Pleuralopathy periarthritis: causes, symptoms, principles of treatment

Pleuralopathy periarthritis is a medical term that unites a whole group of various pathologies of the musculoskeletal system and the peripheral nervous system. In the International Classification of Diseases, there is no such formulation of the diagnosis as a humeropathy periarthritis. This is more a syndrome of "problems in the shoulder joint zone," which occurs under the influence of various causes, provided that the joint itself remains healthy. Shoulder-scapular periarthritis manifests itself mainly in pain in the shoulder joint zone and restriction of movements in it. When minor symptoms are ignored for some time, the humeroparous periarthritis passes into the chronic stage, which is fraught with complications in the form of immobility of the shoulder joint. Treatment includes, first of all, medicamentous effects, as well as special exercises in physiotherapy or, more simply, gymnastics. In those rare cases, when this is not enough, they resort to surgical removal of the problem. This article will tell you about the main causes, symptoms and principles of treatment of humeroparous periarthritis.

Pleuralopathy periarthritis is a rather frequent pathology. The morbidity statistics show that about 25% of the world's population at least once in their life faced such a problem. Both men and women suffer equally. The lion's share of all cases of humeroparous periarthritis is in the middle and old age.

The shoulder joint belongs to one of the most mobile joints in the body. On it a big load falls every day. Around the joint is a lot of ligaments, tendons, muscles, blood vessels and nerve fibers. In those cases when the tissues immediately surrounding the shoulder joint develop damage and inflammation, and there is a humeropathy periarthritis ("Shoulder-blade" means in the area of ​​the articulation of the shoulder and shoulder blade, the prefix "peri" means "around", and "arthritis" means inflammation of the joint). It should be noted that the joint itself is not affected, that is, no pathological processes occur inside the joint.

The causes of humeroparous periarthritis

Modern medicine no longer considers humeropathy periarthritis a homogeneous disease. In connection with the expansion of diagnostic capabilities it became known that a variety of diseases can have identical symptoms of humeropathy periarthritis. This is the pathology of the rotator cuff of the shoulder, and the adhesive capsulitis, and the osteochondrosis of the cervical spine, and myofascial pain syndromes, and neuralgic amyotrophy of the shoulder girdle. And the immediate causes of the symptoms of brachial periarthritis are:

• increased loading on untrained shoulder joints;
• a hand injury (a fall on an outstretched hand, on the shoulder, a blow to the shoulder itself). The trauma itself may be minor, but it is sufficient for the development of microdamages around the shoulder joint in the tissues of the muscles, tendons and ligaments, which serves as a further cause of the onset of symptoms. And the symptoms often appear not immediately after the injury, but in a few days (3-7);
• deterioration of the blood supply of the shoulder joint and a number of located tissues. Usually, this situation occurs with myocardial infarction, when the tissues of the zone of the left humerus are deprived nutrients and oxygen, as a result of which they become more brittle, tear and become inflamed. Deterioration of blood flow can occur also after operations on the mammary gland, with liver diseases;
• infringement of the nerves of the cervical and brachial plexus. At the same time muscles are spasmed, they squeeze the blood vessels passing through them, which worsens the blood flow in the periarticular tissues. In the future, the scenario described above is played out.

Symptoms of humeroparous periarthritis

There are two main symptoms of humeropathy periarthritis: pain and restraint. But these symptoms have their own peculiarities, which make it possible to suspect that the humeropathy periarthritis. About them and talk.

Clinical features of pain and movement disorders in the shoulder joint depend on the form of the humeropathy periarthritis. Depending on the time of onset and the nature of the symptoms, it is customary to distinguish the following forms of humeropathy periarthritis:

• simple;
• acute;
• chronic;
• ankylosing.

The humeropathy periarthritis can be either unilateral (which happens more often), and bilateral.

Simple form

A simple form of the humeroparous periarthritis occurs as the initial stage of the disease. It is characterized by:

• minor severity of pain in the shoulder region;
• restriction of movements in the joint is due to difficulties in drawing the outstretched arm to the side, institution bent at the elbow joint of the arm behind the back (as if trying to reach the spine with fingertips);
• if you rotate an elongated arm around your axis, overcoming resistance, then the pain syndrome increases. Rotation without opposition does not lead to increased pain.

A simple form is often not noticed by the patient, since its symptoms are imperceptible or mild. The simple form lasts 2-4 weeks, sometimes it can pass independently (under condition of complete rest and absence of load on the shoulder joint). If the simple form does not pass independently or is not treated, then it passes into the next, into an acute form.

Acute form

It can be either a consequence of an untreated simple form, or an independently arising problem. The acute form implies the following features of the course of the disease:

• pains in the shoulder area become strong, sharp;
• pains are given to the neck, to the whole hand;
• pain intensifies with movements in the shoulder joint (with the rotation of the outstretched arm, with the outstretched arm extended upwards through the side). At the same time lifting the outstretched arm forward remains painless. Sometimes, because of pain, such movements become simply impossible;
• the intensity of pain increases at night, which is why sleep is disturbed;
• The pain syndrome decreases if the arm is bent at the elbow and pressed to the chest;
• when carefully examined, it is possible to detect swelling on the anterior surface of the shoulder joint;
• it is possible to raise the body temperature to a low-grade figure (37 ° C-37.5 ° C).

The acute form lasts several weeks, with the treatment the symptoms gradually come to naught, and the volume of movements is restored. In the absence of adequate treatment, the process can go on into a chronic form.

Chronic form

For this stage of the disease, the following symptoms are characteristic:

• pain syndrome becomes moderate or even insignificant, the nature of the pain is aching;
• pains in the shoulder area are periodically amplified, especially with rotation or unsuccessful movement, become sharp, sweeping. To foresee their appearance is impossible;
• at night (more often in the morning) there is an ache in the shoulder joint, which prevents sleep.

Chronic form can exist for several months and even years. Occasionally, independent treatment is possible without the intervention of physicians, but more often in the absence of therapy the disease passes into the following form, ankylosing.

Ankylosing form

It often becomes the final stage in the development of the disease, but in some cases it develops primarily, that is, without passing through the previous forms of the disease. It is characterized by:

• dull, aching, low-intensity pain in the shoulder region, but when pain is attempted, pain intensifies dramatically;
• movements in the shoulder joint become severely limited. The hand does not rise above the horizontal level to the side, it does not start behind the back, it is practically impracticable to rotate around its axis. Because of such signs, this stage is also called the "frozen shoulder";
• the tissues of the shoulder joint become denser, which is determined even by the touch;
• occasionally the ankylosing form can be painless, when the movements are limited, and there is no pain.

Principles of treatment of humeroparous periarthritis

Virtually all forms of the humeropathy periarthritis respond well to treatment, with the exception of ankylosing (although it can be effectively controlled). The earlier the treatment is started, the better for the patient, the sooner the recovery will come and the lower costs it will require, both material and temporary.

If possible, the cause of the humeroparous periarthritis should be eliminated. If this is a degenerative process in the spine (osteochondrosis), then it is necessary to treat it, if it is a myocardial infarction, then, first of all, it is necessary to normalize the blood flow and so on.

We will stop in detail on medicamentous treatment of a humeroscapular periarthritis.
The basic basis of therapy is usually non-steroidal anti-inflammatory drugs (Diclofenac, Ibuprofen, Nimesulide,Ketoprofen, Meloxicam, Lornoxicam, and so on). They can be used in the form of tablets, injections, ointments, gels and even patches. What form of release of a preparation will appear is more preferable in a concrete case, the doctor solves. Nonsteroidal anti-inflammatory drugs remove tissue swelling, reduce inflammation, lower temperature. Sometimes the treatment is limited only to their use (especially with a simple form).

If the above drugs are not effective, then resort to the use of steroidal anti-inflammatory drugs, that is, hormones (Diprospan, Metipred and others). They can also be used as ointments, periarticular injections, as compresses (in combination with Dimexide). A good analgesic effect has injections of anesthetics (Novocaine, lidocaine and similar drugs) into the periarticular region. Injections are carried out not "anywhere", but at specific points, therefore, should be performed only by the attending physician. Sometimes enough 2-3 injections, and the disease recedes.

In addition to drug therapy, physiotherapy is widely used in the treatment of humeroscapular periarthritis. This can be laser therapy, acupuncture, acupressure, magnetotherapy, hydrotherapy, ultrasound and electrophoresis, electrostimulation and mud therapy. Part of the patients helps hirudotherapy (treatment with leeches) provided there is no allergy to them.

Separately, one should speak about such methods of treatment of humeropathy periarthritis as post-isometric relaxation and therapeutic exercise. They are prescribed in combination with drug treatment.

Postisometric relaxation consists in performing a series of exercises that cause tension and tension of individual muscles with their fixation in this position and subsequent relaxation. The complex of special exercises of physiotherapy exercises is aimed at restoring and improving the mobility of the periarticular tissues, increasing the elasticity of the capsule of the shoulder joint. Physiotherapy requires daily exercise and patience, since the effect occurs approximately 3-4 weeks after the beginning of their implementation. And it's also important not to overdo it with exercises, trying to quickly achieve the desired result.

With humeroscapular periarthritis, folk medicine can be useful. Most often these are various infusions and decoctions of herbs (nettle, calendula, St. John's wort, the root of table horseradish and others), which are used as lotions and compresses.

There is also a surgical treatment for humeroparous periarthritis. It is used very rarely (these are cases with long ineffective conservative treatment, frequent relapses, the stage of the "frozen shoulder"). The operation is called subacromial decompression. Its essence is to remove a small piece of scapula (acromion) and an adjacent ligament (coracoacromial). After surgical treatment, a course of drug therapy is required, and physiotherapy exercises, which lead to the restoration of the volume of movements, are necessary. Up to 95% of cases of surgical intervention with periarthal periarthritis give a positive result in the weighted selection of patients for this method of treatment.

Thus, humeropathy periarthritis is a complex problem in the shoulder joint zone, the main signs of which are pain in the joint region and restriction of movements in it. Most often this problem is managed by conservative methods of treatment, but in some cases, surgery is necessary. The disease is absolutely not dangerous, but it is very unpleasant, therefore, having found out in itself similar symptoms, it is not necessary to postpone a campaign to the doctor in the long box. Be healthy!

Traumatologist-orthopedist Dmitry Polyakov tells about a humeroscapular periarthritis:

Shoulder-scapular periarthritis. What is hidden under this diagnosis?

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TV channel "Russia 1", the program "On the most important", the issue on the topic "Plecherelopathy periarthritis": "

Arm hurts. Shoulder joint. Shoulder-scapular periarthritis. "On the most important thing" with Sergei Bubnovsky.

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Medical Center "Quadro", a story on "Pleural Shoulder Periarthritis: Treatment with Shockwave Therapy":

Shoulder-scapular periarthritis. Treatment by shock wave therapy (UVT).

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