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What is AC Joint osteolysis?

AC Joint osteolysis is when a bone at the AC joint erodes faster than it can heal, which causes pain.

The AC Joint is a joint between two bones in the shoulder (the acromium and the clavicle) and osteolysis is the process of a bone eroding. In the case of AC Joint osteolysis, the end of the clavicle that forms the AC Joint erodes faster that it can be repaired causing pain and reduced function.

Gym ball assisted shoulder stretches under supervision of physiotherapistAbove: Gym ball assisted shoulder stretches under supervision of physiotherapist

How does AC Joint osteolysis happen?

As osteolysis is the process of a bone eroding faster than it can be repaired, AC Joint osteolysis is caused by regular, heavy loading of the shoulder joint. It can also be caused by repetitive, heavy overhead tasks. This can result from occupations such as building or heavy stacking jobs. Sports that can cause this injury are weightlifting or rugby.

What are the symptoms of AC Joint osteolysis?

The main symptoms that result from AC Joint osteolysis are:
  • Gradual onset of pain localised to the AC Joint
  • Gradual reduction of movement at the shoulder

What should I do if I have AC Joint osteolysis?

If you have or suspect you have AC Joint osteolysis, you should consult a physiotherapist. It can be useful to consult your GP as x-rays can confirm any bone erosion. You should also rest the shoulder as this allows the bone to heal rather than being excessively worked to prevent healing.

What shouldn’t I do if I have AC Joint osteolysis?

If you have or suspect you have AC Joint osteolysis, you should not ignore the problem and continue to use the shoulder. Do not do heavy, overhead tasks. This may lead to your problem getting worse so that the bone becomes further damaged and the pain increases.

Physiotherapy treatment for AC Joint osteolysis.

Physiotherapy treatment is aimed at reducing pain in the shoulder and returning movement and function. Treatment may involve:
  • Pain relieving techniques
  • AC Joint injection to relieve pain
  • Shoulder mobility exercises
  • Shoulder strengthening exercises
  • Education for prevention of the problem in future or self management if there is a re-occurrence of the problem
If the above does not improve the problem, surgery can be performed to remove the damaged bone.

Could there be any long-term effects from AC Joint osteolysis?

If the correct advice is followed, there are no long term effects of AC Joint osteolysis, but the problem can re-occur if physiotherapy advice is not followed.

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