A shoulder dislocation happens when the ball of the upper arm bone comes out of its socket in the shoulder blade. This page explains the symptoms, the right first aid and when to see a doctor.
Note: If the hand feels numb or cold, looks pale or blue, or the shoulder is badly deformed, go to emergency care straight away.
Symptoms
These signs can follow a shoulder injury, and they need an in-person examination to explain:
- Sudden, severe shoulder pain
- A change in the shape of the shoulder or an unusual bump
- Being unable to move the arm
- A feeling that the arm hangs loose or the shoulder has slipped out
- Swelling and bruising around the shoulder
- Numbness or tingling in the arm or hand
- Muscle spasm around the shoulder
What causes a shoulder dislocation
A dislocation usually follows a force that pushes the ball out of the socket. Common causes include:
- Falling on an outstretched arm or onto the shoulder
- A hard tackle in contact sports
- Road accidents or falls from a height
- Forceful overhead arm movements
- Naturally loose ligaments, which can make dislocation easier
Diagnosis
The doctor asks how the injury happened, then checks the shoulder, the nerves and the blood supply to the arm. An X-ray confirms the dislocation and looks for any broken bone.
An MRI may be requested to look at the ligaments, the cartilage around the socket and the tendons. Your own condition can only be assessed through an in-person examination.
Treatment options
Non-surgical treatment
Putting the shoulder back in place should be done by a trained professional in a suitable medical setting. Afterwards the arm is usually rested in a sling for a period set by the doctor, followed by physiotherapy to restore movement and strength.
First aid while you get to a doctor:
- Do not try to put the shoulder back yourself, and do not let anyone untrained try.
- Support the arm in the most comfortable position close to the body, using a pillow, a sling or a cloth.
- Apply a cold pack wrapped in a cloth for short periods.
- Do not move, lift or stretch the shoulder.
- Go for a medical assessment as soon as possible.
Surgical treatment
Not every dislocation needs surgery. Surgery may be considered if the shoulder keeps dislocating, if ligaments, cartilage or bone are damaged, or for some athletes. Dr. Emeel Hourani treats dislocation and stabilises the shoulder arthroscopically when needed, through small incisions.
Recovery and rehabilitation
Recovery time varies from person to person and is set by the surgeon after assessment. Following your rehabilitation plan can lower the risk of another dislocation.
- Protecting the shoulder in a sling as advised
- Controlling pain and swelling
- Gradually restoring movement
- Strengthening the shoulder and surrounding muscles
- A gradual return to daily activity and sport with the surgeon's approval
When to see the doctor
Seek urgent care straight away in the situations below, and see a doctor after any dislocation:
- Numbness or loss of feeling in the arm or hand
- A pale, cold or blue hand
- Severe deformity of the shoulder
- Unbearable pain or being unable to move the fingers
- An open wound or a serious accompanying injury
- The shoulder slipping out more than once, see recurrent dislocation