Osteolysis or bone loss is a condition that occurs when the body stops
producing enough new bone cells to replace the old bone cells. The distal or
end portion of the clavicle or collarbone which forms the AC Joint can get
inflamed due to osteolysis setting in over a period of time. Distal clavicle
osteolysis that results in shoulder joint pain because of the bone
disintegration and damage is most commonly seen in weightlifters or other
athletes performing bench presses regularly, in tennis players, swimmers and
also among construction workers or military personnel. Though rare, Ddistal
Clavicle Osteolysis can also happen from direct trauma to the collarbone during
a fall or direct blow.
This condition is normally seen as an overuse injury caused by repeated
microfractures that the body attempts to repair. But the remodeling of bone
becomes more jagged and uneven with each microfracture. This consequently
places undue stress on the end of the clavicle causing deterioration of
cartilage on the adjacent AC joint where the clavicle meets the shoulder blade.
The causes of Distal Clavicle Osteolysis can be due to a single injury to the
AC joint or to the end
of the clavicle, minor repetitive injuries to the AC joint or to the end of the clavicle,
repetitive stresses on the AC joint, repetitive overhead activities or also
because of a pre-existing disease that might affect the mineralization of the
bone structure, like rheumatoid arthritis, hyperparathyroidism, infection,
multiple myeloma, and scleroderma.
In Distal Clavicle Osteolysis, a sharp or aching pain at the junction of
the acromioclavicular joint (AC joint) and collarbone is usually felt during
activity, but persistent tenderness around the joint during non-activity or inflammation
and swelling are also other symptoms. Reduced strength and reduced mobility can
also happen gradually. The diagnosis of this shoulder condition is usually made
by physical examination, although imaging tests can also be used to confirm the
diagnosis or rule out other causes of shoulder pain. Blood tests are sometimes
performed to rule out infection in the bone.
The treatment plan for Distal Clavicle Osteolysis depends on the amount
of bone loss. Avoiding or modifying of activities that cause the symptoms along
with anti-inflammatory medicines and ice can should allow the clavicle to re-mineralize.
The condition may take at least two years to resolve completely and the symptoms
could also recur if the earlier activities are restarted. Steroid injections
can also give long term pain relief. As for surgical intervention to manage the
condition, the most common form of surgery for distal clavicle
osteolysis is a distal clavicle resection, or arthroscopic distal clavicle
resection, in which the affected portion of the bone is removed. The recovery
period for this could be anywhere from one to two weeks.
As for the prevention of Distal Clavicle Osteolysis many athletes may
not be able to completely eliminate bench pressing from their weightlifting
routine, but some modifications can be made to ease the stress on the joint and
collarbone like reducing the hand spacing on the barbell or placing towels on
the chest to protect it during the descent phase of the bench press. For those
recovering from the condition, work out with the doctor the exercises that can
or cannot be done to avoid any further trauma to the AC joint.