Neck & Shoulder

What It Is

The acromioclavicular joint (known as the AC joint, or ACJ) is the joint between the clavicle (collar bone) and the acromion (the top of the shoulder blade). The ends of the bones are covered in cartilage, and when the cartilage wears out, degeneration (arthritis) can occur (American Academy of Orthopaedic Surgeons, n.d.).

Most ACJ arthritis is caused simply by wear and tear of the joint over several decades. Hence the risk of developing osteoarthritis in the shoulder, as well as physical limitations and pain, increases as you grow older. It often develops in people who put the joint under constant stress, particularly with repeated overhead lifting, and weight-lifters are known to be at risk (Chaudhury et al., 2018).

An injury, such as a fracture or dislocation of the shoulder, can lead to arthritis in the joint, regardless of how old you are. This is known as post-traumatic arthritis (American Academy of Orthopaedic Surgeons, n.d.). As the cartilage wears away, the bone ends can rub together, causing pain, and bone spurs can develop.

Most of the time, the condition occurs in those who are over the age of 50 (American Academy of Orthopaedic Surgeons, n.d.). Arthritis of the AC joint often shows up on X-rays without causing many symptoms; when it does cause pain, the pain is usually felt on the top of the shoulder (American Academy of Orthopaedic Surgeons, n.d.).

Acromioclavicular Osteoarthritis Anatomy

The shoulder is composed of two joints, the glenohumeral joint and the acromioclavicular joint. The AC joint is where the collarbone joins the acromion, which is at the tip of the shoulder blade. The glenohumeral joint is where the top part of the arm bone meets the shoulder blade. Osteoarthritis is more common in the acromioclavicular joint than in the glenohumeral joint (American Academy of Orthopaedic Surgeons, n.d.).

ACJ arthritis can be linked with other problems, such as shoulder impingement. The arthritic joint can become enlarged, and bone spurs can form on the underside of the joint. These can press on the rotator cuff tendon (supraspinatus) that sits under the joint, and this impingement can be painful and limit arm movement (Chaudhury et al., 2018; Compagnoni et al., 2019).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Acromioclavicular Osteoarthritis

Exercises guided by a therapist can improve the range of motion, strength and function of your shoulder (American Academy of Orthopaedic Surgeons, n.d.), and NICE guidance says hands-on treatment should only be used alongside an exercise programme (National Institute for Health and Care Excellence, 2022). I can guide you through exercises to keep your shoulder moving and build its strength, with hands-on treatment to help you move more comfortably. See the My Approach tab for how I work.

1. Gentle Movement, But Try To Avoid Pain

You may need to change the way you move your arm to avoid provoking pain when performing regular daily activities (American Academy of Orthopaedic Surgeons, n.d.). Someone who wears clothes that go over the head might find it easier to wear those that zip up the front. Propping up hairdryers might help instead of trying to hold onto them for the whole time you are drying your hair.

2. Anti-Inflammatory Medication

The American Academy of Orthopaedic Surgeons (n.d.) says anti-inflammatory medicines such as ibuprofen or naproxen may reduce pain and inflammation in shoulder arthritis. These medicines can irritate the stomach, and you should speak to your doctor first if you have had stomach ulcers or take blood-thinning medicine. Discuss with your doctor, as it may not be a long-term solution. (This medicine information comes from the American Academy of Orthopaedic Surgeons, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

3. Ice

Apply ice to the shoulder for 20 to 30 minutes at a time, two or three times a day, to help ease pain (American Academy of Orthopaedic Surgeons, n.d.). Do not apply ice directly to your skin; wrap it in a thin towel.

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Steroid injection: an injection of a steroid (cortisone) into the joint, which can reduce pain and inflammation, although the effect is often temporary (American Academy of Orthopaedic Surgeons, n.d.).
Surgery: the most common operation for AC joint arthritis removes a small amount of bone from the end of the collarbone, and may be considered if pain is not relieved by non-surgical treatment (American Academy of Orthopaedic Surgeons, n.d.).

How I can help (see the My Approach tab)

Exercises to keep your shoulder moving and build strength

Hands-on treatment for the muscles around the shoulder

Advice on changing tasks that aggravate the joint

Tips

Most of the time, osteoarthritis is related to ageing and to repeated use of the joint over many years, which wears away the cartilage.
A previous shoulder injury, such as a fracture or dislocation, can make arthritis in the joint more likely (American Academy of Orthopaedic Surgeons, n.d.).
Where you can, change the way you do tasks that involve repeated overhead lifting, as these put constant stress on the joint (Chaudhury et al., 2018).
Arthritis seen on an X-ray does not always mean it is the cause of your pain, so your symptoms matter as much as the scan (American Academy of Orthopaedic Surgeons, n.d.).

Treatment

My Approach

AC joint arthritis is a long-term condition, so I treat it as ongoing care rather than a quick fix. My aim is to ease the pain on top of your shoulder, keep the whole shoulder moving, and build strength in the muscles around it so the joint is better supported day to day.

I start by assessing how your shoulder and shoulder blade move, which movements bring the pain on, and the strength of the muscles around the shoulder. I'll also check your neck and upper back, and ask about your work, training and daily tasks, especially anything overhead or across your body. That tells us what is irritating the joint and where to focus.

Hands-On Treatment

Warmth first to loosen things, then massage, trigger point and myofascial work for the muscles around the shoulder, neck and upper back
Gentle joint mobilisation for the shoulder and shoulder blade, within a comfortable range, to ease stiffness
Light pressure only over the joint itself, as it can be tender
If the joint has flared up, cool applications in the clinic instead of heat, and I'll show you how to use ice safely at home
Hands-on work always goes alongside exercise, not instead of it

Movement and Strength

Range-of-motion exercises to keep the shoulder moving, staying out of the positions that provoke pain
Strengthening for the shoulder blade and rotator cuff muscles, starting with gentle holds and building to fuller movement and resistance
A home programme to do between visits
If you lift weights, a look at which exercises aggravate the joint and how to adapt them, then a gradual build back up

Day to Day

Changing how you do overhead or repetitive tasks, such as dressing, drying your hair or reaching up to shelves
Pacing busy days so the joint doesn't flare
Simple self-massage you can use at home

If your pain keeps getting worse despite treatment, or it stops you sleeping or using your arm, talk to your family doctor or nurse practitioner about the other options.

What to Expect

Typical Course

Typical course: Most people come about once a week for the first 4 to 6 weeks while we ease the pain and set up your exercises, then we reassess and space visits out, often to every few weeks, with extra visits if it flares. Pain and movement usually improve gradually over 6 to 12 weeks of regular exercise, and because this is a long-term condition, the aim is to keep it well managed day to day.

What I Focus On

Assessment

Shoulder Mobility

Muscle Release

Shoulder Blade & Rotator Cuff Strength

Activity Changes

Sources

References

American Academy of Orthopaedic Surgeons (n.d.) Arthritis of the shoulder. OrthoInfo. Available at: https://www.orthoinfo.org/en/diseases--conditions/arthritis-of-the-shoulder/ (Accessed: 7 October 2026).
Chaudhury, S., Bavan, L., Rupani, N., Mouyis, K., Kulkarni, R., Rangan, A. and Rees, J. (2018) 'Managing acromio-clavicular joint pain: a scoping review', Shoulder & Elbow, 10(1), pp. 4–14. doi: 10.1177/1758573217700839
Compagnoni, R., Stoppani, C., Menon, A., Cosmelli, N., Fossati, C., Ranuccio, F. and Randelli, P. (2019) 'Management of acromioclavicular osteoarthritis in rotator cuff tears: a scoping review', Joints, 7(4), pp. 199–204. doi: 10.1055/s-0041-1730378
National Institute for Health and Care Excellence (2022) Osteoarthritis in over 16s: diagnosis and management (NICE guideline NG226). Available at: https://www.nice.org.uk/guidance/ng226/chapter/Recommendations (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooAcromioclavicular Osteoarthritis

What It Is

Acromioclavicular Osteoarthritis Anatomy

Self-Care & Treatment

How to Treat Acromioclavicular Osteoarthritis

1. Gentle Movement, But Try To Avoid Pain

2. Anti-Inflammatory Medication

3. Ice

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Hands-On Treatment

Movement and Strength

Day to Day

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooAcromioclavicular Osteoarthritis

What It Is

Acromioclavicular Osteoarthritis Anatomy

Self-Care & Treatment

How to Treat Acromioclavicular Osteoarthritis

1. Gentle Movement, But Try To Avoid Pain

2. Anti-Inflammatory Medication

3. Ice

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Hands-On Treatment

Movement and Strength

Day to Day

Typical Course

References

Related Conditions

Frozen Shoulder

Glenohumeral Joint Osteoarthritis

Acromioclavicular Joint Sprain

Anterior Scalene Syndrome

Book a session