Currently, it is not clear what the precise cause of shoulder periarthritis is; Scientific studies on the subject, however, have shown a correlation between this annoying joint condition and factors, such as prolonged immobility of the shoulder joint, diabetes, cardio-pulmonary diseases, thyroid diseases, tuberculosis, Parkinson's etc.
Debilitating condition, shoulder periarthritis typically manifests itself with pain and a sense of joint stiffness: in an early stage of the disease, pain prevails over stiffness; then the situation s "reverses.
For the diagnosis of shoulder periarthritis, the patient's symptom report, physical examination and anamnesis are fundamental; only in rare cases, diagnostic research also involves the use of imaging tests.
Today, those suffering from shoulder periarthritis have only symptomatic treatments; fortunately, however, the condition tends, albeit very slowly (over 1-3 years), to a spontaneous resolution.
Fun fact: who first described shoulder periarthritis?
To describe for the first time the shoulder periarthritis was the US surgeon Ernest Codman, back in 1930.
Shoulder and Bachelor-Humeral Joint: a brief review
- In human anatomy, the shoulder is the even region of the human body located in the latero-superior portion of the trunk, which marks the meeting between three very important bones: the clavicle, the scapula and the humerus.
- The scapulohumeral (or glenohumeral) joint of the shoulder is the most important of the 5 joints included in the shoulder region.
Belonging to the category of enarthrosis (or sphere diarthrosis), the scapulo-humeral joint of the shoulder results from the perfect interlocking of the head of the humerus inside the glenoid cavity of the scapula. - As an enarthrosis, the scapulohumeral joint includes, among its components, the two articular surfaces, the joint capsule, the articular cartilage and a series of ligaments and synovial bags.
Epidemiology
The most recent statistics say that 3 out of 100 people develop shoulder periarthritis at some point in their life; some experts, however, believe that, thanks to a diagnosis that they often say is approximate, the aforementioned numerical data is exaggerated and that scapulo-humeral periarthritis is less common than expected.
Surely, shoulder periarthritis is more common in adults than in young people; to be precise, it tends to mainly affect individuals between the ages of 40 and 60.
Another aspect about which there is no doubt is the fact that shoulder periarthritis affects women more often than males: the numerical data in this regard say that 70% of patients with bachelor humeral periarthritis are women.
the formation of scar-like tissue follows the joint capsule of the scapulohumeral joint, making the joint capsule itself thicker, abnormally rigid and with signs of retraction.
What are the Causes of Shoulder Periarthritis?
Currently, the precise causes of shoulder periarthritis are unknown; the scientific evidence on the subject, however, suggests that the risk of developing this annoying and debilitating condition increases in the presence of factors such as:
- A period of forced shoulder immobility following a rotator cuff injury, surgery, humerus fracture, or stroke;
- Diabetes mellitus;
- Diseases of the thyroid gland (eg: hyperthyroidism and hypothyroidism);
- Breast cancer
- Mastectomy;
- Heart disease;
- Lung diseases;
- Tuberculosis;
- Parkinson's disease.
Furthermore, taking up an epidemiological data reported above, it should be noted that shoulder periarthritis is more frequent among individuals over 40 years of age and in the female population.
Did you know that ...
10-20% of people with diabetes mellitus develop scapulohumeral periarthritis.
has the characteristics described above, namely: it gets worse with movement and during the night, if you sleep resting on the affected shoulder.
The freezing phase of shoulder periarthritis can last from 6 to 9 months.
FROZEN PHASE
The frozen phase corresponds to the second symptomatic phase in temporal order of scapulo-humeral periarthritis.
During the frozen phase, the pain in the shoulder subsides (compared to the previous phase), while the sense of joint stiffness increases significantly.
In this phase, the sense of joint stiffness is such as to make it difficult to carry out all the activities that require the use of the upper limbs, including the most trivial ones.
The frozen phase of shoulder periarthritis can last from 4 to 12 months.
DEFROST PHASE
Thawing phase corresponds to the third symptom phase in temporal order of scapulo-humeral periarthritis.
During the thawing phase, the pain in the shoulder is further attenuated and the joint stiffness begins to gradually decrease, making it less of an obstacle to the movements of the suffering upper limb.
The thawing phase of shoulder periarthritis can last from 6 months to even 2 years.
When to see a doctor?
An individual should contact their doctor or an orthopedist when they experience pain and stiffness in the shoulder, which makes them unable to perform the simpler movements with the affected joint.
shoulder;Physical examination
During the physical examination, the doctor asks the patient to perform, with the affected joint, movements which, in case of shoulder periarthritis, would evoke pain and would be difficult to perform (the presence of pain and stiffness when performing these movements, therefore, represents an alarm bell).
Sometimes, the aforementioned analysis could be followed by an evaluation of the passive mobility of the suffering shoulder; this evaluation requires the doctor himself to move the joint, in order to establish the degree of rigidity (the patient only has to keep the shoulder relaxed).
Anamnesis
Through the medical history, the doctor establishes whether the patient falls into a category at risk of shoulder periarthritis (eg if he is diabetic, if he has suffered a rotator cuff injury in the past, etc.).
The presence of symptoms, such as pain and joint stiffness, associated with one or more risk factors for scapulohumeral periarthritis is a definitive diagnostic indicator.
Exams of Imaging
The exams of imaging, such as X-rays, magnetic resonance and / or ultrasound, are used in case of doubt, to exclude that the present symptoms are due to other types of problems in the shoulder joint.
shoulder.
Symptomatic Therapy of Shoulder Periarthritis
CHOICE OF TREATMENT
The choice of treatment for the symptomatic management of shoulder periarthritis varies according to the intensity of the symptoms: in general, the more intense the symptoms, the more clinically relevant the symptomatic treatment adopted will be.
THERAPEUTIC OPTIONS
Symptomatic therapy of shoulder periarthritis includes more or less invasive measures.
Less invasive treatments include:
The management of the symptoms of shoulder periarthritis can take place with more or less invasive therapeutic approaches.
Less invasive therapeutic approaches include:
- The administration of over-the-counter anti-inflammatory drugs, such as acetaminophen or NSAIDs. These drugs work against inflammation and reduce pain.
- Physiotherapy. It aims to relieve symptoms, through exercises to stretch and strengthen the shoulder muscles, and exercises to improve the mobility of the shoulder blade.
The moderately and significantly invasive therapeutic approaches, on the other hand, include:
- The injection of a corticosteroid directly into the aching joint. Corticosteroids are powerful anti-inflammatory drugs; the injection of a corticosteroid directly into the joint, therefore, has an important pain relieving effect.
To say that, when used improperly or for long periods of time, corticosteroids have unpleasant side effects - Joint hydro-distension. Practiced under local anesthesia, it consists in the injection directly into the suffering joint of a physiological solution, with the aim of stretching the joint capsule and making it less rigid.
- Manipulation of the shoulder under general anesthesia. While the patient is asleep (therefore he is unconscious), he foresees the mobilization of the scapula humeral joint with the aim of "dissolving" the scar tissues present on the joint capsule.
It should be noted that the efficacy and safety of this treatment raise some doubts. - The surgery. It involves arthroscopic surgery (shoulder arthroscopy), through which the surgeon removes the scar tissue present on the joint capsule of the shoulder blade joint.
The use of surgery in the presence of shoulder periarthritis is very rare and is reserved only for clinical cases that do not derive any benefit from previous treatments.
