How long will I be off work?

For isolated AC joint resection, a sling is typically used for about 2 weeks. Many return to desk-based work within several days once pain is controlled. Manual or overhead roles may require 6 weeks or more.

Will I lose shoulder movement after distal clavicle excision?

No. The AC joint has small normal motion and removing a short segment of bone usually does not limit function. Most patients regain full, comfortable range with rehabilitation.

Do injections cure AC joint arthritis?

Injections can reduce pain and inflammation to enable rehabilitation but they do not regrow cartilage. They are most effective as part of a comprehensive non-operative program.

How do I know if pain is coming from the AC joint?

Top-of-shoulder pain, tenderness directly over the AC joint, and pain with cross-body adduction are clues. Examination and targeted imaging confirm the diagnosis.

Labeled diagram of the shoulder bones including clavicle, acromion, scapula and humeral head — Shoulder anatomy: clavicle (collarbone), acromion, scapula, and humeral head.

AC Joint Arthritis (Acromioclavicular Joint)

The acromioclavicular (AC) joint sits at the top of the shoulder where the acromion (part of the shoulder blade) meets the end of the clavicle (collarbone). AC joint arthritis occurs when the smooth, glistening cartilage lining the joint wears away.

AC joint arthritis is not the same as “shoulder arthritis”. Doctors usually use the term shoulder (glenohumeral) arthritis for degeneration of the main ball-and-socket joint, where the humeral head (upper arm bone) meets the glenoid (part of the scapula). AC arthritis involves the smaller joint on top of the shoulder.

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Symptoms of AC Joint Arthritis

If you have AC joint arthritis, the pain is usually felt on the top of the shoulder. It is often a dull ache but can be sharp or burning with certain movements. Pain can occur at rest, at night (especially when sleeping on the painful shoulder), and during activity.

Movements that often aggravate AC joint pain include:

Reaching across to touch the opposite shoulder (cross-body adduction)
Raising your arm until it touches your head (end-range elevation)
Pressing/lifting movements and prolonged overhead tasks

What causes AC Joint Arthritis?

Wear-and-tear from years of shoulder use is the most common cause. Because the shoulder is used so frequently, the cartilage can gradually thin. AC joint degeneration is often part of the normal ageing process and may be painless—however, it sometimes becomes symptomatic.

Injuries such as an AC joint sprain/dislocation or fracture-dislocation can increase the risk of developing arthritis.

AC joint pain can also occur together with other shoulder issues such as subacromial impingement/bursitis and rotator cuff tears, but it may present in isolation.

Risk factors for developing AC Joint Arthritis

Risk factors include:

Previous injury to the AC joint (dislocation, fracture)
Age — risk increases over time
Occupational or sporting loads with repetitive overhead activity

Investigations

X-ray

X-rays can demonstrate joint space narrowing, osteophytes (spurs), and other bony changes of AC joint arthritis. Targeted shoulder views help confirm the diagnosis.

MRI

MRI is useful when symptoms persist, or when there may be coexisting conditions such as rotator cuff tears or subacromial bursitis. It helps plan treatment if surgery is being considered.

How is AC Joint Arthritis treated?

Treatment depends on pain severity and function

Mild to Moderate Pain

Activity modification to avoid aggravating positions (cross-body reach, end-range elevation, heavy pressing)
Physiotherapy focusing on scapular control, rotator cuff strength, and thoracic mobility
Short-term analgesia/anti-inflammatories as advised by your GP
Ultrasound-guided corticosteroid injection may help when pain limits rehab

Severe or Persistent Pain

If symptoms persist despite an adequate period (often 3–6 months) of high-quality non-operative care, surgery may be recommended.

Arthroscopic Excision of the AC Joint

Through two 1 cm keyhole incisions, an arthroscope (camera) and instruments are inserted to remove a small portion of the distal clavicle. This creates space for scar tissue to form, reducing bone-on-bone contact that causes pain. In selected cases, the procedure can also be performed through a small open incision.

Recovery: for isolated AC joint resection, rehabilitation usually takes about 8 weeks with physiotherapy. A sling for ~2 weeks helps wounds heal and swelling settle. If other procedures (e.g., rotator cuff repair) are performed, recovery is longer.

Key point: Whether you pursue non-operative or operative care, a structured, progressive rehab program is critical to long-term success.

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FAQ’s
How long will I be off work?
It depends on your job and available modified duties. For isolated AC joint resection, you’re typically in a sling for ~2 weeks. Many return to desk-based work within several days once pain is controlled. Manual or overhead roles may require 6 weeks or more.
Will I lose shoulder movement after distal clavicle excision?
No. The AC joint has small normal motion and removing a short segment of bone does not usually limit function. Most patients regain full, comfortable range with rehab.
Do injections cure AC joint arthritis?
Injections can reduce pain and inflammation, allowing you to progress rehab. They do not “regrow” cartilage but can be very helpful in a comprehensive program.
How do I know if pain is coming from the AC joint?
Location on the top of the shoulder, pain with cross-body adduction, and focal tenderness over the joint are clues. Examination and targeted imaging confirm the diagnosis.