Prognosis of inflammation in the shoulder
In general, inflammations in the shoulder have a good prognosis. Especially in the case of bursitis and tendosynovitis, the patient can usually be helped very well and very easily. The situation is different with omarthritis. Here, protracted therapies may be necessary and the patient often has to live with a certain amount of residual pain or with a certain restriction in the shoulder area. This makes it all the more important that the patient undergoes a long period of physiotherapy to achieve the best possible results.
Special form of inflammation (periarthritis humeroscapularis)
- Definition The inflammation of the shoulder joint is usually referred to as frozen shoulder. This means: frozen = frozen, stiff and shoulder = shoulder. There are a variety of causes for this very painful condition, which affects soft tissues, muscles and tendons near the joint.
Mostly it is degenerative diseases in the shoulder joint that lead to the pain and the stiffness of the shoulder. The technical term for shoulder joint inflammation is periarthritis humeroscapularis. The first part of the term is made up of the Greek words peri (around, around), arthros (joint) and -itis (inflammation).
The second part of the word means that it is an inflammation between the humerus (humerus) and the shoulder blade (scapula).
- Symptoms Inflammation of the shoulder joint causes shoulder pain and restricted movement. In most people, only one joint is affected, but in one in three cases both shoulders are inflamed. Both active and passive movement is severely restricted.
If no previous damage or an accident can be determined, it is called the primary frozen shoulder. (English and means stiff/”frozen” shoulder). There are three different phases of the disease in the primary form.
In each phase there are characteristic symptoms: Phase 1: Pain occurs mainly at night. The affected persons wake up when they turn from one side to the other. Pressure on the diseased shoulder joint also causes pain.
Increasingly, the joint stiffens – also due to the fact that the patient hardly moves his arm at all in order to keep the pain as low as possible. Phase 2: Here the pain becomes less and tends to recede into the background. In return, the mobility of the joint becomes more and more limited.
Due to the lack of movement, the shoulder muscles also degenerate. In order to prevent the pain, most patients take a bad posture, which then causes further pain, for example in the neck. Phase 3: Here the stiffness of the shoulder slowly decreases.However, the inflammation often does not heal completely and considerable restrictions of movement often remain.
- Phase 1: The pain occurs mainly at night.
The affected persons wake up when they turn from one side to the other. Pressure on the diseased shoulder joint also causes pain. Increasingly, the joint stiffens – also due to the fact that the patient hardly moves his arm at all in order to keep the pain as low as possible.
- Phase 2: Here the pain becomes less and recedes more into the background.
In return, the mobility of the joint becomes more and more limited. Due to the lack of movement, the shoulder muscles also degenerate. In order to prevent the pain, most patients take a bad posture, which then causes further pain, for example in the neck.
- Phase 3: Here the stiffness of the shoulder slowly decreases.
However, the inflammation often does not heal completely and considerable restrictions of movement often remain.
- Cause In most cases, inflammation of the shoulder joint results from degenerative changes in the shoulder girdle, such as bursitis (inflammation of the bursa), tendonitis (inflammation of the tendons) or impingement syndrome (bottleneck syndrome – for example, due to thickening of the soft tissues, the space under the acromion can become smaller, resulting in a bottleneck – there is too little space to provide enough room for all the structures running there). Torn tendons or calcification can also lead to inflammation. Immobilisation of the joint also very quickly leads to a frozen shoulder.
- Therapy In the first place, therapy always depends on the cause, duration and intensity of the pain.
In most cases conservative treatment methods are used. This means that no surgery is necessary. The effective alternative methods are mainly physiotherapy and treatment with medication, and very rarely radiotherapy or acupuncture.
With the alternative treatment methods, an improvement of the symptoms only occurs in a few weeks or months. In physiotherapy, it is important, especially in the beginning, that the exercises do not overload the shoulder joint and do not put the wrong strain on it. The exercises should be well adapted to the pain in order not to worsen the condition of the shoulder.
In addition to manual therapy and physiotherapy, electrotherapy or heat and cold treatments are often used. The form of treatment depends very much on the stage of shoulder stiffness. In the first stage, it is important that mobility is maintained and that the pain is relieved.
In the 2nd stage, the pain does not increase much, but the joint becomes increasingly stiff. Here, pain relief and relaxation are the first priority. In the last stage the pain decreases and here again the training of mobility is in the foreground.
One should always keep on the ball, as the treatment of shoulder inflammation is very lengthy. In very rare cases an operation is necessary if the cause cannot be fought in any other way or if there is no improvement after about 6 months.
- Diagnosis In the case of an inflammation, the medical examination is usually successful, during which the doctor takes a comprehensive anamnesis and can thus find out about any accidents. Since the shoulder causes pain, the doctor can trigger pressure pain during the examination.
During the ultrasound examination (sonography), muscle tears and the resulting joint effusions are mainly found. He can also best check the tendons and ligaments here. Magnetic resonance imaging is mainly used before an upcoming operation.
Rarely is arthroscopy (joint endoscopy) necessary, during which the doctor can examine the leading structures and treat the cause to some extent. In some cases, a previous accident can also lead to joint inflammation.
- Prophylaxis It is hardly possible to prevent inflammation of the shoulder joint, but it is very advisable to consult a doctor at the first signs and to start therapy very early. Furthermore, it is important to relieve the shoulder and to refrain from strenuous sports activities and work with the shoulder as much as possible.
- Phase 1: The pain occurs mainly at night.
The affected persons wake up when they turn from one side to the other. Pressure on the diseased shoulder joint also causes pain. Increasingly, the joint stiffens – also due to the fact that the patient hardly moves his arm at all in order to keep the pain as low as possible.
- Phase 2: Here the pain becomes less and recedes more into the background.
In return, the mobility of the joint becomes more and more limited.Due to the lack of movement, the shoulder muscles also degenerate. In order to prevent the pain, most patients take a bad posture, which then causes further pain, for example in the neck.
- Phase 3: Here the stiffness of the shoulder slowly decreases. However, the inflammation often does not heal completely and considerable restrictions of movement often remain.
