Pain where the shoulder meets the collarbone is a common issue that can affect daily activities. This area involves the acromioclavicular (AC) joint, the primary connection between the shoulder blade (scapula) and the collarbone (clavicle).
Anatomy of the Shoulder-Collarbone Junction
The acromioclavicular (AC) joint is the primary connection point where the shoulder meets the collarbone. It is formed by the lateral end of the collarbone (clavicle) and the acromion, a bony projection of the shoulder blade (scapula). This gliding joint allows for slight movement, facilitating overall shoulder motion.
The AC joint’s stability relies on strong ligaments. The acromioclavicular ligament reinforces the joint capsule, providing horizontal stability. The coracoclavicular ligaments (conoid and trapezoid) connect the collarbone to the coracoid process of the scapula, offering vertical stability and preventing upward displacement of the clavicle. Pain in this area typically points to the AC joint.
Common Causes of Pain
Acromioclavicular (AC) joint sprains or separations are frequent injuries, typically resulting from a direct fall onto the shoulder or a hard impact. These injuries are graded by severity: mild (Grade 1) involves stretching, while more severe grades (Grade 2 and 3) involve partial or complete tears of the AC and coracoclavicular ligaments, leading to instability and a noticeable bump.
Clavicle fractures, or broken collarbones, are another common source of pain. These fractures often occur from a direct fall onto the lateral shoulder, direct blows to the clavicle, or falls onto an outstretched hand. Pain from a clavicle fracture is usually localized and can be accompanied by a snapping or cracking sound at the time of injury.
Osteoarthritis of the AC joint can cause chronic pain, particularly in individuals over 40. This condition results from gradual cartilage wear, leading to inflammation and pain that intensifies with movement, especially overhead activities. Rotator cuff tendinopathy or tears can sometimes cause pain felt near the AC joint. Pain originating from other areas, such as the neck, can also be referred to the shoulder-collarbone region.
Recognizing Symptoms and When to Seek Medical Attention
Pain where the shoulder meets the collarbone is commonly felt on top of the shoulder, ranging from a dull ache to sharp, intense pain. Moving the arm overhead, reaching across the body, or lifting objects typically worsens AC joint pain. Sleeping on the affected side can also intensify discomfort.
Other signs of injury include swelling, bruising, and tenderness to the touch, especially after an acute injury. A noticeable bump or change in the shoulder’s shape, sometimes called a “step deformity,” can occur with more severe AC joint separations due to bone displacement. Popping or clicking sounds, limited range of motion, and instability may also be present.
Seek medical attention if you experience severe pain, immediate swelling, or a visible deformity after an injury. An inability to move the arm, numbness or tingling in the arm or hand, or pain that does not improve with rest and home care within a few days also warrant a healthcare provider consultation. These symptoms could indicate serious issues like significant ligament tears, fractures, or nerve involvement, requiring timely diagnosis and management.
Treatment and Recovery Approaches
Self-care measures often begin the management of shoulder-collarbone pain. The RICE method—Rest, Ice, Compression, and Elevation—is commonly recommended after an injury. Rest involves avoiding aggravating activities, while applying ice packs helps reduce swelling and pain. Over-the-counter pain relievers, such as NSAIDs like ibuprofen, can also manage discomfort and inflammation.
For more severe or persistent conditions, medical interventions are necessary. Physical therapy is key to recovery, focusing on exercises to restore range of motion, strengthen surrounding muscles, and improve joint stability. Corticosteroid injections into the AC joint can provide temporary relief by reducing inflammation and pain, particularly for osteoarthritis or persistent inflammation. Immobilization with a sling or brace may support the injured area and promote healing, especially after sprains or fractures.
Surgery is typically reserved for severe cases, such as highly displaced clavicle fractures or high-grade AC joint separations where ligaments are completely torn and the joint is unstable. Procedures may involve realigning bone fragments and securing them with plates and screws for fractures, or reconstructing torn ligaments for AC joint separations. Recovery timelines vary based on injury severity and treatment, ranging from a few weeks to several months. Adherence to medical advice and rehabilitation programs is important for optimizing recovery and regaining full function.