The collarbone consists of two paired bones located above the first rib and connecting the upper limbs of a person to the rest of the body. It performs several important functions, providing the necessary range of motion to the arm and transmitting physical impulses from the arms to the axial skeleton. Pain in the collarbone can occur due to injury, but in addition it can be caused by diseases of the internal organs and the musculoskeletal system.
If you have pain under your collarbone or between your collarbones, if the pain is localized on the right or left side, don’t tolerate it! Contact the CELT Pain Clinic, and our specialists will find out the reason why it occurs and prescribe effective treatment. We have modern equipment for diagnostics and treatment, which will definitely help you!
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Causes of the disease
A person can raise his arms up using the upper limb girdle, which consists of the shoulder joints, shoulder blades and collarbones. Together they form mobile, active joints. Thus, at the junction of the semicircular part of the scapula (acromion) and the proximal end of the clavicle, the acromioclavicular joint is formed. It includes cartilage, ligaments, surrounding soft tissue. It is noteworthy that there is very little synovial (intra-articular) fluid in the AC joint capsule.
Specific loads on the upper body cause instability of the ligamentous apparatus of the joint, which in turn leads to a violation of the integrity of the cartilage tissue. At the next stage, pathological growth of bone cells occurs and growths (osteophytes) are formed. The combination of pathogenetic factors leads to an inflammatory, destructive process – AC joint arthrosis.
Experts have identified a category of patients among whom arthrosis of the acromioclavicular joint is most often diagnosed:
- weightlifters working with heavy weights;
- bodybuilders who load the belt of the upper limbs in order to sculpt the muscles of the back, arms, and chest;
- track and field athletes competing on specific apparatus – uneven bars, rings, horizontal bar;
- boxers;
- miners;
- welders;
- movers;
- blacksmiths.
The main factors provoking the onset of degenerative changes are:
- heavy physical labor associated with lifting and carrying heavy objects;
- prolonged forced raising of arms;
- congenital anomalies in the development of bone and cartilage tissue associated with weakness of ligaments, muscles, and improper formation of chondrocytes;
- injuries to the collarbones and shoulder blades;
- surgical interventions in the articulation area
- placing your arm bent at the shoulder under your head while sleeping.
Long-term loads on the acromioclavicular joint lead to the replacement of cartilage tissue with bone. The formation of osteophytes causes a decrease in motor amplitude. The pathological process of arthrosis takes a long time without specific symptoms. The appearance of pain indicates an advanced form of the disease.
If the root cause of acromioclavicular arthrosis is not established, they speak of the primary form of the disease. In this case, the pathological process spreads throughout all osteochondral joints. Primary ACS is most often transmitted genetically.
The secondary type of ACS is spoken of when the main pathogenetic factor of the disease is known:
- pathologies of the endocrine system;
- violation of metabolic processes;
- multiple microtraumas;
- progressive osteoporosis;
- excess weight;
- lesions of the articulation elements, acquired or congenital
Features and types of humeral cyst
A bone cyst is a pathological cavity in bone tissue filled with fluid of a different nature. It can be a consequence of injury, local circulation disorders, the production of enzymes that have lytic activity towards bone cells and other reasons. But in all cases, the resulting cyst of the humerus increases the risk of pathological fracture and deformation of the shoulder or elbow joint. After all, it can form both in the area of the proximal and distal epiphysis.
There are 3 main types of cysts. Children are most often diagnosed with:
- Solitary cyst (SCC). It is a single-chamber cavity, usually in the epiphysis or proximal metaphysis (neck of the humerus), filled with serous fluid. When it reaches a large size, it “swells” the bone. More common in boys.
- An aneurysmal cyst (ACC) is a multi-chamber neoplasm with a number of vascular spaces filled with blood. It is distinguished by active growth and can reach very large sizes, which is accompanied by a pronounced clinic. It is more often observed in girls and women under 20 years of age.
In adults, an aneurysmal bone cyst of the humerus may also be detected, although the diagnosis of subchondral cysts is also possible. They are usually the result of severe degenerative changes in the joints and, unlike other types of similar formations, are formed directly in the head of the bone under the hyaline cartilage covering it. Subchondral cysts can be either single or numerous, have different sizes and shapes, but are always associated with destruction of the joint as a result of the progression of one or another chronic disease.
Signs of acromioclavicular arthrosis
At the beginning of destruction, a person does not notice any unpleasant symptoms of acromioclavicular arthrosis. The clinical picture of the pathology appears years later. Sometimes symptoms appear singly, but very often the problem is signaled by several specific signs:
- Pain syndrome. Pain appears first. At the beginning of the pathological process, it makes itself felt after physical activity and training. The patient experiences short-term pain that goes away on its own. Without therapy, the pain becomes persistent and is not relieved by analgesics.
- Crunching in the shoulder joint. In a healthy joint, a crunching sound (crepitus) may occur. With ACS, it occurs along with pain.
- Deformation, swelling. The growth of bone processes entails a change in the shape of the joint. The shoulder swells, the color of the skin over the joint changes, and the local temperature rises.
- Impaired motor function. As the disease progresses, the patient cannot perform the usual movements or move his arm behind his head. Most patients have problems getting dressed.
The patient's general condition is rapidly deteriorating. Due to the inability to take a comfortable position in bed, insomnia develops. The pain intensifies when lying down. Somatic symptoms cause changes in the central nervous system. Patients become irritable and prone to depression.
Treatment of bone cysts of the shoulder
Treatment tactics depend on the characteristics of the clinical picture, the size of the cystic cavity, its type, the age of the patient and the risk of complications. In most situations, treatment is carried out conservatively.
Its main component is puncture. This is a minimally invasive procedure that allows you to instantly reduce the pressure inside the tumor and stop further destruction of the humerus. It involves inserting a needle into the bone cavity under CT guidance and removing its contents. The manipulation is performed under local anesthesia, so the patient does not experience pain during it. Also, as part of the puncture, the cavity is washed with physiological solution, its walls are perforated and special drugs are introduced that inhibit the activity of enzymes and thereby prevent further growth of the tumor.
The number of punctures in each case is determined individually. For large cysts, they are initially performed on average once every 3 weeks, and then every 4-5 weeks. To achieve a positive result and reduce the size of the formation, about 6-10 procedures are usually required.
Additionally, patients are prescribed drug therapy, physiotherapy and exercise therapy. If, due to the size of the cyst, there is a high risk of fracture of the humerus, it is recommended to limit the load on the affected limb and avoid potentially traumatic situations.
Diagnostic methods
The earlier the diagnosis of acromioclavicular arthrosis is made, the greater the patient’s chances of slowing down the process and maintaining quality of life. To reach a correct conclusion, you will need a set of measures:
- examination by a specialist with mandatory palpation of the joint;
- CT scan is necessary to determine changes in the structure of bone tissue;
- MRI – shows the condition of cartilage, ligaments, bone elements;
- Ultrasound of the shoulder joint;
- radiography - shows a narrowing of the gap between the distal part of the scapula and the collarbone;
- blood test for markers of autoimmune disorders;
Evaluation of the examination results is the basis for prescribing one or another type of treatment and the use of physiotherapeutic methods.
What is the cause of the unpleasant crunching sound?
If the shoulder “crunches,” there is a high probability that there is damage to the scapulothoracic joint. As a rule, it occurs due to frequently repeated physical activity in a position with arms raised up. If the shape of the chest is even slightly changed, pain may occur. With osteoarthritis of the shoulder joint, with bone growths, imbalance in the shoulder girdle and curvature of the spine become pronounced.
Don't fight the consequences - look for the cause of the clicks in the shoulder
Stages of disease development
Traumatologists distinguish four stages of acromioclavicular arthrosis:
- Stage I – not accompanied by any symptoms. Patients note discomfort and some pain when pressing on the area of the acromioclavicular joint, when performing sharp swings of the arms. Patients ignore the first symptoms, which is why the cartilage tissue continues to thin out - the pathology begins to progress;
- Stage II – the patient constantly experiences pain in the affected joint. The painful sensations are aching and intensify when dressing, raising your arms up, or moving behind your head. After suffering injuries, a crunching sensation occurs in the joint. The amplitude of hand movements decreases. The patient experiences severe pain when lifting minor weights, at rest;
- Stage III – formed osteophytes injure soft tissues. The affected joint hurts constantly and loses mobility. Painful sensations are difficult to relieve with medications. Patients report a feeling of frozenness in the joint. Spasms of surrounding muscles and contractures are detected;
- Stage IV – develops in the absence of adequate treatment. The pain becomes unbearable due to the destruction of the joint. Most often, patients require joint replacement.
Pain in the collarbone: causes of the disease and methods of treatment
The collarbone is two small bones resembling the letter S, which perform the protective function of the chest organs.
Symptoms of diseases
If there is a problem in the collarbones, then, of course, the first symptom will be pain. But these sensations are different, so you should pay special attention to this:
- shooting/aching/pulling/stabbing/cutting;
- paroxysmal and prolonged;
- weak/strong/moderate;
- only in the area of the collarbone itself, or it radiates to other parts of the body (for example, a severe headache
).
It is important to observe how painful sensations intensify and under what conditions this occurs (for example, during deep breaths or certain movements of the limbs).
Causes of pain
The origin of pain in the left or right clavicle bone is explained by two categories of factors. First of all, this is damage to the bone itself or problems in the functioning of other organs.
The first category includes:
- dislocations;
- cracks;
- development of a purulent process;
- periostitis;
- periarthritis.
Also, discomfort in the collarbone can provoke diseases of other organs:
- neuralgia;
- neck osteochondrosis
; - inflammation of the neck muscle.
The most common diseases affecting the collarbone are described below.
Damage to the clavicle bones
The most common problem usually occurs from a direct blow or a fall on an outstretched arm. Symptoms (are typical):
- strong pain;
- obvious displacement of fragments;
- crunching noise with any movement;
- bruises.
To make an accurate diagnosis, an x-ray is taken. Next, the bones are fixed with a special knitting needle through surgical intervention. After this, the patient recovers much faster. If it is impossible to use this method, the damaged area is cast for several months, but this approach requires a longer recovery time.
Bone dislocation
The acromial process of the clavicle is often damaged by an unsuccessful sudden movement of the shoulder. Dislocation of the sternal process is much less common, since for this to happen a very strong blow to the chest must occur. But if this does happen, the patient will suffer from severe discomfort and pain when trying to lift the limb. Attempts to move your arm will be very painful, and the displacement of the collarbone will become clearly visible.
To make a diagnosis, you need to see a doctor and get an x-ray. Treatment involves conservative therapy, but in some cases joint plastic surgery may be necessary.
cervical osteochondrosis
A disease that is accompanied by pain in the neck and supraclavicular area. Basically, it is accompanied by a crunching sound, numbness of the hands (exacerbated after waking up from sleep), as well as weakness of the limbs when exposed to the spinal nerves.
As a rule, this disease is typical of office workers (people with sedentary work). As soon as you suspect the presence of this disease, you must undergo examination by a neurologist. If there are symptoms of an intervertebral hernia, then you should consult a neurosurgeon.
First of all, the patient will be prescribed certain medications, physical therapy sessions and exercises in the pool.
Plexit
The cause of inflammation of the cervical plexus can be injury or an infection that has gotten inside. The disease is accompanied by pain in the neck, which radiates to the clavicular area. Also, plexitis can be accompanied by stabbing pain in the heart, constant hiccups and numbness in the ear area. If these symptoms occur, it is better to immediately contact a neurologist. Modern diagnostics guarantee a complete recovery.
Myositis
Inflammation of the muscle tissue located close to the bones contributes to collarbone pain. Myositis can occur after hypothermia or respiratory illness. The pain brings about tightness and tension in the muscles, so more rest is usually recommended for the patient. If this method does not help, then certain medications are prescribed to relieve pain and inflammation.
Diagnostics
After examination by a doctor, the patient is prescribed a diagnosis that helps confirm the diagnosis and the causes of pain. It is expected that CT, MRI, X-ray, and ultrasound diagnostics will be performed. Based on the results obtained, appropriate treatment is selected.
Treatment methods
All stages of therapy are based on the reasons that provoked the disease. To relieve pain, a variety of medications with analgesic and anti-inflammatory composition are used. The patient can apply a warming gel to the affected area, use injections (only if there is an urgent need to get rid of pain), and the tablet form of the drugs helps well with moderate pain. To speed up the healing process and restoration of the entire body, aqua aerobics, swimming, physiotherapeutic procedures, massages, acupuncture and manual therapy are recommended.
Prevention from illnesses
By following a few simple rules, you can easily prevent the development of pain and inflammation in the joints:
- do not overcool/avoid overheating;
- correctly distribute the load on the back;
- do not lift more than ten kg without the necessary training;
- be sure to complete the treatment of viral infections;
- If you have any complaints about discomfort in the collarbone area, immediately contact a specialist.
It is also very important to maintain the overall health of the whole body.
This means a complete abstinence from nicotine and alcoholic beverages and daily exercise. Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr
Who's at risk
A crunch in the shoulder with pain occurs more often in young people who play certain sports. Particularly dangerous are activities in which throwing movements are performed or the arms are often raised upward. Those at risk include builders, painters, hairdressers and conductors. Due to prolonged sitting at a computer, muscle tone suffers, so in the absence of periodic exercise, programmers, system administrators and representatives of other IT professions also run the risk of hearing a characteristic click.
Snapping shoulder syndrome is a common condition among hairdressers.