Shoulder Dislocation

ExitCare ImageYour shoulder is made up of three bones: the collar bone (clavicle); the shoulder blade (scapula), which includes the socket (glenoid cavity); and the upper arm bone (humerus). Your shoulder joint is the place where these bones meet. Strong, fibrous tissues hold these bones together (ligaments). Muscles and strong, fibrous tissues that connect the muscles to these bones (tendons) allow your arm to move through this joint. The range of motion of your shoulder joint is more extensive than most of your other joints, and the glenoid cavity is very shallow. That is the reason that your shoulder joint is one of the most unstable joints in your body. It is far more prone to dislocation than your other joints. Shoulder dislocation is when your humerus is forced out of your shoulder joint.

CAUSES

Shoulder dislocation is caused by a forceful impact on your shoulder. This impact usually is from an injury, such as a sports injury or a fall.

SYMPTOMS

Symptoms of shoulder dislocation include:

  • Deformity of your shoulder.

  • Intense pain.

  • Inability to move your shoulder joint.

  • Numbness, weakness, or tingling around your shoulder joint (your neck or down your arm).

  • Bruising or swelling around your shoulder.

DIAGNOSIS

In order to diagnose a dislocated shoulder, your caregiver will perform a physical exam. Your caregiver also may have an X-ray exam done to see if you have any broken bones. Magnetic resonance imaging (MRI) is a procedure that sometimes is done to help your caregiver see any damage to the soft tissues around your shoulder, particularly your rotator cuff tendons. Additionally, your caregiver also may have electromyography done to measure the electrical discharges produced in your muscles if you have signs or symptoms of nerve damage.

TREATMENT

A shoulder dislocation is treated by placing the humerus back in the joint (reduction). Your caregiver does this either manually (closed reduction), by moving your humerus back into the joint through manipulation, or through surgery (open reduction). When your humerus is back in place, severe pain should improve almost immediately.

You also may need to have surgery if you have a weak shoulder joint or ligaments, and you have recurring shoulder dislocations, despite rehabilitation. In rare cases, surgery is necessary if your nerves or blood vessels are damaged during the dislocation.

After your reduction, your arm will be placed in a shoulder immobilizer or sling to keep it from moving. Your caregiver will have you wear your shoulder immoblizer or sling for 3 days to 3 weeks, depending on how serious your dislocation is. When your shoulder immobilizer or sling is removed, your caregiver may prescribe physical therapy to help improve the range of motion in your shoulder joint.

HOME CARE INSTRUCTIONS

The following measures can help to reduce pain and speed up the healing process:

  • Rest your injured joint. Do not move it. Avoid activities similar to the one that caused your injury.

  • Apply ice to your injured joint for the first day or two after your reduction or as directed by your caregiver. Applying ice helps to reduce inflammation and pain.

  • Put ice in a plastic bag.

  • Place a towel between your skin and the bag.

  • Leave the ice on for 15-20 minutes at a time, every 2 hours while you are awake.

  • Exercise your hand by squeezing a soft ball. This helps to eliminate stiffness and swelling in your hand and wrist.

  • Take over-the-counter or prescription medicine for pain or discomfort as told by your caregiver.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your shoulder immobilizer or sling becomes damaged.

  • Your pain becomes worse rather than better.

  • You lose feeling in your arm or hand, or they become white and cold.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.