What is acromioclavicular joint pain?

 

Acromioclavicular joint pain also known as AC joint pain is pain located at the top of the shoulder between the acromion and the clavicle (see image below). This can be an overuse injury or can result from a fall onto the point/side of the shoulder.

acromioclavicular joint pain - A graphic representation of the acromioclavicular joint structure

Patients with acromioclavicular joint pain have difficulty moving their arm above shoulder level and particularly across their body. It is often painful to touch the area and patients experience pain lying on that side at night.
If it occurs because of a fall onto the shoulder then this can result in a disruption of the joint, sometimes called an AC joint separation or sprain and can result in a ‘step’ or a ‘bump’ on the top of the shoulder.

acromioclavicular joint pain - A female athlete wearing a pink running top stretching her left arm across the front of her body

Is a steroid injection effective for acromioclavicular joint pain?

Steroid injections are very effective for acromioclavicular joint pain when placed directly into the joint under ultrasound guidance. Steroid is a strong anti-inflammatory and can significantly reduce the pain in the joint. This procedure is well supported in the medical literature.

When should you consider a steroid injection for acromioclavicular joint pain?

Steroid injections should not be the first treatment option for acromioclavicular joint pain particularly if you have had a fall and sustained an acromioclavicular joint separation/sprain. We only advise steroid injections for acromioclavicular joint pain if it has been there for over 6 weeks and is not improving with a course of physiotherapy. However, if you have sustained a separation from a fall onto the shoulder then we normally advise waiting 3 months. Separation type injuries often take a little longer to improve depending on the severity of the separation.

Before considering a steroid injection we would advise you follow these steps:

  • Rest from aggravating movements and exercises, for example avoid overhead exercises in the gym
  • Local ice massage – putting ice over the area can help to reduce inflammation
  • Anti-inflammatory creams – the joint is very superficial so topical medication may be helpful onto the painful area (speak to a pharmacist)
  • Physiotherapy – to restore normal joint movement and muscle balance and strength
  • Taping/offloading straps – to reduce the pressure on the joint

How many steroid injections can you have for acromioclavicular joint pain?

Most of our patients with acromioclavicular joint pain only receive one steroid injection. One injection normally provides complete pain relief and gives a window of opportunity to focus on restoring the full range of movement and function of the shoulder.

acromioclavicular joint pain - A back shot of a male athlete wearing a grey sports top holding his left shoulder with his right hand.

The main reason for more than one injection being carried out is if the patient has known osteoarthritis (wear and tear) of the joint causing their pain.

If you think you might have an acromioclavicular joint injury please email us on injections@complete-physio.co.uk or call 02074823875, we can also arrange a call with one of our expert clinicians who will help you to decide if an injection is the best treatment for you.