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Shoulder dislocation ( the ball coming out of the socket) is a traumatic injury. Pain is severe, and patient is unable to move shoulder normally. This most commonly requires a visit to the ER for reduction (putting shoulder back in place) under anesthesia. Occasionally patients with history of dislocation or shoulder instability with have the shoulder reduce by itself or with gentle manipulation. Subluxation ( the feeling of the shoulder coming out of place, but not completely) can occur after injury or with activity. This usually reduces by itself, although patient may report shoulder felt like it came out of place.
Depending injury, age of patient, frequency of instability, and activity level, will determine treatment options. Examination by the doctor, x-rays, and possible MRI may be needed to determine diagnosis. Fractures and injury to soft tissue such as labrum and rotator cuff tendon are common with dislocations. Young patients are more likely to have recurrence and more likely need surgery. Treatment includes, sling or immobilizer, activity modification, limits on motion, therapy, and possible surgery.
Arthritis in the shoulder is becoming a more common occurrence. Pain in the shoulder joint, limited motion, stiffness in morning or after rest, and increased pain with activity, grinding with motion, can all indicate arthritis. Loss of motion, especially rotation (turning shoulder in or out, is the most common early sign of arthritis). Examination by the doctor and x-rays are needed to confirm the diagnosis. Depending on the severity of arthritis, your age, and activity level, treatment options will be discussed. Treatments include, NSAIDS, injections, PRP, physical therapy, assistive devices, activity modification, bracing and joint replacement surgery.
Pain in the region of the shoulder can come from problems in the joint itself or surrounding muscle and tendons. Neck issues can commonly refer to the shoulder and can overlap with shoulder issues. Pain in the shoulder region, pain with movement, weakness, numbness or “dead arm” can all be related to shoulder pathology. Depending on the location and nature of the discomfort, as well as aggravating and relieving factors can help establish the diagnosis.
Problems such as bursitis, tendonitis, labral tearing, and muscle strains are common in the shoulder. Examination by the doctor and testing such as X-rays or MRI may used to identify the problems. Treatments can include medications, therapy, injections, and even surgery.
The rotator cuff is the most common tendon injured in the shoulder (see rotator cuff section for information). Other tendons such as the bicep tendon can be injured. The portion called the long head of the biceps can become inflamed or even rupture causing shoulder pain. Patients experience pain in front of shoulder radiating down the arm. A painful “pop” with swelling and burning down arm can occur with rupture.
Examination by the doctor, X-rays and possibly MRI is are needed to confirm diagnosis. The majority of proximal bicep tendon ruptures are treated without surgery. Ice, activity modifications, NSAIDS, injections, PRP, and physical therapy are recommended treatments. In rare cases surgery can be considered.