Arthritis in AC Joint

Arthritis in the AC joint, also known as acromioclavicular joint arthritis, is one of the most common forms of osteoarthritis there is. The acromioclavicular (AC) joint is located in the shoulder where the collarbone (clavicle) meets the top of the shoulder blade (acromion, the top of the scapula).

The collarbone and shoulder blade are held together by three ligaments.

On top of the bones and ligaments lie the muscles of the shoulder: the trapezoid, the deltoid, the infraspinatus, and the upper part of the pectoralis major.

There is cartilage between the clavicle and acromion, as there is between the bones in every joint. This cartilage acts as a cushion. The cartilage in the AC joint keeps the acromium from rubbing or grinding the clavicle, or collar bone, as the arm rotates at the shoulder.

The AC joint is not the same thing as the “ball and socket” joint of the upper arm bone (humerus) and upper rib cage (glenoid) known as the rotator cuff. The AC joint forms at the end of the collar bone, and can be felt and actually seen on some people as a “bump” next to the shoulder. It allows a person to lift his arms above his head and across his body. It also allows a wider range of motion and rotation of the shoulder.

How arthritis in the AC joint occurs

Johns Hopkins Medicine Department of Orthopaedic Surgery says that AC joint arthritis usually forms in one of two ways. The first way is through some kind of injury to the shoulder. This can be due to a fracture, where some bones in the shoulder were broken in an accident. More likely, the shoulder was separated or otherwise injured playing sports.

The Journal of Emergency Medicine, suggests that in diabetic patients, bacteria from infection sites in one part of the body can infect the AC joint and cause septic arthritis.

The most common way to develop arthritis in AC joints is through the normal wear and tear of using the joints repeatedly over time in the process of aging. This can occur from simple daily activities like hair brushing, reaching for the back pocket, or reaching across the body while dressing.

Bodybuilders who lift weights above their head often and other athletes experience AC joint arthritis so often, the medical community gave it its own name: osteolysis.

AC joint arthritis is characterized by anywhere from mild to excruciating pain, stiffness, and swelling in the AC joint at the top of the shoulder. The pain is noticeable with movement and activity, especially when crossing the arms, playing tennis or golf, or while lifting heavy objects above the head.

Some people experience a “click” or a feeling that the shoulder gets “caught” on something during routine activities. The shoulder area is tender to the touch.

What is the medical community’s protocol for AC joint arthritis?

Medical doctors often suggest the following protocol for the treatment of AC joint arthritis:

• Take NSAIDS for pain, such as ibuprofen or acetaminophen
• Apply heat and ice packs to the shoulder after work outs or training sessions, or as often as every two hours for twenty minutes if the pain becomes unbearable
• Modify work outs and sports activities, or make adjustments to the daily routine in order to reduce movement in the shoulder
• Physical therapy
• Cortisone shots, which the medical community admits have unpredictable outcomes
• Surgery, where a camera is inserted into the shoulder joint, the end of the collarbone is cut off, and AC joint cartilage is replaced with scar tissue as the shoulder heals

Patients who have undergone this surgery experience pain relief. Physical therapy is required for six weeks, followed by six weeks of normal activity in order to regain a full range of motion in the shoulder.

There is a risk of infection at the surgical site, a risk that there might still be some slight but permanent pain, and a risk that the resulting scar tissue will reduce flexibility in the shoulder to some degree. There may be post-operative pain due to the deltoid and trapezius muscles being detached during surgery. There may be a longer recovery time as the muscles heal and re-attach.

Are there any alternative solutions for AC arthritis?

Fortunately, there is a long list of scientifically proven healthy alternative solutions for AC joint arthritis.

The first thing anyone with arthritis should consider when seeking alternative solutions or complements to medical treatment is his or her diet. While most athletes are probably familiar with sports nutrition or “clean eating,” it may be wise to add foods that are specifically known to be “anti-inflammatory.”

Livestrong.com breaks down clean eating into five steps:

1. Eat a large amount of fresh vegetables every day, and choose fruit over fruit juices
2. Include high quality lean proteins such as chicken breasts, eggs, and grass-fed beef, plus wholesome complex carbohydrates such as brown rice, oats, and sweet potatoes
3. Drink copious amounts of water and herb tea. Avoid any beverages with added sugars or high fructose corn syrup, including sodas, sweetened energy and sports drinks, and dessert-like coffee treats
4. Exchange bad fats for healthy fats. Refined fats such as margarine, vegetable cooking oils, and anything labeled “hydrogenated” are unhealthy. Healthy fats include plant fats such as avocados, coconut oil, extra virgin olive oil, raw nuts, and seeds. They also include small amounts of animal fat such as fatty fish, egg yolks, bacon, butter, and cream
5. Eat several smaller meals spread out throughout the day to keep the metabolism rate high and to avoid overeating due to hunger

Dr. Andrew Weil, director of the Arizona Center for Integrative Medicine in Tempe, AZ, advises an “anti-inflammatory” diet for people who have arthritis. This daily nutrition plan includes the following healthy foods:

• 4-5 servings of organic vegetables in a variety of colors
• 3-4 servings of fresh, organic, seasonal fruit
• 3-5 servings whole grains
• 1-2 servings beans and legumes
• 5-7 servings healthy fats, especially raw walnuts, hemp seeds, flax seeds, and avocados
• 1-2 servings soy-based foods such as edame, tofu, or soy milk
• Unlimited amounts of cooked Asian mushrooms
• Unlimited amounts of herbs and spices such as turmeric, ginger, cayenne, and cinnamon
• 2-4 servings green or white tea
• Daily nutritional supplements such as cod liver oil
• No more than 1-2 optional glasses red wine per day
• Whole grain pasta 2-3 times a week
• Fatty fish 2-6 times a week, including wild caught Alaskan salmon and sardines
• Lean protein 1-2 times a week, including cheese, eggs, lean meat, skinless chicken breasts, and yogurt
• One ounce dark chocolate once a week or sparingly

For patients with rheumatoid arthritis, the Italian medical journal La Clinica Terapeutica suggests these basic dietary guidelines:

• 55-60% of daily caloric intake should be from complex carbohydrates such as sweet potatoes, brown rice, oats, and quinoa
• A high protein diet is recommended
• 25-30% of daily caloric intake should be from healthy fats such as olive oil, flax seed oil, coconut oil, and avocados
• Take omega-3 fatty acids supplements such as fish oil
• Reduce omega-6 fatty acids such as soybean oil, vegetable oil, corn oil, canola oil, mayonnaise, and margarine
• Supplement with Vitamins A, B12, C, and D, plus calcium and selenium
• Experiment with elimination diets

Are there any dietary supplements proven to help with AC joint arthritis?

A double-blind, placebo-controlled, randomized clinical study published in the March 2006 issue of Osteoarthritis and Cartilage showed that 3g twice daily of methysulfomethane (MSM) significantly reduced joint pain and increased physical function in middle aged men and women over a twelve week period without any adverse effects.

Web MD suggests the dietary supplements glucosamine and chondroitin for AC joint arthritis, although, as the website states, “evidence is conflicting” as to whether or not the two supplements actually work.

This statement was probably made because of the confusion surrounding the “famous” 2008 Glucosamine Arthritis Intervention Trial. The GAIT study was supposed to settle, once and for all, whether glucosamine and chondroitin actually “worked” to reduce pain and swelling associated with osteoarthritis in the knee.

The GAIT study involved sixteen research facilities across the U.S., followed hundreds of patients over a six month period, and cost $12.5M. Some participants received a placebo, others took prescription arthritis medications, and others took glucosamine and chondroitin either separately or in combination.

At the end of the trial, scientists were even more confused. Glucosamine and chondroitin in combination seemed to work very well for patients with moderate to severe knee arthritis. However, the supplements made little difference in participants with mild arthritis.

Are there any herbs or botanicals known to have a positive effect on AC joint arthritis?

A 1994 study published in Pharmacology proved that ginger oil significantly reduced joint swelling in rats. The rats were given ginger oil and eugenol orally at 33mg/kg for 26 days.

Ginger extract was found to be successful in reducing knee pain associated with osteoarthritis, according to a clinical study published in the November 2001 issue of Arthritis and Rheumatism. Since the only difference between knee arthritis and AC joint arthritis is location on the body, ginger extract should be equally effective on AC joints.

Another botanical spice that has been clinically proven to be even more effective than ginger for osteoarthritis symptoms is turmeric. Turmeric is the yellow spice often found in Indian curry. Turmeric contains anti-inflammatory cytokines as well as anti-oxidants.

According to Web MD, capsicum, better known as cayenne pepper, chili pepper, or African bird pepper, can be used in topical creams and deep heating rubs to reduce the pain associated with AC joint arthritis and bring circulation to the area.