AC joint injection is used to treat pathology such as AC joint arthritis. When is an AC joint effective, how do we do it, and what do we use? Are there alternatives to cortisone for AC joint pain?
What is the acromioclavicular joint?
The acromioclavicular joint is found at the top of the shoulder. It joins the collarbone (clavicle) with the top of the shoulder bone (acromion). Strong ligaments between the collarbone, acromion, and 1st rib keep the joint together.
AC joint arthritis typically develops with age as the joint space narrows and the cartilage wears away. Also, trauma to the joint can occur after a fall on the shoulder or a hit during a contact sport. This trauma can also lead to early AC joint arthritis.
AC joint arthritis differs from shoulder joint arthritis, which affects the ball-and-socket joint. Not only are these two conditions different in anatomical terms, but they also exhibit significant differences in symptoms and treatments.
Symptoms of AC Joint Arthritis
Acromioclavicular joint pain is common. Often, patients point to the AC joint as the source of their pain. For example, lying on the shoulder at night can be painful. Moreover, moving your arm across your body can recreate the pain. The joint may look swollen and be tender to the touch. Additionally, other tests, such as shoulder strength and neck mobility, are typically normal.
It is essential to exclude other causes of shoulder pain, especially when weightlifting. Shoulder pain from weightlifting has many potential causes. In particular, distal clavicular osteolysis is common in men who lift heavy weights.
Often, X-rays show typical AC joint arthritis changes of a narrowed joint space and bony spurs. However, ultrasound and MRI can also aid in diagnosis if the initial assessment is uncertain.
Treatment of Acromioclavicular Joint Degeneration
Overall, treatment depends on the severity of the symptoms and the presence of other shoulder issues, such as rotator cuff tears.
In mild cases, anti-inflammatory tablets such as ibuprofen can reduce pain. Physiotherapy can help strengthen the shoulder. Additionally, manual therapy and postural correction offer benefits. If you go to the gym, your technique may need to be modified. Also, an AC joint injection can help with shoulder pain.
In severe cases that fail conservative measures, surgery may be needed. Generally, surgeons perform keyhole surgery to remove the end of the clavicle to open up the joint. Removing the bone allows for normal movement without the bones rubbing against each other.
More on AC joint injection
A cortisone shot into the AC joint effectively relieves the pain of AC joint arthritis by reducing inflammation and swelling. Cortisone is a potent anti-inflammatory that can immediately alleviate pain and improve shoulder mobility.
You can perform injections either sitting or lying. The doctor directs a needle with a small syringe containing cortisone and local anaesthetic into the joint. Sometimes, entry into the joint can be difficult due to a narrowed space. Using ultrasound makes AC joint injections more straightforward. Additionally, image guidance enhances effectiveness and reduces side effects, such as the accidental injection of cortisone into soft tissue, which can cause skin thinning and depigmentation.
Additionally, pain relief following an AC joint injection confirms the joint as the source of pain.
In some cases, if pain recurs after a cortisone injeciton, other options such as hyaluronic acid or PRP might help.
AC joint injection technique
Typically, we use a small needle to enter the joint from the front or back. Using ultrasound makes the injection more accurate. A recent study found that landmark-guided injections (not using imaging) were only 65% accurate in targeting the joint, whereas ultrasound-guided injections were 100% accurate. Additionally, ultrasound guidance ensures that the injection is less painful and potentially has fewer side effects, such as skin changes, as the cortisone is injected directly into the joint rather than outside.
AC joint injection side effects
Generally, a cortisone shot in the AC joint is well tolerated. However, side effects of cortisone injections include skin depigmentation, flare, and infection. Additionally, it is recommended to avoid repeated injections into the same joint within a short period (2-3 months).
Other commonly asked questions about AC joint injection:
What size needle for steroid injection in the shoulder?
Generally, we use a small needle, typically 23 or 25 gauge, for AC joint injections. Using ultrasound means that accuracy is improved.
How long does a steroid injection in the AC joint last
It depends on the reason for a steroid injection. But for AC joint arthritis, a steroid injection lasts for 3-6 months and perhaps for longer.
PRP injection for AC joint arthritis: Is it effective?
Although evidence for PRP injections in knee arthritis is promising, there is no evidence that PRP injections are effective in AC joint arthritis.
Final word from Sportdoctorlondon about AC joint injection
AC joint injeciton is used successfully for AC joint arthritis. AC joint arthritis is a common but underappreciated cause of shoulder pain in active people. Generally, a careful examination can confirm the diagnosis. Typically, a cortisone injection into the AC joint is a great way to ensure a diagnosis and help with rehab.
Does an AC joint injection heal the joint or does it just numb it
Hi, It can reduce swelling and inflammation. But no – it does not heal the joint. No injeciton will reverse the damage.
https://sportdoctorlondon.com/can-osteoarthritis-be-reversed/