Understanding and Managing Acromioclavicular (AC) Joint Pain

Pain in the acromioclavicular (AC) joint, where the acromion (the tip of your shoulder blade) meets the clavicle (collarbone), can be both painful and disruptive to daily life. This joint, which connects the shoulder blade and collarbone, is cushioned by cartilage and synovial fluid. AC joint pain can stem from various causes, and effective treatment depends on identifying the underlying issue.

What Does AC Joint Pain Feel Like?

AC joint pain usually presents as an ache at the top of the shoulder, often accompanied by tenderness. The pain can affect your daily activities, such as putting on a seatbelt or reaching for objects. Common symptoms include:

  • Pain that intensifies with arm movements, especially horizontal or overhead motions
  • Discomfort that might disrupt sleep if lying on the affected side
  • Stiffness, particularly after periods of inactivity
  • Clicking or popping sounds (crepitus) during shoulder movement
  • Weakness in the shoulder and arm
  • Tenderness with possible bruising, swelling, or noticeable bumps

Sources of AC Joint Pain

AC joint pain can be due to arthritis or injury, with each presenting similar symptoms:

Arthritis

  • Osteoarthritis: Over time, the cartilage in the AC joint deteriorates, causing the bones to rub together. This leads to inflammation, pain, and swelling, especially with activity. Bone spurs may also develop, enlarging the joint further.

Injury

  • AC Joint Injuries: Common in people aged 20 to 30, especially those involved in contact sports or strenuous activities. Injuries often result from direct trauma or falls onto the shoulder, leading to sprains, tears, or separations of the ligaments:
  • Type 1: Stretching or spraining of ligaments without tearing.
  • Type 2: Torn AC ligament with minor damage to the CC ligament.
  • Type 3: Complete tearing of both ligaments, causing separation of the collarbone from the shoulder blade.
  • Types 4 to 6: More severe damage, including extensive tissue injury.
  • Fractures: Broken collarbones can also cause AC joint pain, though fractures of the shoulder blade are less common.
Dr. MAnish Singh - Orthopaedics Surgeon- Noida

Will Joint Pain Ever Go Away?

Pain from arthritis often fluctuates and generally worsens over time. However, with appropriate treatment, injuries can heal, relieving pain and restoring mobility. While complete recovery is possible, some residual pain or limited range of motion may persist.

Treatment

Managing AC joint pain involves various strategies based on the cause:

For Arthritis:

  • Activity Modification: Avoid activities that exacerbate the joint pain.
  • Warm Compresses: Apply moist heat to alleviate discomfort.
  • Ice Therapy: Use ice packs (wrapped in a cloth) to reduce inflammation.
  • Physical Therapy: Engage in exercises to improve strength and range of motion.
  • Medications: Use over-the-counter NSAIDs (e.g., Advil, Aleve) for pain and inflammation, and corticosteroid injections for severe cases.

For Injuries:

  • Rest and Immobilization: Use a sling to minimize shoulder movement.
  • Dislocation Treatment: An anesthetic may be used to reposition a dislocated shoulder (reduction).
  • Surgery: Typically needed only for severe cases or when ligaments need repair. Recovery can range from weeks to months.

AC Joint-Friendly Exercises

Exercise can relieve pain, enhance strength, and restore range of motion. Perform exercises under professional guidance to avoid worsening the pain:

  • Pendulum Exercise: Gently swing the arm in various directions while keeping the shoulders relaxed.
  • Stretches: Lift a light pole or bar over your head to stretch the shoulder.
  • Strength Training: Squeeze shoulder blades together while lying on your back with knees bent.
  • Rotation: Use an exercise band for controlled arm rotations.
  • Posture Exercise: Pull the elbows back with an exercise band to strengthen shoulder muscles.

Healing and Sleeping Tips

Follow your orthopedician’s advice for optimal healing. Adjust your sleeping position to minimize shoulder pressure by avoiding the affected side and using pillows to support and elevate the arm.

Summary

AC joint pain can significantly impact daily life, often caused by arthritis or injuries like dislocations. While arthritis pain tends to worsen over time, treatments such as physical therapy and medication can offer relief. Injuries generally heal with rest and conservative care, though severe cases may require surgery. Proper exercise and sleep adjustments can further aid in recovery and pain management.