Acromioclavicular Joint (AC joint) Osteoarthritis

The AC joints are important for the mobility of the shoulder girdle, which consisits of the two clavicles and the two shoulder blades as well as the connecting joints and muscles. The two pairs of joints that are part of the shoulder girdle are the sternoclavicular joint and the acromioclavicular joint on each side.

The AC joints are particluarly mobile and important. Unfortunately these are also the ones that tend to get osteoarthritis in the late 30's or mid 40's. At that time they are prone to develop little shoulder bone spurs that can be as sharp as internal small knives causing osteoarthritis pain. If they point down in the direction of the supraspinatus tendon, this can become the source of an irritation causing chronic supraspinatus tendinitis and eventually a rotator cuff tear. In the presence of a congenital shoulder impingement syndrome this is particularly painful and devastating.

These cases need the attention of an orthopedic surgeon who can do a shoulder arthroscopy and clean out the spurs. Early detection by clinical examination and MRI scan are essential to prevent disaster (a supraspinatus tendon tear). In severe cases of AC joint arthritis the joint needs to be surgically removed by doing a shoulder decompression. This consists of cutting away the distal 1/3 of the clavicle (collar bone) and removal of a wedge of the acromion. This procedure often has to be done as an "open procedure" (meaning through a large incision) although most of the time shoulder surgeons do this procedure with arthroscopy (through "pinhole surgery").

There is an FDA approved non-drug method available, IceWave patches from Lifewave, which will control pain. This is mentioned in the book "Breakthrough" by Suzanne Somers (Ref. 7) where newer insights of antiaging medicine are also reviewed. Although the patches are placed over acupuncture points, there are no needles involved. Nanotechnology, a newer technology, was used in the manufacturing of these patches and infrared (heat) waves from body heat are utilized to stimulate an acupuncture point, which modifies pain perception and reduces pain to half or less. Medically this would be considered an excellent pain reliever. For more info on the patches see the IceWave patches from Lifewave link above (click "products"). In the US a 5 pack of the IceWave spray is available that can be directly sprayed onto the skin in the area where the pain is located.

Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999.

2. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999.

3. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders

4. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

5. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

6. Wheeless' Textbook of Orthopaedics: http://www.wheelessonline.com/ Several topics can be found under this link by entering the term you search for.

7. Suzanne Somers: "Breakthrough" Eight Steps to Wellness-- Life-altering Secrets from Today's Cutting-edge Doctors", Crown Publishers, 2008

Last Modified: June 18, 2009