Shoulder dislocation (patient information)
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Overview
A dislocated shoulder is an injury when your upper arm bone pops out of the socket attached to your shoulder blade. This is not to be confused with a separated shoulder where the ligaments are damaged in the area that connects your upper arm with your shoulder.
What are the symptoms of Shoulder dislocation?
Symptoms of a dislocated shoulder include:
- A deformed or out of place shoulder
- Inability to move the joint
- Intense pain at the shoulder
- Swelling or discoloration at the site
Other symptoms can include numbness, weakness and/or tingling at the joint. This can also be felt in the neck and the arm. Pain can be increased because of muscle spasms due to the displacement.
What causes Shoulder dislocation?
The shoulder is the easiest to dislocate because of its ability to move in many directions. It can be dislocated forward, backward, downward, completely or partially. The usual cause for dislocation is a strong force to the shoulder that pulls the bone out of the socket. Extreme rotation of the shoulder joint can pop the bone out of place. Other common reasons include:
- Falling: Falling from a ladder or rung and trying to break your fall with your hand can cause dislocation.
- Sports injuries: Contact sports, like football and hockey, are more likely to have shoulder dislocations, but sports that include falling, like gymnastics or volleyball, also have a chance for shoulder dislocation.
- Trauma: A blow to the shoulder from getting hit or falling down from a motorcycle accident is a common source of shoulder dislocation.
Who is at highest risk?
- Males: Men are at a higher risk than females.
- Previous shoulder dislocation: If you have had a shoulder dislocation you are more likely to get another one.
- Teens or 20s: People in this age group are usually more physically active, which can increase risk for injury.
Diagnosis
Other than a doctor examining your shoulder, there are tests that your doctor may want:
- MRI: MRI stands for Magnetic Resonance Imaging and it uses a magnetic field to make images of your body. Doctors can look at the tissue around the joint to look for damage.
- X-ray: This uses x-rays to examine your shoulder and look for dislocation, broken bones and damage to the shoulder joint.
- EMG: EMG stands for Electromyography. The test measures the electical discharges that your muscles give off. The data helps doctors evaluate the nerve damage from should dislocations
When to seek urgent medical care?
If you have the symptoms and believe that you have a dislocated shoulder get medical attention as soon as possible.
Treatment options
Treatments include:
- Closed reduction: Your doctor may try gentle pushes to move your bones back into place. You may have to take a muscle relaxant to help with the maneuvering of your bones. The pain should get better immediately.
- Surgery: Surgery may be required if you have a weak shoulder joint or ligaments or if your nerves or blood vessels are damaged because of the dislocation.
- Immobilization: Your doctor may put your shoulder in a sling or splint from a few days to three weeks. The time depends on the state of dislocation and how soon after the dislocation was the splint applied.
- Medication: Your doctor may prescribe pain relievers or muscle relaxants when your shoulder is healing.
- Rehabilitation: After the splint or sling is removed, a rehabilitation program will be used to restore motion and strength.
Lifestyle remedies can be used after treatment to help healing. Examples include:
- Resting your shoulder: Avoiding painful movements and limiting the amount of heavy lifting or overhead activity helps it heal until your shoulder starts feeling better.
- Apply ice and heat: Ice on the shoulder can reduce inflammation and pain for 15 to 20 minutes at a time for the first two days. Using heat packs two to three days later can relax sore muscles. This should also be applied to 20 minutes per time.
- Pain relievers: Over-the-counter medications like Advil, Motrin, Aleve and Tylenol can help relieve pain. Make sure to read the labels on the drugs and stop taking it when the pain gets better.
After the injury heals continue to exercise your shoulder to restore strength and reduce the recurrence of dislocation. Talk to your doctor or physical therapist for help on an exercise routine.
Where to find medical care for Shoulder dislocation?
Directions to Hospitals Treating Shoulder dislocation
Prevention
Some tips to reduce the probability of getting a shoulder dislocation or a repeat dislocation. Some tips:
- If you feel shoulder pain during physical activity, stop immediately and rest.
- Stretching your shoulder before exercising.
- If you have had a dislocation before, ice your shoulder after physical activity.
- Protective gear can help you protect yourself from falls.
What to expect (Outlook/Prognosis)?
The prognosis depends on the how bad your shoulder injury is, your age and your athletic activity. If you are a teenager and play contact sports your risk for a shoulder dislocation may increase to be as high as 90% for a second shoulder dislocation. If it keeps happening it can be unstable enough to warrant surgery. Surgery can restore stability and reduce risk to 5% or less. Adults in their 30s on the other hand, have a low risk of a second dislocation around 25% of the time and the risk is even less for older people.
Possible complications
Complications for a shoulder dislocation include:
- Muscles, ligaments and tendons around the shoulder joint can be teared.
- Nerves or blood vessel can be damaged.
- Re-injury if you had severe or repeated dislocations.
If any of these complications occur, surgery may be needed to repair the damage.
Sources
http://www.mayoclinic.com/health/dislocated-shoulder/DS00597
http://www.webmd.com/fitness-exercise/dislocated-separated-shoulder
http://www.medicinenet.com/dislocated_shoulder/article.htm
http://www.sparkpeople.com/resource/health_a-z_detail.asp?AZ=424