Acromioclavicular joint pain
The acromioclavicular joint sits at the top of the shoulder and is formed where the collar bone (clavicle) meets the bony prominence (acromion process) that sweeps upwards from the shoulder blade. A fall directly onto the shoulder or landing on an outstretched arm while playing squash, for example, can jar the joint leading to pain at the cap of the shoulder with tenderness to touch and pain at the extremes of shoulder movements. Placing the arm across the body at shoulder height, as if putting on a scarf, will increase the pain and this helps with the diagnosis.
The pain may settle in a week or so without treatment but if it persists, physiotherapy can help with a specific massage technique called ‘frictions’ to the ligaments spanning the joint and mobilisations to ease a little movement and to stop the joint stiffening. Ultrasound can also be helpful in promoting healing and easing the pain. Occasionally a steroid injection is needed, especially if osteoarthritis is present, and if the joint is very unstable an orthopaedic opinion should be sought.
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