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A sling decreases pressure on the AC joint.
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Arthritis can develop in any joint that moves. The acromioclavicular joint, also known as the AC joint, is formed by the collarbone and part of the shoulder blade. Arthritis in AC joint often develops from previous injuries to the ligament between the bones or from the gradual breakdown of the padding between the bones.
The AC joint is on top of the shoulder. Minimal movement occurs in this joint. The collarbone rotates slightly with shoulder movement and a small amount of gliding forward and backward occurs as the shoulder blade moves. Osteoarthritis -- breakdown of the cartilage that pads the joint -- is a common cause of pain at this joint. This form of shoulder arthritis most frequently affects people over the age of 50. It can develop in younger people with a history of trauma to the joint or repetitive overhead activities.
Symptoms and Diagnosis
Pain at the top of the shoulder is typically the first symptom of AC joint arthritis. This pain often increases with reaching overhead or lying on the arm while sleeping. Movements that bring the bones closer together, such as reaching the arm across the body, also increase pain. Clicking and popping sometimes occur at the joint. Shoulder mobility may decrease over time.
AC joint arthritis is diagnosed through physical examination and discussing symptoms. Pain and tenderness occur over the joint. X-rays are sometimes used to help with the diagnosis. Decreased space or extra bone growth between the acromion and the collarbone on x-ray are typical findings with arthritis of this joint.
Pain from AC joint arthritis may go away with conservative treatment. Medications such as naproxen (Aleve, Naprosyn), ibuprofen (Advil, Motrin) and aspirin may be used to decrease pain and inflammation. Cortisone is sometimes injected directly into the joint.
Physical therapy uses heat, ultrasound and electrical stimulation to decrease pain and inflammation. Range of motion exercises improve movement of the shoulder, and strengthening exercises improve posture to relieve pressure on the AC joint. Massage is sometimes performed by the therapist to decrease the tightness associated with scar tissue in the ligament between the bones.
Surgery is sometimes needed to treat AC joint arthritis. The end of the collarbone is typically removed to alleviate compression at the AC joint. The procedure can be performed arthroscopically with tiny incisions used to insert a miniature camera and surgical instruments through the skin. An open surgical procedure can also be performed, allowing the doctor to see the joint directly.
This surgery, called an AC joint resection, requires cutting certain muscles so the surgeon can operate on the AC joint. The muscles are reattached after the joint repair. This can lead to weakness down the road. Looseness of the nearby ligaments after surgery can also cause instability of the joint. Surgery successfully alleviates AC joint pain in most people who have this procedure, according to the authors of a June 2008 article published in "Current Reviews in Musculoskeletal Medicine."