Experiencing Shoulder
AC Joint Pain?
AC joint pain can create both limitation in motion as well as shoulder joint pain. How can you tell if your AC joint is the source of your pain and what can you do if it is?
What is the AC Joint?
The acromioclavicular (or AC) joint is the joint created by the end of the collar bone (clavicle) connecting to the acromion of the shoulder blade (scapula).
Pain in this region of the shoulder is most commonly caused by trauma, specifically falling on either an outstretched arm or a fall landing directly on the tip of the AC joint.
When such a trauma occurs, it is called a sprain as the ligament that connects the bones becomes stretched or torn. This type of AC sprain is also called a shoulder separation.
Shoulder separations are classified as either 1st (mild), 2nd (moderate), or 3rd (severe) degree sprains. A 3rd degree AC joint sprain is the most severe with the result being what is termed a “stair step” deformity. This is when the end of the clavicle appears elevated because the ligament connecting the bones is completely torn.
Less common is an AC joint that is painful because it has become stiff and arthritic. No recent trauma is associated with this type of injury, but rather the pain and limited mobility of the joint gradually worsens over time.
Typical Symptoms
Most commonly, when the AC joint is involved in shoulder pain, the AC joint itself will be very tender to the touch. Pain will be very specific to the tip of the shoulder. Lifting the arm up and reaching overhead will often be painful. Reaching into overhead cabinets, washing your hair, and getting shirts on or off are symptomatic. And, reaching across your body to the opposite shoulder will also recreate pain in the AC region. Sleeping on the involved shoulder will reproduce pain and may wake you at night.
Typical Treatment
For AC joint pain that is the result of trauma, ice and rest is the initial treatment of choice. In addition, over the counter anti-inflammatory medication can also be helpful to reduce joint inflammation (consult your doctor regarding medications). Utilizing
ice therapy
(no heat!) to reduce pain and swelling is also recommended. For best results, apply ice to the shoulder 10 to 15 minutes, three times a day. Often because the weight of the arm hanging next to the body can cause discomfort, utilizing a sling can help in reducing pain and decreasing stress on the joint. The severity of the injury generally determines how quickly pain will diminish and function will improve. Most sprains take 6 to 8 weeks to heal. In rare cases when a 3rd degree sprain occurs, healing will take longer and surgery may be warranted.
Physical Therapy Exercise
As with other joint sprains, treatment goals include reducing inflammation, restoring range of motion (ROM), and restoring strength. The following is a link to a physical therapy exercise program for assisting in restoring ROM and strength following an AC joint injury:
Exercises for AC Joint Pain.
AC joint pain unrelated to recent trauma could signify arthritic changes in the joint. Ice can be helpful in reducing the local inflammation associated with these arthritic changes. Of course, with all joint arthritis, anti-inflammatory medications can be helpful (consult your doctor regarding medications). However, in cases where the joint is stiff, seeking physical therapy treatment can be greatly helpful as manual mobilization of the joint may be necessary to improve joint mobility. For arthritic joints, restoring normal ROM is necessary to reduce pain.
Summary
• AC joint pain is most often related to trauma.• The most serious of AC sprains results in a stair step deformity. • Rest, ice, medication, and at times a sling can help reduce joint pain. • Follow the exercises for AC joint pain to restore your shoulder mobility and strength and help to reduce your shoulder joint pain.
AC joint pain can by annoying and limiting. Following simple recommendations can help to relieve your AC pain and get you back to your life.
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