About the disease
Shoulder instability is a condition whereby the head of the upper arm bone leaves the shoulder socket and as a result the sufferer is unable to move their hand properly. Practically speaking, shoulder instability is the inability of the shoulder tissues to keep the shoulder socket in place.
Shoulder instability is most often caused by trauma or continuous overuse of the shoulder. Overuse of the shoulder is very common in people whose profession predisposes constant movement of the shoulder. It is observed in swimmers, basketball players, tennis players and painters. Shoulder instability can also develop after someone has dislocated their shoulder, resulting in the upper arm bone being prone to popping out of its socket. Having chronic shoulder instability can lead to restricted shoulder mobility and can mean the end of a professional sports career if not treated in time. Rarely, a patient can also be diagnosed with multidirectional instability of the shoulder, meaning that the upper arm bone may from time to time dislocate to the front, bottom or side of the shoulder. This condition can be caused by constant strain of the shoulder. 90% of people with shoulder instability experience shoulder dislocation, which can be either the cause or complication of this condition.
Symptoms
- Unusual position of the shoulder, when it protrudes forwards or backwards
- Pain in the arm
- Inability to move the shoulder and hold it in one position for long periods of time
- Repeated instances of shoulder dislocation
- Feeling of shoulder being loose
Diagnosis
- A general examination can determine the range of shoulder mobility.
- An X-ray of the shoulder can help to identify problems with the shoulder joints that cause the upper arm to fall out of its socket.
- Imaging tests, such as an MRI or CT scan, create an image of the shoulder. They are very effective, because they create accurate images of the tissue surrounding the shoulder and can therefore determine whether it is able to hold the socket in place. It can also show signs of tendonitis.
Treatment
- Anti-inflammatory drugs are used to relieve the signs of inflammation and reduce the swelling. Nevertheless, they are not enough to completely treat the instability.
- Arthroscopic surgery is a procedure during which a surgeon makes several incisions to reach the shoulder joint and repair it. This surgery repairs soft tissue with pencil-thin instruments and reinstates stability in the shoulder.
- Open surgery allows the surgeon to have direct visualization of the shoulder. However, because larger incisions are made, the patient’s recovery time will be longer.
Surgery recovery time ranges from several days to several weeks but it usually has good results.
Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko
