AC joint arthritis
The acromioclavicular ( AC) joint is located in your shoulder, at the point where the collarbone (clavicle) meets the acromion process of the shoulder blade. The AC joint is used most when you lift your arms above shoulder height or lift a heavy weight.
AC joint arthritis is a degenerative disease of the AC joint. It is very common and almost everybody who has done any type of contact sport or has fallen off a bike will normally have a degree of arthritis in their collar bone joint.
In the majority of cases, the AC joint itself does not become sore and so it is not a problem people are aware of. In other cases, people can get pain in the AC joint, sometimes quite severe. This tends to be most common in people who are either high-level sportsmen (such as weightlifters) or people who do a lot of work with their arms above their head, like mechanics and roofers.
The main symptom is pain or discomfort, specifically over the AC joint (i.e. at the end of the collarbone). This pain may be fairly mild or quite severe, depending on the extent of the arthritis in the joint. Most people find their pain becomes worse when they lift their arm above their head.
When I see you for a consultation, I will examine your shoulder and move your arm into various positions to help me assess the severity of the problem. I may need to arrange further diagnostic tests for you, such as X-ray, MRI or CT, to confirm diagnosis and to give an accurate view of the extent of your AC joint arthritis.
This consultation is also your chance to ask any questions and raise any concerns you may have. Nobody knows the joint pain you are experiencing better than you, and it is important you tell me the different ways it is affecting you so that I can ensure any treatment options I advise are right for you.
As a shoulder specialist, many of the conditions I treat are a result of trauma or injury to the shoulder. AC joint arthritis is different to most other shoulder conditions, as its not caused by trauma or injury but rather a degenerative disease.
While there is currently no 'cure' for arthritis, there are non-surgical treatment options to help manage the pain and surgical options if needed in more severe cases.
The first treatment I normally suggest is a corticosteroid injection directly into the AC joint. This often relieves the pain significantly and the effects can last a reasonable time. I would also recommend physiotherapy to work on posture and shoulder strengthening to try and take the pressure off the joint.
If you still have AC joint pain, or the arthritis has progressed to the point where non-surgical treatments are no longer effective, I can carry out a special type of surgery known as arthroscopy to help clear out the joint and relieve the pain you're experiencing.
Arthroscopy is a type of keyhole surgery. Using only tiny cuts into the shoulder, I'll insert a thin tube known as an arthroscope into the joint. The arthroscope has a light and a camera and gives me a really good view of the joint. Once I have assessed the health of the AC joint, I will insert small surgical tools through the arthroscope and shave a few millimeters of the collarbone joint to stop the arthritic surfaces from rubbing. This will help to relieve the pain that was being caused by your arthritis.
Shoulder arthroscopy will usually improve your pain, but it's important to be aware that it will take a good couple of months to fully settle down. The operation itself is carried out as a day case procedure and you will be wearing a sling for a few days afterwards, but other than that, it is important to give the joint time to rest and fully recover. Physiotherapy is important, helping with your recovery and ensuring you don't lose mobility in your shoulder as you recover. We can work with your therapist or provide therapy at Circle.
During my training as an orthopaedic surgeon, I developed a particular interest in shoulder and elbow surgery. After my initial training, I completed two year-long fellowships specialising in shoulder and elbow surgery (firstly, at the Glasgow Royal Infirmary and then at the internationally renowned Wrightington Orthopaedic Hospital in its prestigious Upper Limb Unit).
During my years working as a shoulder and elbow specialist, I have been privileged to see the difference good, effective treatment makes to people's lives. For people struggling with AC joint arthritis, it can mean the difference between having to stop their favourite sport or to be able to carry on. It may just mean that getting dressed in the morning is now pain-free.
If you have pain or discomfort in your shoulder, a consultation will help us find out exactly what the problem is. Once we know the cause of your pain, we will be able to talk through treatment options so that you can make an informed decision. It's easy to schedule an appointment with me here at Circle, my private secretary will be delighted to help you book a time and day that is convenient for you.