Medicines for Dislocated shoulder

What it is

A dislocated shoulder is when the top of the upper arm bone (the ball) pops out of the shoulder socket. The shoulder is the body’s most mobile joint, which also makes it the most commonly dislocated. It usually happens from a fall onto the arm or shoulder, a sports injury, or a blow, and most often the arm bone dislocates forwards (an anterior dislocation). The symptoms are usually obvious and can include: severe, sudden pain in the shoulder; the shoulder looking clearly out of shape or "square" rather than rounded; being unable to move the arm, and holding it still; swelling or bruising; and sometimes numbness, tingling, or weakness in the arm or hand (if nearby nerves are affected). A dislocated shoulder is a medical emergency in the sense that it needs prompt assessment and treatment to put the joint back into place (relocation), which should be done by a health professional; you should not try to force it back yourself, as this can cause further damage. After assessment (usually including an X-ray to confirm the dislocation and check for any associated fracture), the shoulder is relocated, often under pain relief or sedation, and then the arm is usually supported in a sling for a period to allow the injured tissues to settle, followed by physiotherapy and exercises to restore movement and strength. A dislocation can sometimes damage the surrounding structures (such as ligaments, the joint lining, or occasionally nerves or the bone), and, particularly in younger people and after a first dislocation, the shoulder can become prone to dislocating again (recurrent dislocation), as the supporting structures may be stretched or damaged. Rehabilitation helps recovery and stability, and for recurrent dislocations, further treatment (including surgery) may be considered. The key messages are to get a dislocated shoulder relocated promptly by a professional (not to force it yourself), to follow rehabilitation, and to be aware it can recur.

How it is treated

A dislocated shoulder needs prompt professional assessment and relocation, followed by rehabilitation, and it is important not to try to force the joint back yourself. If a shoulder is dislocated — severe pain, the shoulder looking out of shape, and inability to move the arm after an injury — urgent medical help is needed (at an urgent care or A&E setting; call emergency services if there is severe pain, the arm is numb or cold, or the person cannot get to hospital). Do not try to push the shoulder back into place yourself, as this risks damaging blood vessels, nerves, or the joint. In hospital, the shoulder is examined, the arm and hand checked for any nerve or circulation involvement, and usually an X-ray is done to confirm the dislocation and check for any associated fracture. The shoulder is then relocated (put back into the socket) by a trained professional, usually with pain relief or sedation to relax the muscles, and a further X-ray may confirm it is back in place. After relocation, the arm is usually supported in a sling for a period to rest the injured tissues, with pain relief, followed by rehabilitation — physiotherapy and exercises to gradually restore movement, strength, and stability, and a graded return to activity, avoiding positions that risk re-dislocation early on. Because a dislocation can stretch or damage the structures that stabilise the shoulder, the shoulder can become prone to dislocating again, particularly in younger, active people and after a first dislocation; rehabilitation helps reduce this, but for recurrent dislocations, or where there is significant associated damage, further assessment and treatment — including, in some cases, surgery to repair or tighten the stabilising structures — may be recommended. Following the rehabilitation programme and any advice on avoiding certain movements early on supports recovery and stability. It is important to seek prompt attention if, after the injury or relocation, there is numbness, tingling, weakness, or coldness in the arm or hand, or the shoulder dislocates again. The reassuring messages are that a dislocated shoulder is usually treated effectively by prompt relocation and rehabilitation, and that most people recover good function — while the shoulder can be prone to recurrence, particularly in younger people, in which case further treatment may help.