Understanding Acromioclavicular Joint Pain
What is the Acromioclavicular Joint?
The acromioclavicular (AC) joint is a small joint located at the top of the shoulder, where the collarbone (clavicle) meets the highest point of the shoulder blade (acromion). This joint plays a crucial role in shoulder movement and stability, allowing the arm to be raised above the head.
Causes of Acromioclavicular Joint Pain
AC joint pain can be caused by various factors, including:
Traumatic Injury
A direct blow to the shoulder, such as from a fall or collision during sports, can cause an AC joint separation or dislocation. This occurs when the ligaments that hold the collarbone and shoulder blade together are partially or completely torn.
Osteoarthritis
Degenerative changes in the AC joint can lead to osteoarthritis, a condition characterised by the breakdown of cartilage and the development of bone spurs. This is more common in older individuals and those with a history of shoulder injuries.
Overuse Injuries
Repetitive overhead movements, such as those involved in weightlifting, swimming, or certain occupations, can place excessive stress on the AC joint, leading to inflammation and pain.
Symptoms of Acromioclavicular Joint Pain
Symptoms of AC joint pain may include:
- Pain and tenderness at the top of the shoulder
- Swelling and bruising around the AC joint
- Weakness or instability in the shoulder
- Difficulty moving the arm, particularly when reaching across the body or overhead
- A visible bump or deformity at the AC joint (in cases of severe separation or dislocation)
Diagnosing Acromioclavicular Joint Pain
Physical Examination
To diagnose AC joint pain, we will perform a physical examination of the shoulder, assessing range of motion, strength, and tenderness. We may also ask about your medical history and any recent injuries or activities that may have contributed to the pain.
Imaging Tests
Imaging tests such as X-rays, MRI, or CT scans may be ordered to visualise the AC joint and surrounding structures. These tests can help identify fractures, dislocations, arthritis, or other abnormalities that may be causing the pain.
Treatment Options for Acromioclavicular Joint Pain
Conservative Treatment
In most cases, AC joint pain can be managed with conservative treatment measures, such as:
Rest and Activity Modification
Avoiding or modifying activities that aggravate the AC joint can help reduce pain and promote healing. This may involve temporarily limiting overhead movements or weightlifting.
Ice and Heat Therapy
Applying ice to the affected area can help reduce swelling and pain, particularly in the acute phase of an injury. Heat therapy may be beneficial for chronic pain or stiffness.
Physical Therapy
Here at MSKClinic, we design a personalised rehabilitation program to help strengthen the muscles around the AC joint, improve the range of motion, and promote proper shoulder mechanics. This may include exercises, manual therapy techniques, and modalities such as ultrasound or electrical stimulation.
Medications
Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, can help manage pain and inflammation. In some cases, a healthcare provider may prescribe stronger pain medications or corticosteroid injections to provide targeted relief.
Surgical Intervention
In severe cases of AC joint separation or dislocation, or when conservative treatment measures have failed to provide relief, surgical intervention may be necessary. Surgical options may include:
- AC joint reconstruction: Repairing or reconstructing the damaged ligaments to restore stability to the joint
- Distal clavicle excision: Removing a small portion of the collarbone to prevent painful bone-on-bone contact
After surgery, a comprehensive rehabilitation program is essential to restore strength, range of motion, and function to the shoulder.
Prevention and Self-Care Strategies
To help prevent AC joint pain and promote overall shoulder health, consider the following strategies:
- Maintain good posture and shoulder alignment during activities
- Use proper form and technique when engaging in sports or weightlifting
- Gradually increase the intensity and duration of overhead activities
- Incorporate shoulder strengthening and stretching exercises into your fitness routine
- Take frequent breaks and avoid prolonged periods of repetitive overhead movements
If you experience persistent or severe AC joint pain, take a consultation with us for an accurate diagnosis and appropriate treatment plan. At MSKClinic, our team of experienced physiotherapists is dedicated to helping you find relief from AC joint pain and restore optimal shoulder function.