Acromioclavicular Joint Arthritis Of The Shoulder: Causes, Symptoms, Treatment
What Is Acromioclavicular Joint?
The acromioclavicular joint is situated at the tip of shoulder where the scapula and clavicle meet. This point is situated at the upper part of shoulder blade and is called as acromion. The two bones are attached together by ligaments. A set of ligaments cover the joint to form a type of a capsule which encompasses the joint. These ligaments are known as Acromioclavicular Ligaments. Another set of ligaments function to keep the shoulder stable by holding the clavicle in its normal position by connecting it to a projection at the surface of the shoulder called as the coracoid process. These ligaments are referred to as the coracoclavicular ligaments. There is also a network of cartilage that facilitates smooth movement of the shoulder. As we move then shoulder this acromioclavicular joint facilitates smooth motion of the clavicle and the scapula and hence facilitating smooth motion of the shoulder itself.
What Is Acromioclavicular Joint Arthritis Of The Shoulder?
Acromioclavicular Joint Arthritis is the most common type of arthritis found in people above the age of 50. It starts to develop when the cartilage in the Acromioclavicular Joint starts to wear out due to normal aging process and stress of everyday use. With development of Acromioclavicular Joint Arthritis the affected individual will experience severe pain with motion of the shoulder and with use along with restricted motion of the shoulder.
Causes Of Acromioclavicular Joint Arthritis Of The Shoulder
The root cause of Acromioclavicular Joint Arthritis is normal wear and tear of aging and stress of everyday usage of the shoulder joint. As we all know, shoulder joint is one of the most used joint in the body. Due to this stress put on the shoulder the cartilages start to wear out with time and arthritis develops. Acromioclavicular Joint Arthritis can also develop in people who work in occupations where they have to use their hands for extended periods of time in an extended position. Weightlifters also put extra stress on the shoulder joint constantly and are also prone to Acromioclavicular Joint Arthritis. Footballers and rugby players are also prone to Acromioclavicular Joint Arthritis due to constant falls on the shoulder and the ligaments getting stressed.
Symptoms Of Acromioclavicular Joint Of The Shoulder
The classic sign of Acromioclavicular Joint Arthritis is severe pain and tenderness along with restricted range of motion of the shoulder. The affected individual may find it uncomfortable sleeping on the affected side. The pain may become worse with movement of the arm away to the side or across the chest. The patient may also note some swelling along the affected shoulder joint. There may also be audible clicking or popping with movement of the shoulder joint.
Diagnosis Of Acromioclavicular Joint Arthritis Of The Shoulder
In order to diagnose with Acromioclavicular Joint Arthritis, the treating physician will first begin by taking a detailed history of the patient as to when the symptoms started and whether there is any prior history of injury to the shoulder joint. Then the physician will perform a detailed physical examination of the affected shoulder checking for range of motion, pain and tenderness along the affected shoulder. In majority of the cases, Acromioclavicular Joint Arthritis is diagnosed by physical examination itself. The physician may then inject local anesthesia to see if the pain is resolved. If the pain is resolved albeit temporarily then it confirms the diagnosis of Acromioclavicular Joint Arthritis. Sometimes radiologic studies in the form of x-rays may be done to rule out any bone spurs around the shoulder joint.
Treatment Of Acromioclavicular Joint Arthritis Of The Shoulder
Acromioclavicular Joint Arthritis can be treated utilizing both conservative as well as surgical approaches.
Nonsurgical Treatment: The main aim of treatment for Acromioclavicular Joint Arthritis is to relieve pain and improve range of motion of the shoulder so that the patient can perform ADLs without any discomfort. Treatment usually begins with resting the shoulder and activity restriction along with NSAIDs like Tylenol or ibuprofen to relieve pain and swelling. Application of ice to the affected shoulder for 15-20 minutes two to three times a day is also effective ion relieving pain and swelling of the shoulder. Steroid injection in the form of cortisone can also be given for pain relief.
Surgical Treatment: If all the above treatment fails to provide any significant relief to the patient then the next route is to address the problem surgically. The most preferred surgery for treatment of Acromioclavicular Joint Arthritis is Acromioclavicular Joint Arthroplasty. The procedure involves removal of some part of the collarbone which has been worn out. The major ligaments are left as is as they are intact. After the procedure there is development of scar tissue which prevents further abrasion of the bone. This procedure makes the shoulder more flexible. This procedure is usually done on an outpatient basis and the patient can be discharged the same day as the procedure. The patient is put in a sling for immobilization for a few weeks till the wound heals which usually takes about a week. Usually postsurgery, it takes about three months for complete recovery from the procedure and returning back to normal activities.
What Are The Results And Risks Of Surgery From Acromioclavicular Joint Arthritis?
Majority of patients achieve complete pain relief from the procedure and return back to their normal activities and rarely are there any complications from the procedure, although as it is with any surgical procedure there is a risk for infection or failure of the procedure to relieve the pain completely from Acromioclavicular Joint Arthritis.