper limb down, while the sore arm slowly begins to rise to the ceiling. When the first signs of pain appear, stop the movement and fix it in this position for three seconds. After that, very smoothly return to the starting position.
• You need to take a stick, ideally a gymnastic one, but any other will do. Lean the stick vertically on the floor at arm's length from the victim. Write the letter "O" with your sore hand. The circle should be as big as possible.
• With your healthy hand, help to fix the palm of the sore arm on the healthy shoulder. With your healthy hand, grab the elbow of the affected arm. Start very carefully, without jerking, lifting the sore arm by the elbow, monitoring the sensations in the shoulder joint. At the top point, fix the position for three seconds and smoothly lower it down. Every day, the amplitude of the lift should be slightly increased.
• Clasp your lowered hands together in front of you. Smoothly begin to raise your hands up. The main load goes to the healthy limb. It pulls the sick one along like a tug.
• Place a chair in front of you, stepping back a little. Lean your healthy upper limb on its back, with your torso bent at the waist and the sore limb just hanging down. Start making a pendulum movement with your sore arm, gradually increasing its amplitude. You can make movements back and forth, right and left, and circular movements.
• We raise our upper limbs in front of us parallel to the floor and place the palm of our left hand on our right elbow, and the palm of our right hand on our left elbow. In this position, we begin to swing them first to one side, then to the other.

Folk treatment of tendinitis of the shoulder joint

Traditional medicine remedies with analgesic and anti-inflammatory properties can also provide good additional help:

• Curcumin is effective in the treatment of tendonitis, which is taken with food as a seasoning at a daily dose of half a gram. It has proven itself to be an excellent pain reliever and copes well with inflammation.
• Bird cherry fruits are infused in a glass of boiled water and drunk two to three times a day as tea. The tannins of the berries are excellent for relieving inflammation and have a strengthening effect on the body.
• A glass of collected partitions of the Volotsk (walnut) nut is poured with half a liter of vodka. Insist in a dark place for three weeks. 30 drops of tincture should be taken 30 minutes before a meal, washed down with a large volume of cooled boiled water.
• An infusion made from a mixture of two components has proven itself to be excellent: sarsaparilla root and ginger root taken in equal proportions. A teaspoon of the crushed composition is poured with a glass of boiling water and drunk instead of tea. It is advisable to drink tea like this twice a day.
• In the first day after the injury, a cold compress should be applied to the sore spot, and in the following days, on the contrary, warming therapy is preferable.

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Prevention of shoulder tendinitis

To try to prevent the occurrence of this pathology, prevention of shoulder tendinitis is necessary.

• Before starting more active sports activities (increased loads), it is necessary to warm up and stretch the muscles and tendons well.
• It is necessary to avoid, if possible, long monotonous movements.
• Be more attentive, thereby minimizing the likelihood of injury and static or dynamic overloads.
• The increase in loads and their intensity should be gradual.
• Periods of stress must be alternated with periods of rest.
• Regular exercise and active recreation will help keep your muscles and ligaments in good shape.
• If pain occurs during work or sports, you should stop the activity and rest. If the pain symptoms do not go away after a break, you should consult a doctor.
• In all actions, adhere to safety rules.

Shoulder Tendinitis Prognosis

If we talk about the future, the prognosis for shoulder tendinitis is quite favorable, but still a great deal of responsibility for the expected result lies with the patient himself, how responsibly he will approach therapeutic exercise classes. After all, for this you need to force yourself, overcoming laziness.

It is much easier to prevent any disease than to deal with it later. This statement is also applicable to such a pathology as shoulder tendinitis, a fairly common inflammatory disease. There is no need to make great efforts if the therapy has already captured the initial stage of the disease. But if the primary process is left to its own devices, the pathology can go into a chronic phase, which already requires much greater efforts. But the danger is that chronic tendinitis can develop into immobilization of the joint and, as a result, atrophy of the muscle and connective tissues of the shoulder joint, which over time can lead to irreversible consequences. Therefore, you should not rely on "maybe it will go away on its own." Only a specialist can make a correct diagnosis and give effective recommendations.