| How to Cure a Gout Attack Posted: 28 Nov 2016 04:00 PM PST Gout is a complex form of arthritis that often affects men; however, women are increasingly susceptible to gout after menopause. A gout attack can occur suddenly, often waking you up in the middle of the night with the sensation that a joint or muscle is on fire. The affected joint or muscle will be hot, swollen, and so tender that even the weight of a bedsheet may seem intolerable. Fortunately, there are treatment to relieve a gout attack.[1] EditRecognizing the Symptoms of a Gout Attack - Check the joint for intense pain, swelling, or redness. Usually gout causes severe pain in one joint, like the base of your big toe, or joints like your ankle, wrist, or elbow. Affected joints will swell and the skin may look read or inflamed.[2]
- Any joint can be affected by gout, and sometimes two or more joints can be affected at one time.
- Note if it is painful to walk. Putting any pressure on the affected joint will be very painful if you are experiencing a gout attack, and even the weight of a sheet or a blanket can hurt the affected joint. You may also have limited mobility or be unable to move the affected joint at all.[3]
- Sometimes, gout is mistaken for other forms of arthritis. If you are not sure if you are suffering from gout, you should get checked by your doctor to confirm your diagnosis.[4]
- Treat the gout attack as soon as possible. If you experience sudden, intense pain, you should call your doctor immediately. If left untreated, gout can lead to worsen pain and joint damage. You should seek immediate medical care if you have a fever and a joint is hot and inflamed, as these are signs of a possible infection.[5]
- If left untreated, a gout attack can last several days, but usually goes away completely within 7-10 days.
- Some people only ever experience one gout attack in their lifetime, while others may experience a gout attack weeks, months, or even years after their last attack.
EditUsing Home Treatment - Uncover and elevate the affected limb. Remove all surrounding clothing or bedding from the limb so it is open to the air. Raise the limb by sliding a cushion under the limb. Avoid knocking around or damaging the affected limb when you elevate it.[6]
- Apply an ice pack to the limb. It's important to keep the affected limb cool to ease any pain or swelling. Wrap an ice pack or a bag of frozen peas in a towel before applying it to the limb.[7]
- Continue to apply the ice pack for 20 minute intervals. Only apply the ice pack to your limb for 20 minutes at a time. Do not apply it directly to your skin or for longer than 20 minutes at a time as this could damage your skin.[8]
- Touch the affected limb to make sure the temperature of the affected limb has returned to normal before reapplying the ice pack.
EditUsing Medication - Get a prescription for anti-inflammatory painkillers (NSAIDs). Many people who suffer from gout will have a supply of NSAID tablets ready at home in case an attack occurs. The painkillers will ease most gout attacks and soothe your symptoms within 12-24 hours. There are several types and brands your doctor may prescribe, including diclofenac, indomethacin , and naproxen.[9] Most people can take these drugs without any complications, but some side-effects may occur, including:
- Bleeding from the stomach. This is more of a risk if you are over 65 years old or have a stomach ulcer. If you have either of these risks, you avoid taking these tablets and talk to your doctor about other possible medications.
- Some people with asthma, high blood pressure, certain kidney problems, and heart failure may not be able to take anti-inflammatory painkillers.
- If you are taking medication for other conditions, they could interact negatively with anti-inflammatory painkillers. Talk to your doctor if you are on other medications before taking the painkillers.
- Take one anti-inflammatory painkiller at a time. Follow the dosage prescribed by your doctor and don't take too many painkillers at once. Continue to take this medication throughout the attack and for 48 hours after the attack has finished.[10][11]
- Ask your doctor for proton pump inhibitors (PPI). NSAIDs should be prescribed together with PPIs, which reduces the risk of the NSAID causing indigestion, stomach ulcers, and bleeding from the stomach.[12]
- These medications will also protect your stomach if you have already taken aspirin and then experience a gout attack. Aspirin plus an anti-inflammatory medication will increase the risk of stomach bleeding. PPIs will help to counteract this risk.
- Your doctor may also try interleukin-1 inhibitors (IL-1) to control pain. IL-1 may rapidly reduce pain for those who do not respond to NSAIDs.[13]
- Try colchicine if NSAIDs are ineffective. Colchicine is a medication that is derived from the Autumn crocus plant. It is not a painkiller, but it works to reduce the ability of the urate crystals that inflame your joint lining, thereby reducing some of the inflammation and pain during a gout attack.[14]
- Colchicine will be prescribed by your doctor and can be an effective treatment for gout if taken in the first 12 hours of the attack. But it should only be used at low doses as it can cause side effects like nausea, abdominal pain, and diarrhea.[15]
- Always follow the recommended dosage. For most people, this means no more than 2-4 colchicine tablets a day.
- Talk to your doctor about corticosteroid tablets. These are a type of steroids for people that do not respond to other treatments and are unable to take an NSAID or a colchicine. A short course of steroid tablets provides relief but can't be used long-term in high doses as they can cause side effects such as:[16]
- Weight gain
- Osteoporosis, or thinning of your bones
- Bruising and thinning of your skin
- Muscle weakness
- Increased vulnerability to infection
- Corticosteroids can also exacerbate diabetes and glaucoma, an eye condition that can cause blindness if left untreated.
- Do not use corticosteroids if you have impaired kidney function, impaired liver function, or a risk of heart failure.
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| How to Pass Final Exams Posted: 28 Nov 2016 08:00 AM PST If you're a student, exams are an important part not only of any class, but also your final grade. Preparing throughout the semester is the most effective way to do well on your final exams. Ultimately, there's just no shortcut for knowing the material. However, even if it's the night before your final exam and you're feeling unprepared, don't panic. There are things you can do to help you pass your exams. EditPreparing Throughout the Semester - Read the syllabus. At the beginning of any term, teachers or professors will usually hand out a syllabus with the assignments and expectations for a class. Make sure you read the syllabus carefully to know exactly what you need to do to pass the course.[1]
- Make sure to pay attention to the breakdown of how assignments, attendance, and exams factor in to your grade. This will help you prioritize how much you need to study, and where to focus your attention.
- If you have any questions on the syllabus, ask the professor. It's much better to ask a question at the beginning than plow on with no idea of what you're doing.
- Attend class regularly. You cannot successfully pass a class or exams if you do not attend the class. This will allow you to hear vital lectures and take notes, as well as help you understand your readings and assignments.[2]
 - Most exams are based on what happens in class, so skipping class is never advisable. Some teachers will penalize absences, meaning you might not even pass the class if you skip.
- Teachers and professors usually discuss what is on an exam during classes, so if you aren't in class you can't get this crucial information.
- If you cannot attend class, let your professor know in advance. Ask her what you will miss in class and if there is anything you can do to make up for the absence and get the information.
- Don't ask your teacher or professor questions like "Did I miss anything in class yesterday?" The assumption is that all days give you valuable information, and questions like this come across as disrespectful of your teacher.
- Don't "zone out." Sometimes, it's tempting to play solitaire or check your phone during class instead of listening, especially if you're in a class you feel you understand pretty well. However, you might miss something important if you do this. Stay attentive for the whole class period.[3]
- Take notes. Lectures and discussions are a key component to a class and contain information you will need to pass the exams. By paying attention and taking notes throughout the term, you will have a built in study aid that will help you effectively study without scrambling for additional information.[4]
 - Come prepared. Use a binder or notebook, and bring pens or pencils to class. If you will be discussing things from a book, bring a highlighter too. Teachers will often say things like, "This passage is very significant for understanding ____ in general" or "Make sure you understand the information in this sidebar." If your teacher notes something specific in class, mark it immediately.[5]
- Taking notes is a delicate balancing act between getting too little and too much information. You don't want to write down everything a professor says, just the important information. For example, it's less important to know what type of planes bombed Dresden in February of 1945 than why the bombing was significant for World War II.
- Try using keywords instead of trying to copy out full sentences. Trying to take dictation from your professor could mean you don't get the essence of what's really important. Try using key phrases and words instead of full sentences.
- Take notes by hand. Studies have shown that people learn more by writing notes instead of typing them in to a computer or recording them on a device.[6]
- Check out some note-taking systems. There are a bunch of systems for learning how to take notes. Cal Poly has information on several types, along with their pros and cons.[7]
- Do all reading assignments. Most professors and teachers will assign reading during the semester and then draw upon this as they write the exam. By doing the reading assignments, you will not only be able to participate in class discussions, but will also have the information you need to pass the exam.
- Make sure to take notes on the reading assignment as you read. Just like taking notes from lectures, you only need to write down the most important information.[8]
- Skim back over your reading assignments every few weeks. You don't have to go through everything in-depth, but going back over the main points will help them "gel" in your memory, so you can access them later on the exam.
- Do papers and other class assignments. Since class assignments are usually meant to help you learn a subject more thoroughly, it's important that you do them. They may even serve as practice for an exam question.
- The material you use and produce for any type of assignment may show up on an exam. Everything from math or scientific problems to short essays will help you be prepared and pass an exam.
- Participating in class discussions will also help you pass an exam because it gives you a chance to verbalize and work out your thoughts with other students and the professor.
EditPrepping for Each Exam - Know where you stand in the class. It's important throughout a term to know what your grade is. If you keep this information in mind, it will help you know how much time you need to devote to studying for an exam.
- If you aren't sure what your grade is, check your syllabus. Most teachers give "weights" to assignments and other course elements (participation, etc.). You should be able to get a rough idea of how you're doing from this.
- If you're still unsure about your performance, talk with your teacher.
- Find out what material the exam is going to cover and what format it is. Teachers and professors have different methods and formats for final exams. Some will make an exam comprehensive, while others will only test on a certain section of the material covered in class. Some exams are essays while others are multiple choice. Finding out what information the exam will cover and its format can help you more effectively study.[9]
- Check the syllabus to see if this information is on there. Paying attention in class will also help, since most teachers and professors will announce what material the exam will cover.
- If you are not sure or missed a day of class, you can ask your teacher or professor, but it's important to not annoy them with repeated or overly detailed requests. Simply asking "could you please tell me what material I need to know for the exam" is enough to direct your study time.[10]
- Understand how you study best. Every individual learns differently. Knowing the conditions under which you study best will help you most effectively learn and retain information that you need for your exam.[11]
- For example, if you know that you need absolute silence to concentrate on the material you need to learn, you can either study in a library or in a quiet room at home. You may also be someone who needs a little noise or commotion to help you focus.[12]
- "Multitasking" is a myth. While you might think you're able to watch TV, text your friends, and study for exams at the same time, your brain simply can't handle that many competing streams of information. Give yourself some quiet, dedicated study time, and leave the other stuff for your leisure time.[13][14]
- Prioritize your study time. Figure out which exams are the most important and devote the most study time to them. By doing this you will optimize your study time and help ensure that you pass your exams.[15]
- If you are in college and have an exam in one of your major or minor fields, you'll want to give the most time to studying for these exams over general education courses, for instance.
- If you are doing poorly in any class, devote enough time to studying for this class to make sure that you pass it and don't have to repeat it.
- Start studying early. It is never too early to start studying for a final exam, but a month before the test date is a good time to begin your preparations. This will ensure that you're not cramming information too close to the exam and then forgetting it on test day.[16]
- You can study simply by reviewing your notes for 20-30 minutes a day. If you have questions, ask the professor.
- Study. No matter in which class you have an exam, from the easiest subject to the most difficult, you need to study. Even if it's only reviewing class notes for 30 minutes, studying the material from your class will benefit you on the final exam.
- Study by reviewing class notes, thinking of discussions, or going to a study group will often remind you of information you forgot over the course of the term.
- It's important to have confidence that you will pass. But beware of overconfidence, which can sabotage your ability to think clearly about an exam.
- Consider making free associations between information you learn and what you know. You can also make up things to help you out.[17]
- It may also help you to write index cards with information you need to know.
- Join a study group or class study session. Taking part in a study group or attending a class study session can be very useful in understanding course material for an exam. Just make sure that you're actually studying and not socializing.[18]
- Study groups with friends or classmates can be very helpful study tools. Every person has different strengths with learning and material you may not understand someone else likely will.[19]
- Teachers and professors will sometimes offer study sessions for their classes. These are an excellent opportunity to learn material that will likely be on an exam as well as ask any lingering questions you may have.
- Switch up your study spots. Studies suggest that changing your environment after spending a long time studying in one place can help improve your brain's retention.[20] Having a couple of different study spots -- your room, a quiet coffee shop, the library -- may help boost your brainpower.[21]
- Do a practice exam. Practice exams are an excellent, highly effective way to study for tests. They will help you relax and point out any weak areas you may have going in to the final exam date. In fact, some studies suggest that practice-testing is a more effective way to study than highlighting, re-reading, or summarizing material.[22]
- You can take any essay or problem and use it as your mock exam.[23]
- Make sure you do the mock exam in the same allotted time as the actual exam.[24]
- If you test yourself just twice, you will remember 75-80% of the material two weeks later. With no practice tests, that figure is just 20%.[25]
- Stop studying. At some point, you cannot study any longer without stressing yourself out or confusing yourself. Within a day of the exam, set aside your study material and be confident in the fact that you've done the work.[26]
- You will not learn a lot of new content within 24 hours of an exam.[27]
EditCaring for Your Body and Mind - Get enough rest. It may sound like a good idea to stay up all night cramming, but without sleep, your brain just won't function. Almost all students pull all-nighters at some point, but they can have damaging effects on your brain for up to four days.[28]
- Stick to your regular sleep cycle as much as possible. Disrupting your sleep schedule by staying up too late or waking up before your body has fully rested messes with your REM (rapid-eye movement) sleep, which will leave you feeling sluggish and can hinder your memory.[29]
- Set aside a specific time to study for an exam and use that time wisely. Then, go to bed![30]
- Take off at least one full day a week to give your brain and body a chance to rest and recover from studying.
- Eat well. If you're not eating properly, your brain won't be able to function at its best. Getting enough nutrients will allow your body and brain to function optimally on exam day and while you study. Make sure that you eat at regular intervals and don't mindlessly snack on junk.[31]
 - Try starting your day off with complex carbohydrates, such as oatmeal and whole grains. Complex carbohydrates help your body produce energy that your brain needs to perform.[32] Because they digest slowly over a longer period of time, you're less likely to get nasty blood sugar spikes and crashes, too.
- You might also want to incorporate some eggs into your diet. Eggs contain choline, which is linked to memory and cognitive performance.[33]
- Oily fish that contain omega-3 fatty acids, such as salmon, are also tied to brain function. A salmon croquette isn't going to ace your test for you, but the protein and nutrients will definitely help boost your brainpower.[34]
- Avoid simple carbohydrates and processed sugar. These may give you a temporary energy bump, but they cause crashes and fatigue later. If you crave something sweet, go for fruits -- especially those that contain vitamin C, which may help improve your mental functioning.[35] Salty snackers may prefer pumpkin seeds or nuts, which have vitamin E and zinc.
- Stay hydrated. It's tempting to load up on caffeinated beverages when you're studying for final exams, but be careful. Caffeine is a diuretic, meaning it will dehydrate you. It can also give you a wicked case of the caffeine jitters. Dehydration can cause fatigue, so drink plenty of plain, clear water.[36]
- Adolescents (under 18) should limit caffeine intake to about 100mg a day.[37] Depending on the variety, that can be as little as a single cup of coffee, or two 12-ounce cans of cola.[38] Adults should keep caffeine intake between 200mg-400mg a day.[39]
- Men need, on average, 13 cups (3 liters) of water per day. Women need about 9 cups (2.2 liters) of water per day.[40]
- Get yourself a refillable water bottle. You may be more likely to drink water from a bottle than a glass, especially if you often drink bottled soft drinks.
- Avoid alcohol, especially the night before a big exam. In addition to the hangovers and other nasty side effects, alcohol dehydrates you, which can cause fatigue on test day.
- Use visualization. There are several ways that visualization can help you feel more prepared for a final exam. You can use "outcome and process visualization" to help you imagine achieving your goal, and relaxation visualization to help you destress.[41]
- Use outcome and process visualization to imagine yourself achieving your goal. Imagine what it looks like for you to pass your final exam. Imagine this success in as much detail as possible. Then, imagine the steps you need to take to achieve your goal. In this case, things like "taking notes," "going to class," and "studying" are obvious steps you could envision.[42]
- Use the "palming method" of visualization to help you relax. Close your eyes and cover them with the palms of your hands. Don't touch your eyeballs. Imagine a scene that's very relaxing to you, such as a day at the beach or curled up in bed with a good book. Picture as many details as possible to make it realistic, and spend 1-2 minutes enjoying the relaxing scene. Open your eyes and wait 1-2 minutes, then repeat the visualization scene. This process will give you a "safe place" to help you feel calm and relaxed before you sit down to your exam.
- Reduce your anxiety. This probably sounds counterintuitive: you wouldn't have anxiety if you weren't worried about passing your final exam, right? However, research shows that anxiety blocks your ability to focus, which can really put a damper on your studying and test performance.[43] Try some relaxation techniques when you're feeling freaked out.
- A few minutes of deep breathing will oxygenate your brain and help you feel relaxed and ready to perform. Inhale deeply through your nose for a 4-count. Hold the breath for 1-2 seconds, then slowly release the breath through your mouth for a 4-count. Repeat this 6-8 times per minute for 5 minutes or so.[44]
- Try yoga. The deep breathing and meditation in yoga have been scientifically shown to reduce test anxiety.[45]
- Try the "tensing and differential relaxation method." This involves tensing and relaxing your muscles all at once. Put your feet flat on the floor while sitting in a chair. Grab the seat. Push down with your feet, and pull up on the chair at the same time for 5 seconds. Relax for 5 seconds, then repeat 2-3 times.
- Get some exercise. Physical exercise has been proven to reduce stress. It also helps you get better sleep, improves your alertness and concentration, and can even enhance how your brain functions.[46] Regular aerobic exercise can even boost your learning and memory![47]
- Get at least 2.5 hours of moderate-intensity activity, such as jogging or brisk walking, per week.[48]
- Try things that get your heart rate pumping, like swimming, jogging, martial arts, or even dancing.
- A little is better than none. Even 20 minutes a day of cardio can boost your memory.[49]
- Take regular breaks. Study breaks are important for several reasons. There's a limit to what your brain can handle in any one study session. Trying to push past that without giving your body any time to recover will just leave you tired.
- Your brain consumes glucose when you're studying. Give yourself a mini-break (5 minutes or so) every hour. Stretch, take a short walk, or grab a brain-boosting snack such as fruit or almonds. This gives your body time to replenish your glucose stores.[50]
EditPerforming on Exam Day - Cram for the exam. If you didn't have time to prepare for your exam in advance, you may need to cram, or learn as much as possible in a short period of time, for the exam. It's not a very effective way to study, but cramming is better than not preparing at all.
- Read over your course notes the morning of the exam. Figure out if there were any subjects the professor highlighted in lectures and focus on these.
- If you haven't done any reading, read the introductions and conclusions of any article and books. This will help you figure out the most important arguments and facts about a subject.
- Have a study group with friends the night before the exam if you can. Talk through any points that you may not understand.
- Review the hardest stuff right before you go to bed the night before the exam. This may help you recall it more easily during test-time.[51]
- Stay calm. You will likely be a bit nervous on the day of the exam, and it's important to stay as calm as possible so that you can effectively take the test. There are different ways to help calm yourself, including have a good breakfast and taking a walk.[52]
- A good meal will give your body and brain energy to perform their best during the exam.
- Eat and drink to stay alert. You want to make sure that your body and brain are as alert as possible before and during an exam. Eating and drinking the right foods and beverages will help ensure that that you not only are awake but also attentive to your exam.
- Don't eat heavy meals before an exam, which will divert blood from your brain for digestion. Soup or a salad with some protein are good, light choices that will give you energy without weighing you down.
- Make sure that you're hydrated before an exam. One of the symptoms of dehydration is fatigue, so bring a bottle of water with you.
- You can have a cup of coffee or tea if you like. One or two cups may temporarily increase feelings of alertness.[53] The effect wears off fairly quickly, however, and more than two cups could actually cause impairment, so use moderation.[54]
- Chewing mints or mint gum will also help you stay alert. Studies have shown that mints or mint gum increased alertness, accelerated reaction time, and increased how people process information.[55]
- Don't load up on sugar just before a test. If you're craving something sweet, try dark fruits (plums, blueberries, etc.) or a small square of dark chocolate.[56]
- Be confident. If you've attended class, taken notes, done the assignments, and studied, you can be confident that you're ready to take the exam. Having this confidence and visualizing yourself passing the exam will help you be successful.
- If you attended class, did your work, and studied, you can be confident that you will pass the exam.
- If you took the time to go to a study session or discuss the exam and your standing in class with your professor, you can have confidence in your ability to pass the exam.
- Knowing that you have formulated a plan to complete each section of the exam will also instill confidence in you.
- Arrive before the exam starts. In order to help yourself remain calm, make sure to arrive at the exam room before the exam starts. This will not only relax you but also ensure that you can get settled in to take the test.
- Make sure to find out where your exam is ahead of time, and note the location in a place you can easily find it later.
- Set an alarm so you arrive on time. In fact, setting more than one alarm may help you feel more at ease.
- Pace yourself. You only have a certain amount of time to complete an exam, so pace yourself as you work. This will ensure that you get through every section of the exam.[57]
- Before you start, read over the entire exam and identify the easiest, most difficult, and most time consuming sections of the exam.[58]
- Break the time of the exam down by section. For example, if you have two hours to finish two essays, you can take one hour to compose each. Or if there is one essay and eight identification and short essays, you can break this up based on time as well as your strengths and weaknesses.[59]
- Decide on the best strategy for you. After you've read the exam, figure out the best strategy to finish the exam based on your strengths and weaknesses.[60]
- Attack the exam strategically. After you've given the exam a once-over, approach it strategically. This will help you maximize your knowledge and avoid getting "stuck" on things you don't know.[61]
- Answer easy questions first. Not only will this get them out of the way, it can help boost your confidence for the harder stuff.
- Eliminate any obviously wrong answers. If you can, cross out any answers that are obviously wrong. Even if you don't know the right answer, you increase your chances of guessing correctly.
- For essay questions, write an outline before writing the essay. Note down your main "argument" or thesis plus the main points you want to hit. This will help you stay on track as you write your response.
- Review your answers before you submit your exam. Look for any incomplete or missing answers, errors, etc.[62]
- Don't cheat. Whatever you do to pass an exam, never cheat. Looking at your notes, writing information on your hands, and copying off of another person's exams are all forms of cheating.
- Cheating will guarantee not only that you fail a class, but also could have other significant consequences such as expulsion.
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| How to Fix a Dislocated Shoulder Posted: 28 Nov 2016 12:00 AM PST Dislocated joints, particularly of the shoulder, are painful injuries that cause immediate short-term disability — movement of the joint is essentially impossible until it's relocated or reset. The shoulder is especially vulnerable to dislocation because it's the most mobile joint in the body and people tend to fall with an outstretched arm, which puts the joint in an awkward position.[1] It's always best to have a dislocated shoulder fixed or reset by a trained health professional, although there may be unusual (emergency) circumstances that warrant trying to do it yourself. Not resetting a dislocated shoulder in a timely fashion may eventually necessitate surgery to properly fix it. EditDealing with a Dislocated Shoulder - Recognize the symptoms. A dislocated shoulder is usually caused by either falling onto an outstretched arm or the shoulder being impacted from behind. The injury causes sudden and severe pain, preceded by a popping feeling and/or sound. The shoulder will look visibly deformed or out-of-place, and swelling and bruising appear quickly.[2] Moving the shoulder is not possible until it is relocated.
- A dislocated shoulder hangs lower than the uninjured side and you can usually see a depression or groove in the lateral (deltoid) muscle of the shoulder.
- A shoulder dislocation may also cause numbness, tingling and/or weakness down the arm and into the hand. If blood vessels are damaged, the lower arm and hand on the injured side will feel cold and turn a bluish color.
- About 25% of first-time shoulder dislocations involve fractures of the upper arm (humerus) or shoulder girdle.[3]
- Immobilize your arm. While you're waiting to get medical attention, it's important to not move (or attempt to move) a dislocated shoulder because you may make the injury worse. A bone fracture, damaged nerve or ripped blood vessel may be involved, so any movement could have dire consequences. Instead, bend your elbow, wrap your forearm around your stomach area and hold it in position with a sling.[4]
- If you don't have access to a ready-made sling, then make one from a pillow case or article of clothing. Put the sling under your elbow/forearm and tie the ends around your neck. Slings immobilize and protect the shoulder from further injury, and often greatly reduce the degree of pain.
- About 95% of shoulder dislocations are in the anterior direction, which means the upper arm bone (humerus) is pushed forward out of its socket.[5]
- Ice your shoulder. Getting ice or something cold onto a dislocated shoulder joint as soon as possible is important in order to inhibit inflammation, which usually translates into less pain.[6] Ice causes small blood vessels to constrict (narrow), which limits the amount of blood and inflammation that can flow into and around the injured area. Apply the crushed ice to the shoulder for about 15 – 20 minutes at a time (or until the area feels numb) every hour or so.
- Always wrap ice in a thin cloth, towel or plastic bag before applying it to bare skin — it'll help prevent frostbite or skin irritation.
- If you don't have access to crushed ice or ice cubes, then use some frozen veggies from the freezer or a frozen gel pack.
- Take pain medications. Once the dislocated shoulder is immobilized and covered in a bag of ice, consider taking some over-the-counter medication to further combat the inflammation and pain. The pain from a dislocated shoulder is often described as almost unbearable due to all the stretched and/or torn ligaments, tendons and muscles that occur, in addition to potential bone fractures and cracked cartilage. Ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn) are likely the best choices because they are strong anti-inflammatories, although acetaminophen (Tylenol) can be helpful for pain control also.[7]
- For a dislocated shoulder that also involves significant internal bleeding (you'll see lots of bruising), avoid ibuprofen and naproxen because they tend to "thin" the blood and reduce its clotting ability.
- A muscle relaxant medication might also be indicated if the muscles around the dislocated joint are spasming. However, never mix different types of drugs concurrently — pick one or the other.
EditRelocating in Emergency Situations - Relocate your shoulder only in emergency situations. Under most situations, waiting for professional medical help is the best idea and certainly the safest way to go, but sometimes that's not possible. If you're in an isolated situation far from medical attention (camping, mountain climbing, traveling abroad), the potential risks of fixing your own shoulder — or that of a friend or family member — may not outweigh the benefits of experiencing immediate pain relief and increased arm/shoulder mobility.
- As a general rule of thumb, if you can get medical assistance within 12 hours, then wait patiently and try to reduce the discomfort with ice, painkillers and a sling. If a much longer waiting time is apparent, particularly if you need some mobility in your shoulder to get to a hospital, then relocating your shoulder might be considered.
- The main complications related to trying to relocate your own shoulder are: further tearing muscles, ligaments and tendons; damaging nerves and blood vessels; life-threatening bleeding; severe pain that results in loss of consciousness.[8]
- Ask for help in an emergency situation. If you're forced to consider relocating your own shoulder in an emergency situation, then realize that putting it back in without assistance is nearly impossible. As such, ask for help or offer to help someone else if in an emergency situation. People may be reluctant to help you because they don't want to cause you more pain or risk injuring your shoulder more, so try to reassure them and release them from any liability.
- If you're needed to help someone else relocate his shoulder, make sure to get his consent and tell him clearly about your lack of medical training (if applicable). You don't want to face any litigation for trying to be helpful if things go wrong.[9]
- If you have a phone and can make a call, try contacting emergency services for advice and support. Even if they can't send medical personnel to you right away, they may be able to offer helpful instructions.
- Lay on your back and abduct your arm. Probably the easiest way for non-professionals to relocate your shoulder joint is if you lay flat on your back with your injured arm away from your body at a 90 degree angle. Then get your friend or a bystander to firmly grab your hand or wrist and slowly (but firmly) pull on your arm, which will create traction. The person may have to position her feet against your torso for additional leverage. Pulling the arm at that angle allows the head of the humerus to slide under the bone of your shoulder blade and back into its socket with relative ease.[10]
- Remember to use a slow, steady pull (without any fast or jerky movements) directly away from the body until the shoulder re-articulates. If it successful, you will hear a "clunk" and feel the shoulder get back into position.
- As soon as the shoulder relocates, the level of pain associated with the injury will reduce significantly. However, the shoulder will still be unstable, so make a sling and immobilize the arm if possible.
EditGetting Medical Attention - See a doctor as soon as you can. Getting to a doctor (or an appropriately trained medical professional) quickly is important when dealing with a dislocated shoulder because when the muscles, tendons and ligaments around the injury tighten up, the head of the humerus becomes very difficult to relocate without surgical intervention. Most doctors will likely want to x-ray your shoulder area before doing anything else in order to rule out a fracture.[11]
- If nothing is broken or badly torn, then the doctor can perform a closed reduction maneuver on the shoulder joint, although you may need a sedative, strong muscle relaxant or general anesthetic before the physical manipulation can be done due to the severe pain.
- A common reduction method for the shoulder joint is called the Hennepin maneuver, which utilizes external rotation of the shoulder.[12] While laying flat, the doctor will flex your elbow to 90 degrees and gradually rotate your shoulder outward (external rotation). Some gentle pushing while in this position is usually enough for the joint to relocate.
- There are a handful of other reduction techniques that doctors use — it depends on what they feel comfortable with.
- Prepare yourself for the possibility of surgery. If your shoulder is regularly dislocating (due to a bone deformity or ligament laxity), or if any bones are fractured or nerves and/or blood vessels ripped, then you'll need surgery to repair the damage and have the shoulder joint reduced openly.[13] Surgery is sometimes the best option because it can fix internal damage and stabilize the joint, which greatly reduces the risk of dislocation in the future.
- There are many different surgical procedures that are performed, so it depends on the extent of the damage and the patient's lifestyle/activity level as to which technique is used.
- Some studies suggest that surgical "open" reduction may be the best course of action for active adults younger than 30 years due to lower recurrence rates and better quality of life outcomes.[14]
- Rehabilitate your shoulder. Regardless if you get a closed manual reduction or an open surgical reduction, you should get a referral for physiotherapy and strengthen your shoulder joint.[15] Physical therapists, chiropractors and/or athletic therapists can show you specific stretches to regain full mobility and range of motion in your shoulder, as well as exercises that strengthen and tighten the joint so that it's unlikely to dislocate in the future.
- It often takes two to four weeks of recovery before a referral to physical therapy is appropriate. Wearing a sling, applying ice and taking over-the-counter medications is all part of the recovery phase.[16]
- The total time to rehabilitate and recover from a shoulder dislocation ranges from three to six months, depending on the severity of injury and if the patient is an athlete or not.[17][18]
- After a few days when the pain / inflammation have ceded, applying some moist heat to your shoulder might help relax the tight and sore muscles. Microwavable herbal bags work well. However, limit heat applications to 15 – 20 minutes at a time.
- Once you've dislocated your shoulder joint once, you become more at risk of future dislocations, especially if you participate in contact sports.
- Relocate your shoulder as soon after the accident as you are able, as difficulty relocating it increases with time.
- A dislocated shoulder is different than a separated shoulder. The latter is a ligament sprain to the joint that holds the collarbone (clavicle) to the front part of the shoulder girdle — the glenohumeral joint is not dislocated.
- After relocating a dislocated shoulder, you should always check the pulse in the affected limb below the site of the dislocation. It should be the same as the other arm (unaffected limb). If there is a slower pulse or no pulse, then it's a medical emergency and requires immediate assistance, as cell death begins quickly and could result in loss of the arm.
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