Dislocated Shoulder (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Shoulder dislocation facts
- What is dislocation of the shoulder? What causes a shoulder dislocation?
- What are the symptoms and signs of a dislocated shoulder?
- How do physicians diagnose dislocated shoulders?
- What is the treatment for a dislocated shoulder?
- What happens after reduction of a shoulder dislocation?
- What is appropriate follow-up following a shoulder dislocation?
- What are potential complications of a shoulder dislocation?
- Find a local Orthopedic Surgeon in your town
What happens after reduction of a shoulder dislocation?
Once the shoulder has been reduced, the health-care professional will want to reexamine the arm and make certain that no nerve or artery damage occurred during the reduction procedure. Often, the clinician will take another X-ray to reassess the bones.
Significant damage occurs to the joint with a shoulder dislocation. The labrum and joint capsule have to tear, and there may be associated injuries to the rotator cuff. These are the structures that lend stability to the shoulder joint, and since they are injured, the shoulder is at great risk to dislocate again.
A sling or shoulder immobilizer may be used as a reminder not to use the arm and allow the muscles that surround the joint to relax and not have to support the bones against gravity.
For a patient who sustains their first shoulder dislocation, the clinician will often immobilize the shoulder in mild external rotation, meaning that the arm is placed in a special sling that supports the arm away from the body.
The physician may place repeated dislocations in a regular sling or immobilizer for comfort and support.
The length of time a sling is worn depends upon the individual patient. A balance must be reached between immobilizing the shoulder to prevent recurrent dislocation and losing range of motion if the shoulder has been kept still for too long.
Once a clinician reduces a shoulder dislocation, much of the pain is resolved. Physicians may recommend ibuprofen (Advil) as an anti-inflammatory medication and prescribe narcotic pain medications like codeine or hydrocodone for the short term.
Ice is an important component of pain control, helping to decrease the swelling associated with the injury.
Special situations/recurrent dislocations
In certain situations, it's possible to reduce dislocations immediately. This is especially true in the sports medicine arena, where a health-care professional may reduce the dislocation on the field of play. This is a reasonable treatment alternative because the care provider was able to see the injury occur, examine the patient and come to the diagnosis, and then reduce the injury before muscles spasm sets in.
Many patients experience shoulder subluxation or partial dislocation. These are patients who have had previous dislocations and are aware that their shoulder has dislocated again and then spontaneously reduced. They may choose not to seek urgent or emergent care, but this situation should not be ignored. Once a shoulder dislocates, it becomes unstable and more prone to future dislocation and injury.
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