From the Research
Treatment for chronic high-grade AC separation typically begins with conservative management, including rest, ice, anti-inflammatory medications, and physical therapy focusing on strengthening the rotator cuff and scapular stabilizers, as most patients can achieve good outcomes with non-surgical management 1. The goal of conservative management is to reduce pain and inflammation, improve range of motion, and strengthen the surrounding muscles to stabilize the AC joint.
- Conservative management may include:
- Rest and ice to reduce pain and inflammation
- Anti-inflammatory medications, such as ibuprofen 400-600mg three times daily or naproxen 500mg twice daily for 1-2 weeks
- Physical therapy to strengthen the rotator cuff and scapular stabilizers
- A sling may provide temporary comfort but should be used minimally to prevent shoulder stiffness For persistent pain despite 3-6 months of conservative treatment, surgical options may be considered, including AC joint reconstruction or resection of the distal clavicle, with the decision for surgery depending on pain severity, functional limitations, and patient activity level 2. Recovery typically involves gradual return to activities as pain allows, with full recovery potentially taking several months regardless of treatment approach. The presence of well-corticated ossific densities noted in the imaging suggests that the body has already formed stabilizing scar tissue around the injury site, which supports the use of conservative management as the initial treatment approach 3. It is essential to note that the treatment algorithm for AC separation may vary depending on the severity of the injury and the patient's individual needs, and a clear understanding of the mechanism of injury, clinical picture, diagnostic imaging, and updated surgical techniques can provide the best care for patients with AC joint separation 1.