Shoulder dislocation

If you are experiencing agonising pain in your shoulder after a fall, you may have suffered a shoulder dislocation and should seek medical attention straight away through the nearest A&E department. The large ‘ball-and-socket’ joint inside the shoulder is one of the easiest to dislocate, as it is one of the most mobile in the body and is therefore prone to instability. A&E staff will likely reduce the pain you are experiencing through medication, which can make you feel more relaxed, or even drowsy.

Should you have suffered a previous shoulder dislocation and are now struggling with stiffness, pain or a lack of mobility, the Circle Health team will be able to quickly diagnose the cause(s) and provide you with prompt treatment to help alleviate your pain. Generally, shoulder instability problems are more common in young people.

A shoulder dislocation occurs when the bone in your upper arm (the ‘humerus’) pops out of its socket (known as the ‘glenoid’) due to a strong, sudden blow. You will most likely be able to spot this for a number of reasons:

  • You won’t be able to move the affected arm,
  • Your shoulder will look square rather than round,
  • A lump may appear at the front of your shoulder under the skin,
  • You may notice swelling and/or bruising begin to appear,
  • You will be in pain and discomfort.

Shoulder dislocations are usually caused by:

  • A sports-related impact, such as being tackled in a contact sport,
  • A heavy fall onto your shoulder or with your arm outstretched,
  • A trauma or direct impact to your shoulder, such as from a car accident.

Occasionally, a shoulder dislocation can occur for other reasons, such as having a shallow glenoid, hypermobility syndrome (an inherited condition affecting connective tissue and increasing the range of joint movement), and other shoulder issues such as a labral tears and previous fractures.

The first step for an orthopaedic consultant after a brief physical exam will be to take an X-ray to confirm the dislocation and check whether or not you have fractured any bones. If no fractures are detected, your doctor will use a technique known as ‘reduction’ to manoeuvre the arm back into its socket.

Pain medication and sedatives are often offered during this process, depending on your level of pain and swelling. Within a few minutes, your doctor should be able to realign your shoulder bones into the correct positions by rotating your arm around the shoulder joint. Once this is done, you should feel some instant pain relief.

If a fracture or other concerns have been raised from your x-ray, your consultant may propose other diagnostic scans. This could include a CT scan to highlight any fractures not picked up on the x-ray, an ultrasound scan to assess the health of the tendons in your rotator cuff, or an MR arthrogram (a form of MRI scan using a dye injected into the shoulder) to look at the condition of your labrum (the rim of cartilage that acts as a ‘cushion’ around the ball-and-socket joint).

Usually you will have another X-ray once the shoulder is back in place to double check the positioning.

If complications have arisen due to your shoulder dislocation, such as a torn ligament or tendon, you may require surgery to repair these tissues. This is carried out under general anaesthetic, and our highly trained anaesthetists will be monitoring you closely throughout the procedure.

Keyhole surgery is the most common approach, where your surgeon will make a small incision at the front of your shoulder and insert an arthroscope to provide a clear view of the joint. An arthroscope is a small, flexible tube about the length and width of a drinking straw, containing a light and camera that sends a video feed to a screen or directly to your surgeon’s eyepiece. At this point, any fractures can be repaired and tears to the tendons or labrum can be stitched together.

In some instances, open surgery may be needed if your shoulder bones are to be moved around to prevent further dislocations, and our expert orthopaedic surgeons will discuss this with you in detail so you are absolutely clear on what is to happen.

Whether or not you’ve had surgery, your doctor will likely provide you with a splint or sling to prevent your shoulder from moving while you recover, and you may be prescribed pain medication and muscle relaxants to ease any discomfort you may experience.

Once your splint or sling is no longer needed, our physiotherapy team will work closely with you, introducing you to a dedicated rehabilitation program designed to gradually restore strength and functionality to your shoulder. This may take several months in order to get the best possible results, ensuring you make a full recovery.

If you are concerned that you may have a shoulder dislocation, or you are struggling to fully rehabilitate from a previous dislocation, speak to our team today to book an appointment. With no waiting lists, Circle Health is able to offer appointments at short notice with some of the leading orthopaedic consultants and surgeons in the country, helping you make a prompt, full recovery. Thanks to our state-of-the-art diagnostic equipment and unrivalled surgical expertise, you can rest assured that your shoulder pain will be treated by the very best.

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Circle Health Group, 1st Floor, 30 Cannon Street, London, EC4M 6XH