Shoulder and Clavicle Dislocation: Symptoms and Treatment Options

Shoulder joint and clavicular dislocation?

In March of this year, I suffered a dislocation due to an accident and delayed seeking medical attention for two weeks.
I felt that my shoulder joint was about to drop out, so I visited a traditional Chinese medicine clinic.
The doctor advised me to see a physical therapist for adjustments, but mentioned that I would need long-term treatment.
After the adjustments, I had an X-ray taken, and the Western medicine doctor said there was nothing wrong, only a bruise.
He also mentioned that I have a tendency towards osteopenia, and that even if I dislocate my shoulder, it would likely self-reduce.
He prescribed muscle relaxants and anti-inflammatory medication.

However, it has now been over six months, and my shoulder joint still feels like it can dislocate on its own.
There is still a popping sound when I move it.
The clavicular joint only hurts if I sleep in a position that puts pressure on it, but otherwise, it is fine the next day.
I also consulted my uncle, who is a doctor, and he said that if there is a cartilage issue, it may not show up on an X-ray.
If necessary, an MRI could be performed, and if the situation is severe, surgery might need to be considered.

I am studying in the field of information electronics, which requires frequent computer use and soldering work.
My shoulder and clavicular joints often hurt.
What can I do to improve this situation?

mini, 10~19 year old female. Ask Date: 2007/10/08

Dr. Luo Zhongwei reply Orthopedics

Answered in the mini private mailbox on the same day.

Reply Date: 2007/10/08

More Info

Shoulder and clavicle dislocations can be quite debilitating, especially if they are not properly addressed in a timely manner. Based on your description, it seems you have been experiencing ongoing issues since your dislocation incident in March, and it is understandable that you are seeking clarity on your symptoms and potential treatment options.

Symptoms of Shoulder and Clavicle Dislocation
The symptoms you are experiencing, such as the feeling that your shoulder joint is "dropping" and the "clicking" sounds during movement, are common in cases of shoulder instability. This instability can occur due to several factors, including:
1. Soft Tissue Injury: Damage to the ligaments, tendons, or muscles surrounding the shoulder joint can lead to instability. This is often seen in cases of dislocation where the surrounding soft tissues are stretched or torn.

2. Rotator Cuff Issues: The rotator cuff is a group of muscles and tendons that stabilize the shoulder. If these structures are injured, it can lead to pain and instability.

3. Labral Tears: The labrum is a cartilage structure that deepens the socket of the shoulder joint. A tear can lead to a feeling of instability and may not always be visible on X-rays.

4. Bone Changes: While X-rays can show fractures or dislocations, they may not reveal subtle changes in the bone or cartilage that could contribute to ongoing symptoms.

Treatment Options
Given that you have already consulted with both traditional Chinese medicine and Western medicine practitioners, and considering the ongoing nature of your symptoms, here are some treatment options you might consider:
1. Physical Therapy: Engaging in a structured physical therapy program can help strengthen the muscles around the shoulder and improve stability. A physical therapist can design a program tailored to your specific needs, focusing on strengthening the rotator cuff and improving range of motion.

2. Imaging Studies: Since you mentioned that your uncle, who is a doctor, suggested that soft tissue issues might not be visible on X-rays, it may be beneficial to pursue an MRI. An MRI can provide a detailed view of the soft tissues, including the rotator cuff and labrum, and help identify any underlying issues that may require intervention.

3. Medications: You mentioned being prescribed muscle relaxants and anti-inflammatory medications. Continuing to manage pain and inflammation can be crucial in allowing you to engage in physical therapy and daily activities without exacerbating your symptoms.

4. Injections: If conservative measures do not provide relief, corticosteroid injections into the shoulder joint may help reduce inflammation and pain, allowing for better participation in physical therapy.

5. Surgical Options: If conservative treatments fail and your symptoms significantly impact your quality of life or ability to perform your job, surgical intervention may be warranted. This could involve repairing any torn ligaments or tendons, addressing labral tears, or stabilizing the shoulder joint.

6. Activity Modification: Given your work with computers and soldering, it may be beneficial to modify your workstation ergonomics to reduce strain on your shoulder. Taking regular breaks and incorporating shoulder-friendly movements can also help.

Conclusion
It is essential to take your symptoms seriously, especially since they have persisted for over six months. A multidisciplinary approach involving physical therapy, imaging studies, and possibly surgical consultation may provide the best pathway to recovery. Make sure to communicate openly with your healthcare providers about your symptoms and concerns, and do not hesitate to seek a second opinion if you feel it is necessary. Your quality of life and ability to perform daily tasks are paramount, and addressing these issues proactively can lead to better outcomes.

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