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Joint dislocations

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What are joint dislocations?

A joint dislocation is when the bones that make up a joint are separated and forced out of their usual position. Most joint dislocations are caused by injury or overuse.

Any joint in the body can be dislocated, but the most commonly affected joints include:

  • shoulder - the most common type of joint dislocation. It is more common among men than women
  • elbow - the second most common type of joint dislocation. It is over twice as likely to happen in men than women
  • finger
  • hip - artificial hip joints dislocate more commonly than natural hips. Up to 5% of people who have a total hip replacement have a hip dislocation within the first year of surgery
  • kneecap (patella) - kneecap dislocations are more common than dislocations of the actual knee joint

Some injuries do not lead to a complete joint dislocation; instead, the bones in the joint are partly pushed out of place. This is a partial dislocation, also known as a subluxation.

What are the symptoms of joint dislocations?

Joint dislocations tend to happen suddenly. If you have a dislocated joint, it is likely to be very painful because the tissues around the joint will usually have been stretched and torn.

The pain will often be worse on moving the joint and you may feel scared to try and move it.

Other symptoms of a joint dislocation include:

  • swelling around the joint
  • being unable to use the dislocated joint as normal
  • bruising around the dislocated joint due to bleeding under the skin
  • numbness or unusual sensations, such as tingling

What causes joint dislocations?

Joint dislocations are most commonly caused by physical injury to the joint. This may be from direct force, general wear and tear, or overuse (e.g. athletes overtraining).

Double-jointed people (joint hypermobility) and those with certain disorders such as Ehlers-Danlos syndrome are more prone to dislocations. Younger men who play sport are also at a higher risk of joint dislocations, as are older women - due to their increased risk of falls.

A dislocated hip, dislocated shoulder, dislocated kneecap and dislocated finger all have other specific causes.

How are joint dislocations diagnosed?

A doctor will usually examine the affected joint if a dislocation is suspected. You may need imaging tests to confirm the diagnosis and identify any fractures.

These can include:

  • X-rays - useful for diagnosing dislocations and fractures
  • MRI scan - useful for diagnosing subtle injuries in the knee and shoulder
  • CT scan - useful for diagnosing subtle injuries in the elbow and hip

Treatment for joint dislocations

Treatment for a joint dislocation usually involves returning the joint to its normal position. This should be done in a hospital and by a health professional.

Do not try to put the joint back in yourself as this could damage the nerves, tissue and blood vessels around the affected joint. Instead, go to the emergency department or call an ambulance if you cannot walk or have severe injuries.

While waiting for medical attention, try the following self-care measures.

Self-care

  • keep the injured joint as still as possible and support it with a pillow
  • keep the injured limb raised above heart level, if possible. This can help to to limit swelling
  • apply ice (wrapped in a towel or cloth) to the injured joint. This can help to control pain and swelling
  • take painkillers to help reduce any pain

Hospital treatment

Before a dislocated joint is put back into place, you may need imaging scans, such as X-rays, to check for broken bones.

Putting a dislocated joint back into its normal position is known as a reduction. You may need painkillers or anaesthetic to numb the area before the reduction.

During a reduction, a doctor moves the affected joint back into place by pulling or turning the limb it is connected to. This can usually be done without surgery, but in some cases, you may need surgery.

After the joint is back in place, it should be kept from moving (immobilised) to allow it to heal. This is typically done using 1 of the following:

  • a cast - usually used for severe injuries that need to be kept still for weeks
  • a splint - usually used for less severe injuries that need to be kept from moving for a few days
  • a sling - useful when it is inconvenient keep an entire limb still, eg a shoulder sling allows you to use your hand, while limiting shoulder and elbow movement
  • a swathe - a strap or piece of cloth that can be used with a sling to stop the arm from swinging around

Rehabilitation after a joint dislocation

Once a dislocated joint has been returned to its normal position, treatment often involves rehabilitation. This usually involves physiotherapy to help restore movement, strength and normal function of the injured joint.

How quickly you recover from a joint dislocation tends to depend on the joint you injured, the severity of the dislocation, your age and if you have any other health conditions.

When will I be able to return to sport and exercise?

You should only return to sport and exercise once you have fully recovered.

A physiotherapist can work with you to develop an exercise programme to help you gradually return to physical activity and to reduce the risk of dislocating the joint again.

Speak to your doctor or physiotherapist before beginning exercise after a joint dislocation. They can let you know if (and when) it is safe to do so.

If you are worried that you may have a joint dislocation, check your symptoms by downloading our free Self-Assessment Tool.

Related articles

Dislocated shoulder

Dislocated kneecap

Broken finger and finger dislocation

Broken ankle

Dislocated hip

Date of last review: 26 June 2020

References

Joint dislocation - Symptoms, diagnosis and treatment | BMJ Best Practice [Internet]. Bestpractice.bmj.com. 2020 [cited 28 February 2020]. Available here.

Overview of Dislocations - Injuries and Poisoning - MSD Manual Consumer Version [Internet]. MSD Manual Consumer Version. 2020 [cited 28 February 2020]. Available here.

Sports injuries - Treatment [Internet]. nhs.uk. 2020 [cited 28 February 2020]. Available here.

Dislocated shoulder [Internet]. nhs.uk. 2020 [cited 28 February 2020]. Available here.

PIP Joint Dislocation [Internet]. Dynamed.com. 2020 [cited 28 February 2020]. Available here.

Knee Dislocation - Emergency Management [Internet]. Dynamed.com. 2020 [cited 28 February 2020]. Available here.

Elbow Dislocation [Internet]. Dynamed.com. 2020 [cited 28 February 2020]. Available here.

Hip Dislocation - Emergency Management [Internet]. Dynamed.com. 2020 [cited 28 February 2020]. Available here.

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