A dislocation is an injury to a joint — a place where two or more of your bones come together — in which the ends of your bones are forced from their normal positions. This painful injury temporarily deforms and immobilizes your joint.

Dislocation is most common in the shoulders and fingers. Other sites for dislocations include the elbows, knees and hips. If you suspect a dislocation, seek prompt medical attention to return your bones to their proper positions.

When treated properly, most dislocations return to normal function after several weeks of rest and rehabilitation. However, some joints, such as your shoulder, may have an increased risk of repeat dislocation.

A dislocated joint may be:

  • Visibly deformed or out of place
  • Swollen or discolored
  • Intensely painful
  • Immovable

You may also experience tingling or numbness near or below the injury — such as in your foot for a dislocated knee or in your hand for a dislocated elbow.

When to see a doctor

It can be difficult to tell a broken bone from a dislocated bone. If you or your child appears to have either type of injury, get medical help right away. If possible, ice the joint and keep it immobile while you're waiting for medical treatment.

Dislocations can occur in contact sports, such as football and hockey, and in sports that may involve falls, such as downhill skiing, gymnastics and volleyball. Basketball players and football players also commonly dislocate joints in their fingers and hands by accidentally striking the ball, the ground or another player.

A hard blow to a joint during a motor vehicle accident is another common cause of dislocation, as is landing on an outstretched arm during a fall.

Risk factors for a joint dislocation include:

  • Susceptibility to falls. Experiencing a fall exposes you to the possibility of a dislocated joint, if you use your arms to brace for impact or if you land forcefully on a body part, such as your hip or shoulder.
  • Heredity. Some people are born with ligaments that are looser and more prone to injury than those of most people.
  • Sports participation. Many dislocations occur during participation in high-impact or contact sports, such as gymnastics, wrestling, basketball and football.
  • Motor vehicle accidents. These are the most common cause of hip dislocations, but you can greatly reduce your risk of injury by wearing a seat belt.

Complications of a joint dislocation may include:

  • Tearing of the muscles, ligaments and tendons that reinforce the injured joint
  • Nerve or blood vessel damage in or around your joint
  • Susceptibility to reinjury if you have a severe dislocation or repeated dislocations
  • Development of arthritis in the affected joint as you age

If ligaments or tendons that support your injured joint have been stretched or torn, or if nerves or blood vessels surrounding the joint have been damaged, you may need surgery to repair these tissues.

Besides physically examining your injury, your doctor may order the following:

  • X-ray. An X-ray of your joint is used to confirm the dislocation and may reveal broken bones or other damage to your joint.
  • MRI. Magnetic resonance imaging (MRI) can help your doctor assess damage to the soft tissue structures around a dislocated joint.

Treatment of the dislocation depends on the site and severity of your injury and may include:

  • Reduction. During this process, your doctor may try some gentle maneuvers to help your bones back into position. Depending on the amount of pain and swelling, you may need a local anesthetic or even a general anesthetic before manipulation of your bones.
  • Immobilization. After your bones are back in their right positions, your doctor may immobilize your joint with a splint or sling for several weeks. How long you wear the splint or sling depends on the joint involved and the extent of damage to nerves, blood vessels and supporting tissues.
  • Surgery. You may need surgery if your doctor can't move your dislocated bones back into their correct positions or if the nearby blood vessels, nerves or ligaments have been damaged. Surgery may also be necessary if you have had recurring dislocations, especially of your shoulder.
  • Rehabilitation. After your splint or sling is removed, you'll begin a gradual rehabilitation program designed to restore your joint's range of motion and strength.

Try these steps to help ease discomfort and encourage healing after being treated for a dislocation injury:

  • Rest your dislocated joint. Don't repeat the specific action that caused your injury, and try to avoid painful movements.
  • Apply ice and heat. Putting ice on your injured joint helps reduce inflammation and pain. Use a cold pack for 15 to 20 minutes at a time. For the first day or two, try to do this every couple of hours during the day. After about two or three days, when the pain and inflammation have improved, hot packs or a heating pad may help relax tightened and sore muscles. Limit heat applications to 20 minutes at a time.
  • Take a pain reliever. Over-the-counter medications, such as ibuprofen (Advil, Motrin IB, others), naproxen (Aleve) or acetaminophen (Tylenol, others), may help relieve pain.
  • Maintain the range of motion in your joint. After one or two days, do some gentle exercises as directed by your doctor or physical therapist to help maintain range of motion in your injured joint. Total inactivity can cause stiff joints.

To help prevent a dislocation:

  • Take precautions to avoid falls. Get your eyes checked on a regular basis, and if you're taking medications, ask your doctor if any of those drugs have the potential to make you dizzy. Also, be sure your home is well lighted and that you remove any potential tripping hazards from the areas where you walk.
  • Play safely. Wear the suggested protective gear when you play contact sports.
  • Avoid recurrence. Once you've dislocated a joint, you may be more susceptible to future dislocations. To avoid a recurrence, do strength and stability exercises as recommended by your doctor to improve support of your joint.
Jan. 25, 2014