Mr Harry Brownlow

BSc (Hons), MB ChB (Hons), MD, FRCS (Eng), FRCS (Tr&Orth)

Consultant Orthopaedic Surgeon

Circle Reading Hospital

0118 922 6888

AC joint pain

Diagnosis of a problem within the AC joint is made by both clinical judgment and an X-ray, which can help to show certain changes in the joint. If things are still a bit unclear, I will arrange for you to have an MRI scan at Circle as this will give us extremely detailed images of the joint to help confirm a diagnosis.

Generally, when somebody first comes to see me about pain that is being caused by their AC joint, they will mostly complain of a significant amount of pain in their shoulder. They may be finding it uncomfortable to lie on their shoulder at night, and when I ask them to point to where it is sore, they will invariably point to where the AC joint is. If they lift weights, they may find the pain becomes noticeably worse when trying to perform overhead exercises, such as the bench press or shoulder press.

When I examine your shoulder, there are certain things I will be particularly looking out for to determine whether the AC joint is the cause of your pain. It will become more painful as you push up high. As you raise your arm up as high as you can, so that your arm is touching your ear, you may also feel a popping, crunching or grinding in the joint.

The pain can often radiate down the line of the biceps. As a result, it is quite common for people to misdiagnose it as a problem with the biceps tendon. In my experience however, biceps tendon disease by itself is incredibly rare. Almost always, it turns out upon further examination that the primary source of the trouble is in fact the AC joint.

There are a few different options available for successfully managing and treating AC joint pain, and the approach we take will depend upon the severity, extent and cause, as well as your personal preference. Rather than a one-size-fits-all approach, treatment is tailored to you. The key thing to know is that treatment is available and can be very effective; you don’t have to remain in pain.

Most people come to see me when over-the-counter painkillers (e.g. paracetamol) are not helping to manage the pain enough. Where pain medication is not helping, I would normally advise an injection of a corticosteroid into the AC joint. This is a very straightforward procedure and the pain-relieving effects can be effective and very quick. One of the limitations of this treatment is that it does wear off over time, although the exact duration varies for every person. Quite frequently, when it wears off, the pain will come back once more exactly as it was before.  

The definitive treatment for AC joint pain is a minor arthroscopic operation. This is a form of keyhole surgery and it is used to clean up the AC joints by removing any debris and smoothing out any rough surfaces within the joint. This type of procedure is done as a day case, meaning you will be able to return home the same day. Recovery times are excellent, and you will normally be able to drive again within 4-5 days.

This is probably the operation I do most frequently and is a very low-risk method for treating AC joint pain. In fact, I have carried out this arthroscopic treatment for many high-level athletes, including those involved in rugby, CrossFit, weight training and powerlifting, and they have all been able to return to full activity again.

If you are experiencing pain in your shoulder and are unsure of the cause, why not arrange a visit with me? We will talk about your symptoms and I will carry out a full and detailed examination of your shoulder. If there are any treatments that would be helpful for you, I can talk you though them so that you have all the information you need to make an informed choice. At Circle, you can see me without the need to join a waiting list, meaning we can get you treated and back to full strength and activity again as quickly as possible.

I first noticed that something was wrong with my shoulder a few years ago. Whenever I went to the gym and lifted heavier weights than normal, my shoulder would start to hurt. It was the kind of pain where it felt like my shoulder joint just needed to ‘click’ and the pain would stop.

I'd go through a cycle of going to the gym for a couple of months, then having to stop and wait for the pain in my shoulder to improve, before starting back at the gym again. It was frustrating as I was never able to keep the gains I made in the gym.

I decided to get some physio on it, but my experience wasn’t good unfortunately (they weren't Circle physios!); after 10 sessions, the physio told me that I must be making the pain up because they couldn’t fix it with physiotherapy! This was so frustrating, especially as the pain was waking me up at night. I asked if they could refer me to a specialist and (fortunately) they put me in touch with Harry.

I found the process of booking an appointment with Harry was really smooth and incredibly quick. At my first appointment, Harry played around with my shoulder a bit and worked out within minutes what the problem was. He told me that no amount of physiotherapy would have fixed it and that surgery was the only way to correct the problem.

I needed an MRI scan before the surgery, and Harry arranged this. I was surprised how quickly everything was done; there was hardly any waiting at all. In fact, on the day of the surgery when I turned up and went upstairs to the waiting room, I was half-expecting to be waiting for a while. However, as soon as I sat down, it seemed that I saw the nurse, physio, anesthetist and then Harry himself, without any overlap or wait at all. I was massively impressed with this.

The operation went well, and Harry came and talked with me about it when I had woken up. He explained what had been wrong with my shoulder and what he had done to fix it. He told me to expect a full recovery to take between 3-6 months and then gave me some exercises to do to help with my recovery.

I came back to see Harry three weeks after my surgery and my shoulder had pretty much healed by then. There was still a little bit of pain, but he'd clearly done such an amazing job that the recovery was brilliant. In fact, within 5 weeks of having the surgery I was back at the gym, building up my strength again. Today, my shoulder feels absolutely fine, with absolutely no niggles or issues.

I can't sing Harry's praises enough. He has been absolutely brilliant throughout. I think that my right shoulder is going to have to go through the same process at some stage in the future and I will definitely be asking Harry to do that one as well!



Fast track your treatment with Harry Brownlow

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Fast track your treatment

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020 3613 6779

Circle Reading Hospital, 100 Drake Way, Reading, RG2 0NE


Overall rating 24th October 2019