AC joint pain is pain arising from the acromioclavicular joint — the small joint at the top of the shoulder where the collarbone meets the shoulder blade. It is a common source of pain felt right on the point of the shoulder, often from a fall, a sporting knock, or simple wear and tear over the years. It usually responds well to the right care. At Back in Action in Penwortham, we care for people across Preston and Lancashire with AC joint pain.
Understanding the AC joint
The acromioclavicular, or AC, joint sits at the very top of the shoulder, where the outer end of the collarbone meets a bony part of the shoulder blade called the acromion. It is a small joint, held together by ligaments, and it plays an important role in allowing the shoulder blade and arm to move smoothly through their full range. Because it sits at the top of the shoulder and takes load when you reach across the body, lift overhead or press, it is vulnerable both to sudden injury and to gradual wear over the years.
AC joint problems generally fall into two groups: an injury, such as a sprain of the joint from a fall onto the shoulder or outstretched hand, and gradual wear, where the joint develops osteoarthritis over time much as other joints do. Both are mechanical and, in most cases, manageable. Identifying the AC joint as the source is straightforward once it is considered, because the pain and tenderness are typically very localised to the top of the shoulder.
A sprain of the AC joint, sometimes called a shoulder separation, is graded by severity, with the great majority being mild to moderate and recovering well without the need for surgery. Wear-related AC joint pain, meanwhile, behaves much like arthritis elsewhere: it tends to grumble and flare rather than steadily worsen, and it usually responds to keeping the shoulder moving and strong.
What AC joint pain can feel like
Symptoms usually centre right on the top of the shoulder and include:
- Pain and tenderness localised to the point at the top of the shoulder
- Pain when reaching across the body or lifting the arm overhead
- Discomfort when lying on the affected shoulder at night
- A weak or painful feeling when reaching across to the opposite shoulder
- Pain with pushing, pressing or carrying loads
- Discomfort with movements that bring the arm across the front of the body
- Sometimes a small visible bump or step at the top of the shoulder after an injury
- Discomfort that eases with rest but returns with loaded use of the arm
The very localised nature of the pain, right on top of the shoulder, is one of the most useful clues that the AC joint is involved. People can often point to the spot with a single finger, which is unusual for shoulder pain and helps set it apart from problems such as impingement or rotator cuff issues that tend to be felt more diffusely.
Common causes and risk factors
AC joint pain commonly arises from:
- A fall onto the shoulder or an outstretched hand
- A direct blow to the top of the shoulder, common in contact and collision sports
- Repetitive overhead or pressing activities, in work, training or weightlifting
- Previous injury to the joint, which can predispose it to later wear
- Gradual wear-and-tear changes in the joint over time
- Weightlifting, dips and similar loaded overhead or pressing activity
Part of our assessment is confirming the AC joint as the source and understanding whether the problem is an injury, wear and tear, or a combination.
When to seek help
Most AC joint pain settles well with sensible care, but some injuries need medical assessment to gauge their severity. Please seek prompt medical attention if, after a fall or blow, there is an obvious deformity or a significant step at the top of the shoulder, severe pain, or you cannot use the arm, as a more significant injury to the joint may need specific management.
How chiropractic care can help
Chiropractors care for many people with shoulder pain, including from the AC joint. The aim of our care is to settle the symptoms, restore comfortable movement, and rebuild the strength and control that support the shoulder. For a mild to moderate sprain, our hands-on, drug-free care in the early stage focuses on settling symptoms and protecting the joint, with advice on managing the injury. As things settle, and for wear-related pain, the emphasis shifts to mobilisation of the shoulder, shoulder blade and upper back, soft-tissue work, and a graded rehabilitation programme to restore movement and strength around the shoulder. Because we are a multi-practitioner clinic, we can also draw on physiotherapy. We will be honest about what care can offer and refer you on where appropriate.
What to expect at Back in Action
Your first visit is mostly about understanding your shoulder pain. We will take a careful history — including any injury and how the pain behaves — and carry out a physical examination of the shoulder, AC joint, neck and upper back, including tests of movement and strength and specific tests for the AC joint. We will explain what we have found in plain language and discuss whether chiropractic care is appropriate. Where an injury looks more significant, we will be clear that medical assessment is the right first step.
You can read more on our new patients page, with current charges on the fees page. We will set out a realistic plan, taking account of whether the problem is a recent injury or longstanding wear and tear, since the two are approached a little differently, and review your progress as we go.
Helping yourself: self-care and recovery
There is plenty you can do to help AC joint pain:
- In the early days after an injury, protect the joint and avoid heavy lifting or reaching across the body
- Use simple early measures to ease the pain while the joint settles
- Keep the shoulder gently moving within comfortable limits
- Reduce, rather than completely stop, the activities that aggravate it
- Build strength around the shoulder and shoulder blade gradually as symptoms allow
- Be patient with wear-related pain, which tends to grumble and flare rather than resolve outright
- Adjust how you sleep if lying on the shoulder is uncomfortable
- Take care with heavy pressing or carrying while the joint is settling
If you would like guidance tailored to you, we can build a safe, progressive exercise and self-care plan around your particular problem.
Related conditions and treatments
AC joint pain is closely linked to shoulder pain, shoulder and arm pain, impingement syndrome and osteoarthritis. The care we provide draws on approaches such as exercise and rehabilitation and chiropractic manipulation, and may form part of a wider plan alongside our chiropractic and physiotherapy services.
Take the first step
If pain at the top of your shoulder is getting in the way of your life, you do not have to simply put up with it. We are happy to talk it through and help you understand your options. You can get in touch to book an appointment, or to ask any questions before your first visit.