AC / ACJ ACROMIOCLAVICULAR JOINT ARTHRITIS

The acromioclavicular joint is the one at the tip of the shoulder. The acromioclavicular joint is often plagued by arthritis. And the pain caused is severe and degenerating. The pain due to the AC joint arthritis may be localized or it may extend to the neck or down the outer side of the shoulder.

The AC joint is located where the shoulder blade meets the collarbone at a point called acromion. A pad of cartilage is present in the joint between the two bones. This connective tissue acts as the smooth surface on which the bones can move on each other without any friction to either. With age, the cartilage begins to wear out and the joint can wear out too. This leads to enlargement of the region and may give rise to spurs or unhealthy projections.

The AC joint arthritis is also known as joint arthrosis or osteoarthritis of the AC joint. This occurs usually in middle aged or older people. This condition arises when the cartilage protecting the AC joint begins to wear out. It is natural for the joint to wear and tear with age. But this condition speeds up the degenerative process. The AC joint arthritis may cause deformation in the shoulder and it may jut out in odd angles. The shoulder may also look larger than the other unaffected shoulder. Spiny projections or spurs may develop around the joint.

What are the main causes of AC joint arthritis?

The main reason for the occurrence of AC joint arthritis is use. Constant use of the shoulder joint throughout one’s life leads to the wear and tear of the cartilage. This often causes the painful condition of the arthritis. Another common cause is an injury to the AC joint in the past. Any activity or accident that causes stress on the shoulder joint may lead to the acutely painful condition of AC joint arthritis.

People who use their shoulder joint extensively and intensively all their lives are more prone to AC joint arthritis. For example, weightlifters and people who work in construction sites are always lifting heavy weights above their heads are more vulnerable to this form of arthritis.

What are the symptoms of AC joint arthritis?

The first symptoms of this arthritis are pain in the shoulders and a feeling of tenderness in the in the front of the shoulder around the joint. Sleeping on the side may increase restlessness and pain. Movements like bringing the arm close to the chest and trying to bring the shoulder under the chin may become very difficult and enhance the pain. As a result, shoulder and arm movement may get restricted.

If there has been an injury to the joint in the past, the site may swell and become increasingly painful. There may be a snap or click every time there is some form of movement around the joint.

When a doctor is consulted, he or she will feel for the tenderness at the joint site and look for pain if the joint is compressed. These form the first step of the diagnosis. An injection from the local anesthetic may reduce the pain temporarily. Then, an X-Ray is performed to check for the narrowing of the joint.

Treatment of AC joint arthritis

Initial treatment may be nominal, with rest forming the major piece of advice. Regular non-steroidal analgesics accompanied with rest often provide relief. Applying ice to the affected area to reduce inflammation for half an hour once or twice a day may help to reduce the pain. If the pain persists even after such medication, strong steroidal injections like cortisone are pushed to relieve the patient of pain. Shoulder pain from arthritis can be significantly improved by following some simple exercises, like those highlighted in my book “Exercise your Shoulder Pain Free”.

And if all these fail, the only treatment option for acromioclavicular joint arthritis would be surgery. Resection arthroplasty is what happens to the patient with AC joint arthritis. This involves the removal of the most affected bit of collarbone. Ligaments remain intact with a gap in between the bones. Scar tissues develop to replace the hollow. This allows easier movement of the shoulder joint. Movement of the shoulder is possible immediately after removal of the stitches. In the worst of cases, a complete shoulder replacement is advised.