Shoulder Pain Dislocation and Separation
June 02, 2017
Submitted by McLean County Orthopedics
Shoulder pain is very common and occurs in men, women, and children of all ages. Pain may be felt in one small spot, in a larger area, or down the arm. It may come on suddenly as the result of a fall or injury, or it may be a gradual progression that gets worse over time.
Shoulder pain can impact almost every aspect of daily life, such as moving and raising your arms to brush your teeth, putting on a seatbelt, or getting dressed can cause excruciating pain.
There are many different types of shoulder problems, including sprains, strains, dislocations, separations, tendinitis, bursitis, torn rotator cuffs, frozen shoulder, fractures, and arthritis. The symptoms and treatment will vary widely, depending on the specific problem. Let’s first talk about dislocations and separations.
The shoulder joint is the most frequently dislocated major joint of the body. Dislocation occurs when a strong force causes the ball at the top of the bone in the upper arm to pop out of the socket. Dislocation commonly occurs when there is a backward pull on the arm that either catches the muscles unprepared to resist or overwhelms the muscles. When a shoulder dislocates frequently, the condition is referred to as shoulder instability. A previously dislocated shoulder may remain more susceptible to re-injury, especially in young, active individuals. Ligaments may have been stretched or torn, and the shoulder may tend to dislocate again.
- Symptoms. The shoulder can dislocate either forward, backward, or downward. When the shoulder dislocates, the arm appears out of position. Other symptoms include pain, which may be worsened by muscle spasms, swelling, numbness, weakness, and bruising. Problems seen with a dislocated shoulder are tearing of the ligaments or tendons reinforcing the joint capsule and, less commonly, bone or nerve damage.
- Diagnosis. Doctors are usually able to diagnose a dislocation by a physical examination; however, x-rays may be taken to confirm the diagnosis and to rule out a related fracture.
- Treatment. Doctors treat a dislocation by putting the ball of the humerus back into the joint socket. The arm is then stabilized for several weeks in a sling or other device. Rest and ice several times a day are usually recommended. After pain and swelling have been controlled, it’s important to begin a rehabilitation program that includes exercises. The goal is to restore the range of motion of the shoulder, strengthen the muscles, and prevent future dislocations.
A shoulder that dislocates severely or often, injuring surrounding tissues or nerves, usually requires surgical repair to tighten stretched ligaments or reattach torn ones. This is most often done through a tiny incision into which a small scope (arthroscope) is inserted to observe the inside of the joint. After this procedure, called arthroscopic surgery, the shoulder is generally stabilized for about six weeks. Full recovery takes several months.
A shoulder separation occurs when the ligaments between the collarbone and the shoulder blade are torn. The injury is most often caused by a blow to the shoulder or by falling on an outstretched hand.
- Symptoms. Shoulder pain or tenderness and, occasionally, a bump in the middle of the top of the shoulder are signs that a separation may have occurred.
- Diagnosis. Doctors may diagnose a separation by performing a physical examination. They may confirm the diagnosis and determine the severity of the separation by taking an x-ray. While the x-ray is being taken, the patient makes the separation more pronounced by holding a light weight that pulls on the muscles.
- Treatment. A shoulder separation is usually treated conservatively by rest, ice, and wearing a sling. After a period of rest, a physical therapist will work to develop exercises to regain range of motion. Most shoulder separations heal within two or three months without further intervention. However, if ligaments are severely torn, surgical repair may be required to hold the clavicle in place.
Shoulder problems are a growing concern for the aging population, athletes, and laborers. Using the shoulder too much can cause the soft tissue to break down faster as people get older. Doing manual labor and playing sports may also cause shoulder problems.
Next month’s article will discuss rotator cuff disease. If you missed the previous article about shoulder pain, you may read it online at HealthyCellsBN.com or call 309-664-2524.
For more information on any orthopedic problem, call 309-663-6461 to schedule an appointment with the board-certified physicians at McLean County Orthopedics or visit their website at www.mcleancountyorthopedics.com. Their new office is located at 1111 Trinity Lane in Bloomington.
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