AC Joint Arthritis Overview

AC Joint Arthritis: A Detailed Overview

Osteoarthritis of the acromioclavicular joint, or AC joint arthritis, is a condition when the cartilage begins to wear out at the front of the shoulder. This can cause significant pain, impacting shoulder mobility and limiting the motion of the arm.

What is AC joint arthritis?

AC Joint Arthritis, or acromioclavicular joint arthritis, is a degenerative condition affecting the acromioclavicular joint, which is located where the clavicle (collarbone) meets the acromion (a part of the scapula, or shoulder blade). This joint plays a crucial role in shoulder movement, and arthritis in this area can lead to significant pain and impairment. Over time, the cartilage that cushions the bones in the AC joint wears down, causing the bones to rub against each other, leading to pain, inflammation, and decreased mobility.

What causes AC joint arthritis?

Several factors can contribute to the development of AC joint arthritis. Ageing is a primary cause, with wear and tear on the joint accumulating over time. Repetitive stress from activities that involve heavy lifting, overhead motions, or strenuous shoulder use can also accelerate the degeneration of the joint.

Certain sports can cause this condition, after damage to the labrum when the biceps tendon pulls sharply against it. For example, golfers can be susceptible with a golf club repeatedly hitting the ground during a swing. Also, weightlifters that hold heavy weights overhead.

Additionally, previous injuries, such as fractures or dislocations of the shoulder after a fall, can increase the risk of developing arthritis in the AC joint. Genetic predisposition and conditions like rheumatoid arthritis can also play a role in its onset.

What are the symptoms of AC joint arthritis?

The symptoms of AC Joint Arthritis often include pain localised at the top of the shoulder, especially noticeable during movements such as lifting the arm, reaching across the body, or performing overhead activities. The pain can radiate down the arm or into the neck. Patients may also experience swelling and tenderness around the joint, along with a grinding or clicking sensation during shoulder movements. In severe cases, there may be visible deformity or a noticeable lump over the AC joint.

How is AC joint arthritis diagnosed?

Your London Shoulder Specialist can confirm a diagnosis of AC joint arthritis after performing several checks. Normally, this will be a combination of discussing medical/injury history, a thorough physical examination, and imaging studies. During the physical examination, your London Shoulder Specialist will assess the shoulder’s range of motion and pinpoint areas of tenderness. They may perform specific tests, such as the cross-body adduction test, where the patient moves the arm across the chest to see if it elicits pain in the AC joint.

Imaging studies, including X-rays, can reveal the extent of joint degeneration, bone spurs, and narrowing of the joint space. In some cases, further investigations including a blood test, as well as an MRI or CT scan, may be used to get a more detailed view of the joint and surrounding tissues. This will help inform your Specialist of the most appropriate treatment options.

What makes AC joint arthritis worse?

Certain activities and behaviours can exacerbate the symptoms of AC joint arthritis. Repetitive overhead motions, such as those performed in certain sports or occupations, can increase stress on the joint and worsen symptoms. Heavy lifting and activities that involve significant use of the shoulder can also lead to increased pain and inflammation. Poor posture, especially when sitting or working for long periods, can strain the shoulder and aggravate arthritis. Additionally, cold weather can sometimes increase joint stiffness and discomfort.

How should I sleep with AC joint arthritis in my shoulder?

Finding a comfortable sleeping position is essential for managing AC joint arthritis. Sleeping on the unaffected side can help reduce pressure on the arthritic joint. Using a supportive pillow to prop up the affected arm can also alleviate discomfort.

Some patients find relief by sleeping on their back with a pillow placed under the shoulder and arm to provide additional support and reduce strain. It’s important to avoid sleeping directly on the affected shoulder, as this can exacerbate pain and stiffness.

What are the treatment options for AC joint arthritis?

Treatment for AC joint arthritis will depend on individual factors such as age and any sporting involvement. Usually, treatment begins with conservative measures aimed at reducing pain and improving function. Rest and activity modification are often recommended to minimise stress on the joint. Physical therapy can help strengthen the shoulder muscles, improve range of motion, and reduce pain. Anti-inflammatory medication and cortisone injections can be an effective temporary measure for reducing inflammation and alleviating pain.

If conservative treatments fail to provide sufficient relief, surgical options may be considered. The most common surgical procedure for AC joint arthritis is distal clavicle excision, also known as the Mumford procedure, where a small portion of the clavicle is removed to eliminate bone-on-bone contact and relieve pain. Arthroscopic surgery, which is minimally invasive, can also be used to clean out the joint and remove any loose fragments or bone spurs.

Is surgery necessary for AC joint arthritis?

Surgery is not always necessary for AC Joint Arthritis and is typically considered only when conservative treatments have not provided adequate relief and the symptoms significantly interfere with daily activities. The decision to undergo surgery depends on several factors, including the severity of the arthritis, the patient’s activity level, and overall health. For many individuals, non-surgical treatments can effectively manage symptoms and improve quality of life. However, for those with severe pain and limited function that do not respond to other treatments, surgery can offer significant relief and improve shoulder mobility.

What is recovery like after surgery for AC joint arthritis?

Recovery after AC joint arthritis surgery varies depending on the age and medical history of the patient, as well as the surgical approach used.

Physical therapy is a crucial component of recovery, focusing on regaining shoulder strength, flexibility, and range of motion. Individuals will gradually return to activities and sports, following a structured rehabilitation program. A full recovery can take between four to six months.

AC joint arthritis can be diagnosed by your London Shoulder Specialist who can recommend an appropriate treatment plan and ways to effectively manage your condition.