Dislocated shoulder/worsening pain

[tania43]

I dislocated my shoulder two weeks ago, and had an x-ray in the emergency room which showed no broken bones.  I have since seen a physiotherapist, last week, where I have been given exercises and have been told to return in two weeks, to see if there is improved movement of my shoulder/arm, and to see if the pain has subsided.  The pain continues to wake me at night, and today, the pain has been severe.  I have been unable to do any exercises  due to the pain.  I have difficulty in lifting my arm to the side and the pain extends down my arm and hand where, at times, I also have numbness and tingling.  The pyshiotherapist did suggest I could have joint/ligament/nerve damage but wanted to give my shoulder more time to heal before sending me for further testing.  I wondered if it's normal for continued and/or worsening pain after two weeks, and would I be wasting my time if I went to an emergency room as I'm not sure I can deal with this worsening pain.  I have been given Diclofenac but this hasn't helped.  I appreciate any advice.  Thank you.

[Michael L Gross, MD]

When treating dislocated shoulders, I usually use a sling for comfort and restrict activity for several weeks. Generally I don't start physical therapy for at least two weeks after the injury. Usually it takes that long for the initial inflammation and pain to subside. Traditional treatment called for 6 weeks of immobilization, before starting any PT, but recent studies suggest no advantage to prolonged immobilization vs. immobilization for comfort. However, I do think that starting PT right off was too soon.  Other sources of pain include a tear in the rotator cuff, which occurs commonly in patients over 60, or a traction injury to the axillary nerve.

[tania43]

Thank you for your response!