Tendonitis of the shoulder joint

Most inflammation in the shoulder begins with a tendon (tendobursitis) or vagina of the shoulder joint (tendosinovitis, tenosynovitis) and only then spreads to the tendon itself - this pathology and is diagnosed as tendonitis of the shoulder joint.

This disease affects not only people, they are sick and animals. Modern medicine distinguishes two forms of its manifestation: acute and chronic.

Causes of tendonitis of the shoulder joint

Sources that can provoke the nucleation and progression of the inflammatory process in the human body are many. And in order to prevent the disease, it is necessary to remove the cause provoking it, and for this, the "enemy" must be known. We learn the most common causes of tendonitis of the shoulder joint:

• A sufficiently high risk to acquire this disease in people whose professional activities are associated with heavy physical exertion. The athletes of such sports as tennis, basketball, volleyball, hammer throwing (nucleus, spears), handball, gymnastics are considered to be in the risk zone. "Dangerous" and such professions: almost all construction (painter - plasterer, mason), drivers of vehicles and many others.
• Numerous micro-trauma associated with increased motor activity.
• The presence of a history of human diseases related to the bone and muscle systems:
  • Arthritis of a reactive nature.
  • Osteochondrosis.
  • Gout - a disease associated with a malfunction that occurred in the work of metabolic processes. It has a negative effect on bone, connective and muscle tissue.
  • Osteoporosis is a pathology in which bones lose their strength, become more fragile and can easily break down.
  • Rheumatoid arthritis.
  • And others.
• Congenital or acquired pathology of tendons, loss of elasticity and elasticity.
• Problems with posture.
• Infectious diseases, provoked by pathogenic flora. Disease bacteria quickly spread with blood throughout the body and primarily affect its weakest point.
• Stressful, depressive states of a person can provoke muscle spasms, which pulls an increased burden on connective tissues.
• To provoke tendinitis of the shoulder joint can also an allergic reaction of the body to taking medications.
• Inherited or received in the process of life joint dysplasia.
• Diseases of the endocrine system: diabetes, thyroid disorders.
• Deterioration of the body's defenses.
• The need for a long time to use gypsum or a tight bandage.
• An error in the prescribed therapy and in the process of rehabilitation rehabilitation after surgical intervention associated with the area of the shoulder joint.
• Features in the anatomical structural configuration of the patient - if the violations are associated with a deviation in the normal structure of the shoulder joint, then its degradation can cause the formation of a foci of inflammation, and hence the development of tendonitis of the shoulder joint.
• Provoke this pathology can and osteochondrosis of the cervical vertebrae.
• Can lead to this development of events and a long stay in the draft, climatic cataclysms (fell under the cold pouring rain).

[1], [2]

Symptoms of tendonitis of the shoulder joint

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

• First, a person feels pain in the shoulder only during movement, but gradually it begins to pester and in the rest position.
• On the skin of the shoulder zone hyperemia begins to appear: the epidermis becomes reddish, when touched, its greater density and increased temperature are felt.
• When driving, even without using a phonendoscope, you can hear light clicks.
• In some cases, you can observe a slight puffiness, which slightly restricts movement in the joint. It is difficult for a person to take an item from a shelf or put it back, and there are problems with clothes.
• Over time, pain can also appear during sleep. And after a while, spread to the elbow joint.
• Pain can be either monotonous, or sharp and prolonged.
• Prolonged disregard of the problem can lead to complete or partial atrophy of the muscular tissue of the shoulder region. This pathology is much more difficult to cure, and sometimes it is simply not possible.

Calcifying tendinitis of the shoulder joint

If in the process of a disease or a way of life, on the tendons of the shoulder zone salt is observed, the specialists diagnose already calcifying tendinitis of the shoulder joint. In the tissues adjacent to the salt accumulations an inflammatory focus begins to form (this pathology often infects people after 40 years). The reasons for the emergence of this pathology have not been thoroughly studied, but physicians suggest that this development of the scenario can be facilitated by multiple micro-ruptures, injuries, and 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.

For the calcifying tendinitis of the shoulder joint, there are inherent pain sensations that appear when the upper limb moves (it is very difficult to raise your hand). As a result of this change in position, discomfort begins to increase, the pain symptomatology intensifies mainly at night. The protocol of medical therapy attributed to the attending physician largely depends on the radiography data.

[3], [4], [5], [6], [7], [8]

Tendonitis of the supraspinum muscle of the shoulder joint

The joint of a man is quite a complex, one can say, unique design, from the joint work of all elements of which the adequate functioning of the "mechanism" as a whole depends. One of these components is the supraspinatus, which completely fills the supraspinal fossa of the scapula. Its main function is to divert the shoulder and stretch the joint capsule in order to protect it from infringement. Tendonitis of the supraspinatus of the shoulder joint can develop if the muscle capsule is injured by an acromioclavicular joint, an acromial-beak-like ligament or the acromion itself. Such damage is fraught with the subsequent deterioration of the physiological characteristics of the joint complex, the induction, slow or rapid inflammation 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 supraspinous muscle of the shoulder joint.

Diagnosis of tendonitis of the shoulder joint

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, other negative effects and lead to pathological changes in the human body. Diagnosis of tendonitis of the shoulder joint includes:

• Detection and analysis of patient complaints.
• Specialist examination aimed at determining the location of pathology, pain symptoms during palpation of the area, determining the mobility of the joint, establishing the presence of edema and hyperemia.
• It is necessary to differentiate this disease from other pathologies. For example, arthritis is characterized by constant pain even at rest, whereas tendonitis of the shoulder joint is pain associated with motor activity.
• Laboratory studies usually do not show any changes. An exception is tendonitis, which developed on the basis of bacteriological damage to the patient's connective tissue (infection or rheumatoid processes).
• The method of radiography will be informative only if the calcifying tendinitis of the shoulder joint is diagnosed. In this case, a cluster of calcinates (crystals of calcium salts) can be seen on the film - this is a rather late stage of the disease.
• Computer and magnetic resonance imaging makes it possible to determine degenerative changes in the structure of the shoulder joint: tendon ruptures, structural structure defects. Such a survey result may indicate the need for surgical intervention.
• Sometimes an ultrasound is used as an additional diagnostic. This technique allows you to establish changes that have affected the structure of connective tissue, its contractility.

[9], [10], [11]

Treatment of tendonitis of the shoulder joint

First of all, it is necessary to say that the treatment of tendonitis of the shoulder joint largely depends on the stage and severity of the course of the disease. In the case of diagnosing the disease in the early stages of its manifestation, the protocol of therapy is fairly sparing, and includes:

• The maximum restriction of mobility and load on the affected joint, and, consequently, on the affected tendon.
• Cold therapy is used as an auxiliary therapy.
• To fix the joint and bring it to rest, use tires, bandages, the imposition of elastic bandage.
• Actively used physical therapy:
  • Laser therapy.
  • Shockwave therapy
  • Magnetic therapy.
  • Exposure to ultraviolet and ultrasonic rays.
  • In the case of a chronic manifestation of the disease, mud and paraffin applications, lidase-based electrophoresis are practiced.
• Not the last place is taken by medical treatment - antibiotics, analgesics and anti-inflammatory drugs, antimicrobial drugs.
• After cupping the acute form of the disease and the effective course of therapy, the doctor connects the patient with a set of exercises of physical therapy.
• If there is no exacerbation, massages of the affected area are also shown.

In the case of more severe forms of lesion, the treatment of tendonitis of the shoulder joint begins with conservative therapy using anti-inflammatory drugs. If the tendonitis of the calcifying form is diagnosed, then a procedure is carried out to remove the salt deposits. To do this, two needles with a large opening are inserted into the joint and saline is washed out with a physiological solution. Then add cold therapy, massages, physical therapy, medical exercises. If such measures do not lead to a positive result, then one must resort to surgical methods of treatment. In this case, it would be appropriate to use an arthroscope - a medical device equipped with a video camera. It is introduced into the lumen of the joint and carries out the necessary manipulations. But a classical strip operation can also be carried out. The term of postoperative rehabilitation usually lasts two to three months, but it's not until three or four months later that you return to your usual active life.

Drug therapy may include multidirectional drugs. They are classified as non-steroid drugs.

Nimesil

This anti-inflammatory and analgesic is not prescribed for patients under 12 years of age. The drug is administered orally (orally) immediately after ingestion. The average daily dosage of the drug is 0.2 g, divided into two doses. Nimesil is prepared immediately before the reception. To do this, pour the contents of the sachet into a glass of warm water and mix well. Duration of treatment is no more than two weeks.

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

Nyz

This drug is used externally. Before the procedure, the skin area in the area of inflammation should be washed and toweled. Gel a small layer on the skin (length of the path to 3 cm). Strongly not rub. The number of daily procedures is from three to four. It is not recommended to use more than ten days.

Contra-indications of the drug include: acute phase of erosive and ulcerative gastrointestinal lesions, internal bleeding, various types of dermatoses, a tendency to allergic manifestations, renal and hepatic insufficiency, spasm of bronchial tubes. Nyz is not prescribed to women during pregnancy and lactation, as well as to children under the age of seven.

Ketorol

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

Ketorol is not recommended for people suffering from individual intolerance to the components of the drug, acute form of erosion and ulcerative lesions of the digestive system, problems with blood coagulability, stroke, and problems in the respiratory system. Do not prescribe the drug and women in the period of bearing the baby and breastfeeding, as well as children under 16 years.

Nurofen

This is a wonderful analgesic and antipyretic agent with a lot of liquid. For patients older than 12 years, the starting dose of the drug is 0.2 g, taken three to four times throughout the day. If necessary, a single dose can be raised to 0.4 g, while the maximum amount of a drug that is allowed per day is 1.2 g. For babies from 6 to 12, the drug is prescribed in an amount of 0.2 g four times throughout the day. Do not forget that nurofen can be given to children, whose weight has already reached 20 kg. The gap between the injections of the drug should not be less than six hours.

Categorically contraindicated drug in the case if the patient's history is present: cardiovascular insufficiency, severe form of arterial hypertension, ulcer pathology of the gastrointestinal tract, hypersensitivity to the components of the drug, as well as in case of pregnancy (its third trimester), lactation and at the age of infants up to six years.

Physiotherapy in tendonitis of the shoulder joint

In the treatment of tendinitis, exercise exercises are simple enough and are no longer directed to the pressure of the patient's joint, but to his "development", gradually making more deviation. The doctor can offer such exercises:

• To carry it out, you need a towel (it should be a long one). Throw it through some horizontal pole, holding hands separately for each end. Begin to smoothly lower the healthy upper limb down, while the patient hand will slowly begin to rise to the ceiling. At the moment when the first signs of pain appear, the movement is stopped and locked in this position for three seconds. After this, very smoothly return to the starting position.
• It is necessary to take a stick, ideally a gymnastic one, but any other one will do. Operate the stick vertically on the floor at arm's length from the victim. With a sick hand write the letter "O". The circle should be as much as possible.
• A healthy hand helps to fix the palm of a sick hand on a healthy shoulder. With a healthy brush, grasp the elbow of the affected arm. We begin very carefully, without jerks, to raise the elbows by the elbow, following the sensations in the shoulder joint. At the upper point, fix the position for three seconds and smoothly lower it down. Daily, the amplitude of the rise should be slightly increased.
• Hold your hands in the lock in front of you. Smoothly begin to raise your hands up. In this case, the main load goes to a healthy limb. She is like a tug behind a sick person.
• Put the chair in front of you, a little back from him. A healthy upper limb leans against his back, while the trunk is bent in the lower back, the diseased limb simply hangs. We begin to carry out the patient's hand motion of the pendulum, gradually increasing its amplitude. Movements can be made back and forth, and to the right - to the left, and circular motions.
• The upper limbs raise in front of him parallel to the floor and fold the palm of the left hand to the right elbow, and the palm of the right hand to the elbow of the left arm. In this situation, we begin to swing them in one direction or the other.

Alternative treatment of tendonitis of the shoulder joint

Quite additional help can be provided by alternative medicine, which has analgesic and anti-inflammatory properties:

• Effective in the treatment of tendonitis curcumin, which at a daily dosage of half a gram is taken in conjunction with food as a condiment. He declared himself as an excellent remedy to relieve pain, and copes well with inflammation.
• Fruits cherries insist in a glass of boiled water and drink two or three times a day as tea. Tanning substances of berries perfectly remove the inflammation and strengthen the effect on the body.
• A glass of collected septicles of the Volotsk (walnut) nut is poured into half a liter of vodka. Insist in a dark place for three weeks. 30 minutes before meals, take 30 drops of tincture, washed down with a large volume of chilled boiled water.
• The infusion, made of a mixture of two components: perfectly taken in equal proportions of sassaparilla root and ginger root, showed itself perfectly. A teaspoon of the crushed composition is poured into a glass of boiling water and drunk instead of tea. It is desirable to tea like this twice throughout the day.
• In the first day after the injury, a cold compress should be applied to the sore spot, and the following days, warming therapy is preferable.

[12], [13], [14], [15]

Prevention of tendonitis of the shoulder joint

To try to prevent the emergence of this pathology, prevention of tendonitis of the shoulder joint is necessary.

• Before you start more active exercise (increased stress), you must first warm up and stretch muscles and tendons.
• If possible, avoid prolonged monotonous monotonous movements.
• Be more attentive, thereby minimizing the likelihood of injuries and static or dynamic overloads.
• The growth of loads and its intensity should be gradual.
• Mandatory load periods should alternate with the rest time.
• Regular exercise with sports and active rest will give the opportunity to constantly keep the muscles and ligaments in tone.
• If there is pain in the course of work or playing sports, the action must be stopped and rest. If the pain symptomatology does not go away after a break, you should consult a doctor.
• In all actions adhere to safety rules.

Prognosis of tendonitis of the shoulder joint

If to speak about the future, the prognosis of tendinitis of the shoulder joint is favorable enough, but the responsibility for the expected result is borne by the patient himself, how responsible he will be in the treatment of physical exercises. After all, you have to force yourself to do this by overcoming laziness.

Any disease is much easier to prevent than to mess with. This statement is acceptable and to such a pathology as tendonitis of the shoulder joint, a fairly common inflammatory disease. There is no need to make great efforts if the therapy has captured the initial stage of the disease. But if the primary process is neglected, the pathology can go into a chronic phase, which already requires much more effort. But the danger is that chronic tendonitis can develop into immobilization of the joint and, as a consequence, atrophy of the muscular and connective tissues of the shoulder joint, which in time can lead to irreversible consequences. So do not rely on "maybe it will pass itself." Only a specialist is able to deliver the correct diagnosis and give effective recommendations.