A broken shoulder, or shoulder fracture, occurs when one of the bones forming the shoulder joint sustains a break. These bones include the clavicle (collarbone), the scapula (shoulder blade), or the humerus (upper arm bone). Such an injury can cause considerable pain and restrict movement, making professional medical attention a necessary step for proper healing and to prevent complications.
Immediate Care and When to Seek Help
If a broken shoulder is suspected, immediate actions can help manage the injury. Immobilizing the affected arm is a primary step, by holding it close to the body or using a sling if available. Applying an ice pack to the injured area for 15 to 20 minutes can help reduce swelling and pain. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, may be used if the pain is tolerable.
Certain signs indicate the need for immediate medical attention. These include severe or sudden pain, especially following a fall or injury, and visible deformity or significant swelling around the shoulder. An inability to move the arm, numbness or tingling in the arm or hand, or a grinding sensation when attempting to move the shoulder also require urgent evaluation. If there is an obvious bone protrusion or severe bleeding, emergency medical care is necessary.
Medical Diagnosis and Treatment Paths
Diagnosing a broken shoulder begins with a physical examination by a healthcare provider, who will ask about the injury and symptoms. Imaging tests are ordered to determine the fracture’s exact location and severity. X-rays are the initial imaging test, providing general views of bone structures and helping to detect damage. For more detailed views, a CT scan may be used, which combines multiple X-ray images to create cross-sectional views of the shoulder’s structures. An MRI scan offers detailed images of both bone and soft tissues, making it useful for detecting issues like rotator cuff tears or labral damage that might accompany a fracture.
Treatment approaches for a broken shoulder vary depending on the fracture type and its displacement. Non-surgical treatment is recommended for stable fractures or those with minimal displacement, where the bone fragments remain in relatively correct alignment. This approach involves immobilizing the arm with a sling for a period of two to six weeks, depending on the specific bone fractured and the severity. Pain management is addressed with either over-the-counter medications like acetaminophen or prescription pain relievers for more severe discomfort. Rest is also an important component, helping to control inflammation and promote healing.
Surgical intervention may be necessary for more complex cases, such as severely displaced fractures where bone fragments are significantly out of alignment, open fractures where the bone breaks through the skin, or fractures involving joint surfaces. One common surgical procedure is open reduction and internal fixation (ORIF). During ORIF, the surgeon makes an incision to access the broken bone, manually realigns the fragments (open reduction), and then secures them in place using internal fixation devices like plates, screws, pins, or rods. These implants remain in the bone to stabilize it while it heals, though they may be removed later if they cause irritation.
Navigating Recovery and Rehabilitation
The recovery timeline for a broken shoulder varies widely, influenced by the fracture’s severity, the specific bone involved, and whether surgical or non-surgical treatment was performed. Complete recovery can take anywhere from three months to a year, with significant functional improvement seen within six to nine months post-injury. Initially, immobilization with a sling or brace is common, lasting between two to six weeks, to support the shoulder and allow initial healing.
Physical therapy plays an important role in restoring strength, flexibility, and range of motion to the injured shoulder. Gentle movements, such as pendulum exercises, may begin as early as one to two weeks after the injury or initial immobilization to prevent stiffness in adjacent joints. As healing progresses, active range of motion exercises are introduced, allowing gradual use of the shoulder muscles. Strengthening exercises are then added, three to six months into recovery, to rebuild muscle strength around the shoulder joint.
Throughout the recovery period, continued pain management is addressed with prescribed medications that are gradually tapered as healing progresses. Adherence to the physical therapy regimen and doctor’s instructions is important to optimize recovery and prevent complications like chronic pain, inflammation, or a “frozen shoulder”. A gradual return to daily activities, including work and sports, is advised, ensuring the shoulder is not overstressed during its remodeling phase, which can take months to years.