Dislocated shoulder

Diagnosis

A healthcare professional examines the injured area for tenderness, swelling and changes in shape. The exam also includes a check for signs of nerve or blood vessel injury. An X-ray of the shoulder joint is the best way to confirm that the shoulder is dislocated. A CT scan or MRI may be needed to identify broken bones or other damage to the joint.

Treatment

Dislocated shoulder treatment may involve:

• Closed reduction. In this procedure, gentle movements may help move the upper arm bones back into position. Depending on the amount of pain and swelling, a muscle relaxant or sedative is given before moving the bones. Rarely, general anesthesia medicines may be given so that you are asleep during the procedure. When the bones are back in place, severe pain typically improves almost immediately.
• Surgery. Surgery may help those with weak shoulder joints or ligaments who have repeated shoulder dislocations even after strengthening and rehabilitation. In rare cases, damaged nerves or blood vessels may require surgery. Surgical treatment may reduce the risk of reinjury in young athletes.
• Immobilization. After closed reduction, wearing a special splint or sling for a few weeks can keep the shoulder from moving while it heals.
• Medicine. A pain reliever or a muscle relaxant may provide comfort while the shoulder heals after treatment.
• Rehabilitation. When a splint or sling is no longer needed, a rehabilitation program can help restore range of motion, strength and stability to the shoulder joint.

A simple shoulder dislocation that doesn't involve major nerve or tissue damage typically gets better in a few weeks. Before returning to regular activities, it's important to have full movement in your shoulder with no pain and your strength back. Going back to activity too soon can lead to another shoulder injury.

Self-care

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

• Rest the shoulder. Don't repeat the action that caused the shoulder to dislocate. Try to avoid movements that cause pain. Limit heavy lifting and any activity where you have to reach over your head until the shoulder feels better.
• Apply ice, then heat. Putting ice on the shoulder helps reduce inflammation and pain. Use a cold pack, a bag of frozen vegetables, or a bag of ice wrapped in a towel for 15 to 20 minutes at a time. Always put a thin cloth between your skin and ice. Do this every couple of hours for the first day or two.
• Take pain relievers. Medicines such as aspirin, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others) might help relieve pain. Follow label directions and stop taking the drugs when the pain improves.
• Maintain the range of motion of the shoulder. After one or two days, your healthcare professional may have you do some gentle exercises to help maintain the shoulder's range of motion. Being inactive can cause joints to stiffen.

Once the injury heals and the shoulder has good range of motion, keep exercising. Daily shoulder stretches and a shoulder-strengthening and stability program may help prevent another dislocation. Ask your healthcare professional to help you plan an appropriate exercise routine.

Preparing for your appointment

Depending on the severity of the injury, the healthcare professional you see first may recommend that an orthopedic surgeon examine the injury.

What you can do

Be ready with:

• Detailed descriptions of the symptoms and the cause of the injury.
• Information about past medical issues.
• The names and doses of all medicines and dietary supplements you take.
• Questions to ask your healthcare professional.

For a dislocated shoulder, some basic questions may include:

• Is my shoulder dislocated?
• What tests do I need?
• What treatment approach do you recommend? Are there alternatives?
• How long will it take my shoulder to heal?
• Will I have to stop playing sports? For how long?
• How can I protect myself from injuring my shoulder again?

What to expect from your doctor

Be prepared to answer questions, such as:

• How severe is your pain?
• What other symptoms do you have?
• Can you move your arm?
• Is your arm numb or tingling?
• Have you dislocated your shoulder before?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?