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dislocated shoulder. I am in absolute agony!

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Ihurt my shoulder falling down some steps. I lived with it for 3 weeks as I am in Spain and don't speak Spanish. When I could stand it no more the doc at the hospital x rayed it and told me it was dislocated, he put it back and sent me on my way. He didn't give me a sling and didn't say anything about going back.... What should I do now I am in absolute agony!!!!!!!!!!!!
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replied September 25th, 2011
Especially eHealthy

You can fashion a sling for yourself. Mainly you want it to keep your hand and forearm across your chest. It is best if the hand can be elevated above the height of the elbow (close to the opposite shoulder), or swelling of the hand may occur.

Treatment for a dislocated shoulder (which has no other associated injuries) has traditionally been relocation, followed by a short period of rest, then begin rehabilitation. Recently, the trend has changed a little. It is now felt by some orthopedic surgeons that all dislocated shoulders should be operated on. But, the majority feel, that surgery should be reserved for the young, athletes and those with associated injuries.

But, dislocated shoulders have been treated nonoperatively for centuries, and it continues to be the most common method of treatment. It is felt that if the patient develops instability later down the road, then surgery can be done then. That way, only those that truly need surgery are operated upon.

But, again, trends change. It is basically up to you to determine how aggressive you want to be in your treatment. However, you are already out of the acute stage, and many surgeons would now feel that you are sort of, by default, placed into the 'rehab and see' category.

In terms of rehab, like stated before, the shoulder is rested for a short period of time ('longer for very young, shorter for very old'). Generally the time is between 2 to 6 weeks, depending upon the age of the patient. Then shoulder range of motion is started, followed by strengthening.

However, no matter what treatment you decide upon, right now, you do need to do elbow, wrist, and finger range of motion. You can do elbow motion by taking the sling off, holding the upper arm against the body using the opposite hand, and flexing and extending the elbow. The wrist and fingers can be moved while in the sling. You should do this ROM at least 4 or 5 times a day. If you do not move these joints, they will become very stiff and atrophied. The range of motion will also help to pump the venous blood and edema back into the body's core. This will help to reduce any swelling in the extremity.

So, you basically have to decide how you want this treated. Good luck.
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