Shoulder Instability

Shoulder instability is a chronic condition that causes frequent dislocation of the shoulder joint. A dislocation occurs when the end of the humerus (the ball portion) partially or completely dislocates from the glenoid (the socket portion) of the shoulder. A partial separation is referred to as a subluxation; whereas, a complete separation is referred to as a dislocation. The common symptoms of shoulder instability include pain with certain movements of the shoulder, popping or grinding sound, and swelling and bruising of the shoulder immediately following subluxation or dislocation. Visible deformity and loss of function of the shoulder occur after subluxation, or sensation changes such as numbness or even partial paralysis can occur below the dislocation as a result of pressure on nerves and blood vessels.

The risk factors that increase the chances of developing shoulder instability include:

• Injury or trauma to the shoulder
• Falling on an outstretched hand
• Repetitive overhead sports activities such as baseball, swimming, volleyball or weightlifting
• Loose shoulder ligaments or an enlarged capsule

Treatment

The goal of conservative treatment for shoulder instability is to restore stability, strength and full range of motion. Conservative treatment measures may include the following:

• Closed reduction: Following a dislocation, your orthopaedic doctor can often manipulate the shoulder joint, usually under anesthesia, realigning it into proper position.
• Medications: Over-the-counter pain medications and NSAIDs can help reduce the pain and swelling. Steroidal injections may also be administered to decrease swelling.
• Rest: Rest the injured shoulder and avoid activities that require overhead motion. A sling may be worn for 2 weeks to facilitate healing.
• Ice: Ice packs should be applied to the affected area for 20 minutes every hour.

When these conservative treatment options fail to relieve shoulder instability, your surgeon may recommend shoulder stabilization surgery. Shoulder stabilization surgery is done to improve stability and function to the shoulder joint and prevent recurrent dislocations. It can be performed arthroscopically with smaller incisions, depending on your particular situation. Arthroscopy is a surgical procedure in which an arthroscope, a small flexible tube with a light and video camera at the end, is inserted into a joint to evaluate and treat a condition. The benefits of arthroscopy compared to the alternative, open shoulder surgery are smaller incisions, minimal soft tissue trauma and less pain, leading to faster recovery.