Arthritis is the process of deterioration of one or more joints. We distinguish between inflammatory (rheumatic) arthritis, in which the process begins with irritation of the joint and subsequent deterioration of the cartilage, and degenerative arthritis (arthrosis), in which there is deterioration of the cartilage of the joint due to aging or injury.
The causes of osteoarthritis are not fully understood and are difficult to define. There are, however, some risk factors that influence the occurrence of this problem – shoulder injuries, irritations / inflammatory conditions, shoulder surgery, excessive use of the shoulder. Athletes (weightlifting, for example), as well as people whose activities involve frequently raising their arms above shoulder level, are particularly at risk. Rheumatoid arthritis is a common disease in which the patient’s immune system itself, “by mistake”, attacks the joints, thus causing their irritation and damage.
About the symptoms most often there is pain in the shoulder and stiffness. Pain and stiffness vary in intensity and often occur at night and interfere with sleep. The intensity of the pain increases with increased activity. As the disease progresses, almost any movement can cause pain. There may also be a crackling or creaking sound during movements, which is a sign of complete deterioration of the cartilage. The pain occurs in the shoulder area and can spread to the neck, down the arms, or towards the chest.
Types of arthritis:
- Osteoarthritis. In this type of arthritis, joint cartilage is damaged or destroyed. As it is damaged, it becomes uneven and rough and the bone becomes bare. When moving, the bones in the joint touch each other and this causes pain. This type of arthritis most often affects the population over 50 years of age.
- Rheumatoid arthritis . This type of arthritis usually affects multiple joints in the body at the same time and is symmetrical – it most often affects the same joints on both sides of the body. A mucous membrane (synovium) is present in the joints, which produces joint fluid that lubricates the joints and makes it easier for the joint to move. In an acute condition, it is swollen, but there is no damage to the articular cartilage. In chronic rheumatoid arthritis, there is a deterioration of cartilage and damage to the joint itself. It occurs most often in younger people. This condition has the characteristics of an autoimmune condition, which means that the immune system attacks its own tissue. Our defense system, instead of protecting against infections, damages normal, healthy tissue and softens bones. Primary treatment is in the domain of rheumatologists.
- Post-traumatic arthritis . A form of degenerative arthritis that develops after injuries such as shoulder fractures or shoulder instability with falling out.
- Arthropathy due to rupture of the rotator cuff. This is a type of degenerative arthritis that occurs as a result of a rupture of the rotator cuff tendon. As a result, the head of the upper arm does not lie stably in the socket and moves upwards towards the scapula (acromion), causing cartilage damage and bone degeneration. The combination of tendon damage and advanced arthritis can cause severe pain and complete paralysis of the shoulder. Most of the time, the patient is unable to raise his or her arm to the side.
- Avascular necrosis. This problem occurs when there is a disturbance in blood circulation in the head of the upper arm – bone cells do not get enough blood and begin to die. In the bone that is just below the cartilage, cysts appear, there is no support for the cartilage that dents and the entire joint is deformed. Initially, the damage occurs only in the head of the humerus, but as the process progresses, damage to the socket itself occurs. The most common cause of this type of arthritis is a fracture of the shoulder, but it can also occur with the use of steroids, excessive alcohol consumption, etc. Sometimes, however, it is not possible to determine the clear cause of this situation.
Treatment of rheumatoid arthritis is the responsibility of rheumatology specialists. With modern drugs, it is possible to bring the disease into a chronic state where the deterioration of the joint is largely stopped. In advanced and aggressive forms, treatment is surgical – by implanting an artificial shoulder joint.
Treatment of degenerative forms of arthritis can be conservative and operative.
Conservative treatment in the form of physical therapy is always recommended as the initial therapy. The goal is to reduce pain and increase the mobility of the shoulder joint. It may be recommended to give blockages to the shoulder joint to slow down the process, but it should be borne in mind that their effect is temporary.
Surgical treatment is applied in cases where conservatively does not give the desired effect. The definitive treatment is the installation of an artificial shoulder. Arthroscopic procedures are used as a temporary solution to delay the installation of an artificial shoulder.
