Dislocated Shoulders: What to Expect With Injury, Treatment, and Recovery

Shoulder dislocations are more common than any other joint dislocation. When it happens, the humerus (the upper arm bone) pops out of its socket. This injury often happens with contact sports, falls, or car crashes. 

When someone dislocates their shoulder, it’s usually pretty obvious. The pain is often severe, the shoulder looks abnormal, and the person can’t really move their arm. The good news is that these symptoms are instantly fixed when a healthcare provider pops it back into place. 

Let’s look at how to recognize a shoulder dislocation and what to expect when you go to the emergency room (ER). 

What are the different types of shoulder dislocations?

The shoulder joint is specifically designed to allow your arm to move in many different directions. But the anatomy that allows for all of that movement also puts it at risk for popping out. It also means that shoulders can pop out in three different ways:

1. Anterior: This is the most common type — it accounts for over 95% of shoulder dislocations. In anterior dislocations, the humerus pops forward. 

2. Posterior: Fewer than 5% of shoulder dislocations fall into this category. In this type, the humerus pops backward, and it’s more likely to be associated with a fracture (a small break in the bone). 

3. Inferior: This is the rarest type, making up less than 1% of shoulder dislocations. The humerus pops downward. It’s the type most likely to cause nerve or blood vessel injury.

What are the symptoms of a shoulder dislocation?

Most of the time, the symptoms of a shoulder dislocation are obvious. And people know the diagnosis the moment it happens. It commonly occurs with contact sports. A blunt force on the shoulder can cause a shoulder dislocation, as in a motor vehicle collision or fall.

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Here are the most common symptoms of a shoulder dislocation:

• Pop: Many people describe a popping sensation the moment their shoulder dislocates. 

• Pain: The pain usually starts immediately and can be very intense. 

• Difficulty moving the arm at the shoulder joint: Once the humerus is out of the socket, it can no longer move freely.

• Deformity: The shoulder will often look funny or slightly asymmetric from the other side. But this is not always the case — posterior dislocations tend to be less noticable.  

• Numbness and tingling: People can sometimes experience a tingling sensation in the arm. This can happen when the nerve stretches, but it does not necessarily mean there’s serious damage to the nerve. 

• Bruising: As the bone moves out of the socket, it can injure the surrounding tissue and cause some bruising. 

How do you diagnose a shoulder dislocation?

Most healthcare providers can diagnose a shoulder dislocation with just a physical exam. Even so, they’ll usually recommend an X-ray. This helps to confirm the diagnosis and find any other possible injuries. For example, sometimes the force of a dislocation can also break off small pieces of bone.

What is the treatment for a shoulder dislocation?

The treatment for a shoulder dislocation is to get the joint back into place — the medical term for this is “reduction.” Here we’ll explain what happens before, during, and after this procedure.

Pain management 

Pain medication is often the first step in treatment. This provides you with much needed relief, and it also helps to relax the muscles around the shoulder. This makes it easier to get the shoulder back into place.

There are several approaches to pain relief for a shoulder dislocation:

• Injection: Providers often inject a numbing medication, such as lidocaine, into the shoulder. This is so you don’t feel pain from the injury or reduction. Studies have shown that this works as well as sedation. And ER visits are quicker with this method. 

• Pain medications: There are many options to treat pain, and they can be oral or intravenous (IV). Examples of IV medications include an anti-inflammatory like ketorolac or an opioid such as morphine. The best option for you depends on factors such as your other health conditions or medications. 

• Sedation: In some ERs, sedation is an optional treatment right before the reduction. The provider will give you medications that make you feel a little out of it for the procedure. They’re often the same medications used for general anesthesia, but in slightly smaller doses. These medications also tend to help with any pain or anxiety you may feel before the reduction. 

Reduction

This is the actual procedure where a provider pops your shoulder back in. Most of the time this happens in the ER — where you can get medication beforehand, and a skilled provider can do it safely. 

The sooner you get a reduction, the better. When a shoulder is dislocated for longer than 24 hours, there’s an increased risk of complications — like long-term shoulder instability or nerve injury. It can also be harder to reduce.

There are many different techniques that providers can use to get a shoulder back into place. And there’s no single best approach. Your provider will take into account the type of dislocation as well as your natural anatomy to figure out the right technique. Sometimes they may need to try a few different approaches. 

Posterior and inferior dislocations are more likely to result in an unsuccessful reduction attempt. In these cases, you may need a trip to the operating room. But this is not necessarily because you need surgery. It’s so you can receive a full dose of general anesthesia to put you to sleep. This way the muscles are more relaxed and the provider can use more force to reduce the joint. 

Immobilization

After the reduction, it’s important to keep the shoulder in place. This is called “immobilization,” and providers usually do it with a technique called “sling and swathe.” 

The provider places your arm in a sling so that it’s flexed at the elbow. Then they use an elastic bandage to bind your bent arm against your body. This stabilizes the joint in a comfortable position. 

What does recovery from a shoulder dislocation look like?

It’s important to keep your shoulder immobilized as the joint heals. This prevents recurrent dislocation, which can happen while the muscles and tendons are stretched out after the injury. The total time can be as little as 1 week or as long as 6 weeks.

The length of time that you need to immobilize your shoulder depends on several factors, including:

• Age: The older you are, the less time you need to be immobilized. This is because the risk of a second dislocation decreases with age, especially after 40. Studies have shown that older people have better joint movement and improved rehabilitation with a shorter immobilization time.

• Type of dislocation: For anterior dislocations, immobilization of more than 1 week did not decrease the chance of another shoulder dislocation. But inferior and posterior dislocations are often immobilized for longer — sometimes up to 6 weeks.

• Other injuries: Sometimes you may need a longer period of immobilization for another injury, like a fracture or a broken bone.

• Previous recurrences: People who dislocate their shoulder more than once often need longer immobilization. 

Once the provider repositions your shoulder in the joint, your pain should noticeably improve. In addition to immobilization, the following may help with any pain or soreness you experience in the days after your dislocation: 

• Pain medications: You can take ibuprofen (Advil) or acetaminophen (Tylenol) for any lingering discomfort. In some cases, such as a fracture, your provider may prescribe a stronger pain medication. 

• Ice: There may be swelling at first. You can apply ice three to four times to decrease the discomfort. Put ice (or frozen peas) in a plastic bag and then directly on the skin. Ice usually works best when you leave it on for 15 minutes at a time. To avoid cold injury to the skin, do not ice for more than 15 minutes every hour.

After a shoulder dislocation, providers often provide a referral to see a specialist for a follow-up appointment. This might be an orthopedic specialist (bone surgeon) or a sports medicine specialist. 

In some cases, your provider may recommend rehabilitation to help strengthen the shoulder. Physical therapy can help you regain strength, stability, and mobility in your shoulder. 

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Written by:

Jill L. Jaimes, MD

Jill L. Jaimes, MD, is a board-certified pediatric emergency medicine physician with over 20 years of clinical experience. She received her medical degree from Baylor College of Medicine and completed her residency and fellowship training at Texas Children’s Hospital.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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