Treatment of shoulder and scapular periarthritis

Treatment of shoulder and scapular periarthritis in Vilnius - ‘Paupio Kinezioteka Clinic’. Unique 3-stage programme for chronic cases. We relieve pain, restore shoulder mobility, eliminate the cause of the problem. Individual approach, modern methods of kinesiotherapy. Sign up for a diagnosis!

Treatment of shoulder and scapular periarthritis in the centre ‘Paupio Kinezioteka Clinic’.¶

Why shoulder pain develops into brachial-femoral periarthritis ###¶

Shoulder-laparoscapular periarthritis: is an inflammatory and degenerative disease of the soft tissues surrounding the shoulder joint (ligaments, tendons, muscles, and synovial sacs) without affecting the joint itself.

The main causes of shoulder and scapular periarthritis:¶

Many people, experiencing pain in the shoulder, prefer to ignore it, hoping that ‘it will go away on its own’.

But it is this neglect of their health that often leads to the development of shoulder and scapular periarthritis.

Minor injuries - bruises, sprains or overloads - seem like nothing, but without proper treatment they provoke chronic inflammation of the tissues around the joint.

Especially at risk are those who constantly load the shoulder with monotonous movements: athletes, painters, loaders. Over time, microtraumas accumulate, tendons and ligaments wear out, and now an ordinary swing of the arm causes sharp pain.

Another common cause is ignoring problems with the spine.

Osteochondrosis of the cervical department disrupts the innervation of the shoulder, and lack of movement due to fear of pain worsens blood circulation. After heart attacks or operations, people often spare the arm without developing it, which also leads to congestion and inflammation. Age-related changes aggravate the situation: without prevention and moderate loads, tissues lose elasticity, and any awkwardness can provoke the disease. As a result, mild discomfort develops into a chronic problem, and simple treatment at an early stage is replaced by a long struggle with a ‘frozen shoulder’.

The link between cervical osteochondrosis and shoulder periarthritis¶

The shoulder joint is innervated primarily by nerves originating from the cervical plexus (C5-C8) and upper thoracic roots (Th1).

The most important are:

C5 and C6 roots - provide sensation and motor function of the shoulder (subclavian, supra scapular, axillary nerves).
Root C7 - is involved in innervation of the muscles that retract and rotate the shoulder.

With osteochondrosis, protrusion or hernias in the segments C4-C7 nerve fibres are compressed, which leads to:

reflex muscle spasm around the shoulder joint,
impaired blood supply and tissue trophism,
the appearance of reflected pain (imitating the lesion of the joint itself).

This creates conditions for the development of periarthritis - inflammation of periarticular structures without true cartilage damage. Chronic root irritation aggravates symptoms, forming a vicious circle: pain - restriction of movement - muscle atrophy - progression of stiffness.

Timely diagnosis of the cervical region (MRI, X-ray) is mandatory in case of persistent shoulder pain syndrome. Treatment should include not only local therapy, but also correction of the spine (manual therapy, physical therapy, kinesiotherapy).

Stages of shoulder and scapular periarthritis and its symptoms:¶

Shoulder and scapular periarthritis is an inflammatory disease of the shoulder joint that can lead to a number of symptoms that affect daily life.

At the onset of the disease, it is most common to see a gradual deterioration in shoulder function, which may manifest as restricted movement.

Patients may notice that raising the arm above the head or making turns becomes increasingly difficult. This is accompanied by a feeling of tension and fatigue in the shoulder joint.

Over time, if treatment is not started, symptoms may worsen. One of the characteristic signs is the appearance of a painful sensation in the shoulder, which can be constant or arising with certain movements.

The pain can be sharp or dull, sometimes it spreads to the humerus and scapula. The pain may be worse at night, making it difficult to sleep peacefully.

In addition to pain and restriction of movement, patients may experience a feeling of inferiority of the shoulder, as if it is ‘falling out’ or ‘falling off’. This is due to a deterioration in the stability of the joint due to inflammation and atrophy of the muscles that support the shoulder joint.

Over time, if the condition is not treated, a chronic form of periarthritis can develop.

In this case, symptoms become constant and shoulder movement is restricted even further. Deformities of the joint may appear, further reducing the functionality of the arm. In such cases, patients may have significant difficulty performing everyday tasks such as dressing, washing or cooking.

It is important to note that the progression of symptoms can vary depending on individual body characteristics and the extent of the disease. Starting treatment early can greatly improve the prognosis and prevent further deterioration of the condition.

Forms of shoulder and scapular periarthritis and their manifestations¶

Simple (mild) form of shoulder and scapular periarthritis¶

At first, the disease may only manifest itself as mild pain - for example, when you try to put your arm behind your back or lift something heavy. Many people do not pay attention to it, writing it off as fatigue or awkward movement.

Acute shoulder and scapular periarthritis¶

If nothing is done, the inflammation increases, and then the acute stage begins - the shoulder is pierced by sharp pain that radiates to the neck and the whole arm, preventing even sleep. Sometimes the joint swells, and any touch becomes painful.

Chronic shoulder and scapular periarthritis¶

If left untreated for a long time, the disease turns chronic: the pain is not so strong, but becomes constant, aching, and the shoulder gradually loses mobility. As a result, the arm seems to ‘freeze’ - it becomes almost impossible to lift it or turn it.

Save your shoulder!

Do not tolerate discomfort and consult a doctor at the first symptoms! And in our centre ‘Paupio Kinezioteka Clinic’ our specialists will help you to eliminate the root causes of shoulder and scapular periarthritis.

The story of treatment of shoulder and scapular periarthritis in our centre¶

A 50 year old woman came to us with shoulder pain for 8 years. Her story we have tried to present to you as a work on mistakes for most people, who in a long search for the right solution, allow shoulder-loparietal periarthritis to develop into a chronic form.

‘I don't know what to do with this shoulder anymore...’¶

For eight years now, my right arm has been my main tormentor. At first it was just a nuisance - pops when I move, pulls when I pull my arm back. I thought: age, it will go away. But nights became a nightmare - as soon as I turn on my right side, the pain immediately wakes me up. And during the day - these nasty goosebumps in my fingers and aching neck, as if someone pulled a bowstring from the shoulder to the back of my head. By evening I feel completely broken, like I've been carrying sacks all day, even though I haven't done anything heavy.

I've been trying to heal! I went to massage therapists - after sessions I felt better, but after a couple of weeks everything came back. I went to an osteopath to ‘rule’ something, but the effect didn't last long. I did blockades - the pain went away, but not for long. I drank vitamins, collagen, ointments.... It seemed to help for a while, but then I had the same symptoms again. Each time I gave up treatment as soon as it got a little better, I thought - I can cope on my own. But in the end, over the years, the problem only took root.

Now I realise: all my attempts were fragmentary, haphazard. Massage, injections, pills - but never all together and never to the end. No one explained that I needed to change my habits, to do exercises every day, to work not only with my shoulder but also with my neck. Instead, I floundered from one method to the next, never bringing any of them to fruition. And now my shoulder feels rusty - it moves with difficulty, aching even at rest. Apparently, I trapped myself in this trap....

Comprehensive diagnosis and explanation of the causes of chronic shoulder periarthritis.¶

After a complete diagnosis at our centre, the patient was diagnosed with:: chronic shoulder-loparietal periarthritis with elements of neurological symptomatology (goosebumps in the fingers indicate possible involvement of cervical roots). The main reason for the neglect was the lack of a comprehensive approach:
- Treatment was interrupted at the first improvements, - There was no systematic rehabilitation (physical therapy, posture correction), - The connection with the cervical spine was ignored.

Recovery Strategy

For complex recovery in shoulder-laparoscapular periarthritis in our centre we proposed the following plan, which includes kinesiotherapy methods, diet, change of psychological background and lifestyle:

1. Kinesiotherapy and Therapeutic exercises¶

Individual exercise programme: We will develop a set of exercises to improve shoulder mobility and strengthen the muscles of the shoulder girdle and neck. Exercises will include gentle stretches, isometric exercises and stabilisation exercises.
Gradual increase in load: We will start with easy exercises, gradually increasing in intensity and difficulty to avoid overload and injury.
Regular exercise: It is recommended to exercise daily, devoting at least 30 minutes a day to exercise.

2. Diet¶

An anti-inflammatory diet: Include foods rich in omega-3 fatty acids (fish, flaxseed oil), antioxidants (berries, herbs) and vitamins (fruits, vegetables) in your diet.
Enhance protein intake: Consuming adequate protein (meat, fish, legumes) is recommended to support muscle mass and tissue repair.
Hydration: Drink sufficient water to maintain hydration and improve metabolic processes.

3. Psychological background¶

Psychological support: We recommend counselling with a psychologist to work with your emotional state and motivation. This will help manage chronic pain and stress.
Relaxation Techniques: Master relaxation techniques such as meditation, breathing exercises and qigong to reduce stress levels and improve your overall well-being.

4. Lifestyle changes¶

Posture Correction: Pay attention to your posture in your daily life. Use ergonomic furniture, watch your body posture when working on the computer.
Active Lifestyle: Incorporate moderate physical activity into your daily routine, such as walking outdoors, swimming, light fitness and qigong exercises.
Sleep and Rest: Ensure that you get adequate sleep and rest. Avoid sleeping on the affected side, use an orthopaedic pillow to support your neck.

5. Medical support¶

Regular consultations: Visit your doctor periodically to monitor your condition and adjust your treatment plan.
Physiotherapy: Include physiotherapy treatments in the first phase such as ultrasound, magnetotherapy or electrophoresis to reduce inflammation and pain.

The Importance of a Strategic Plan

Without a clear plan for the entire recovery cycle, it is very easy for a person to lose the right path and plunge back into the fruitless search for a magical method of recovery.

A comprehensive approach and systematic implementation of all the recommendations of our specialists are guaranteed to significantly improve the condition of the shoulder and the quality of life.

Our specialists accompany patients at every stage of recovery to achieve the best results.

Main stages of the programme for the treatment of shoulder and scapular periarthritis¶

For the comprehensive treatment of chronic shoulder and scapular periarthritis, our centre uses a three-module recovery programme.

(Each module: 5-7 weeks, cycle ‘doctor's appointment - 6 sessions - control doctor's appointment - 6 sessions - final doctor's appointment’).

The programmes are formed individually, but conditionally they can be divided by goals:

Module 1: Acute pain relief and decompression.¶

Goal

Eliminate inflammation, improve joint mobility, reduce compression of nerve roots C5-C7.

Example procedures:¶

Decompression hangs on a trainer with electronic weights Speedience with emphasis on the shoulder joint
Shoulder girdle myofascial release with rolls of different stiffnesses
Isometric exercises to relieve spasm
Passive traction of the shoulder on an orthopaedic table
Ultrasound therapy with hydrocortisone

Why 5-7 weeks?

Physiologically it takes to relieve chronic inflammation: - 21 days - the minimum period for the resolution of the inflammatory process - 42 days - restoration of microcirculation in the affected tissues - 6-8 weeks - adaptation of the nervous system to the new motor stereotype

Peculiarities of working with a chronic case

In case of 8-year history of the disease it is important: 1. Start with gentle methods, avoiding the provocation of pain. 2. Combine localised work on the shoulder with work on the neck. 3. Gradually increase the load, monitoring the tissue response

Check with your doctor:¶

VAS pain assessment
Shoulder range of motion test
Neurological testing of finger sensitivity
Palpatory diagnosis of muscle tone

Module 2. Restoring mobility and muscle balance¶

Goal

Strengthen stabiliser muscles, restore neuromuscular control, correct imbalances.

Example exercises:¶

Asymmetrical pulls with elastic bands
Dosed shoulder rotations with breath control
Kinesiotaping for scapula correction
Manual correction of the cervical region (C5-C7)

Physiology

To form a new motor stereotype it is necessary: - 300-500 repetitions - initial consolidation of the skill - 3000-5000 repetitions - automatisation of the movement - 6-8 weeks - reorganisation of neuromuscular connections.

Kinesiotaping for periarthritis

The taping scheme includes: 1. Decompression tapes over the painful area 2. Corrective bands to stabilise the scapula 3. Lymphatic drainage elements for oedema. Effect: - Reduction of pain sensation by 40-60% - Improved proprioception - Support of weakened muscles

Doctor's check-up:¶

Shoulder girdle electromyography
Assessment of force imbalance
Dynamic scapula position monitoring
Movement pattern analysis

Module 3. Stabilisation and relapse prevention¶

Goal

To consolidate the result, to create a muscle corset, to teach self-control.

Example exercises:¶

Functional training with imitation of everyday movements
Biofeedback exercises
Complex multi-joint movements
Breath-movement co-ordination
Self-massage and self-correction training

Treatment Result

In this clinical case achieved: - Restoration of 95% mobility of the shoulder joint - Complete disappearance of night pain - Normalisation of sensitivity in the fingers - Formation of stable self-control skills.

Features of rehabilitation in our centre¶

Integrative approach:
- Combination of kinesiotherapy, physical therapy and manual techniques
- Simultaneous work on the shoulder and neck.
- Gradual increase of load under the supervision of a specialist
Monitoring techniques:
- EMG monitoring of muscle activity
- Video analysis of movements
- Computerised progress assessment
Physiological rationale:
- Taking into account the timing of connective tissue regeneration
- Adaptation of the programme to individual recovery rates
- Cycling of sessions according to the phases of rehabilitation

A real story of treatment of shoulder and scapular periarthritis in our centre¶

Patient Story:¶

Woman 50 years old, chronic shoulder and scapular periarthritis (8 years), with symptoms:

Nocturnal pain, inability to sleep on her right side
Limitation of arm extension (maximum 30°)
Goosebumps in the fingers of the right hand
Pulling pains in the neck
Fatigue in the evening

Previous treatment (unsuccessful):

Massages (10 sessions)
Osteopathy (5 sessions)
Medication blockades (3 sessions)
Vitamins and collagen

Treatment performed:¶

Module 1: Decompression and pain relief (5 weeks)¶

Procedures performed:¶

Decompression hangs on an exercise machine with electronic weights Speedience:
- 3 times per week.
- Initial load: 30% of body weight
- Gradual increase up to 50%
Myofascial Release:
- Daily independent work with the massage roll
- 2 times a week professional massage
Physiotherapy:
- Ultrasound with hydrocortisone (10 treatments)
- Magnetotherapy (12 treatments)

Specific results:

After 3 weeks: 50% reduction in night pain.
After 5 weeks: ability to move arm 45° without pain.
Disappearance of goosebumps in fingers.

Module 2. Restoration of mobility (6 weeks)¶

Exercises performed:

Stabilisation of the scapula:
- Elastic band exercises (5 sets of 10 reps)
- Shoulder balance training (2 times a week)
Kinesiotaping:
- Application of tapes according to the ‘lymphatic drainage + support’ method
- Change of tapes every 3 days
manual therapy:
- Correction of C5-C7 vertebrae (once a week)

Specific results:

After 4 weeks: arm lifting up to 90° without discomfort.
Complete disappearance of neck pain
Restoration of arm strength (+40% according to dynamometry data).

Module 3. Stabilisation (7 weeks)¶

Treatments performed:

Functional training:
- Simulation of household movements (pulling objects from a shelf)
- Exercises with visual control of posture
Home programme:
- Daily 15-minute complex
- Self-massage before bedtime
Control tests:
- Video analyses of movements (once every 2 weeks)
- EMG control of muscle activity.

Final results:

Full recovery of mobility (180° abduction)
Ability to sleep on the right side
Disappearance of fatigue in the evening
Persistence of the result after 6 months of follow-up

Conclusions:¶

Systemic approach is the key to success with chronic cases
Consistency of steps is critical
Discipline of the patient is 95% of success
Combination of methods produces a synergistic effect

Important

Even 8 years of chronic periarthritis is treatable with the right comprehensive approach!

Bring back freedom of movement! Treatment of shoulder and scapular periarthritis in ‘Clinica Paupio Kinezioteka’¶

Tired of constant pain in your shoulder?
Can't lift your arm or sleep on your side?
Have you tried everything, but the result is temporary?

At our centre we specialise in complex cases of shoulder and scapular periarthritis in particular:

When the pain lasts for years
When combined with neck problems.
When previous treatments have failed.

Why 92% of our patients improve?¶

Unique 3-step system (doesn't just relieve pain, it addresses the cause).
We work with advanced cases (even with 8-10 years of disease).
Monitoring at every stage (video analysis, EMG, computer diagnostics)
Self-help training (to maintain results forever)

Our Benefits:¶

Individualised programme for each case
A team of experts (neurologist, kinesiotherapist, rehabilitation therapist)
Modern equipment (Speedience electronic weight machines, biofeedback)
Honest predictions - we tell you at once what you can achieve

Don't delay - every day without treatment increases stiffness!

Your shoulder deserves professional help!