The acromioclavicular (AC) joint is the small joint at the top of the shoulder where the collarbone meets the shoulder blade. It can be sprained or separated by a fall onto the point of the shoulder, or become painful from wear-and-tear arthritis in middle age. Most AC joint injuries and arthritis are managed without surgery.
Also known as acromioclavicular joint injury, AC joint separation, shoulder separation, AC joint arthritis
Symptoms
- Pain at the very top of the shoulder, over the end of the collarbone
- A bump or step at the top of the shoulder after an injury
- Pain reaching across your body or overhead
- Pain lying on that side
- Tenderness when pressing on the joint
Causes and risk factors
- A fall directly onto the point of the shoulder, for example from a bike or in contact sport
- Being male and aged 20 to 40 (for injuries)
- Age-related wear of the joint (for arthritis)
- Repeated heavy lifting or pressing, such as weight training
- A previous AC joint injury
What the evidence says helps
- There is broad agreement that milder AC joint injuries (grades I and II) are managed without surgery, and that grade III injuries are usually treated non-surgically at first.3
- A 2026 review of trials found that people with grade III to V separations had similar results after one year whether or not they had surgery, with earlier recovery in those managed without surgery.2
- For AC joint arthritis, there is little research on exercise or other non-drug treatments, so care is guided by symptoms and clinical judgement.5
- Steroid injections into the AC joint can reduce pain for some months, and surgery to remove the end of the collarbone is usually considered after several months of non-surgical care.4
Things you can try at home
- After an injury, use a sling briefly for comfort if advised, then start gentle movement early.
- Avoid heavy lifting, bench pressing and dips while the joint is sore, then build back gradually.
- Use ice and simple pain relief to settle pain.
- Avoid lying on the affected side at night.
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- A visible deformity, severe pain or being unable to move the arm after a fall or blow: go to A&E or an urgent treatment centre.
- Skin over the end of the collarbone that is tented, broken or blanching after an injury: go to A&E.
- Numbness, tingling or weakness in the arm after a shoulder injury: go to A&E or call NHS 111.
- A hot, red, swollen shoulder with fever or feeling generally unwell: get same-day help from your GP or NHS 111, as this can signal a joint infection.
- Shoulder pain that comes with chest pain, tightness, breathlessness, sweating or feeling sick: call 999, as this can be a heart problem.
How Apollo can help
We assess your shoulder to find out whether the AC joint is the main source of pain and check for any related problems. Our osteopaths and sports therapist offer advice on load and activity, hands-on care where appropriate, and a progressive strengthening plan to get you back to work, the gym or sport. If X-rays, an injection or an orthopaedic opinion are needed, we write to your GP to refer you on.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
Will the bump on my shoulder go away after an AC joint injury?
The bump after a higher-grade separation often stays. For most people it is a cosmetic issue rather than a problem with function. Surgery can improve the look but research shows similar long-term function with or without surgery for many injuries.
How long does an AC joint sprain take to heal?
Milder sprains often settle relatively quickly. More severe separations can take several months to recover strength and full function, and recovery times vary with the grade of injury and your activities.
Can I keep going to the gym with AC joint pain?
Usually, yes, with changes. Exercises such as bench press, dips and deep push-ups tend to load the AC joint. Reducing or modifying these while you build strength elsewhere is often helpful.
References
- Skjaker SA et al. (2020). Young men in sports are at highest risk of acromioclavicular joint injuries: a prospective cohort study. Knee Surgery, Sports Traumatology, Arthroscopy. View source
- Lameire D et al. (2026). Outcomes after operative versus nonoperative management of type III to V acromioclavicular joint dislocations: a systematic review and meta-analysis of randomized controlled trials. Orthopaedic Journal of Sports Medicine. View source
- Beitzel K et al. (2013). Current concepts in the treatment of acromioclavicular joint dislocations. Arthroscopy. View source
- Welch M et al. (2023). A systematic review of the treatment of primary acromioclavicular joint osteoarthritis. Shoulder & Elbow. View source
- Farrell G et al. (2019). Current evidence for nonpharmacological interventions and criteria for surgical management of persistent acromioclavicular joint osteoarthritis: a systematic review. Shoulder & Elbow. View source
- Mall NA et al. (2013). Degenerative joint disease of the acromioclavicular joint. American Journal of Sports Medicine. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
