AC-joint osteoarthritis
What is AC-joint osteoarthritis?
AC-joint osteoarthritis is wear of the small joint between the collarbone and the acromion at the top of the shoulder. It may occur with age, after previous injury or in patients who perform repeated pressing, overhead or contact activities.
Common symptoms
Pain is usually localised to the top of the shoulder and is aggravated by cross-body reaching, bench press, push-ups, overhead work or sleeping on the affected side. The joint may feel prominent, tender or swollen.
Diagnosis and imaging
Examination focuses on local AC-joint tenderness and cross-body adduction pain. X-rays usually show joint narrowing, osteophytes or cystic change. Diagnostic injection can be useful when symptoms overlap with rotator cuff or biceps pain.
Non-surgical treatment
Initial treatment includes activity modification, physiotherapy to optimise shoulder mechanics, anti-inflammatory medication and image-guided corticosteroid injection. Many patients can manage symptoms without surgery if the pain settles and loading is adjusted.
Surgical treatment
Persistent, well-localised AC-joint pain may be treated with arthroscopic or open distal clavicle excision. This removes a small amount of bone from the end of the clavicle while preserving stability and shoulder function.
Recovery and follow-up
After injection, patients usually return gradually as pain allows. After distal clavicle excision, early range of motion is encouraged, with progressive strengthening and return to heavier pressing once pain and control have improved.
AC-joint osteoarthritis FAQs
How do I know the AC-joint is the source of pain?
Pain directly over the top of the shoulder, pain with cross-body movement and relief after a targeted injection are strong clues that the AC-joint is the main pain generator.
How is ac-joint osteoarthritis diagnosed?
Diagnosis starts with a focused history and examination, then uses imaging selectively to confirm the pattern of injury, exclude related problems and plan treatment accurately.
Can I keep training with AC-joint arthritis?
Often yes, but pressing volume, grip width and provocative exercises may need to be modified. The goal is to maintain strength while avoiding repeated irritation.
Will I need surgery for ac-joint osteoarthritis?
Many patients improve without surgery. Surgery is considered when symptoms remain limiting despite appropriate non-surgical care, when there is significant structural damage, or when delay may compromise function.
When can I return to weights and upper-body training?
Return depends on the diagnosis, treatment type, tissue healing and the physical demands of the activity. The plan is usually staged, with strength, range of motion and confidence rebuilt before unrestricted loading.
Reconstructive Orthopaedics Melbourne (ROM)
We restore mobility, reduce pain, and improve quality of life — through reconstructive orthopaedic surgery driven by evidence and advanced biomechanics.