Shoulder Instability/Dislocation Treatment

The shoulder is a ball and a socket joint and is also the most flexible joint in your body. This means the round top of your arm bone (top of the humerus) fits into the groove in your shoulder blade (the scapula). This joint maintains a wide range of motion, helping you lift your arm, rotate it and reach up over your head. This greater range of motion, however, can cause instability and may result in sudden injury.

Once your shoulder has been dislocated, it is prone to happen again. When the shoulder is loose and slips out of place repeatedly, it is considered as chronic shoulder instability.

When you have a dislocated shoulder, it means the humeral head has slipped out of the shoulder socket. A shoulder subluxation on the other hand, occurs when your shoulder is partially dislocated, where only part of the ball is out of the socket.

Some symptoms of shoulder subluxation include: visibly deformed shoulder, swelling, numbness, arm weakness and immobility of the arm.

Common Symptoms of Chronic Shoulder Instability

• • Pain caused by shoulder injury
  • Repeated shoulder dislocations
  • Repeated instances of the shoulder giving way; sometimes stuck in position
  • A persistent sensation of the shoulder feeling loose, slipping in and out of the joint

Causes of Shoulder Dislocation

• • Sport Injuries
  • Falling on an outstretched arm
  • Repetitive overhead movement
  • Seizures / Shock
  • Stroke
  • Previous dislocation

Shoulder Dislocation Treatment

Non-surgical Treatment For Shoulder Dislocation Include:

• • Closed Reduction:

  This is a non-surgical shoulder dislocation treatment procedure where the doctor typically administers local anaesthesia to reduce discomfort before repositioning your shoulder back to its proper position. Once the shoulder is back in place, there should be immediate pain relief. X-rays are then taken to check if there are other injuries such as fractures and to ensure that the shoulder is back in its proper position.

• • Immobilisation:

  After the shoulder is back in place, it may remain swollen and sore for several days. Doctors would recommend using a sling or brace for 1 – 3 weeks to limit the shoulder’s range of motion. This allows the muscle and soft tissues surrounding your shoulder to rest and recover.

• • Rehabilitation:

  After long periods of immobilisation, the shoulder joint may become stiff, weak and less flexible. Doctors would recommend physical rehabilitation as part of the recovery process. This involves conditioning exercises and stretches that improve the strength of your shoulder joints, minimise stiffness and restore your original range of movement. This will also help to prevent a future shoulder dislocation. The duration of shoulder rehabilitation will depend on the person’s age, medical history and severity of the injury.

Surgical Treatment for Shoulder Dislocation Includes:

• • Shoulder Arthroscopic Surgery:

  This is a common surgical shoulder treatment used to inspect, diagnose and treat injuries inside a joint. During a shoulder arthroscopy, the doctor will make a small insertion and insert a small camera into your shoulder joint. Images will be projected on a high resolution monitor screen. These images will then be used to guide the doctor when he performs minimally-invasive surgery on the shoulder.

  • Shoulder Joint Replacement:

• A doctor may perform a shoulder replacement surgery when shoulder dislocations are caused by severe rotator cuff tears  associated with fractures and/or osteoarthritis. Most of the time, doctors only perform this surgical treatment when other forms of therapy and non-surgical treatments have failed. An orthopaedic surgeon will replace your shoulder ball and socket with an artificial prosthesis. After the surgery, physical therapy will be needed to boost your recovery.

How to Prepare for Shoulder Dislocation Treatment

Your Doctor May Ask:

• • How did you dislocate your shoulder?
  • How severe is the pain?
  • Can you move your arm?
  • Have you dislocated your shoulder before?
  • Do you have any numbness?
  • Do you have any pre-existing medical conditions?

Prior to initiating shoulder dislocation treatments, Dr Siow will conduct a thorough medical history and physical examination. Where indicated, additional information will be obtained through X-ray images or MRI. Patients with multidirectional instability or loose joints may be placed in an arm sling and advised to get plenty of rest. They are also advised to try rehabilitation exercises to speed up the recovery process.

Treatment for shoulder dislocation & instability is based on a variety of factors including the severity of the condition, the patient’s age, activity level, occupation and natural degree of looseness in the joint. It is recommended to seek Dr Siow’s advice to provide appropriate treatment and rehabilitation program for you.