Q: I am 20 years old and do a lot of heavy weightlifting. I recently acquired an injury of my shoulder diagnosed as osteolysis of the distal clavicle. I have stopped all activities causing pain. I plan to take rest. What can I do to recover from this condition? It is only a mild pain during activities but aggravation will make it worse.

A:Distal clavicle osteolysis has been described as a sequela of trauma associated with contact sports, falls, and motor vehicle accidents. The incidence has been increasing with the rapid growth in popularity of weight training over the past two decades. Medical therapy: The natural history of the disease is that of a self-limiting disorder with resolution within 1-2 years with activity modification. -Conservative management consists of rest and avoidance of symptomatic activity. -Nonsteroidal anti-inflammatory drugs can also help alleviate symptoms. -Corticosteroid injections are often given; however, they provide little long-term relief. -While most patients respond to conservative management, symptoms often return with resumption of previous activity. Surgical therapy: The classic procedure for distal clavicle osteolysis is distal clavicle resection, a reliable procedure with very good results. Patients in whom conservative treatment fails or those who refuse to limit their activity are candidates for surgical treatment. While the outcome for conservative treatment is good, many patients are unable to limit their activity. These patients and those who are resistant to conservative treatment can benefit from surgical intervention.