How to treat humeroscapular periarthritis at home. Periarthritis Periarthritis symptoms and treatment

The most common inflammatory disease of the joints is periarthritis, the treatment of which causes much discussion among the world's leading orthopedists. Joint pain is the main reason for visiting a doctor in older people. Currently, the category of people who turn to doctors due to inflammation of the periarticular tissues is getting younger every year.

This disease brings not only discomfort to a person's life, but also brings a lot of suffering and pain. If you do not contact a specialist in time, the disease can not only limit a person’s working capacity, but also significantly worsen his ability to move around.

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Causes of periarthritis

Periarthritis belongs to the category of serious diseases, especially with incorrect and untimely prescription of therapy. It affects the tendons, joint capsule, muscles and ligaments surrounding the joint.

The most common causes of this disease can be:

• old age - 60 years or more;
• frequent hypothermia of the body;
• complications after infectious diseases;
• concomitant diseases;
• congenital pathologies of the musculoskeletal system;
• problems in the work of the endocrine and vascular systems.

The primary cause of post-traumatic periarthritis, which provokes the inflammatory process, may be muscle microtrauma. This applies to people who are engaged in hard physical labor, and athletes.

The main symptoms of this inflammation are aching, pain that constantly increases with movement, swelling in the area of ​​the affected joint, limited mobility. In addition, pain sensations also appear during medical diagnosis, when the doctor probes seals and nodules. Subsequently, additional symptoms may appear that characterize one or another type of periarthritis.

Types of disease

When meeting with the patient, doctors conduct a physical diagnosis, which consists of a thorough study of the medical history and examination of the affected joints. If necessary, studies such as radiography, arthrogram, ultrasound or MRI are carried out.

In some cases, it is difficult to determine the exact diagnosis of the disease, since some diseases have similar symptoms. In order not to make a mistake, doctors conduct differential diagnostics to exclude diseases with similar symptoms.

Periarthritis has an acute and chronic form of leakage, it can be primary or secondary.

Secondary periarthritis develops against the background of an already existing pathology. Based on the existing lesions, doctors distinguish the following types of disease:

1. Periarthritis of the foot.
2. Disease of the elbow joint and fingers.
3. Scapular periarthritis.
4. Periarthritis of the goose foot bursa.
5. Periarthritis of the ankle joint.
6. Disease of the hip joint.
7. Periarthritis of the wrist joint.

When diagnosing periarthritis of the ankle or foot, as well as the hip joint, doctors recommend limiting movement.

One of the most painful types of this disease is the defeat of the foot. It occurs as a result of strong tension in the tendons, which provokes inflammation of the tendons in the muscles of the sole. The result is bone spurs. The inflammatory process that appears as a result of this causes severe pain when stepping on the heel. Swelling or thickening is observed, which occurs due to inflammation of the synovial bag.

With periarthritis of the foot, doctors prescribe drug therapy with the obligatory connection of physiotherapeutic measures. This disease is typical for athletes and people with a lot of weight, so often the treatment of periarthritis begins with dietary recommendations to reduce the load on the foot. Similar symptoms and methods of treatment are inherent in diseases of the ankle joint. When this type of disease is detected, it must be treated comprehensively. For the period of therapeutic measures, the patient is provided with complete immobilization of the joint. In the absence of contraindications, it is recommended to do acupressure.

Much less often occurs periarthritis of the hip joint. It is characterized by pain that can subside when moving, the appearance of a feeling of stiffness in the affected joint, swelling of the hip joint, fever, redness. Most often, the pain manifests itself with prolonged sitting, standing or walking. The treatment of this type of periarthritis is complex, with the use of drug therapy and auxiliary methods of treatment. Treatment procedures, exercise therapy, massage are effective.

With an advanced form of the disease, an operation is performed, which is a prosthesis of the hip joint. This is an extreme measure. With drug treatment at the very beginning, the patient is prescribed non-steroidal anti-inflammatory drugs and intra-articular injections.

Periarthritis of the elbow joint occurs due to an inflammatory process characterized by changes in the tendons at the points of extension of the fingers and forearm muscles. When there is muscle tension, as well as with movements of the thumbs, the patient experiences pain. Characterized by swelling at the base of the thumb. Pain and swelling can also be observed in the interphalangeal joints.

The effect in the treatment of elbow periarthritis is provided by the drugs Diclofenac, Ortofen, Voltaren, etc. It is worth paying attention to contraindications and clearly follow all the instructions specified in the instructions.

The most common occurrence is recognized as wrist periarthritis. This disease is most susceptible to people who strain the muscles of the arm in the process of work. A characteristic symptom of this disease is pain in the place where the process of the radius is located. Pain increases with rotation and extension of the arm. There is obvious swelling under the wrist, and sometimes between the distal crease of the palm at the base of the finger.

Treatment of radiocarpal periarthritis is medical, with the help of non-steroidal anti-inflammatory drugs. After careful analysis, doctors may prescribe blockades with glucocorticoid hormones. The treatment regimen is greatly influenced by the causes of the disease, therefore, they should be established at the very beginning of therapy in order to eliminate the focus of inflammation.

Nodular periarthritis

One of the most dangerous manifestations of periarthritis is periarthritis nodosa, in which arteries and veins are damaged with inflammation and necrosis of the vascular network. The disease affects the work of the kidneys and the nervous system, gradually affecting the digestive tract.

The disease begins quickly, manifests itself in an increase in body temperature, soreness of the joints and muscles in the abdomen. Rashes and redness appear on the body in the affected area. Vascular damage leads to an increase in blood pressure, which, in turn, provokes angina attacks and can lead to myocardial infarction. Nodules form in the joints, this distinguishes this form of the disease from other manifestations of periarthritis. With a long course of the disease, neurological disorders are possible, there is a possibility of blockage of blood vessels that saturate the brain, and a stroke.

The disease has a long period of treatment, during which anti-inflammatory nonsteroidal drugs are prescribed, as well as drugs that normalize blood circulation. Therapy is supervised by a specialist who, as new symptoms appear, prescribes additional drugs and procedures.

Post-traumatic periarthritis

Not a single injury suffered by a person passes without a trace for him, since nerves and blood vessels are affected. This leads to a deterioration in the blood circulation of the articular tissues and a decrease in muscle tone. As a result, joint disease occurs.

Post-traumatic periarthritis appears in case of injuries that have been neglected and not properly treated. As a result, there is a violation of the integrity of the blood vessels and the joint does not receive the proper amount of nutrients.

The affected joint begins to deform over time, its mobility is limited. In the treatment of this type of periarthritis, doctors set two main tasks: to remove pain symptoms and improve the motor function of the affected areas. This disease requires complex and diverse treatment. Patients get a great effect from the use of chondroprotectors, which are extracted from animal cartilage. Not the last role in the treatment is assigned to diets and physiotherapy.

With insufficient results of conservative treatment, surgery is performed. In no case should you self-medicate. With a long course of the disease and the ineffectiveness of treatment, the patient may become disabled.

Post-traumatic periarthritis occurs due to the inability of the joint after the injury to cope with the usual loads to the fullest. This process can lead to destruction of the joint.

folk therapy

Despite the seriousness of joint diseases, more and more often patients resort to alternative methods for their treatment. There are many ways to treat the disease with folk remedies. These include not only the use of medicinal infusions and decoctions. Patients get a good effect from foot baths, rubbing based on natural ingredients.

A big concern with the use of non-steroidal anti-inflammatory drugs, attributed to joint pain, is sometimes caused by side effects. It is especially dangerous to take them for patients with stomach ulcers and those prone to allergies to their components. Traditional medicine recommendations do not have side effects, as they are described in a specific dosage. The main thing is to strictly adhere to the recipe.

Foot baths: 10 pcs. thistle with root, 5 pcs. horseradish leaves, lilac leaves, 2 pcs. butterbur herbs, 5 pcs. plants buttercup field steamed in 1 liter of water. The water should cool to a tolerable temperature, you need to soar your legs in it for 15-20 minutes.

Lilac is very popular for joint problems. Lilac tincture: fill one third of a three-liter jar with lilac inflorescences, pour 1 tbsp. alcohol, insist two weeks. Squeeze the flowers, add 300 ml of grated radish juice and 200 g of honey, leave for another day. Rub as needed for severe pain.

Pain in the joints will help to remove such a recipe: brew horseradish leaves, chickweed, quinoa and nettle in equal proportions in 2 liters of water. Then add 1 pack of burdock root, elecampane, oak bark, chamomile, wild rosemary, string and sage. Remove from stove, add 2 tbsp. salt, mustard, half a bottle of coniferous liquid extract. Let stand until hot, soar legs for the night, after which they need to be insulated. The infusion does not spoil within 5 days. Then they prepare a new one and soar the legs until the systemic pains disappear.

Pour field dandelion into a 1 liter jar, tamp, pour alcohol or 0.5 liters of vodka. Insist 14 days. Rub your knees at night for joint pain and pronounced varicose veins.

A good remedy for removing salts, which are a big problem with joint pain and swelling of the fingers, are teas made from dried leaves of strawberries, gooseberries, raspberries, pears, apple trees and everything that is in the garden. This is an inexpensive but very effective way.

Periarthritis is a lesion of periarticular tissues, namely inflammation of tendons, joint capsules, synovial bags, ligaments, etc. The name of this disease was given at the end of the 19th century by the French physician Simon Dupleix. The most common form of the disease is.

Description of the disease

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In scientific terms, periarthritis is a degenerative lesion of the tendons and periarticular soft tissues. Pathology begins to develop at the site of attachment of the tendons to the bone and is accompanied by inflammation of the serous bags and ligaments.

Shoulder-shoulder periarthritis is a common form of the disease. The main reason for the defeat of the tendons of the shoulder joint is that the ligaments and tendons in this area are constantly "under tension", this is due to the abduction of the shoulder back and its rotation.

Periarthritis most often affects large joints, however, inflammation of the soft tissue structures can develop in any other joint that is periodically or constantly harmed in the form of physical activity or trauma.

In medicine, periarthritis is divided into the following groups:

1. . Periarticular tissues become inflamed on the inside of the knee.
2. Periarthritis of the ankle joint. If the joints of the lower leg and foot are affected, complete immobilization of the limb is necessary. Periarticular inflammation of the tissues in the lower part of the leg brings severe pain to the patient, since the load on the legs is much stronger and more noticeable in comparison with the upper limbs.
3. Periarthritis of the elbow joint. The tendons of the extensor muscles of the hand and fingers are affected at the points of their attachment to the bone.
4. Periarthritis of fingers. The disease affects the interphalangeal joints of the hands. The main cause of inflammation is hypothermia of the extremities, a permanent load.
5. Periarthritis of the hip joint.
6. Scapular periarthritis, or Dupleix syndrome, is the most common form of the disease. The causes of the development of the disease are metabolic disorders, cervical osteochondrosis, joint injuries, etc.

Prerequisites for the development of periarthritis

There are a lot of reasons for the appearance of such a disease as periarthritis. They are more common in women over 40 years of age..

Factors predisposing to the development of the disease:

• congenital defects of the joints of the upper shoulder girdle;
• constant hypothermia;
• psychoneurological disorders;
• the presence of diseases such as sciatica, arthrosis, etc.;
• heart problems (myocardial infarction, coronary disease, etc.);
• tendon microtrauma or joint overload;
• increased and monotonous physical activity;
• infectious diseases of the liver of a chronic nature;
• metabolic disease;
• peripheral vascular disease, etc.

Note. Shoulder-scapular post-traumatic periarthritis, or Dupleix syndrome, is common in athletes and builders.

Forms of the disease and the main symptoms

Doctors distinguish three forms of the disease:

1. simple form. This stage of the development of the disease is characterized by mild pain when moving the limb. A simple form of the course of the humeroulnar periarthritis proceeds without pronounced symptoms. Often the pain goes away on its own.
2. Acute periarthritis is a complication of "undertreated" periarthritis of a simple form.. Joint pain appears quickly and suddenly, pain increases towards the end of the day. The patient has a fever, the affected joint swells and swells.
3. Chronic course of periarthritis. This form develops in patients who have suffered acute periarthritis. Patients complain of joint pain during movement. If the patient is not provided with medical care in a timely manner, the chronic form of periarthritis can lead to adverse consequences - the development of ankylosing periarthritis, capsulitis, etc.

Diagnostic methods

To establish the diagnosis of "periarthritis", an initial examination of the patient and the collection of anamnesis are required. For each stage of the disease, special diagnostic methods are needed. For example, in a simple form of periarthritis, the doctor assesses the presence of a restriction of rotation and movement of the limb, signs of Ergazon and Dauborn, radiological narrowing of the gap, etc.

The acute form of periarthritis differs from simple piercing diffuse pain and a sharp limitation of the motor activity of the affected joint. The patient has swelling and swelling of the extremities. In the chronic course of the disease, the patient complains of moderate pain of the same localization, symptoms of "mechanical blockade" are observed.

Often, the diagnosis of "periarthritis" is established after the patient has excluded diseases such as arthritis and arthrosis.. The patient must pass a general and clinical blood test, undergo an ultrasound and x-ray examination of the joints.

How to treat?

Treatment of periarthritis is primarily aimed at eliminating the symptoms of the disease. Patients are prescribed anti-inflammatory and analgesic drugs. Help to cope with inflammation in periarthritis tablets Voltaren, Ibuprofen, Diclofenac, etc.

The next step in the treatment of this ailment is to unload the affected tendon. To achieve a state of rest of the diseased joint, often the patient is prescribed a complete immobilization of the limb. With a simple form of periarthritis, wooden or wire splints that support bandages are effective. In advanced cases, the patient may be assigned to wear a removable plaster splint. As practice shows, even a few days of immobilization of a limb help to quickly cope with the disease.

For persistent pain, patients are prescribed intra-articular injections of corticosteroids. Injections for periarthritis are repeated after 5-10 days until the pain decreases.

Physiotherapy improves blood circulation and reduces pain. The most effective in the fight against periarthritis are sinusoidal currents, phonophoresis, ultrasound, etc.

Therapeutic gymnastics and regular physical exercises are no less effective in combating the disease. Patients with periarthritis are shown to perform acupressure, acupuncture sessions, manual therapy, etc.

In addition to the traditional complex of treatment, patients are recommended to use folk remedies, but this should be done only with the permission of the doctor.. Well help with periarthritis infusions of burdock root, black currant, nettle, compresses and rubbing.

Important! If all of the above conservative methods of treating periarthritis do not help, the patient is prescribed surgical treatment.

The prognosis of periarthritis is usually favorable, but it should be remembered that therapy for this type of disease must be persistent and long-term.

Surrounding the joint is the periarticular tissue, which includes muscles, ligaments, tendons, and the joint capsule. Periarthritis is an inflammatory process during which all periarticular formations are affected.

A disease that can provoke a similar condition develops from fasciitis, or capsulitis.

It can develop in almost any articular joint, but according to statistics, 80% of calls are humeral periarthritis (ICD code 10 - M75), periarthritis of all directions can be viewed by indexes M00-M99.

It is noteworthy that the disease rarely affects children. A child can get periarthritis only after a severe injury, severe hypothermia. The older a person gets, the more likely they are to get this disease. Older patients predominate among those who come to the doctor for an appointment, and the disease is also typical for people whose professional activities are associated with increased stress on the joint and athletes.

It is believed that the main reason contributing to the development of periarthritis is the load of a permanent nature due to the same type of repetitive actions for a long time. Gradually, this becomes a load for the articular apparatus, with which it ceases to cope, the tissues do not have time to recover. As a response, an inflammatory process develops.

Symptoms

Periarthritis is characterized by a predominantly chronic type of flow. Acute inflammation is rare and may be a response to damage or hypothermia of the joint, a consequence of injury.

The reasons why the disease most often develops are associated with an increase in the load on the joint, which is often provoked by overweight, as well as metabolic disorders, a sedentary lifestyle, and a tendency to hypothermia.

Symptoms appear in much the same way:

• there is pain of a aching nature, which manifests itself at the time of activity;
• hypertonicity of muscle fibers;
• engorgement, swelling of tissues;
• in the periarticular tissues there are distinct nodes and seals;
• the joint itself does not hurt, but it turns out to be stiff due to the soreness of the periarticular tissues.

With a timely visit to the doctor, the treatment prognosis is quite favorable, the patient restores the working capacity and mobility of the limb.

In the case when the visit to the doctor is constantly postponed, degenerative processes develop in the tissues around the joint, which lead to irreversible consequences and damage to the articular cartilage.

Treatment

With periarthritis, folk remedies are actively used: salt, honey, herbal compresses and infusions, hay dust baths, medicinal teas and tinctures. All methods involve either ingestion or distribution of the components of the recipe in a warm form on gauze, applying to a sore spot as a warming effect.

If you do not have an allergic reaction to honey, nettle, hay dust, then you can use folk remedies, combining them with medical treatment. The thing is that the defeat of the periarticular tissues can have a variety of consequences, depending on the accompanying diseases. That is why all procedures carried out at home must be agreed with the doctor.

The thing is that warming up can be ineffective and even harmful under certain conditions. The doctor must conduct an examination and then prescribe adequate treatment, which may include drug therapy, physiotherapy, exercise therapy.

If the patient is shown warming up, then there will be no problems in compresses. However, if the inflammation developed as a response to an infectious disease that accompanies shoulder stress, then this approach may be harmful, provoking a stronger development of the inflammatory process and the spread of infection within the body.

As in any case, when it comes to the treatment of joints or periarticular areas, conservative medical methods will help get rid of inflammation. NSAIDs and corticosteroids are used, depending on the severity of the problem. The task is to rid the tissues of inflammation and solve the problem that provoked it. Therein
including taking antibiotics if periarthritis has become a response to a past disease associated with an infectious agent.

Physical therapy and exercises will help restore joint mobility after the inflammation has been removed. The patient needs to follow the doctor's instructions exactly to help the joint regain mobility and restore cartilage nutrition and blood microcirculation in a given area.

The doctor prescribes pharmacological preparations for external and internal use, so that an integrated approach to therapy becomes as effective as possible. Assigned ointments act locally on the area of ​​​​inflammation without affecting the gastrointestinal tract. Possessing increased absorbency, they penetrate into the affected area and eliminate the cause of inflammation, reducing swelling and restoring mobility to the joint.

Shoulder-shoulder periarthritis

Symptoms indicating the development of humeroscapular periarthritis are primarily difficulty in movement and pain when trying to abduct or adduct the arm. Tendons of ligaments and muscles during monotonous actions are subject to microtraumatization, which provokes the development of inflammation and a degenerative process in the tissues of the joint.

Doctors call another reason a violation of the innervation of soft muscle tissues due to processes in osteochondrosis.
Treatment consists in relieving pain, eliminating inflammation and returning the joint and adjacent tissues to normal functionality. Blockade in case of humeroscapular periarthritis is used at the stage of the acute course of the disease, when pain bothers the patient even at rest.

Later comes the stage of "freezing", which is characterized by a pronounced limitation of mobility due to pain and even a feeling of numbness in the shoulder and shoulder blades. After some time, the shoulder "thaws" - it becomes more susceptible to medication and the implementation of physiotherapy and physiotherapy exercises.

In this case, Popov's set of exercises became very effective. These are specially selected exercises that return mobility to the joint by gradually and consistently stretching. Bubnovsky exercises are also known for a similar action.

Video: a set of exercises according to the method of Dr. Popov

Physicians involved in the rehabilitation of patients are sure that stretching and returning the mobility of the joint with the help of feasible, unsharp movements can have a beneficial effect and return a person to working capacity.

Massage has a good effect on the musculoskeletal system. Consistent study of the periarticular elements restores blood and lymph microcirculation, resumes normal nutrition and production of synovial fluid, and contributes to the normalization of innervation within the ligamentous apparatus.

Daily gymnastics should include exercises to maintain shoulder activity, remove clamps from muscle fibers and ensure its high-quality mobility. Periarthritis of the shoulder joint primarily develops when the functionality is limited and there is a process of stagnation and hypodynamia inside the articular apparatus. Pay attention to the symptoms: cervico-shoulder syndrome and osteochondrosis seem to manifest themselves.

In this case, the periarticular soft tissues near the knee joint will be affected. The most common prerequisite for the development of this form of the disease is the presence of chronic arthritis in the joint.

Women are predominantly prone to the disease. As for men, they are mainly professional athletes who often injure the knee joint or people whose professional activities are associated with prolonged stress on the knee area.

It is noteworthy that with knee periarthritis, the joint itself is rarely involved in the inflammatory process, periarticular tissues and ligaments are exposed to edema and inflammation. The mobility of the joint is preserved.

In addition to the direct development of arthritis or arthrosis, periarthritis can be provoked by metabolic problems, vascular diseases, due to which the nutrition of periarticular tissues deteriorates, and prolonged stress, as a result of which blood vessels and muscles spasm and metabolism and oxygen supply to tissues are disrupted.

Periarthritis of the hip joint

It is detected in 25% of patients who went to the orthopedic doctor with complaints of pain in the hip joints. Due to the specifics of localization, in this case, large articular joints are affected, which bear most of the load in the distribution of body weight. Because of this, damage to the periarticular tissues, bursa, or serous membranes can lead to loss of the ability to move and even disability.

The process develops according to the degenerative-dystrophic type or in the form of inflammation. When contacting a doctor, the patient will complain of aching or pulling pains of a permanent nature, which are aggravated by running or walking. The second manifestation is pain when lying on the side of the affected joint.

During examination, an orthopedist or traumatologist can detect seals in the area of ​​the greater trochanter, muscle fiber tension, signs of swelling, and edema.

If the disease is not treated, not only the formation of calcified areas will develop in the hip joint, the joint fluid will become serous in nature, and then it will not be possible to resolve the issue without surgical intervention.

Periarthritis of the ankle joint

It occurs due to excessive load on the periarticular tissues of the ankle joint. The pathology itself is quite rare, but its occurrence can be characterized by certain specifics:

• Women aged 40-45 who are overweight;
• Professional athletes such as sprinters.

Often in these categories of people, periarthritis is accompanied by the development of heel spurs, which can reach a length of 1 cm or more. Such an outgrowth delivers even more inconvenience and pain when walking, in addition to inflammatory processes and seals directly in the ankle.

The disease can have a serious impact on a person's quality of life, as he will experience pain both when walking and simply while standing. That is why the timely visit to the doctor is especially important.

At first glance, factors that are insignificant at first glance can provoke the development of the inflammatory process - hypothermia, prolonged stay of the feet in dampness, disturbances in the endocrine system and metabolism.

At first glance, periarthritis looks very harmless - which of us has not overworked our shoulders at work. However, ignoring alarm signals can subsequently seriously affect overall health. An important stage of treatment is the return of full mobility of the muscular-ligamentous apparatus of the shoulder with the help of drug treatment and the performance of special exercises.

It is important in every sense not to make sudden movements, because it is they who often cause pain. Gradually, carefully following the doctor's prescription, you will be able to regain full mobility of the shoulder and even restore the innervation of the area in case the problems arose precisely because of the clamp in the neck and shoulder area.

People over the age of 40 need to be especially attentive to themselves. It is during this period that periarthritis begins to assert itself, choosing the most vulnerable joints of the body. Do gymnastics, avoid hypodynamia and excess weight.

Shoulder-shoulder periarthritis is a fairly common pathology that has peculiar forms of flow. This term can be called a syndrome rather than a diagnosis, since there is no such wording in the International Classification of Diseases. The pathological condition involves inflammatory changes in the soft tissues and ligamentous apparatus of the humeroscapular region. As a rule, the joint does not participate in this process - changes in it are complications of the underlying pathology.

Patients with humeroscapular periarthritis note severe pain in the area of ​​the shoulder joint. With the development of the disease and its spread after the involvement of motor nerve endings, mobility is limited, the joint is blocked. In severe cases, he is completely immobilized. Treatment always begins with conservative methods, taking medications and exercise therapy.

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Description

Shoulder-shoulder periarthritis is quite common, every fourth person at least once in his life faced a similar problem.

The most vulnerable patients are after 45 years of age. Up to 2 times more often the pathology occurs in the elderly and senile age. Men and women are equally often affected by this disease.

The shoulder joint has a large range of motion. Every day, a serious load is placed on it, which is helped by a powerful ligamentous apparatus, tendons and muscles located around it. To ensure full functioning, it actively feeds on blood vessels and nerve endings.

The term periarthritis implies an inflammatory process around the articular bag ("peri" - about, "arthro" - joint). With long-term inflammation of nearby soft tissues, a transition to the articular surfaces and cartilaginous structures inside the capsule is possible.



Reasons for development

Shoulder-shoulder periarthritis is rarely an isolated syndrome, more often other pathological conditions of the musculoskeletal system lead to its formation.

Diseases such as adhesive capsulitis, osteochondrosis of the cervical and thoracic spine, myofascial syndrome, amyotrophy of the shoulder girdle can cause a similar symptom complex with characteristic changes.

To isolated humeroscapular periarthritis most often lead to:

• sedentary lifestyle and untrained muscles of the upper shoulder girdle;
• injuries, falls on an outstretched arm, damage to the shoulder joint and bone structures;
• vascular pathology with subsequent violation of the blood supply and nutrition of the humeroscapular region;
• pathological changes in the structure of nerve fibers, often caused by infringement during the development of herniated intervertebral discs.

The disease is able to develop even after a minor bruise, when there is no significant damage to cartilage, bone and soft tissue structures. On the 3rd - 7th day, symptoms appear that indicate inflammation, which is typical for periarthritis.



Kinds

The symptom complex of humeroscapular periarthritis includes the following pathological conditions:

• periarticular lesions;
• tendinitis of the biceps muscle of the shoulder;
• calcific tendonitis;
• adhesive capsulitis;
• impingement syndrome;
• shoulder rotator compression;
• other.

The pathological symptom complex may include one or more of the above disorders, and the clinical picture also depends on them.

According to the form, periarthritis is distinguished:

• simple;
• spicy;
• chronic;
• ankylosing.

Shoulder-shoulder periarthritis develops on the one hand, rarely is bilateral. The severity on the left and right will differ in development and clinical manifestations.

Chronic humeroscapular periarthritis



Symptoms

The clinical picture is largely non-specific, in its features it resembles many other diseases of the musculoskeletal system. Each form of flow is characterized by its own characteristics, which make it possible to suspect the degree of violation.

Symptoms often increase slowly, so patients can rarely unequivocally tell about the moment when the damage occurred or the pathological process began.

Symptoms depending on the form of the disease are described in the table:

Form of periarthritis	Development Features	Clinical manifestations
Simple	It develops more often than others and becomes the basis for the occurrence of more severe forms. It lasts no more than a month, after which it either disappears on its own, or becomes complicated and goes into an exacerbation stage with further chronicity of the process	Pain in the shoulder joint is intermittent and mild. The range of motion is almost completely preserved, sometimes there are restrictions when abducting the arm. When rotating with an outstretched arm, the pain intensifies
Acute	It usually develops as a result of an untreated simple form or after injuries. Duration - no more than a few weeks, if left untreated, it becomes chronic	The humeroscapular region is sharply painful, reddening of the skin is often determined. The pain syndrome sharply increases with minor movements. With a pronounced clinical course, the appearance of a general intoxication of the body, an increase in temperature up to 38 degrees is possible.
Chronic	Differs in long development and course. It rarely goes away on its own, as the resulting changes in the soft tissues are irreversible. In the absence of proper supervision and competent therapy, it passes into ankylosis - complete fusion of the joint	The pain is moderate, appears only after reloading the joint or hypothermia. Unsuccessful movements, an increase in amplitude and other provoking factors increase the pain syndrome. Aching and discomfort, discomfort appear mainly at night, in the morning Patients note a constant ache in the area of ​​the humeroscapular joint.
ankylosing	Represents the final stage of the formation of humeroscapular periarthritis. After serious injuries, it can appear in isolation, without previous stages. Characterized by complete rotation of the articular surfaces and calcification of soft tissue structures	The pain is constant, it is mild, dull and aching. Often characterized by shooting in the hand and neck. Movement in the shoulder joint is impossible, a functional limitation develops. The patient cannot raise his hand above a certain level, circular movements are not available. This medical condition is called "frozen shoulder". With a unilateral process, you can visually see the deformation of the shoulder. Sometimes there is no pain syndrome against the background of pronounced and persistent limitations of mobility in the joint area.

Diagnostics

The treatment of humeroscapular periarthritis is carried out by a therapist, surgeon, neurologist, orthopedist, traumatologist and rheumatologist. Each of the specialists performs a specific function in carrying out diagnostic and therapeutic manipulations. In most cases, it is recommended to first contact a therapist who will conduct an initial diagnosis and be able to choose a further narrow specialist competent in the treatment of a particular form of pathology.

Laboratory studies involve a general and biochemical blood test, a general urine test:

• In the presence of humeroscapular periarthritis, an increase in ESR and leukocytes is diagnosed, which are nonspecific signs of inflammation in the body.
• When conducting biochemistry, an important role is played by rheumatoid factor and C-reactive protein. A positive indicator of the latter will indicate periarthritis. If a positive rheumatoid factor is determined, we can talk about another disease.

The final diagnosis is confirmed by instrumental methods. The most informative are magnetic resonance imaging, x-ray of the humeroscapular region. In some cases, an ultrasound is performed, which allows you to determine the nature of the inflammation and its prevalence.

Treatment

The basis of successful treatment is the early diagnosis of the pathological process, since humeroscapular periarthritis can be stopped by therapeutic methods. With initial changes, a complete cure is possible. Given that the clinical picture in the initial stages is blurred and the person does not pay due attention to the pathological process, irreversible disorders develop that require enhanced therapy and dynamic control.

Along with the main treatment during periods of exacerbations or in the acute phase, constant observance of preventive measures aimed at restoring the integrity of the articular surfaces, periarticular structures and stopping the further development of periarthritis is required.

A person with this disease must observe the regime of work and rest, avoid physical overstrain of the upper shoulder girdle, minimize the risk of injury and possible hypothermia. You need a rational and balanced diet, including in the diet a large amount of vitamins and minerals that contribute to recovery.

Medical therapy

Before conducting drug treatment, it is necessary to perform a detailed diagnosis in order to identify the provoking factor that caused the development of periarthritis. After that, the treatment is to eliminate it.

One of the main factors is osteochondrosis of the cervical and thoracic spine. Patients are often diagnosed with a pathology combined with the spine - cervicoscapular periarthritis.

Drug therapy for all diseases of the musculoskeletal system begins with non-steroidal anti-inflammatory drugs. The main representatives of the group are:

• Diclofenac.
• Ibuprofen.
• Nimesulide.
• Ketoprofen.
• Meloxicam.
• Lornoxicam.

They are available in injections, tablets, ointments and creams for topical use.

Therapy is recommended to start with injectable forms for intramuscular injection. The course of treatment is 3-10 days. If it is not possible to achieve the desired therapeutic effect, aftercare occurs with the help of tablets, the course of which usually does not exceed 14 days.

NSAIDs adversely affect the mucosa of the gastrointestinal tract, so they are prescribed with caution to patients with chronic gastritis, peptic ulcers of the stomach and duodenum. With In order to prevent exacerbation of chronic diseases of the gastrointestinal tract, proton pump inhibitors are simultaneously shown: Omeprazole or Pantoprazole. It is recommended to take non-steroidal anti-inflammatory drugs after eating.

In the absence of a sufficient positive effect from NSAIDs, steroids are prescribed, such as Diprospan, Metipred and others. They are available in the form of injections, tablets and ointments. In extreme cases, when the inflammatory process is widespread and the pain does not stop for 2-3 weeks, injections into the joint and periarticular space are recommended.

Only a qualified specialist is entitled to perform such manipulations, since they are fraught with the development of complications.

As auxiliary means, B vitamins, analgesics, multivitamin complexes are used to eliminate symptoms. There are combined drugs, such as Neurodiclovit (as part of vitamins B1, B6, B12), Diclofenac. They are shown in the aftercare period and for prophylactic purposes.

Chondroprotectors are prescribed to restore the structure of cartilaginous tissues, prevent further development of disorders and for the purpose of prevention. These drugs include: Artra, Teraflex, Dona and others. It is necessary to apply them for long courses, since the effect can be achieved no earlier than after 2-3 years of systematic therapy.

Physiotherapy

In the absence of an acute inflammatory process, immediately after the start of drug treatment, physiotherapeutic procedures are indicated.

Of particular importance are post-isometric relaxation and therapeutic exercises. They represent an integrated approach in the treatment of humeroscapular periarthritis and contribute to the restoration of range of motion.

Postisometric relaxation involves tension with further stretching of certain muscle groups. In the process of these manipulations, they are fixed in the required position, after which the muscles relax. Already after the first course, mobility in the joint area increases, periarticular tissues become more elastic and pliable for performing movements.

Maximum efficiency can be achieved when performing a set of Popov exercises. Dynamics occurs no earlier than 3-4 weeks from the start of treatment, which largely depends on the degree of spread of the pathological process. The patient needs to be patient and perform physiotherapy exercises daily.

Popov's set of exercises

The description of the methods and their duration are described in the table:

The physiotherapeutic effect on the humeroscapular region helps restore blood flow, increase soft tissue nutrition, prevent venous congestion, increase metabolic processes, strengthen muscles and ligaments.

Treatment with folk remedies

Folk remedies have an auxiliary effect in the treatment of humeroscapular periarthritis. This is due to the fact that the disease is often irreversible. Recipes prepared at home help relieve symptoms and stop the further development of the pathological inflammatory process.

In order to increase the blood supply to the affected area and increase the nutrition of soft tissues, leeches are placed on the area of ​​the humeroscapular joint. Hirudotherapy is highly effective in all forms of periarthritis.

Effective recipes to treat the disease at home:

1. 1. 20 g of dry nettle extract is poured into 200 ml of boiling water, kept in a water bath for 30 minutes, poured into a glass container and stored in a refrigerator. Take 1-2 tbsp. l. 3 times a day for 2-3 weeks.
2. 2. Fresh horseradish root is crushed with a grater, mixed in equal proportions with honey, then spread in a thin layer on gauze or other cotton fabric and applied to the site of inflammation for 15-20 minutes. The course of treatment is 7-10 days.
3. 3. 50 g of calendula flowers are poured into a glass container, 500 ml of vodka is poured on top and allowed to infuse for 15 days in a dark place at room temperature. Shake the bottle daily. After the tincture is ready, rub the shoulder area with it 2 times a day, preferably at night. The course of treatment - no more than a month.

In case of failure of conservative treatment, when a persistent loss of functionality develops and complete fusion of the shoulder joint, surgical intervention is indicated. During the operation, a small part of the scapula, which articulates with the articular surface of the humerus, is removed. After that, rehabilitation is necessary: ​​a course of drug therapy, physiotherapy.

Shoulder-shoulder periarthritis usually responds well to conservative treatment at all stages of development and is not fatal. The danger of the pathological process lies in the fact that a person is able to lose the mobility of the upper shoulder girdle, which reduces the quality of life. The timeliness of competent diagnosis and therapy has a fundamental impact on the prognosis.

The following connections are located around the joint: capsule, synovial bag, tendons, muscles, ligaments. When a person has inflammation of the entire periarticular region, he is diagnosed with periarthritis. Thus, this term is understood as the simultaneous defeat of all periarticular tissues with the subsequent development of reactive inflammation in nearby joints. Periarthritis is classified as a rheumatic disease. The word itself is of Greek origin and consists of two roots: peri (around) and arthron (joint).

Periarthritis can affect all tissues and interosseous connections that are present in the musculoskeletal system. Most often, periarthritis is diagnosed in women over the age of 40-45, although men are also susceptible to this disease. Periarthritis accounts for up to 26.1% of all extra-articular inflammations of the soft tissues of the musculoskeletal system.

The most common form of this degenerative process is humeroscapular periarthritis. It accounts for 80% of the total number of rheumatic diseases of the shoulder. This is due to the fact that the tendons at the point of attachment of the shoulder joint are constantly in functional tension. The tendons of the muscles attached to the elbow joint, wrist and hands are less commonly affected. The rarest type of periarthritis is inflammation of the tendons and muscles in the joints of the lower extremities, since there the load falls on the joints, and not on their muscular frame.

Periarthritis is a disease that can seriously impair the patient's quality of life, making him half disabled. After all, bones, joints, muscles and synovial bags are located throughout the body. Therefore, it is necessary to navigate the causes and symptoms of the disease in order not to delay treatment and consult a doctor in a timely manner.

Common symptoms of periarthritis:

Muscle pain that occurs only when performing certain movements.

A slight swelling of the inflamed area, which does not have severe pain.

Muscle tension that is present on an ongoing basis.

The presence of painful palpable points.

During the acute stage of inflammation, a slight increase in local body temperature, swelling and redness of the damaged area are possible.

Limitation of mobility in the joint is not excluded, but not complete, but partial.

During the radiographic examination, it is possible to detect calcifications and periostitis.

If, with periarthritis, only tendons are involved in the pathological process, then this will be manifested by the following symptoms:

tissue swelling;

Accumulation of infiltrate;

Spike of collagen fibers;

Formation of sclerotic areas and calcifications.

When the periarticular bag is affected, the following symptom complex will be observed:

Swelling of the skin over the site of inflammation;

skin hyperemia;

Accumulation of serous exudate;

Deformation of the walls of the synovial bag.

Symptoms of periarthritis will also vary depending on where the inflammation is located:

humeroscapular- This type of inflammation is diagnosed more often than others. With it, the tendon muscle is damaged in the scapular periosteal fossa. The head of the biceps is less commonly affected.

Symptoms of humeroscapular periarthritis:

• Pain in the shoulder area, which can occur both during exercise (with a simple form of inflammation) and at rest (with an acute form of inflammation);

  Severe pain occurs when you try to make rotational movements with your hand or when you try to overcome resistance;

  The inability to raise your hand high, put it behind your back or make other complex movements;

  "Frozen Shoulder Syndrome", which is characterized by loss of sensation in the areas of the shoulder, shoulder blade, arm;

  The acute form of the disease is characterized by subfebrile body temperature, the onset, deterioration in performance, the presence of swelling and sharp pains;

  In the chronic form of the disease, fusion of the walls of the bag is often observed with the further development of capsulitis and calcification of the affected tissues, as a result, the mobility of the upper limb will be seriously limited.

Algodystrophic syndrome "shoulder-hand", as a kind of humeroscapular periarthritis.

Its symptoms:

• The appearance of severe burning pain in the area of ​​​​the affected elements;

  Trophic and vasomotor changes in the hand: blueness of the skin, development,;

  As the disease progresses, it leads to the formation of contractures of the fingers.

In this case, the tendon of the brachioradialis muscle most often suffers at the point of its attachment to the styloid process of the radius.

Symptoms of the disease:




• Pain localized above the wrist joint;

  They tend to increase with rotation of the joint surrounded by inflamed muscles;

  Most often there is a mild swelling of the affected area;

  The disease has a persistent and prolonged course.

Elbow. In this type of periarthritis, tendons become inflamed where the hands, fingers, and forearms meet. Most often, the area of ​​\u200b\u200bthe external epicondyle of the humerus suffers, therefore, the ulnar periarthritis is also called the “tennis elbow”.

Symptoms of the disease:

• Pain in the epicondyle when trying to straighten the forearm;

  It is not excluded an increase in lymph nodes, their soreness;

  The pain radiates both to the upper part of the arm and down;

  Passive movements become partially limited due to pain;

  Most often, after a few months, self-recovery occurs, although subsequent relapses of the disease are not excluded.

Symptoms:




• Inflammation is localized in the inner part of the knee, below the knee bend, it is in this place that pain occurs;

  The pain intensifies while walking, bending the knee, or with a long static position;

  There may be swelling and redness of the skin in the area of ​​​​inflammation.

Hip. In this case, the inflammation is localized in the area of ​​the hip joint.

Symptoms:

• Paroxysmal pain in the pelvic region, which radiate to the thigh;

  The attack of pain proceeds as a painful crisis;

  On palpation, the maximum pain is observed in the region of the greater trochanter, and when pressure is applied to its posterior superior angle, the pain becomes unbearable;

  When the pains gain their maximum strength, the person becomes practically immobilized.

Ankle and foot. There are dystrophic changes in the foot, heel spurs are formed. Most often, athletes and overweight people suffer from this type of periarthritis. A common symptom of inflammation is the occurrence of pain when pressing on the heel. Pain is a consequence of the development of subcalcaneal bursitis.

Constant companions of periarthritis are conditions such as bursitis (inflammation of the synovial bag), capsulitis (inflammation of the joint capsule), tendinitis (inflammation of the tendon), fasciitis (local inflammation of the muscle). Also, periarthritis often gives a reaction to the periosteum, which is in contact with the affected tendons, which leads to the development of periostitis.

Causes of periarthritis

Periarthritis may be due to dystrophic processes. True inflammatory periarthritis is also distinguished, which is extremely rare and is a consequence of chronic arthritis.

The reasons leading to the development of dystrophic periarthritis:

Repeated microtrauma of the tendons. They may be due to the peculiarities of a person's professional activity, or be the result of increased physical exertion during sports. Prone to the formation of periarthritis are people of such professions as a painter, blacksmith, tennis player, etc.

Metabolic disorders are another reason that can lead to the development of inflammation of the periarticular tissues. It is worth noting that most often periarthritis is diagnosed in people with.

Disturbances in the work of the endocrine system contribute to the development of periarthritis. This is especially true for women who are on the threshold, or have already entered it.

Vascular disorders negatively affect the nutrition of periarticular tissues and can cause the development of their inflammation. Often, humeroscapular periarthritis is observed in people who suffer from coronary disease. In this case, inflammation of the tendons develops against the background of subsiding angina attack. In 15% of patients who have had a myocardial infarction, periarthritis also develops.

Do not overlook neuroreflex failures in the body.

The load and frequent injuries of the periarticular tendons lead to the formation of foci of necrosis in them, which subsequently sclerosis and calcification. Very often, reactive inflammation develops in these areas, which spreads to adjacent joint bags.

Additional risk factors that can influence the development of periarthritis are:

Age over 40;

Transferred infections that had a severe course (periarthritis acts as a complication);

Prolonged exposure to cold and damp conditions;

Congenital diseases of the musculoskeletal system.

Diagnosis of periarthritis

Diagnosis begins with examination and listening to the patient's complaints. The doctor should be extremely careful, since periarthritis is very easy to confuse with arthritis and arthrosis.

Evaluation criteria that distinguish periarthritis from true joint diseases:

Patients can complain about pain in the muscles surrounding the joint to such specialists as a general practitioner, surgeon, rheumatologist, orthopedist, neurologist.

After collecting anamnesis and examination, the doctor will refer the patient to undergo a number of additional examinations:

Radiography.

As a rule, x-rays show changes in the joints (deposits of calcium crystals, the development of osteoporosis of the head of the bone) with prolonged and progressive periarthritis.

Invasive diagnostic techniques such as arthrography and arthroscopy can only be used when the patient is undergoing surgery.

Regardless of where exactly the inflammatory process is localized, the treatment of periarthritis should be comprehensive.

It is carried out in the following areas:

Elimination of the symptoms of the disease.

Restoration of the volume of lost muscle movements.

Carrying out a set of measures aimed at preventing the recurrence of the disease and the development of complications.

Elimination of destructive changes in the joints.

Treatment of comorbidities, if any.

It is worth considering that periarthritis tends to become chronic, so treatment should be persistent. Experts recommend eliminating the load from the affected tendon as much as possible, which is especially important in the acute stage of inflammation. Bandages are used to immobilize the limb. If the case is severe, then plaster may be applied.

To eliminate pain, painkillers and anti-inflammatory drugs are used: Aspirin, Analgin, Indomethacin, Brufen, Reopirin, Butadion. The recommended therapeutic dose should not be exceeded.

To reduce pain, you can use ointments for topical application to the skin. For this purpose, anabolic, warming and painkillers are used. Among these drugs: ointment Diclofenac, Ibuprofen, Indomethacin, camphor, methyl salicylate.

In the acute phase of periarthritis, in the presence of severe pain, infiltration of the affected area with hydrocortisone and novocaine is necessary. Frequency of injections: every 5-10 days. They continue to be administered until the pain is reduced.

Acute pain requires short-term course treatment with glucocorticosteroids. For this, the patient will take oral Prednisolone (10-20 mg per day) for 10-15 days. Gradually, the dose should be reduced, up to the complete rejection of the drug. Additionally, the doctor may prescribe muscle relaxants, angioprotectors, chondroprotectors.

Physiotherapy is also indicated from the first days of the patient's request for help.

For periarthritis, the following types of treatment are applicable:

Phonophoresis with hydrocortisone.

Microwave treatment.

Ultrasound treatment.

Cryotherapy, laser therapy.

Shock wave therapy, acupuncture has proven effectiveness.

Electrophoresis with painkillers and drugs aimed at improving blood circulation.

Hydrogen sulfide and radon baths give an excellent effect in the treatment of chronic periarthritis.

A separate direction in the treatment of periarthritis is therapeutic exercises. It must be started very carefully, with passive movements.

The main goals pursued by physiotherapy exercises:

Reducing the intensity of pain attacks;

Restoration of limb mobility;

Relaxation of the inflamed muscle;

Normalization of muscle tone and muscle strength.

Gymnastic complexes can be performed at home, as well as in a hospital. The emphasis is on exercises that do not cause pain. The joints around which periarthritis has developed should be worked out, but the diseased limb should not be overloaded.

Massage with periarthritis is contraindicated! It is possible to carry it out with a mild course of the disease with a mandatory bypass of the inflamed area.

The operation is performed only when all methods of treating inflammation are ineffective, and the disease continues to progress.

Other indications for surgery:

Inability to relieve pain with corticosteroid injections;

Recurrent pain that does not subside after 6-8 months of treatment;

Patients over 40 years old, whose work is associated with a load on the joint, in the area of ​​\u200b\u200bwhich the inflammatory process occurs;

Tendon injury leading to joint deformity;

Damage to peripheral nerve fibers.

The surgeon performs a dissection of the adhesions, which allows you to restore the mobility of the diseased tendon. At the same time, spurs, salt deposits and other pathological growths are removed.

As for the prognosis for recovery, in most cases it is favorable. If the treatment is carried out in a complex and in the system, then the necrotic foci and calcifications gradually resolve. In parallel, the pain disappears, the mobility of the limb normalizes. However, for a successful recovery, it is necessary to consult a doctor in a timely manner. The long course of the disease can lead to the formation of fibrous adhesions of the tissues surrounding the joint. As a result, it will not be possible to fully restore his mobility, which means that a person will receive a permanent disability, lose the skills of household and professional activities.

To minimize the risks of developing periarthritis, you must adhere to the following recommendations:

Engage in physical education, but training should be moderate.

Do not abuse the load on a particular joint. If this cannot be avoided by the nature of professional activity, then the overloaded joint should be provided with sufficient rest. An excellent prevention of the disease is massage.

Infectious diseases should be treated qualitatively and in a timely manner.

It is necessary to avoid situations that injure the joint. Moreover, the danger is not only macro-, but also microtrauma.

No less important is the prevention of diseases of the musculoskeletal system in general.

To simplify the therapy of periarthritis and make it as fast as possible, if pain occurs in the joint area, do not self-medicate, but immediately go to a specialist.

Education: diploma in the specialty "Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012, she completed postgraduate studies in the specialty "Traumatology and Orthopedics" at the City Clinical Hospital. Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.