A dislocated shoulder cannot safely resolve on its own, and seeking immediate medical attention is absolutely necessary. A shoulder dislocation is a serious, painful injury that occurs when the head of the humerus (upper arm bone) separates completely from the glenoid cavity (the shallow socket of the shoulder blade). This displacement leaves the joint unstable and vulnerable to further harm. Attempting to force the joint back into place without professional help can cause permanent damage to surrounding structures, which is why this injury is considered a medical emergency requiring prompt care.
What Defines a Shoulder Dislocation
The shoulder is a ball-and-socket joint, designed for maximum mobility, making it the most frequently dislocated joint in the human body. This flexibility, however, comes at the expense of inherent stability, as the socket (glenoid) is relatively small compared to the ball (humeral head). Stability relies heavily on surrounding soft tissues, including strong ligaments that connect the bones, the labrum (a rim of cartilage that deepens the socket), and the four muscles of the rotator cuff.
A full dislocation, or luxation, means the joint surfaces are entirely separated and misaligned. This is distinct from a subluxation, which is a partial or incomplete dislocation where the humeral head slips out but spontaneously returns to the socket. Dislocations are typically categorized by the direction of the humeral head’s displacement, with anterior (forward) dislocations being the most common, accounting for up to 97% of all cases.
The Immediate Dangers of Delaying Treatment
Leaving a shoulder dislocated for any period poses severe and progressive risks to arm and shoulder function. One serious acute complication is neurovascular injury, where the displaced humeral head can compress or damage the nearby brachial plexus nerves or the axillary artery and vein. The axillary nerve is frequently at risk, and injury can result in permanent weakness of the deltoid muscle and numbness over the outer part of the shoulder.
The longer the joint remains displaced, the more technically demanding the eventual professional realignment becomes. This difficulty is due to the intense, protective muscle spasms that develop rapidly in the surrounding rotator cuff and shoulder muscles. These spasms clamp the humeral head in its wrong position, requiring deeper sedation or even general anesthesia for a successful closed reduction.
Significant damage to the joint’s soft tissue structures also worsens with time and repeated attempts at movement. Common injuries include a Bankart lesion (a tear of the labrum from the front rim of the glenoid) or a Hill-Sachs lesion (a compression fracture on the back of the humeral head). These injuries can become more severe. In patients over 40 years old, a delay in treatment increases the likelihood of an associated rotator cuff tear.
Urgent Steps and Professional Realignment
The first step after a shoulder dislocation is to immobilize the arm exactly as it is found, using a sling or bandages, and to avoid any attempts to move or “pop” the joint back into place. Applying ice packs to the shoulder helps manage the pain and swelling while awaiting medical transport. It is necessary to go to an emergency room immediately, as a medical professional must assess the injury to prevent complications.
Once in a medical setting, the professional intervention is a procedure called “closed reduction,” which involves manually maneuvering the humeral head back into the glenoid socket without surgery. This manipulation is done under procedural sedation and analgesia to relax the muscles and minimize pain, which is necessary to overcome the severe muscle spasm. Physicians use various controlled maneuvers, such as the Stimson technique (using weight for traction) or the external rotation method (gently rotating the arm to guide the bone back). Successful reduction is often confirmed by a palpable or audible “clunk” and an immediate return of the shoulder’s rounded contour, followed by a post-reduction X-ray to confirm proper placement and check for any fractures.
Post-Reduction Care and Preventing Recurrence
After the shoulder has been successfully reduced, follow-up care involves a period of temporary immobilization, typically using a sling for one to three weeks. This initial period allows the injured soft tissues, such as the ligaments and capsule, to begin the healing process. The physician may order an MRI or CT scan to get a detailed view of the damage, looking for Bankart lesions, glenoid bone loss, or Hill-Sachs lesions, as these affect long-term stability.
Physical therapy is the next mandatory phase, focusing on a structured rehabilitation program to restore the shoulder’s full range of motion, strength, and dynamic stability. This is important because the risk of a repeat dislocation (recurrence) is high, especially in young, active patients treated only with conservative care. When recurrence rates are high or significant bone loss is present, surgical stabilization may be recommended, often involving an arthroscopic Bankart repair to reattach the torn labrum and tighten the joint capsule.