Understanding Shoulder Dislocation: Signs, Treatment & Recovery

We have all seen movies where the hero dislocates his shoulder, snaps it back into place and continues to fight the villains. That is fantasy and far removed from reality. Shoulder dislocations are among the most common of orthopedic injuries, but that does not mean that they are not serious or that people with this injury should act like heroes and ignore the problem and the pain it causes.

Signs of Shoulder Dislocation

The shoulder joint is the most mobile one in the body and allows a wide range of arm movements. This is possible because the top of the upper arm bone fits into the cup-shaped socket that is part of the shoulder blade and this permits the range of rotation and arm movement. When stress or impact causes the bone to snap out of the socket, the shoulder is dislocated. The most common signs of shoulder dislocation are:

• Intense pain in the shoulder
• Inability to move the joint
• The shoulder itself looks misshapen
• Severe swelling and bruising in the shoulder area

Additional signs may include:

• Numbness, tingling sensations in areas near the injury such as the neck or down the arm
• The muscles in the shoulder may spasm which may cause the intensity of the pain to increase

If you suspect that your shoulder has been dislocated:

• Seek immediate medical attention. Do not try to pop the shoulder back into place. Such attempts will increase the pain and may result in damage to the joint.
• While awaiting medical attention, immobilize the arm by placing it in a sling or splint. This will ensure that it does not move. Any movement could damage the joint or the surrounding blood vessels, muscles and ligaments.
• Apply ice to the joint. This will reduce the pain and help to control any internal bleeding and build-up of fluids near the injury.

Treatment for Shoulder Dislocation

There is no one course of treatment for a dislocated shoulder. A treatment plan will be devised only after the injury is examined by an orthopedic specialist and its extent is determined. The possibilities of other associated injuries will also be investigated. The aim is to treat the injury and also reduce any possible instability in the joint after treatment to minimize the possibilities of long-term weakness that may make the joint more susceptible to future dislocations.

Treatment is divided into 2 main options:

Closed Reduction – This involves doing some gentle manipulation of the arm and shoulder to help to joint return to its normal position. In some cases, the severity of the pain and swelling may make it necessary to use a muscle relaxant or sedative before the manipulation is done. In a few rare cases, where the pain is unbearable or there are other complications, general anesthesia may be used. Once the joint is returned to its normal position, there is usually an almost immediate reduction in the pain.

Surgery – If the bones, nerves, or blood vessels are damaged, surgery may be required to repair the damage. If the problem of shoulder dislocation is a recurring one, the doctor may consider surgery to repair any damage to the joint that is not healing fully.

It is most important that any manipulation to reset the joint be done only by an orthopedic specialist. Untrained or unskilled attempts to reset the joint may do more harm than good and increase the extent of the problem.

Recovery

If the joint has been reset by manipulation, without the need for surgery, and there are no other associated medical issues, recovery consists mainly of rest and keeping the joint immobilized. Keeping the arm in a sling or using a special splint are the ways immobility is achieved.  How long the sling or splint will need to be used will depend on the extent of the injury, the patient’s age and overall health and how much stress was placed on the joint between the time of the injury and when it was reset. The typical period of immobility is between 1 to 3 weeks.

Once the sling or splint is removed, a rehabilitation program is usually prescribed to enable the joint to regain its strength and the full range of motion. In some cases, the pain and swelling may disappear quickly while the weakness of the joint remains. Thinking that the joint has recovered and resuming normal activities with the doctor’s approval could lead to a recurrence of the problem or other associated medical issues.

If the pain and discomfort are severe, the doctor may prescribe some pain-relieving medication or muscle relaxants to keep the patient comfortable.

When a shoulder dislocation has occurred, the appropriate first aid actions are the first actions to take. Once that is done, the patient must be examined by an orthopedic doctor with the least possible delay. Home remedies should never be attempted without the doctor’s approval.