Ac Joint Arthritis
What is AC Joint Arthritis?
AC (acromioclavicular) joint arthritis is degenerative or post-traumatic arthritis of the joint where the clavicle meets the acromion. It causes localized pain and may limit shoulder mobility.
- Degeneration at the acromioclavicular joint
- Pain with cross-body movements
- Swelling or tenderness over the joint
- Limited range of motion
- Pain with overhead activities
- Crepitus or grinding sensation
Overview of the Condition
It commonly occurs due to repetitive stress, previous injury (like AC joint separation), or age-related cartilage wear.
Symptoms
- Top of the shoulder pain
- Pain aggravated by cross-arm activities
- Swelling or tenderness over the AC joint
- Limited range of motion
- Pain with overhead activities
- Crepitus or grinding sensation
- Pain radiating to the neck or upper back
- Difficulty sleeping on the affected side
- Weakness in the shoulder or arm
- Stiffness in the shoulder joint
- Pain with lifting or carrying objects
- Pain with reaching behind the back
- Pain with pushing or pulling movements
Causes
Repetitive microtrauma (weightlifting, overhead work) or residual damage from AC joint separations can lead to cartilage degeneration.
Diagnosis
- Patient history and physical examination
- Imaging studies (X-rays, MRI) to assess joint space narrowing and osteophyte formation
- Physical exam tests (cross-arm test) to reproduce pain
- Diagnostic injections to confirm the source of pain
- Assessment of range of motion and strength
- Evaluation of shoulder stability and function
- Exclusion of other shoulder conditions (rotator cuff tears, impingement syndrome)
Treatment Options
- Conservative management with NSAIDs and activity modification
- Corticosteroid injections for pain relief
- Surgical resection of the distal clavicle in persistent cases
Conservative Management
- Rest and activity modification
- Physical therapy for strengthening and range of motion
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Corticosteroid injections for inflammation
Rehabilitation Exercises
- Shoulder range-of-motion exercises
- Rotator cuff and scapular muscle strengthening
- Gentle cross-arm stretching
Surgical Options
Distal clavicle excision (Mumford procedure) may be done arthroscopically or open, relieving joint contact and pain.
Anatomy Overview
The AC joint is formed by the acromion process and the distal clavicle, stabilized by ligaments. Degeneration here leads to AC joint arthritis.
Affected Areas
- Acromioclavicular joint
- Surrounding ligaments
Frequently Asked Questions
| Question | Answer |
|---|---|
| Is surgery always needed? | No, most cases improve with conservative treatments; surgery is for persistent symptoms. |
| Can AC joint arthritis affect overhead activities? | Yes, overhead motions and cross-body actions typically exacerbate pain. |
| What is the recovery time after surgery? | Recovery varies; typically, 6-12 weeks for full function, depending on the procedure. |
| Are there any long-term effects? | Some may experience chronic pain or limited mobility, but many return to normal activities. |
| Can physical therapy help? | Yes, physical therapy can improve strength and range of motion, reducing pain. |
| What are the risks of surgery? | Risks include infection, nerve injury, and persistent pain. Discuss with your surgeon. |
| Is it common in athletes? | Yes, especially in sports with repetitive overhead motions (e.g., baseball, swimming). |
| Can I continue exercising? | Consult your doctor; low-impact activities may be safe, but avoid aggravating movements. |
| What lifestyle changes can help? | Weight management, ergonomic adjustments, and avoiding repetitive overhead activities can help. |
| Is there a link to age? | Yes, age-related wear and tear increases the risk of AC joint arthritis. |
Prevention Strategies
- Use proper lifting techniques
- Avoid repetitive overhead motions
- Strengthen rotator cuff and scapular stabilizers