From the Guidelines
The best treatment modality for pain and stiffness related to chronic left acromial clavicular joint capsule injury is a multimodal approach, including exercise, weight loss if applicable, and pharmacologic interventions such as topical NSAIDs, with a strong recommendation for patient participation in a regular, ongoing exercise program. When considering treatment options, it's essential to prioritize interventions with a low risk of harm, as noted in the 2019 American College of Rheumatology guideline for the management of osteoarthritis 1. The treatment plan should be tailored to the individual patient, taking into account their preferences, access to exercise programs, and the need for supervised or self-efficacy and self-management programs. Some key considerations include:
- Regular exercise program to enhance effectiveness and patient preferences
- Weight loss for patients who are overweight or obese
- Topical NSAIDs for localized pain relief
- Oral NSAIDs for more severe cases or polyarticular involvement
- Intraarticular glucocorticoid injections for temporary relief in persistent symptoms
- Patient education on self-efficacy and self-management programs. It's crucial to note that the availability, accessibility, and affordability of these interventions may vary, and clinicians should work with patients to choose the most appropriate options, as suggested by the guideline 1. In cases where symptoms persist despite conservative management, further evaluation and consideration of other treatment modalities, such as surgical options, may be necessary. Ultimately, the goal of treatment is to alleviate pain and stiffness, improve joint function, and enhance the patient's quality of life, while minimizing the risk of adverse effects and harm.
From the FDA Drug Label
Naproxen has been studied in patients with rheumatoid arthritis, osteoarthritis, juvenile arthritis, ankylosing spondylitis, tendonitis and bursitis, and acute gout Improvement in patients treated for rheumatoid arthritis was demonstrated by a reduction in joint swelling, a reduction in duration of morning stiffness, a reduction in disease activity as assessed by both the investigator and patient, and by increased mobility as demonstrated by a reduction in walking time In patients with osteoarthritis, the therapeutic action of naproxen has been shown by a reduction in joint pain or tenderness, an increase in range of motion in knee joints, increased mobility as demonstrated by a reduction in walking time, and improvement in capacity to perform activities of daily living impaired by the disease In patients with ankylosingspondylitis, naproxen has been shown to decrease night pain, morning stiffness and pain at rest
The best treatment modality for pain and stiffness related to chronic left acromial clavicular joint capsule injury is Naproxen.
- Key benefits of naproxen include:
- Reduction in joint pain or tenderness
- Increase in range of motion
- Decrease in morning stiffness
- Improvement in capacity to perform activities of daily living 2
From the Research
Treatment Modalities for Chronic Left Acromial Clavicular Joint Capsule Injury
The treatment for chronic left acromial clavicular joint capsule injury can be divided into non-surgical and surgical options.
- Non-surgical treatment is often recommended for type I and II injuries, and may include immobilization, pain medication, cryotherapy, and physiotherapy 3, 4.
- Surgical treatment is often recommended for type IV, V, and VI injuries, and may include techniques such as screw fixation of the coracoid process to the clavicle, coracoacromial ligament transfer, and coracoclavicular ligament reconstruction 5, 4.
- For type III injuries, the management remains controversial, with some studies suggesting nonsurgical treatment and others recommending surgical reconstruction of the acromioclavicular joint 5, 4.
Surgical Treatment Options
Surgical treatment options for chronic acromioclavicular joint injuries can be divided into open surgery and shoulder arthroscopy.
- Open surgery methods can be divided into three categories: direct acromioclavicular joint fixation, coracoclavicular space suspension device fixation, and coracoclavicular ligament reconstruction 6.
- Shoulder arthroscopy involves reconstruction of the coracoclavicular ligament under arthroscopy, combined with suture-button suspension fixation 6.
Treatment for Chronic Acromioclavicular Dislocation
For patients with chronic acromioclavicular dislocation or those who do not respond to non-surgical treatment, wire suspension fixation combined with ligament repair may be recommended 6.