Shoulder dislocation: Causes, Symptoms, Treatment and Cost

The upper arm bone coming out of its socket in the shoulder is known as a shoulder dislocation. Humerus (upper arm bone), scapula (shoulder blade), and clavicle are the three bones that make up the shoulder joint (collarbone). When shoulder dislocation happens, one or more of these bones in the shoulder moves out of alignment and can cause pain, swelling, and limited movement.

The three major types of shoulder dislocation are anterior, posterior and inversion.

• Anterior Shoulder Dislocation: This is the most common type of shoulder dislocation, where a fracture of the glenoid (shoulder socket) or humeral head (upper arm bone) has allowed it to slip out of place in an anterior direction. This type of dislocation is usually caused by extreme force or direct trauma to the shoulder joint.
• Posterior Shoulder Dislocation: This type occurs when a person experiences an extreme injury such as a fall on their shoulder that results in a dislocated joint with their arm twisted 80 degrees backwards from its normal position.
• Inversion Shoulder Dislocation: This occurs when you attempt to stand up immediately too quickly after taking part in an activity such as weight lifting; sports such as tennis or volleyball; or waking up suddenly out of sleep without performing any warm up routine beforehand.

• The most common cause of shoulder dislocation is a sudden, forceful impact to the shoulder joint. This can be caused by a fall, direct contact during sports or other activities, or a motor vehicle accident.
• Other causes include medical conditions such as bone disease and muscle weakness that can limit the joint's stability and make it more prone to dislocations.
• Additionally, repeated arm motions over time may weaken the muscles responsible for moving and supporting the shoulder, resulting in an increased risk of dislocations.

• Intense shoulder discomfort that came up suddenly.
• A hand or arm that is weak or numb.
• Visible shoulder malformation
• The joint in the shoulder is immobile.
• Swelling and bruising around the joint.

• Strengthen shoulder muscles to stabilise the joint.
• Increase flexibility through stretching & mobility exercises.
• Wear protective equipment during contact or high risk activities.
• Avoid trauma or falls on outstretched arms.
• Avoid repetitive overhead arm motions that can weaken muscles.

• Physical exam:A physical examination of a shoulder dislocation usually includes inspecting the shoulder in both an extended and flexed position, to assess the movement and degree of displacement. The doctor may also test for tenderness, swelling, nerve impingement, and strength.
• X-rays:X-rays are an invaluable tool for diagnosing shoulder dislocations. By using X-rays, orthopedists can view the alignment of bones, joints, and other structures to identify broken bones or avulsion fractures.
• CT scans:A type of imaging called a CT scan (also known as a CAT scan) creates fine-grained cross-sectional pictures of the body using x-rays. They are often used to evaluate shoulder dislocation, helping doctors diagnose bone
• fractures, tears in muscles and ligaments, and any other signs of injury.
• MRI:MRI of the shoulder is an imaging test that can provide detailed pictures of the soft tissues, bones and ligaments of the shoulder joint. It allows for diagnosis, evaluation and assessment of a wide range of shoulder conditions including dislocations, rotator cuff tears, arthritis, labral tears and bursitis.

• Loss of shoulder movement:Shoulder dislocations can cause a loss of range of motion due to surrounding muscles and ligaments damages.
• Nerve damage:Dislocation may damage the nerves, including axillary nerve and brachial plexus, resulting in temporary or permanent weakness, numbness in the arm or hand.
• Instability:The shoulder joint can be less stable after dislocation, either from recurrent dislocation or from stretched ligaments and weakened structures.
• Arthritis:Long-term instability caused by shoulder dislocation may lead to arthritis in the affected joint over time.

• Massage the shoulder with warm sesame oil or mahanarayan oil.
• Apply a warm compress to the shoulder by either dipping a towel in hot water and squeezing out excess water or wrapping a hot water bottle in a cloth and pressing against the affected area.
• Practice Anulom Vilom Pranayama to improve circulation and reduce pain in the shoulder joint.
• Prepare a decoction by boiling 50mg of ashwagandha root powder with one litre of water till it reduces to half its volume, strain it and have this decoction twice daily for relief from acute pain in the joint.
• Wrap the arm tied around the chest using soft bandages for support during exercises such as Yoga and Pranayamas which increase flexibility around shoulders.

• Foods to eat in the event of a shoulder dislocation should be limited to those that are soft and easy to chew, such as mashed potatoes, yoghurt, oatmeal, applesauce, scrambled eggs, soups, and shakes.
• Choose liquids that provide electrolytes and carbohydrates such as sports drinks and protein shakes like Ensure or Glucerna.
• If you have dietary restrictions or preferences, talk to your doctor about what foods might be safest for you to consume while recovering from a shoulder dislocation.

• Avoid anything with salt:Salt can increase swelling, putting more pressure on the shoulder joint and worsening pain.
• Skip High-Fat Items:High-fat items can stop blood flow to the area and slow down healing.
• Don’t Consume Too Much Protein:Eating large amounts of protein can interfere with building collagen, slowing down the healing process of the joint.
• Avoid Alcohol and Nicotine Products:Both alcohol and nicotine products can decrease blood flow to the area, leading to slower healing speeds or even complications in some cases.
• Say No To Spicy Meals and Food:Spicy meals will worsen inflammation in the affected area, increasing discomfort and preventing recovery.

• Closed reduction:This technique involves a physician manipulating the joint to relocate the bones back into its correct position. It is usually done under anaesthetics and sedatives.
• Physical therapy:After a shoulder dislocation, physical therapy is an efficient technique to regain shoulder strength, range of motion, and proprioception.Physical therapy aims to reduce pain, swelling, and stiffness as well as improve joint mobility, muscle strength, and coordination.
• Immobilisation:Shoulder dislocations are treated by immobilising the joint with a sling or other form of support to keep it in place. This allows the joint to heal and helps prevent further injury, as well as providing support and pain relief.
• Keyhole surgery:This procedure involves making a small incision in the shoulder and relocating the bones in place with the help of small instruments. It is typically done under anaesthetics or sedatives and has fewer recovery time than traditional open surgery.
• Open reduction:This technique requires a larger incision in order to manipulate the joint to put it back into place. Anaesthetics or sedatives may be used, and physical therapy will be needed for recovery afterwards.

For a shoulder dislocation diagnosis and treatment, it is best to speak with a doctor or orthopaedic surgeon.

• Non-steroidal anti-inflammatory drugs (NSAIDs):They include drugs that lessen joint discomfort and inflammation, such ibuprofen or naproxen.
• Muscle relaxants:These are medications that help to decrease the spasms and pain associated with a dislocation. Examples include cyclobenzaprine, carisoprodol, and dantrolene sodium.
• Corticosteroids:Steroids can help to reduce inflammation in the joint caused by a dislocated shoulder, allowing for more comfortable movement. Common steroids used to treat shoulder dislocations like betamethasone, methylprednisolone, and prednisone.
• Opioid analgesics:Opioids can be used when other treatments fail to relieve pain from a dislocation or if severe pain is present after several weeks of treatment with other medications. Examples include oxycodone and hydrocodone.

The length of time needed to recover from a shoulder dislocation depends on how bad the injury was and how it was treated.Generally, a full recovery can take anywhere from 2-8 weeks.

No. Treatment for shoulder dislocation helps to reduce pain and restore function of the shoulder joint, but it does not provide a permanent solution since the dislocations can recur over time.

• After undergoing surgery for a shoulder dislocation, the patient should follow their doctor's instructions closely to ensure a successful recovery and reduce the risk of future episodes of instability.
• Physical therapy exercises are necessary to help improve shoulder joint functions and mobility should be started as soon as possible after the injury has begun to heal (at least 6 weeks post-surgery).
• Adequate rest is essential for healing, and activities that involve overhead movements should be avoided when feasible.
• Anti-inflammatory medications can help reduce pain and soreness during recovery and stretching exercises can also help reduce stiffness in the affected joint.
• Refraining from further physical trauma to the area is recommended until muscular strength has returned; strenuous exercise can further damage weakened ligaments leading to chronic instability of the shoulder joint if not adequately rehabilitated following a dislocation.

The cost of shoulder dislocation treatment in India is determined based on the severity, type of hospital, surgeon’s experience, the diagnostic tests and medications involved. Generally, the cost of basic conservative treatment for shoulder dislocation can range from Rs 2,000 to Rs 10,000. For more complex surgeries or interventions such as partial joint replacement or open reduction surgery costs can range from Rs 25,000 to up to Rs 2 lakh and above.

• Pain:Treatment can lead to temporary pain and discomfort in the joint, especially during movement.
• Joint Stiffness:Shoulder dislocation can cause a decrease in range of motion due to the stiffening of surrounding soft tissues.
• Nerve Damage:Treatments like open reduction can cause damage to nearby nerves, leading to numbness or tingling sensation in the arm or shoulder area.
• Infection:Risk of infection increases with invasive treatments like open reduction and arthroscopy as these techniques make an incision on the skin surface to access the joint for treatment.
• Joint Instability:Open reduction and other surgical treatments can weaken the ligaments surrounding the shoulder joint, which may reduce its stability and increase future risk of dislocation or subluxation episodes.

You should seek immediate medical attention if you experience any shoulder dislocation-related issues since they can lead to 'loss of shoulder mobility, nerve damage, and arthritis,' the severity of which will determine how long it will take to repair.