The scapula is a triangular shaped bone. It consists of a body, coracoid process, axis, acromion process, neck, glenoid cavity, which together with the head of the humerus forms the shoulder joint.
The shoulder blade has quite a lot of muscles.
It performs protective and motor functions in the human body.
A scapula fracture is a serious injury that most often occurs when a person falls directly on the shoulder, back, or receives a strong blow to the bone area or falls.
Most often, men under 45 years of age are subject to such damage, whose injuries occur due to professional activities, sports, or participation in an accident.
Such an injury requires considerable force. Basically, the pathological condition is accompanied by other injuries.
Depending on the location of the injury, the following types of scapula fracture are distinguished:
The most common type of scapula injury is a fracture of the glenoid cavity and acromion.
Such injuries require special treatment, after which the victim may continue to experience pain for some time.
In the photo, classification of a scapula fracture
The main symptoms of a scapula fracture:
Trauma may also affect other organs. This leads to delayed detection of bone injury, which often contributes to improper healing.
The main problem in diagnosing a scapula fracture is the late recognition of the pathology.
As a rule, bone damage is accompanied by injuries to other vital organs, which must be treated first.
After the patient’s life is not in danger, the doctor can diagnose a fracture of the scapula. It happens that time is lost and the bone has time to heal with displacement.
The diagnosis of a scapula fracture is made on the basis of a radiograph in the anteroposterior projection , and, if necessary, in other projections.
Also, to confirm damage to the scapula, a computed tomography method is used, which helps to accurately determine the nature of the injury.
Timely first aid for a fractured scapula is the key to further successful treatment.
The first thing to do is to ensure that your hand is still.
To do this, the limb on the side of the injury is suspended on a scarf used in such cases, and a roller or just a ball of cotton is placed in the armpits. Instead of a scarf, you can use a special bandage.
To reduce pain, the victim is given one of the most effective painkillers and is sent to a medical facility in a sitting position.
First aid for injury can not only reduce the patient’s suffering, but also prevent damage to nerves, blood vessels, muscle ruptures, skin, and displacement of fragments.
It is forbidden to independently correct the position of the bone or realign it.
Treatment of any type of scapula fracture begins with the injection of an anesthetic to the site of injury.
In the treatment of non-displaced comminuted fractures, a conservative method is usually used. Initially, immobilization is carried out.
For a fractured scapula, the following are used:
Additionally, in case of a fracture of the scapula, exercise therapy is prescribed for the fingers, hand, and elbow.
Recovery occurs 4-5 weeks after injury, and full functionality occurs after 2 months.
A cervical fracture is often accompanied by displacement. Therefore, the doctor prescribes treatment with skeletal traction. This method of treatment lasts 1 month.
Then the limb is placed on a special pillow and therapeutic exercises are performed. Gymnastics course - 2 weeks.
For fractures of the acromion process with displacement and the neck without displacement, a plaster thoracobrachial bandage or abduction splint is used.
Immobilization in this case lasts from 4 to 6 weeks.
Surgical treatment is prescribed in difficult cases when there is a possibility of severe dysfunction of the shoulder joint.
As a rule, this condition can occur in fractures with severe displacement of fragments.
The operation is performed under local anesthesia. The patient lies on his stomach and his arm is moved to the side. An incision is made along the outer edge of the scapula to separate the muscles.
Then the neck of the scapula is opened and the fragments are fastened with special plates made of high-strength material.
After the operation, a thoracobrachial bandage is applied for 1.5 months.
What other purposes is the Deso bandage used for? How to apply a bandage correctly - tips, nuances and instructions - everything you need to apply a bandage yourself.
A fracture of the scapula can lead to impaired motor function of the arm .
If the damage occurs in the glenoid cavity of a bone covered with cartilage, where there is contact with the head of the humerus, then dislocations in the shoulder joint can be expected. The reason is the inability to hold the head of the humerus with fragments of the glenoid cavity.
Fractures of this kind are often accompanied by damage to the cartilage, which, in turn, provokes the occurrence of arthrosis of the shoulder joint.
When the neck of the scapula is damaged, pain and dislocation often occur.
A displaced fracture of the body of the scapula can cause its deformation, which prevents the normal sliding of the scapula along the ribs.
As a result, constant pain and crunching may occur during movement. Such consequences often occur when a displaced scapula fracture heals.
After surgery, complications may also arise in the form of:
Surgical treatment to some extent prevents the development of unwanted complications, which are quite difficult to treat.
For the effective treatment of scapula injuries, proper rehabilitation plays a huge role, which can reduce pain and improve the function of the arm. It includes, first of all, physical therapy.
After carrying out all the necessary manipulations, when the hand is fixed, on day 2 you can begin exercise therapy, which consists of performing exercises for the fingers, wrist joint, and shoulder muscles.
In some cases, if 10 days have passed after applying the Deso bandage, the patient’s arm, bent at the elbow, is placed on a scarf.
In this way, the victim performs exercises for the fingers, elbow, wrist and shoulder joints. If about 2 weeks have passed since the injury, you can perform swinging movements with your arm.
A fracture of the neck of the scapula requires placing the arm on an abduction splint for 30 days. In this case, also on day 2, you can begin to perform simple exercises for the fingers, elbow, and wrist joint.
For closed fractures, physical education is prescribed for 4-5 days; for open fractures, it is necessary to wait until the wound heals.
After the healing of the scapula fracture, it is necessary to continue doing arm exercises for some time. In this case, you can successfully use a gymnastic stick or a gymnastic wall.
Gradually you need to increase both the load and range of motion.
With regular exercises, which need to be done quite often - up to 6 times a day, complete recovery occurs within a period of time from 2 to 2.5 months.
Timely assistance, aimed at reducing the patient’s suffering, at preserving damage to nerves, blood vessels, skin, muscles, as well as repeated displacement of fragments, can protect against serious complications.
And correctly prescribed treatment in combination with therapeutic exercises will allow you to quickly restore the function of the scapula after a fracture.
The scapula belongs to the scapular-brachial section of the spine. In the context of the anatomical structure, the human scapula is a paired bone with a triangular shape. It is located on the back with the base up and the sharp end down, on both sides of the spinal column. The bone itself is wide and flat, slightly curved backwards.
The scapula has the following structure at the back:
The blade has two surfaces:
The concave anterior surface is a small depression where the scapular muscle is attached, and the convex posterior surface is the spine of the scapula. The scapular spine is a protruding surface that crosses one-fourth of the scapula.
And also three angles:
The lateral angle is isolated from the main bone by a small restriction called the neck. But between the neck and the upper edge there is a coracoid process.
Its function is to ensure mobility of the upper limb by connecting the humerus and clavicle into one common movable complex.
The following functions are also distinguished:
The protective function is that vital organs, veins and arteries are in close proximity.
The motor function, together with the muscle groups that are attached to the scapula, are capable of performing various movements of the limb. The range of these movements is quite wide:
If the scapula is damaged, quality of life and loss of performance are reduced.
Damage to this anatomical segment occurs for the following reasons:
In this case, injuries can be of a closed or open type. With closed injuries, there is no violation of the integrity of the skin. Open - occur as a result of skin rupture and the appearance of a wound surface.
Fractures are of the following types:
Of all the injuries listed, the most common are injuries to the glenoid cavity and acromion. And the most difficult injury is a fracture of the neck of the scapula, which has serious complications and consequences.
Symptoms include severe pain in the shoulder and forearm, which becomes unbearable when trying to move the limb. Swelling is observed and hematomas are formed. Pathological mobility. With a crack, the above symptoms are not observed.
Traumatization of this area has one characteristic symptom - Comolli's triangle. What is the essence of the phenomenon? It appears as a triangular swelling. When you try to touch the area of injury, the pain becomes more pronounced. And with a displaced fracture, an acoustic phenomenon appears - crepitation of fragments.
In some cases, the following symptom is observed: the shoulder and limb rise. This suggests that the pearl occurred in the joint area. In the part of the elevation, blood accumulates in the joint cavity, so the shoulder increases in size. When the neck is fractured, the shoulder, on the contrary, goes down (hangs), when the acromial process is injured, it protrudes forward, and when the coracoid process is damaged, it deepens.
An open fracture, in which bone fragments are visible and an open wound has occurred, can become infected. Also in this case, blood vessels and nerve endings are damaged.
Intra-articular injuries require surgical treatment to compare and restore bone fragments. Fractures of the body of the scapula usually heal well provided strict bed rest is observed. To do this, the arm bent at the elbow is fixed to the torso with a special splint. The duration of wearing the splint is approximately a month. After which physiotherapeutic procedures, massage and development of the shoulder joint are prescribed.
Such damage is extremely rare. It develops due to a strong jerk of the arm or shoulder to the side, resulting in displacement of the scapula. In this case, a characteristic manifestation is its protrusion and severe pain, especially when trying to move the arm. The dislocation is reduced by a qualified specialist, only in a medical facility and only under anesthesia. Then immobilization is carried out, fixing the arm to the body for 15 days.
This is an inflammatory disease that manifests itself as damage to the periarticular bursae of the shoulder joint. The cause of the disease is most often an infection of both an endogenous and exogenous nature. It can also occur as a result of injury and an autoimmune process. Manifested by the following symptoms:
Treatment is carried out conservatively. The following drugs are prescribed:
Protruding shoulder blades are considered developmental defects. Most often they are congenital, but can also appear as a result of spinal curvature as a result of incorrect back position for a long time. Such damage includes:
Most often, their protrusion does not cause pain, but is considered a cosmetic flaw or defect. After all, it seems that the person has grown a hump. Therefore, this causes him to feel inferior and suffer morally, which significantly affects the quality of a person’s life. Currently, such defects can be corrected with the help of physical therapy and massage.
Why might a scapular crunch occur? The shoulder girdle includes the humerus, collarbone and scapula. There are several large muscles located in the area of the inner surface of the scapula. They are called the subscapularis and anterior scalene muscles. The humerus and subscapularis muscle are connected near the shoulder joint, and the ribs (the lateral surface of the chest) are connected to the anterior scalene.
The bursa is a sac containing a viscous, viscous fluid (known as synovium). It is located between areas that are constantly exposed to friction. Thus, the synovial bursae separate the anterior scalene and subscapularis muscles, the anterior scalene muscle and the chest. Bursitis is the inflammation of the bursa. The disease is primarily characterized by pain and scapular crunching.
The development of bursitis is most often caused by severe overload. Thus, the characteristic crunch in the shoulders and shoulder blades can be provoked by excessive tension or a factor such as regular microtrauma (which results in an inflammatory process in the soft tissues, which also includes the synovial bursa).
A manifestation such as “snapping blade” is very often found as a symptom of occupational diseases, from which athletes (especially baseball players) and construction workers (plasterers, painters, etc.) usually suffer.
A crunching sound when moving in the scapula and shoulder joint may also indicate atrophy of the muscles located next to the scapula. It can be caused by nutritional depletion or, for example, prolonged inactivity.
The result of this is a tighter connection of the scapula to the surface of the ribs, from which the chest wall is formed. Due to increased friction, an inflammatory process develops that affects the synovial bursae.
The consequence of improper healing after a fracture of a rib or scapula is a violation of the congruence of the surfaces of the joints in the scapula (chest).
In this case, friction during movements increases, which again leads to the appearance of a crunch in the shoulder blades.
Among other things, a “clicking scapula” can manifest itself as a pathology such as Luschka’s tubercles. The place of formation of such bone growths is usually the upper edge of the left (or right) shoulder blade.
Most often, underneath them we observe the formation of additional synovial bursae, which are characterized by a periodically occurring inflammatory process that provokes bursitis.
The crunching in the shoulder blades can only be heard by the patient himself, sometimes it can also be heard by people nearby. As already mentioned, in most cases, pathologies associated with the scapula or shoulder are accompanied not only by the clicking syndrome in the scapula, but also by quite strong pain that can hinder a person’s movements. It is worth noting that sometimes one has to observe a complete absence of pain.
The nature of the pain usually differs depending on the cause that caused it. Thus, in the case of many diseases associated with the scapula and shoulder joint, the pain has a sudden onset, but is quite moderate in severity. In diseases caused by professional expenses, patients complain of pain that is aching, squeezing or bursting in nature.
The duration of such an attack can be several days. During this time, pain can change in nature and intensity. Most often, symptoms such as crunching and pain are observed at night or in the morning. Often, symptoms become more pronounced when the weather changes, especially when it gets cold. On palpation, pain usually occurs in the scapula.
During the examination, the specialist is interested in the duration of the symptoms that have appeared and finds out what other complaints the patient has. Particular importance is attached to his type of activity and hobbies. Important information in this case is a history of fractures.
In addition to palpation, the specialist performs auscultation, that is, listens for a crunch in the shoulder blades during the patient’s movements. The diagnosis can be clarified using a chest x-ray.
This method allows us to identify the presence of any pathologies associated with the development or improperly healed fractures.
Also very effective in this case is the use of a computed tomography research method, which is characterized by obtaining detailed information about the desired area.
If bursitis is suspected, the most valuable diagnostic information can be obtained using magnetic resonance imaging.
Treatment of a syndrome such as scapular crunch is primarily aimed at eliminating the cause of its occurrence.
Most often, the beginning of treatment involves the use of conservative methods. In the case of intense pain that bothers the patient, when bursitis is detected, there is a need for treatment with non-steroidal drugs that have an anti-inflammatory effect (for example, taking aspirin, ibuprofen). In addition, the patient is prescribed a course of hardware physiotherapy, which includes laser therapy, magnetic therapy and electroanalgesia.
If, despite the attempted treatment methods, the result is not observed, the patient may be offered steroids, which are injected into the area where the inflamed bursa is located. With the help of steroids, which are powerful agents with anti-inflammatory effects, it is possible to relieve the inflammatory process and get rid of local swelling.
If conservative treatment methods are ineffective, and the clinical picture of bursitis is pronounced and painful, the patient is indicated for surgical intervention.
The purpose of the operation is to remove (resection) the medial angle of the scapula, and the synovial bursa is also removed. Many modern clinics use arthroscopic bursectomy. In this case, an arthroscope is used to remove the synovial bursa in which the inflammatory process takes place.
The appearance of the symptoms described above is a serious reason to contact a specialist. Scapular crunch can have different causes; the sooner you undergo examination and (if necessary) treatment prescribed by a specialist, the sooner you will protect yourself from possible serious complications.
At the same time, strict adherence to all recommendations of the attending physician requires special responsibility. This is the only way the scapular crunch will remain just an unpleasant memory for you.
What causes a scapular crunch? The humerus, collarbone and scapula are the shoulder girdle. On the inside of the shoulder blades are large muscles called the subscapularis and anterior scalene muscles.
The humerus combines with the subscapularis muscles at the shoulder joint. The lateral surface of the chest, where the ribs are located, is responsible for the connection with the anterior scalene muscle.
The bursa is a small sac that contains the viscous, viscous fluid of the synovium. This bag is located between areas that are often subject to friction against each other. In particular, it divides the anterior scalene and subscapularis muscles, the anterior scalene muscle and the pectoralis.
When the bursa becomes inflamed, the doctor diagnoses bursitis. The main symptoms of the disease are frequent pain and scapular crunching.
A disease such as bursitis most often develops with excessive stress on the elbow and wrist. Your toes may also crack. The shoulder and shoulder blade usually click due to severe tension or regular microtrauma. As a result, the soft tissues begin to become inflamed, including the inflammatory process affecting the synovial bursa.
Quite often, the shoulder blade and shoulder can crack due to occupational diseases. They are usually found in athletes, especially baseball and tennis players, people in construction professions - plasterers, painters and other workers. Crunching can be heard during push-ups and other vigorous movements.
If the shoulder joint or shoulder blade clicks during movement, this may be a symptom of atrophy of the muscles that are located in the area of the shoulder blade. The disease may occur due to exhaustion or prolonged inactivity of the muscle system in this area.
As a result of this, the scapula begins to adhere more tightly to the surfaces of the ribs, forming the chest wall from them. Due to increased friction, an inflammatory process develops that affects the synovial bursa.
If the scapula or rib does not heal properly after injury, the congruence of the surface of the joints in the chest area is disrupted. As you move, friction increases, which becomes the main reason why your shoulder or shoulder blade clicks.
In particular, the cause of a crunch in the shoulder blade can be a disease such as the formation of Luschka tubercles. These self-serving growths usually form on the upper edge of the left or right shoulder blade.
In particular, at the site of formation of the tubercles, additional synovial bursae are formed, in which inflammation periodically occurs, provoking bursitis of the shoulder joint.
Similarly, a crunch may appear in the elbow joint, legs, wrist area during push-ups and other intense movements. Fingers or toes often crack.
When the first symptoms appear, you should immediately consult a doctor to prevent the development of the disease and the occurrence of serious complications.
During the examination, the doctor finds out how long the symptoms of the disease last and what type of pain is observed. It is important to find out what type of activity the patient is engaged in in order to identify the cause of inflammation. The presence of fractures and other injuries to the shoulder joints, wrists or limbs is also taken into account.
In addition to palpation, during examination the doctor detects the presence of a crunching sound when the patient moves. To clarify the diagnosis, an X-ray examination of the chest or wrist is prescribed. This will make it possible to detect pathologies associated with improperly healed fractures or the development of other types of disorders.
This includes the method of examining the affected area using computed tomography. As a result of this, the doctor can obtain detailed and complete information about the location of the injury.
If the doctor suspects bursitis, the patient additionally undergoes magnetic resonance imaging and examines the shoulder or other affected area for damage.
When a scapular crunch is detected, you must first do everything to eliminate the cause of its occurrence. Usually the patient is prescribed conservative treatment of the damaged area.
In case of intense pain, if bursitis is diagnosed, the doctor may prescribe treatment with non-steroidal anti-inflammatory drugs.
Such medications include Ibuprofen, Aspirin and other drugs. Additionally, the patient undergoes a course of physical procedures, which include laser therapy, magnetic therapy, and electroanalgesia.
In cases where no therapeutic effect is observed when using non-steroidal drugs, steroid drugs are prescribed to treat joints. Injections are administered into the area of inflammation of the synovial bursa.
Powerful steroids with anti-inflammatory properties relieve inflammation and eliminate local swelling at the site of injury.
If conservative treatment turns out to be ineffective and does not bring the desired results, while the bursitis is pronounced, the patient feels severe pain, the doctor prescribes surgery.
During the operation, the medial angle of the scapula and the affected synovial bursa are removed. Many medical centers now use arthroscopic bursectomy. In this case, an arthroscope is used to remove the synovial bursa.
The shoulder is represented as a joint, which is truly a unique organ of the human body. It differs in its composition, structure and functionality. But, at the same time, you can feel all the pain in your shoulder if you apply the wrong disproportionate physical loads to the shoulder joint. As a result, a serious inflammatory process occurs. Increased stress can lead to swelling of the joint, the so-called joint effusion, as well as directly to rupture of the shoulder joint.
Interestingly, the human shoulder joint can withstand an incorrect load (meaning increased) only to a certain limit. If this limit is at the limit of a person’s permissible capabilities, then as a result the functions of the shoulder joint are impaired - completely or partially. Naturally, a person with such pathological disorders experiences severe pain.
If there is pain in the upper shoulder, then the cause should be sought in problems with the cervical spine. This pain can spread completely throughout the arm and hand. The pain in the right shoulder increases during sudden movements of the neck. Such unpleasant sensations are accompanied by severe numbness or a complete loss of sensation (decreased sensitivity).
When visiting a doctor, the presence of an intervertebral hernia may be noted. What is an intervertebral hernia? When intervertebral discs are damaged over time and, accordingly, loads on them, they completely lose all their elastic properties and become denser. As a result of this degenerative process, the distance between all the vertebrae of the neck becomes much smaller.
If the vertebrae in the cervical region become thicker and the distance between them becomes smaller, this leads to compression of the nerve roots. Which, naturally, leads to severe pain. Swelling appears at the site of compression of the nerve roots, which leads to even greater pain, pinching of the nerve roots and complete immobility of the shoulder. To diagnose a cervical intervertebral hernia, you must consult your doctor. You cannot make a diagnosis on your own.
Capsulitis is a fairly rare disease that is characterized by painful muscle stiffness specifically in the shoulder joint. With capsulitis, it is quite difficult for a person to move his shoulder to the side, raise his arm up, or place his arm behind his back.
It is worth noting that capsulitis develops extremely slowly and is almost imperceptible to humans. If we talk about the severe form of capsulitis, then in this case it is extremely difficult for a person to even bring the sore hand to the mouth along with a spoon.
Capsulitis damage begins from the moment when a person significantly overloaded his arm, and in a rather non-standard position. It could be painting the ceiling or walls, or even the first time doing physical exercise.
If you feel severe pain the next day after exercise, this indicates developing capsulitis.
If capsulitis is suspected, it is necessary to take an x-ray, which will confirm or refute the diagnosis.
Another pathology is tendobursitis, which is characterized by pathological inflammation of the shoulder joint. The reason is calcium deposition on muscle tendons. Such pain occurs in parallel with serious restrictions on joint mobility.
Below is a list of diseases that lead to pain in the shoulder joint:
Above we have listed the main causes of pain in the right shoulder. Now we list those causes of pain that are quite rare, but still occur:
If you experience severe pain in your right shoulder, you should consult an orthopedic doctor.
How does this disease progress? What are the signs of bursitis? How to diagnose pathology, and for what reasons does it appear? Finally, how to treat shoulder bursitis at home successfully? There are many questions in this topic, familiar to every traumatologist and orthopedic specialist. But, first of all, what kind of pathology is this? What is shoulder bursitis?
The articulation of the shoulder with the belt of the upper limb ensures free movement of the entire arm relative to the collarbone and scapula. Since the range of movement here is very large, to successfully perform it with minimal friction and resistance, you need shoulder bags - an auxiliary apparatus of the joint.
Bags are small cavities that contain some liquid. Their role is softening and protective. In the event that the bone has a significant amplitude of displacement, and its protrusion approaches the surface of the skin and muscles during movement, then a “pad” is needed - an elastic cushion, the role of which is taken on by the bag. There are more than one and a half hundred bags in our body, and some of them are located symmetrically, in the limbs.
If an acute or chronic inflammatory process begins in one or more bursae, then they speak of bursitis. The shoulder joint contains the following bursae that can become inflamed:
More often in clinical practice we have to deal with subdeltoid and subacromial inflammation. Which specialist should you contact, which doctor treats bursitis?
A variety of specialists take part in the treatment of this disease, depending on the complaints and clinical picture:
There are ailments that require consultation with several specialists.
Thus, long-term chronic diseases include ossifying bursitis of the shoulder joint (also called calculous bursitis of the shoulder joint). This form can be treated by traumatologists, both conservatively and surgically, or by reconstructive surgeons.
The most common causes of inflammation of the shoulder joint bursae are:
The causes of aseptic bursitis were listed above - conditions in which there are no external pathogenic microbes that are the basis for inflammation. In this pathology, when the bursa is punctured, exudate is obtained, which is serous and non-purulent in nature.
When a microbial infection penetrates, purulent inflammation of the bursae may occur, and, most often, these are injuries that are combined with wounds, abrasions and a violation of the integrity of the skin.
In rare cases, secondary bursitis and synovitis occur, in which purulent inflammation is simply transferred from the primary focus (ENT infections, bacterial endocarditis, erysipelas, phlegmon and abscesses).
Classic acute inflammation of the shoulder bags consists of the following clinic:
Usually, with aseptic inflammation, a feeling of heat in the joint and shoulder girdle is associated with intense previous physical activity. A few hours later, when the joint has rested and the patient has taken anti-inflammatory drugs, the temperature drops. This indicates regression of inflammation.
In the presence of an infectious process and purulent bursitis, the patient experiences a rise in not only the local, but also the general temperature of the entire body: a fever begins, sometimes at febrile levels.
Finally, the final symptom of acute bursitis is a violation of locomotor function - there is a limitation of mobility in the shoulder due to the combined influence of swelling, pain and inflammation.
Typically, acute bursitis either ends in healing, or chronic inflammation develops. The purulent process stands apart. Its outcome can be sepsis, phlegmon, osteomyelitis, purulent arthritis, infectious-toxic shock and death of the patient.
Before treating bursitis of the shoulder joint, taking medications, or applying a complex of exercise therapy, you need to make a correct diagnosis, indicating the location of the inflamed bursa. Puncture makes it possible to clarify the nature of inflammation and determine the nature of the exudate (serous, fibrinous, purulent, hemorrhagic, paracancrosis in malignant tumors and metastatic processes).
It is important to know that puncture of the bursa not only relieves pain, since it reduces pressure on the tissue, but also allows you to wash the cavity of the bursa with antiseptics and local anesthetics, antibiotics, or introduce corticosteroid hormones into the bursa. Therefore, puncture is a very frequent and necessary therapeutic and diagnostic procedure for doctors of various specialties who deal with this pathology in their practice.
Before performing a puncture, instrumental research methods should be used: ultrasound of the tissues of the shoulder joint, radiography in two projections of both shoulder joints. “X-ray” allows you to assess the involvement of bone tissue, find areas of rarefaction and osteomyelitis, show the presence of contrasting stones and various inclusions. Only an X-ray and ultrasound will help prescribe the correct treatment for calcareous bursitis of the shoulder joint.
In addition, MRI and specific methods for diagnosing infectious diseases for brucellosis, tuberculosis, syphilis and other vomiting are sometimes used. PCR, ELISA, and inoculation of the punctate for bacteriological examination are carried out with the isolation of a pure culture.
Like any inflammatory process, bursitis takes a long time to treat. How to treat shoulder bursitis at home? Let's look at the main principles.
The basis is drug therapy and regimen:
Ointment for bursitis, just like gels and creams, is used for application to the skin. Ointment for bursitis and other local forms are used both with NSAIDs (Fastum - gel, Dolgit - cream), and with bee (Apizartron) and snake (Nayatox) venom. This allows you to reduce the symptoms of inflammation and restore joint mobility.
Corticosteroid drugs for the treatment of shoulder bursitis (Diprospan, Kenalog) are used for injection into the bursa in rheumatological practice, and not very often, since they reduce the strength of the tendons.
Antibiotics are indicated for purulent process and identified causative agent of infection.
We will not dwell in detail on the choice of antibiotics, and, especially, on the characteristics of surgical methods. It is important for the reader how to treat shoulder bursitis at home.
In the acute phase, the basic principles of treatment should be:
This is the main thing that allows bags to “rest” from the load. To do this, you can simply hang your elbow on a scarf, and prescribe exercise therapy for bursitis of the shoulder joint no earlier than all the symptoms of exacerbation and inflammation have been eliminated.
Only when the pain in the joint disappears and the swelling decreases, will it be possible to use gymnastics and exercises under the guidance of an experienced instructor: after all, you need to perform special exercises that at the same time spare the affected bursa, but increase blood circulation in its area due to the work of other muscles. This “passive massage” leads to improved resorption of exudate from its cavity.
Exercises for bursitis of the shoulder joint are performed without weights, at a slow pace, and with a large amplitude. They should be opposite to the load that caused the bursitis. So, if a painter got the disease while working with his arm raised up, then the basis of exercises for bursitis of the shoulder joint should be movements with the limb lowered, moving it back, and so on.
Treatment with folk remedies for bursitis of the shoulder joint involves, first of all, warming up, massage, dry heat in the stage of fading exacerbation, when the drug course has already had its effect and the inflammation has been reduced. You can also use folk remedies in the stage of inflammation - for example, wrapping the shoulder area with a raw cabbage leaf or burdock leaf. These methods relieve inflammation and reduce pain.
In any case, treatment of shoulder bursitis at home should be carried out under the supervision of a specialist. It is necessary to undergo tests in a timely manner (for example, peripheral blood parameters that may indicate inflammation - leukocytosis, the presence of acute phase proteins, fibrinogen, increased ESR, a shift in the leukocyte formula to the left).
It is imperative to wait for the results of the puncture of the bag, if one was performed. The analysis can “shed light” on the nature of the disease.
A diagnosis such as inflammation of the shoulder bursa, the symptoms and treatment of which have been discussed, belongs to a common pathology. The disease depends on age and level of physical activity, production factors. Taken together, they all play a big role, since aseptic bursitis is much more common than infectious and purulent lesions, you need to remember this.
The human scapula is a wide and flat paired bone behind the chest, which is the basis of the shoulder girdle and has the appearance of a bayonet shovel, pointing downward. The wide part of the shoulder blade is located in the area of the shoulder girdle (which in everyday life is not quite correctly called the shoulder).
The lateral (outer) edge of the scapula is thickened; in its upper corner there is an articular cavity, which with the head of the humerus forms the shoulder joint (the shoulder is the upper part of the arm: from the same shoulder joint to the elbow). The shoulder joint is one of the most mobile joints of the human skeleton.
There, next to the articular cavity, there are two bony protrusions - the acromion directed backwards and the coracoid process protruding forward. Articulated with the acromion at the acromioclavicular joint is the clavicle, the bone that connects the scapula to the sternum.
The coracoid process does not articulate with the bones - muscles are attached to it: the pectoralis minor, which is responsible for moving the scapula down, forward and towards its inner lateral edge, as well as the biceps (with its short head). The long head of the biceps is attached to a tubercle located above the glenoid cavity of the scapula. The biceps (biceps muscle) is responsible for flexing the shoulder at the shoulder joint and the forearm (the lower part of the arm - from the elbow to the wrist) at the elbow. Also attached to the coracoid process is the coracoid brachialis muscle, which is connected to the shoulder and is responsible for its elevation and minor rotational movements.
The anterior plane of the scapula, facing the ribs, is slightly concave; it is called the subscapular fossa. The posterior surface is convex, it is divided into two unequal parts by a bony protrusion running horizontally - the spine (ridge). The ridge originates from the inner edge of the scapula, rises higher and, approaching the outer edge, passes into the acromion.
The deltoid muscle, which has the shape of a triangle, is attached to the crest, the outer part of the acromion and half of the clavicular bone. It completely covers the coracoid process and the shoulder joint, and its tip is attached to the humerus. This muscle forms the upper part of the shoulder and is involved in abduction of the shoulder joint.
The smaller - upper - part of the scapula above the crest is called the supraspinatus fossa, the lower, respectively, the infraspinatus. The muscles of the same name are attached to the subscapularis, supraspinatus and infraspinatus fossa
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The main function of the subscapularis, supraspinatus and infraspinatus muscles is to hold the shoulder joint, which is poor in its own ligamentous apparatus. The same purpose is used for another muscle – the teres minor, attached to the upper part of the outer edge of the scapula.
In general, the scapula is almost completely enveloped on both sides by muscles responsible only for the shoulder - its fixation and mobility. The scapula itself moves only thanks to the dorsal and pectoral muscles.
Main functions of the scapula:
The shoulder blades are the main link between the shoulder girdle and the arms and sternum.
The processes of the scapula - the coracoid and acromion - as well as their ligamentous apparatus protect the shoulder joint from above. In addition, the shoulder blade bones with their muscles and ligaments, along with the ribs and back muscles, protect the lungs and aorta.
Part of the muscles extending from the shoulder blades strengthens and holds the shoulder joint.
The shoulder blades are involved in the movement of the entire shoulder girdle and arms - performing rotational movements in the shoulder joint, raising the arm, abducting and adducting the shoulder. This participation can be either indirect: with the help of the muscles responsible for the movement of the shoulder, attached to the scapula, or direct: for example, abduction of the shoulder, starting from a certain angle, is possible only when the scapula is rotated. If the scapula is damaged, the mobility of the shoulder girdle is sharply limited and the ability to work is lost.
The scapula bones and joints can be subject to injury and inflammatory processes. There are also malformations of the shoulder blades. The shoulder blades may be in an incorrect position due to spinal deformities. In addition, pain in the scapular region does not always indicate disease of the shoulder blades in particular and the shoulder girdle in general.
Scapula fractures usually occur as a result of a strong blow from the rear or front. There are intra-articular (involving the glenoid cavity) and extra-articular (any area without damage to the glenoid cavity) fractures.
Scapula fractures may be accompanied by the following symptoms:
For intra-articular fractures, surgery is most often required - osteosynthesis, which includes comparison and fixation of bone fragments. Fractures of the body of the scapula usually heal on their own without complications, provided there is complete rest. Depending on the fracture, the patient’s arm, bent at the elbow, is fixed to the chest on the affected side or, conversely, taken to the side using a special splint. Fixation lasts about a month, after which the arm in the shoulder joint is gradually developed.
The scapula is designed in such a way that significant external force is required to fracture it. In addition, vital organs are in close proximity - the heart, lungs, and great vessels. Therefore, if you suspect a fracture of the scapula, you should consult a doctor as soon as possible.
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Scapula dislocations are extremely rare. Their cause is a strong tug on the arm, as a result of which the shoulder blade rotates and moves outward, and its lower edge is compressed between the ribs. This causes stretching and tearing of the muscles attached to the shoulder blade and spine.
The dislocation is reduced by a surgeon under local anesthesia, after which the arm is fixed to the torso for two to three weeks.
Bursitis of the shoulder blade refers to inflammation of the periarticular bursae of the shoulder joint. The cause of the disease can be injury, infection, or an autoimmune reaction.
Bursitis is treated with conservative methods - antibiotic therapy, painkillers, physical therapy - under the supervision of a doctor.
Examples of congenital anomalies of the scapula:
Aplasia is most often combined with the absence of an arm on the same side.
The pterygoid scapula is not only a cosmetic defect - a protruding inner edge, but also a functional disorder - the inability to rotate the arm and raise it. The disease is treated promptly.
Sprengel's disease is characterized by an abnormally high position of the scapula (scapulae), often by impaired development of the muscles of the shoulder girdle, and is also often combined with other anomalies. Complaints: cosmetic defect and difficulty in shoulder abduction. In mild cases, physiotherapy is prescribed; in more severe cases, surgery is prescribed.
Shoulder blades can “stick out” in both children and adults for various reasons, including:
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Depending on the cause, protrusion of the shoulder blades may not bring suffering other than moral, or be accompanied by disorders that significantly reduce the quality of life.
Poor posture can be corrected quite easily with the help of exercises, massage, and developing the habit of keeping your back straight. In other cases, it is necessary to treat the underlying disease.
Pain in the scapula may indicate damage to the scapula itself, its joints or the musculo-ligamentous apparatus, as well as diseases of the internal organs, in which the pain often “radiates” to the scapular region.
So, pain under the left shoulder blade may be accompanied by:
Pain in the area of the right shoulder blade is caused by:
Pain in the area of any shoulder blade can be accompanied by complicated osteochondrosis and neuralgia.
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