Steroid injections for acromioclavicular joint osteoarthritis

Acromioclavicular joint osteoarthritis involves degenerative changes to the cartilage and can become inflamed. The degenerative changes may be due to normal “wear and tear” of aging, overuse of the AC joint due to sports or occupation involving repetitive overhead movements or previous traumatic injury.    

As the cartilage degenerates, the space between the acromion and clavicle narrows and the bones begin grinding against each other. Osteophytes (bony spurs) may form which can then create more friction in the joint and potentially irritate the shoulder tendons.

Symptoms of AC joint pain

• Pain directly on the tip on top of the shoulder.
• Pain is worse when crossing your arm across your chest.
• Restricted of shoulder movement and difficulty with daily activities.
• Difficulty getting comfortable at night.

Acromioclavicular Joint Anatomy

The AC joint is a small joint on the top of the shoulder. It is located where the end of the clavicle meets the tip of the shoulder blade (acromion). It is a stable joint with minimal movement and is secured by the joint capsule and ligaments. The AC joint assists in raising your arms forwards and to the side, as well as transferring weight from your upper limb to the clavicle.

Acromioclavicular osteoarthritis

ACJ osteoarthritis involves degenerative changes to the cartilage and can become inflamed. The degenerative changes may be due to normal “wear and tear” of aging, overuse of the AC joint due to sports or occupation involving repetitive overhead movements or previous traumatic injury..

As the cartilage degenerates, the space between the acromion and clavicle narrows and the bones begin grinding against each other. Osteophytes (bony spurs) may form which can then create more friction in the joint and potentially irritate the shoulder tendons.

How to diagnose

A diagnosis for AC joint osteoarthritis can generally be made by taking a detailed history and undertaking a series of tests. Most people can pin point their pain with a finger to the top of their shoulder. A diagnostic ultrasound can be performed at Oxford Circus Physiotherapy to confirm the diagnosis.

AC Joint Osteoarthritis Treatment

The majority of patients with AC joint osteoarthritis will resolve with over the counter pain relief and a course of physiotherapy. It is important to modify or avoid activities that aggravate your pain and to pace yourself by taking regular breaks.

Physiotherapy aims to improve flexibility and strength of the shoulder joint by prescribing an independent exercise program and providing manual therapy.

Acromioclavicular Joint Osteoarthritis Injection therapy

Injection therapy may be appropriate for you if your symptoms have not improved with physiotherapy and over the counter medication. The injections are performed under ultrasound-guidance to ensure a more accurate and effective treatment, compared to landmark guided injections (Daniels et al, 2018).

Ultrasound-guided corticosteroid injection

A small amount of corticosteroid (an anti-inflammatory medication) is injected into the AC joint under ultrasound guidance. This helps to reduce inflammation and pain within the AC joint.

Ultrasound-guided Hyaluronic acid injection

Hyaluronic acid (HA) is a gel-like substance that is naturally present throughout the human body and provides lubrication to eliminate friction of the joints. Injecting HA into a joint essentially helps lubricate the joint and works as a transport medium for nutrients to assist in healing.

Other Shoulder Conditions:

• Acromioclavicular Joint Osteoarthritis
• Shoulder Impingement
• Frozen Shoulder (Adhesive Capsulitis)
• Acromioclavicular Joint sprain
• Shoulder Bursitis
• Rotator Cuff Tear and Tendinopathy
• Distal Clavicle Osteolysis
• Calcific Tendinopathy Of The Shoulder