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Acromio-clavicular (A-C) joint sprain: Treatment, symptoms, advice and help

About acromio-clavicular (A-C) joint sprain

The acromio-clavicular joint, located at top of the shoulder, is made up of two bones namely the shoulder blade (scapula) and the collar bone (clavicle). These two bones are connected together with the help of several ligaments. Any sprain in these ligaments is called acromio-clavicular joint sprain.

Acromio-clavicular (A-C) joint sprain: Incidence, age and sex

Acromio-clavicular joint sprain is a relatively common occurrence, encountered especially in men between 20 and 40 yrs of age.

Signs and symptoms of acromio-clavicular (A-C) joint sprain: Diagnosis

A person with acromio-clavicular joint sprain may present with one-sided shoulder pain which can range from mild to severe in intensity. The affected shoulder joint may be bruised and swollen. The patient might also experience a restriction of movements at the shoulder joint. Such features clearly point towards acromio-clavicular joint injury.

Acromio-clavicular joint injury or separation has been categorised into 3 grades, depending on the severity of injury. The sprain of acromio-clavicular joint falls under Grade I acromio-clavicular separation in which the ligaments get stretched as a result of injury. Grade II acromio-clavicular separation signifies the incomplete tear of these ligaments and Grade III acromio-clavicular separation is the complete tear of the ligaments. Clinical features remain the same irrespective of the grades, except for shoulder movements which might be significantly restrained in grade III.

Causes and prevention of acromio-clavicular (A-C) joint sprain

Acromio-clavicular joint sprain may be caused by a direct blow to the shoulder. The most common instance causing this to happen, is a direct fall on the shoulder. Athletes are quite prone to this kind of injury, especially in sports like volleyball, basketball, football where collision between players is inevitable. The joint may also get sprained in road accidents involving two wheelers. In such an accident, a person tends to fall on his side, thereby injuring the shoulder joint.

Acromio-clavicular (A-C) joint sprain: Complications

Acromio-clavicular joint sprain may give rise to arthritis if not given ample rest and judicious treatment. This usually happens when grade II and III injuries are ignored.

Acromio-clavicular (A-C) joint sprain: Treatment

The goal of treatment is to relieve the patient from pain along with the healing of the joint. Some pain relieving medications are advisable. Cold compresses also help in pain relief and in minimising the swelling. A shoulder sling is recommended to provide adequate rest to the joint which is essential for its recovery. In most cases, the sprain will heal within 3 to 4 weeks. It is recommended that you consult a physiotherapist for adequate joint mobilisation and relevant exercises to restore flexibility to the joint.

Surgery is usually not needed in acromio-clavicular joint sprain except in case of sportspersons for whom it may be considered appropriate. It is normally indicated in grade III acromio-clavicular joint separation where the ligaments are completely torn. These torn ligaments will need to be surgically reconstructed for the joint to re-acquire normal movement.

The pain and stiffness of arthritic acromio-clavicular joint may be relieved by painkillers and anti-inflammatory medicines. Certain medications like steroids may be directly injected into the joint for pain relief.