Living with shoulder instability: management and treatment

shoulder instability treatmentWhatever the cause, successful treatment often relies upon early detection. Here, we’ll look at how shoulder instability is typically managed and treated.

Shoulder instability treatment

There are several treatment options which can be used to treat shoulder instability. Patients who have never suffered a dislocation of the shoulder joint, will typically find physical therapy offers the best course of treatment.

  • Regular physical therapy sessions will focus on strengthening up the girdle; providing stability to the joint. In addition, electrical and ultrasound stimulation, along with massage can also be used to minimise the pain.
  • Placing ice over the affected area twice daily will also help to reduce pain and limit inflammation. In severe cases, the patient may also be given corticosteroid injections to manage the pain and inflammation.
  • If the shoulder has become dislocated, physical therapy alone will not always be enough to repair the problem. Just one dislocation could be treated without the need for surgery, but if multiple dislocations are identified, an arthroscopy may be needed.
  • The arthroscopy can usually be done as an outpatient procedure. It’s minimally invasive and has shown great success in the treatment of shoulder instability.

It’s worth pointing out, treatment can vary depending upon the age of the patient. Below you’ll discover more about age-related treatment options.

Shoulder instability treatment for older patients

The majority of older patients who present with shoulder instability, have developed the condition after a fall or traumatic incident.

If a patient is over the age of 40, treatment will usually be done non-operatively. A sling will need to be worn, ensuring the joint is immobilised for a set time period. This gives it plenty of time to heal. Once it has been rested, usually within a couple of weeks, physiotherapy will be used to help the patient regain motion and strengthen the shoulder joint to prevent future injury.

Interestingly, the re-occurrence rate of shoulder instability in older patients is very low. A full recovery is also expected within three to six months.

Shoulder instability treatment for younger patients

Younger patients are generally more prone to shoulder instability issues; particularly young athletes. In sports which require frequent overarm movements such as tennis, there’s an especially high chance of shoulder instability.

If the shoulder is dislocated, it is likely to end with future instability in the joint. It’s estimated that 80% of young patients who experience a dislocation, go on to experience recurring instability issues.

Treatment will very much depend upon the severity of the instability. If the shoulder has been dislocated fully, it will need to be reset. However, it’s worth noting that this doesn’t treat the actual instability issue.

The instability is most commonly treated with physiotherapy to start. To address the pain, anti-inflammatory medications may also be prescribed. If very little improvement is seen after physiotherapy, surgery may be the only other option.

Overall, shoulder instability can be treated, though the method and recovery period will depend upon several factors, including the age of the patient. As with any shoulder injury, the earlier instability is detected and managed, the easier it will be to treat.

All strenuous physical activities should be stopped until the shoulder is strengthened and the pain is gone.

London Shoulder Specialist Ms Susan Alexander of the Fortius Clinic reiterated in a recent presentation on shoulder instability “the importance of a close working relationship, with good, open and regular communication between surgeon, physiotherapist and general practitioner to optimise the treatment of this complex condition.