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Acromioclavicular (AC) Joint Arthritis
AC arthritis is a chronic inflammation of the acromioclavicular (AC) joint, one of four joints that work together in the complex system that makes up the shoulder. Like most cases of osteoarthritis (OA), AC arthritis occurs when the cartilage that protects certain bones within the joint becomes thinner. Recognizing AC arthritis as a unique condition is important when it comes to treatment. Although shoulder arthritis may occur in the same area, the conditions are not the same.AC joint arthrosis or osteoarthritis of the acromioclavicular joint is most common in middle-aged people. It develops when the cartilage in the AC joint begins to wear down. In this case, there is usually pain that limits the movement of the arm.
If you have AC joint arthritis, you may feel tenderness and pain in the upper part of your shoulder early on. Other possible symptoms of AC joint arthritis include:
- More pain after sleeping on that side
- Lost range of motion in your shoulder
- More pain when the joint is compressed (such as when crossing your arm across your chest)
- Visible inflammation and increased prominence around the AC joint
AC arthritis pain is mostly due to shoulder movement, but neck and arm pain may also play a role. This can make diagnosis difficult, as several types of arthritis and some other conditions can cause similar symptoms. Specific movements tend to aggravate symptoms. The typical test for AC joint pain is to bring the affected arm to your chest. This compresses the AC joint and often recreates the pain.
AC arthritis is osteoarthritis that is usually the result of repetitive movements that erode the cartilage in the acromioclavicular joint. Since the shoulder is so widely used, it is not surprising that the articular surface wears thinly after years of use.
However, other problems can cause symptoms:
- Inflammatory conditions: Autoimmune diseases such as rheumatoid and psoriatic arthritis can attack the AC joint.
- Septic arthritis: This is caused by an infection in the joint that can be transmitted through the bloodstream or through an injury that transmits germs directly to the joint (for example, a puncture).
- Injuries: Shoulder trauma such as shoulder separation can contribute to the development of AC arthritis.
AC Joint Arthritis Treatment
Treatment for AC joint arthritis depends on the severity of symptoms and the presence of other shoulder problems, including:
- Impingement syndrome
- Glenohumeral arthritis
- Muscle injury (eg, rotator cuff tear)
For Mild-Moderate Symptoms of AC Joint Arthritis-
If AC arthritis symptoms are mild to moderate, anti-inflammatory medications and physical therapy are the most common conservative measures.
Your healthcare provider may inject a local anesthetic or steroid into the AC joint to see if your symptoms improve.
For Severe or Unresponsive Symptoms of AC Joint Arthritis-
Surgery may be needed if symptoms do not respond to conservative treatment or if the pain is very severe. Your healthcare provider may recommend an arthroscopic procedure called isolated AC joint resection. In this procedure, the surgeon removes the end of the collarbone. This allows for normal movement of the AC joint (minimum even in healthy shoulders) while stopping the exposed bones from rubbing against each other.Usually, the incision is about an inch long and they remove less than a centimeter of bone.Then, over time, the AC joint becomes filled with scar tissue.
Treatment begins with careful evaluation of the joint, usually accompanied by X-rays or MRIs, to assess the joint structures and assess the extent of any joint damage. Once the diagnosis of AC joint arthritis is confirmed, treatment begins with conservative options such as non-steroidal anti-inflammatory drugs (NSAIDs) and warm compresses to improve joint mobility. Activity modification and corticosteroid injections may also help. Physical therapy may also be helpful, although some studies show that gentle stretching can help improve symptoms in the AC joint.
When conservative approaches aren’t effective at relieving your symptoms, your doctor may recommend surgery to remove pieces of tissue or reshape the bones in the joint, thereby reducing friction and promoting a normal, painless range of motion. Most shoulder surgery to correct AC joint arthritis can be performed using a minimally invasive technique called arthroscopy, which relies on small incisions and promotes faster healing compared to traditional surgical techniques.
Recovery of AC Joint Arthritis
You can usually go home the same day after AC joint resection. You’ll probably start shoulder movement right away with physical therapy. As you recover, you may have pain and/or fatigue in your shoulder with heavy lifting or strenuous activity. Most people can return to full activity within three months of surgery.
If you are suffering from any kind of the above-mentioned symptoms please contact Spine and Joint Pain Consultants in Interventional Pain Specialist in Houston.
4101, Greenbriar Dr, Suite 208
Houston, Texas 77098
Missouri City Location
3634 Glen Lakes Lane, Suite # 101,
Missouri City , Texas 77459
10190 Katy Fwy Suite 240
Houston – 77043
Mon-Fri: 8:30AM to 5:00 PM