Usually shoulder dislocations are put back into place (reduced) in the emergency room. Treatment thereafter is individualized to the patient. Young, active patients are at extreme risk of recurrent injury, and should consider surgical treatment to greatly reduce that likelihood. Older, more sedentary patients may respond to bracing, although in cases in which the rotator cuff also is torn, surgical repair might be necessary to provide relief.
A person who experiences shoulder dislocation should consult a shoulder expert to ensure that repairable injuries are identified early. This way the patient can make educated decisions about treatment.
Mild tears of the rotator cuff are initially treated non-operatively as listed below. More significant tears associated with marked weakness may require surgical treatment to improve shoulder function and potentially repair the tendons.
Many patients with labral tears will benefit from arthroscopic repair. Often the labral tear cartilage tears away from the bone but it is still connected to the ligament. So when the cartilage is repaired, the ligament is tightened, as well. Patients’ injuries might require an open procedure (using a larger incision than arthroscopy) to adequately stabilize the shoulder.
Acromioclavicular (AC) Joint Sprain
In the case of severe AC joint sprains, reconstruction is usually required to minimize pain and optimize joint function. In cases of less-severe sprains that develop arthritis or remain painful after several months, simple arthroscopic or open removal of the end of the collarbone (clavicle) may provide relief.
Other possible treatments include:
Modifying activity: Athletes who must perform repetitive movements may need to avoid painful activities and/or adapt their moves during rehabilitation.
Medication: Physicians frequently prescribe ibuprofen or naproxen to help reduce inflammation and pain. Physicians may also prescribe injections of steroids or anesthetic to both diagnose the source and treat the pain.
Rehabilitation: Physical therapy may be needed to improve pain and function, including exercise and application of heat or cold to decrease inflammation. Muscle stretching and strengthening can improve the shoulder joint support.
Bracing: In some cases, a sling or brace may be worn to protect the joint and promote healing.
Surgery: Surgical treatment of a shoulder injury may be needed, such as arthroscopic or open stabilization (ligament and cartilage repair), arthroscopic or open rotator-cuff tendon repair, AC joint reconstruction or arthroscopic distal-clavicle resection.