AC Joint Arthritis

FAQS on AC Joint Arthritis

 

About a third of Americans in their sixties face the risk of restricted mobility due to arthritis. The disorder affects your shoulder when either acromioclavicular (AC) joint or glenohumeral joint is inflamed. AC joint arthritis, a common disorder in middle aged or older people, inhibits the flexibility of the shoulder making the rotation of the clavicle painful. Patients unable to perform daily activities due to acromioclavicular joint arthritis now have a variety of treatment options to overcome the problem.

What is AC joint?

Acromioclavicular or AC joint is one of the two joints in your shoulder, the other being the glenohumeral joint. It is the place where the clavicle or collar bone connects with the acromion or the roof of the shoulder blade. AC joint’s primary function is to facilitate the glenohumeral joint movement by allowing the acromion to slide and the collarbone to rotate. The acromioclavicular joint is the key to the movement of the arm, as its flexibility helps the shoulder to elevate and move overhead or across the body.

What is AC joint arthritis?

The collarbone and the shoulder blade are connected together by a tough, sinewy, and rubber-like pad of ligaments called articular cartilage that covers the bone heads acting like a shock absorber. This cartilage allows both bones to move, slide, or tilt smoothly without rubbing with each other. With age, the elastic connective tissue becomes subject to degeneration, wear, and tear. Disease and injury also damage the ligaments. This exposes the bone heads to rub with each other, develop spurs, and get inflamed.

Friction between the shoulder blade and collarbone reduce mobility and cause pain. Similarly, inflammation results in pain forcing patients to restrict a range of acromioclavicular joint-associated shoulder motions.

Depending on causative factors, AC joint arthritis is categorized into various types:

  • Osteoarthritis or degenerative arthritis
  • Post-traumatic or injury-related arthritis
  • Rheumatoid or chronic inflammatory arthritis
  • Septic arthritis or infection-linked inflammation

What are the symptoms of AC joint arthritis?

  • Pain and tenderness around the joint
  • Worsening pain when putting the arm across your chest or brushing
  • Radiating pain often impacting shoulder, neck, and upper chest
  • Stiffness and weakness in the AC Joint
  • Pain aggravates in the winter
  • Shoulder pain when doing overhead or cross arm activity
  • Possibly bump over the acromioclavicular joint
  • Clicking, catching, or snapping feeling as the arm moves
  • Decreased shoulder mobility

What are the main causes AC joint arthritis?

  • Ligament wear and tear that comes naturally with age and use
  • Traumatic injury leading to damage to the cartilage
  • Falling on the shoulder or stress caused by weightlifting
  • Diseases, such as rheumatoid arthritis and Sjogren’s syndrome
  • Shoulder surgery leading to stiffness or damage to the AC joint
  • Problem in blood supply to the joint
  • Bony growths in the joint

Who are at the risk of AC joint arthritis?

Acromioclavicular joint arthritis is common in the middle-aged people. Those engaged in regular activities putting stress on shoulders or using arms for extended periods, such as weightlifting, contact sports, and construction-site jobs, may contact the problem at an early age.

How is AC joint arthritis diagnosed?

  • Physical examination: Doctors look at symptoms, such as origin of pain and tenderness on the shoulder, to diagnose the AC Joint arthritis.
  • Patient history: Doctors ask patients about any previous injury or working stress their shoulders affecting their shoulder to zero on any possibility of ligament wear and tear.
  • Anesthetic injection: If the shoulder pain is reduced following the injection into joint, doctors zero on it.
  • Imaging test: X-ray and MRI tests are suggested to find out bony growths around the area or the nature of traumatic injury.

What are the treatment methods available for AC joint arthritis?

The primary goal of AC joint arthritis treatment is to get rid of pain and restore the ability to perform complete range of shoulder motions. The following are the most common methods used for this purpose.

  • NSAID Medications: Patients are prescribed non-steroidal anti-inflammatory drugs to reduce inflammation and pain in the joint.
  • Surgery: Resection arthroplasty is resorted to remove a tiny part of the collarbone so that there is no friction between the collarbone and the shoulder blade. It allows the acromion to remain flexible without being stiffened.
  • Therapy treatment: Rest, ice, regular exercises, physical therapy, and other conservative treatment methods are used to reduce inflammation and pain in the AC joint.
  • Cortisone injections: Steroid injected to suppress swelling, inflammation, and pain associated with AC Joint arthritis and this, in turn, improves mobility of the joint for months at a time.
  • Anesthetic injections: Lidocaine and similar substances injected to lessen the joint pain and assist in its unhindered movements for months at a time.
  • Lubricant injections: Natural lubricants, such as hyaluronic acid, are injected so that the friction is reduced and inflammation is controlled allowing better flexibility of the joint for months at a time.
  • Prolotherapy or PRP injections: Platelet-rich plasma and similar regenerative elements are injected to promote natural and fast healing of ligaments. Person’s own stem cells are harvested and injected into the injured joint to repair damaged portions and control inflammation. Easy and safe, the process is free from long rehab process or side effects. Even the natural healing process strengthens weakened ligaments and cartilage and stimulates their regeneration.

 

References

Buttaci CJ, Stitik TP, Yonclas PP, et al; Osteoarthritis of the acromioclavicular joint: a review of anatomy, biomechanics, diagnosis, and treatment. Am J Phys Med Rehabil. 2004 Oct;83(10):791-7.

Simovitch R, Sanders B, Ozbaydar M, et al; Acromioclavicular joint injuries: diagnosis and management. J Am Acad Orthop Surg. 2009 Apr;17(4):207-19.

Skedros JG, Hunt KJ, Pitts TC; Variations in corticosteroid/anesthetic injections for painful shoulder conditions: comparisons among orthopaedic surgeons, rheumatologists, and physical medicine and primary-care physicians. BMC Musculoskelet Disord. 2007 Jul 6;8:63.

Docimo S Jr, Kornitsky D, Futterman B, et al; Surgical treatment for acromioclavicular joint osteoarthritis: patient selection, surgical options, complications, and outcome. Curr Rev Musculoskelet Med. 2008 Jun;1(2):1

Horvath F, Kery L. Degenerative deformations of the acromioclavicular joint in the elderly. Arch Gerontol Geriatr 1984;3:259–265.

Blankstein A, Amsallem JL, Rubinstein E, et al. Septic arthritis of the acromioclavicular joint. Arch Orthop Trauma Surg 1985;103:417–418.

Mall NA, Foley E, Chalmers PN, et al. Degenerative joint disease of the acromioclavicular joint: a review. Am J Sports Med 2013;41:2684–2692.

Hossain S, Jacobs LG, Hashmi R. The long-term effectiveness of steroid injections in primary acromioclavicular joint arthritis: a five-year prospective study. J Shoulder Elbow Surg 2008;17:535–538.

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