¿Qué es la artropatía del manguito rotador: signos, factores de riesgo, tratamiento, diagnóstico?

Una artropatía del manguito de los rotadores es una afección que ocurre cuando hay un desgarro grave en los músculos del manguito de los rotadores. El manguito rotador es en realidad un grupo de cuatro músculos y tendones que rodean la articulación de rótula. La función principal de estos grupos de estos músculos es ayudar al movimiento y proporcionar fuerza a la articulación del hombro, además de proporcionar una fuerza integral que ayuda a mantener la bola dentro de la cavidad del hombro. Para diagnosticar la artropatía del manguito rotador, se buscan 3 características clínicas y son:

  • Función inadecuada del manguito rotador (típicamente una rotura sustancial)
  • Artritis articular esférica ( glenohumeral ).
  • Desplazamiento de la bola desde su posición normal dentro del casquillo.

Signos de una artropatía del manguito rotador

Las indicaciones de artropatía del manguito rotador son como la inflamación típica de la articulación del hombro, aunque a menudo hay más debilidad en el hombro. Otros signos de artropatía del manguito rotador incluyen:

  • Dolor en el hombro
  • Pérdida de movilidad
  • Debilidad de la articulación del hombro
  • Hinchazón alrededor del hombro
  • Atrofia muscular alrededor del hombro.

Factores de riesgo para la artropatía del manguito rotador

Los factores de riesgo para tener artropatía del manguito rotador incluyen:

  • Años
  • Índice de masa corporal o IMC
  • Altura
  • Levantamiento recurrente de objetos pesados.
  • Movimientos de cabeza recurrentes
  • Lesiones relacionadas con el trabajo.

Diagnóstico de la artropatía del manguito rotador

Diagnosis of rotator cuff arthropathy includes patient history and physical assessment which also includes description of activities done and acute and chronic symptoms. A proper diagnosis will includes detailed physical examination of the shoulder by checking for tenderness and deformity, palpation, range of motion, neurological evaluation, tests to reproduce the symptoms, and strength evaluation. The diagnostic tests which help for evaluation of rotator cuff arthropathy are:

Treatment for Rotator Cuff Arthropathy

Treatment for rotator cuff arthropathy can sometimes be really challenging. The treatments are decided based on the extent of injury and damage and also by evaluating the pros and cons of each treatment method and its expected outcome. The ways of treatment for rotator cuff arthropathy include:

Non-operative Treatment for Rotator Cuff Arthropathy:

  • Physical Therapy: Physical therapy is the most important way in treating rotator cuff arthropathy. It is important to strengthen the rotator cuff muscles in order to normalize the shoulder function. Exercises taught by the physical therapist can help to alleviate and prevent recurrent shoulder pain. Treatment methods opted by a physical therapist to relieve the pain and inflammation include ultrasound, electrical stimulation like IFT and TENS etc.
  • Cold Compression to the Rotator Cuff: Cold compressions help to reduce pain and inflammation of the shoulder. Cold compressions can be done using ice packs or ice wraps found in the market. It should be applied intermittently for 3-4 times in a day or every time after doing an activity that increases the pain.
  • Aqua Therapy: It is really helpful for patients who are experiencing extremes of pain and are unable to do exercises. Movements done underwater reduce the efforts to be put by the muscles for doing an exercise.
  • Anti-inflammatory Medications for Rotator Cuff Arthropathy: Anti-inflammatory medicines help in controlling the pain and inflammation experienced in cases of rotator cuff arthropathy. However, it must be only taken under the supervision of a doctor.
  • Cortisone Injections: Cortisone injections are given directly on the shoulder joint so that it acts locally on the inflamed area and the reaction is faster. Cortisone injections are well tolerated and have insignificant reactions. In patients with diabetes, cortisone shots may briefly raise the glucose levels and hence, one must observe the glucose levels closely for the first few days.

Operative Treatment for Rotator Cuff Arthropathy:

The 3 different surgical methods for rotator cuff arthroscopy are arthroscopic, mini open and open surgery. In the earlier days, arthroscopy was done for patients who had small tears; while for large tears of the rotator cuff, open surgeries were done. However, with the advancement of science and research, today, even for large tears, arthroscopic repairs are done. Moreover, arthroscopy allows short recovery period while the benefits of it is same as an open surgery.

Post-Surgical Rehabilitation:

Surgery alone can only help in suturing the muscles together. Post-surgical rehabilitation is something very important to improve the muscle strength and increase the range of motion while bringing the shoulder back to its normal functional state. The rehabilitation is done is 3 stages. At first, the arm is kept immobilized for a period of time so as to let the muscles heal. Secondly, a physical therapist assists with passive exercises to slowly regain the range of movement of the shoulder. The third stage includes gradual active movement exercises of the arm and shoulder to regain and enhance strength.

The severity of rotator cuff arthropathy depends on the extent of tear of the rotator cuff muscles and the pain experienced. However, it must not be neglected at any time since the condition might worsen causing severe pain and discomfort.

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Especialista en dolor at | 307-996-2960 | [email protected]

Soy un Neuroanestesiólogo y Especialista en el Tratamiento del Dolor. Me otorgaron el Premio Nacional de Medicina 2018. Soy CEO y fundador de la Unidad Internacional del Dolor de Madrid y editor de Journal Pain Management and Therapy. También es asesor y crítico del AIUM (Instituto Estadounidense de Ultrasonidos en Medicina) y miembro del Comité Organizador de las World Pain Conferences.

Tengo más de diez años de experiencia con terapias regenerativas que incluyen células madre mesenquimales, plasma rico en plaquetas, factores de crecimiento, transferencias de grasa y ácido hialurónico. Inicié Dolor-drdelgadocidranes.com para difundir el conocimiento y la conciencia.

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