Once the shoulder joint is reduced patient feels immediate relief. You will be ordered an x-ray before and after reduction to confirm the diagnosis as well as to evaluate associated injuries like fractures.
When the shoulder dislocates more than 2-3 times, we call it recurrent dislocation which warrants further evaluation with higher imaging like MRI and CT scans (can be done after 1st dislocation also). These usually show labral lesion called as Bankart lesion which has not healed or has healed in an abnormal position. Sometimes bone loss may be apparent which makes the shoulder more vulnerable to re-dislocation.
If you are an athlete or workout enthusiast or involve in activities that need extreme motion of your shoulder then you should learn appropriate techniques to achieve muscle balance and strength in your shoulder. A professional trainer might be able to help to achieve it in a better way. Once one has had a dislocated shoulder, rest to the shoulder is essential to allow adequate healing. You should undergo a shoulder range of motion and strengthening exercises recommended by your doctor or physical therapist to get back to pre-injury status and prevent re-dislocation. Elderly people should use stick or support while walking to avoid fall and injury to the shoulder.
Acute shoulder dislocation and conservative treatment:
- Closed reduction of the shoulder joint: When a patient attends the emergency room with dislocated shoulder it is imperative to reduce it back to the normal location after initial evaluation.
- Rest and shoulder immobilization: Following which shoulder is immobilized in arm pouch or shoulder immobilizer. Sling is generally given for 4-6weeks.
- Ice fomentation: it helps reducing swelling and pain
- Physical therapy: Shoulder exercises started after 2wks once the swelling and pain have subsided. It is important as muscle wasting starts after 3weeks. This remains the mainstay of conservative treatment. Our aim is to archive adequate muscle strength and balance to prevent dislocation.
- Medicines: your doctor may prescribe pain killer and anti-inflammatory drugs to control pain and swelling for short period.
- Lifestyle modification: certain professions which involve repetitive movement of the shoulder, excess external rotation activity (carpenters) are prone to re-dislocations should change their profession if they want to avoid surgery. The activities that provoke dislocation like abduction and external rotation should be avoided. Essential things should be kept at a reachable distance to avoid over-stretching of the arm to get it.