Acromioclavicular Joint Pain (ACJ)
What is it?
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The collarbone (clavicle) has 2 joints: one closer to the shoulder and one closer to the neck.
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The joint closer to the shoulder is called the acromioclavicular joint (ACJ).
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Pain to this area may happen after an injury (falling onto an outstretched hand or sporting injuries) or without injury (gradual onset, often related to osteoarthritic changes).
Typical Symptoms/features:
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Specific pain right over the joint (ACJ), pain may radiate into the adjacent soft tissues.
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Localised swelling over the ACJ (with trauma, the ACJ may even appear raised or more prominent than the other side.
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Pain when reaching across your body.
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Pain when lying on your sides.
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Pain with overhead activities e.g plasterers and athletes.
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Reduced movement of the shoulder with pain at extremes of movement.
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Pain with daily tasks e.g brushing hair, reaching behind your back and reaching forwards whilst twisting.
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Painful clicking.
Management:
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Activity modification
- When you first start noticing shoulder pain, it may help to reduce your activity for a short amount of time to allow the pain to settle.
- However, there is strong evidence that says keeping active and slowly returning to your normal levels of activity can actually help the pain to settle quicker.
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Ice or heat.
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Pain relief.
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Physiotherapy including range of movement exercises and a graded strengthening programme.
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Orthopaedic options: In more severe and/or prolonged cases where pain is limiting conservative measures OR where 3-6 months of conservative management have failed to manage symptoms, more invasive options may be considered.
Do I need imaging?
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After a trauma: if there is an increased prominence of the ACJ with a significant reduction in shoulder movement, an X-ray will likely be required to rule out any bony involvement (fracture or dislocation).
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Without trauma: This does not typically require further investigations unless more invasive measures are being considered.
