From the Guidelines
Treatment of AC ligament pain should initially focus on conservative management with rest, ice, and physical therapy, as surgical intervention is typically reserved for severe or unstable injuries. According to the American College of Radiology's appropriateness criteria for shoulder pain-traumatic 1, most soft-tissue injuries, including those to the acromioclavicular ligaments, can undergo a period of conservative management before considering surgery.
Key components of conservative management include:
- Resting the affected shoulder and applying ice for 15-20 minutes every 2-3 hours for the first 2-3 days to reduce inflammation and pain
- Using over-the-counter pain medications like ibuprofen or naproxen to manage pain and reduce inflammation
- Immobilizing the joint with a sling for 1-2 weeks to protect it while it heals
- Starting physical therapy exercises 1-2 weeks after injury, focusing on shoulder strengthening and range of motion, and continuing for 6-8 weeks
The etiology of traumatic shoulder pain, including AC ligament pain, can often be determined through clinical examination, radiography, and mechanism of injury 1. It's essential to note that unstable or significantly displaced fractures may require acute surgical management, but this is not typically the case for AC ligament pain unless it's part of a more severe injury.
For persistent or severe cases, corticosteroid injections might be considered to reduce inflammation, but surgery is rarely needed and usually reserved for cases where conservative treatments fail or the injury is severe. Proper healing time and rehabilitation are crucial for full recovery from AC ligament pain, which often results from trauma or overuse, causing inflammation and instability in the joint where the collarbone meets the shoulder blade.
From the Research
Treatment Options for AC Ligament Pain
- The treatment of AC ligament pain can be managed through various methods, including conservative management and surgical intervention 2, 3, 4.
- Conservative management may include rehabilitation exercises, physical therapy, and pain management medications 3, 4.
- Surgical intervention, such as ACL reconstruction, may be recommended for patients who want to return to a high level of activity or have severe ligament damage 2, 3, 4.
AC Joint Injections for Pain Relief
- Corticosteroid injections into the AC joint can provide short-term pain relief for patients with AC joint arthropathy 5, 6.
- Ultrasound-guided AC joint injections have been shown to be more effective than palpation-guided injections in improving pain and functional status 5.
- However, the long-term efficacy of corticosteroid injections in treating AC joint pain is still debated, with some studies suggesting that it does not alter the natural progression of the disease 6.
Rehabilitation and Prevention
- Rehabilitation exercises and physical therapy play a crucial role in the management of AC ligament pain and can help improve knee function and reduce pain 3, 4.
- Preventive measures, such as proprioceptive and neuromuscular training exercises, can help improve knee stability and reduce the risk of ACL injuries 2, 3.