An Overview of Subluxation

This condition occurs when a joint begins to dislocate

In This Article

A subluxation is a partial dislocation of a joint. It’s often the result of acute injury or repetitive motions, but it can also occur because of medical conditions where the ligaments are loose. Treatment for subluxations often includes resetting the joint, pain relief, rehabilitation therapy, and in severe cases, surgery. 

Signs of Joint Subluxation
Verywell / JR Bee

Symptoms

Some of the common symptoms of a joint subluxation include:

  • Pain around the injured joint
  • A sensation of the joint being unstable
  • Swelling of the joint
  • Limited mobility of the joint
  • Bruising or discoloration
  • Possible loss of feeling or numbness

If your injury is serious, you should either call 911 or go to the nearest emergency room. Signs of an emergency include severe pain, loss of sensation in a body part, or inability to use the body part or put weight on it.

Joints Commonly Affected

Some joints are more likely than others to be affected by subluxations. Some of the most common places include the spine, shoulder, patella (kneecap), and elbow.

Spine Subluxation

A spinal subluxation can occur with a trauma to the spine, such as an accident or fall. A subluxation, where your vertebra is partially dislocated, may involve ligament rupture without injury to the bone. This type of injury can compress the spinal cord, resulting in pain or improper nerve function.

The term subluxation is also used by chiropractors to describe any misalignment of the vertebrae that needs adjusting. Chiropractors use spinal manipulation to help adjust joints in the spine to put them in proper alignment.

Shoulder Subluxation

A shoulder subluxation means that the ball of your upper arm comes partially out of the socket in your shoulder blade. Severe injury or trauma is often the cause of an initial shoulder subluxation. Sports like swimming, tennis, and volleyball involve repetitive upward motions that can loosen the ligaments in the shoulder and make it more likely to incur a subluxation.

Your shoulder may feel like it’s in pain, loose, or like it’s slipping in an out of the joint.

Patellar Subluxation

The kneecap fits in a groove at the end of the thigh bone. A patellar subluxation happens when the kneecap partially moves out of that groove.

It’s usually caused by a direct fall onto the knee but can also happen if your knee ligaments are loose. Symptoms can vary but may include pain, feeling the knee “give way,” swelling, or a misshapen look to the knee.

Patellar subluxation is the most common knee problem for children and adolescents.

Elbow Subluxation

Elbow subluxations may occur when someone falls onto their hands. While elbow dislocations are typically very painful, subluxation may not be as obvious. The elbow may move well, although there may still be pain.

Children under 7 years old commonly get a type of subluxation called radial head subluxation (a.k.a. nursemaid’s elbow). It often occurs when the child’s arm is pulled, like when an adult helps them get up off the floor or swings them by their arms. Because the bones and muscles are growing, your child’s elbow can become partially dislocated easily.

Nursemaid’s elbow will cause pain but can be easily reset by a doctor.

Causes

Subluxations most often occur after trauma to the joint. That trauma can include:

  • Direct force injury, such as from a motor vehicle accident or sports injury
  • Wear and tear from daily activities 
  • Overuse injuries, including when athletes are training

Subluxations can also occur as a result of loose joints. For example, patients with generalized joint laxity and Ehlers-Danlos syndrome have joints that are overly flexible. They are prone to getting joint subluxations without any trauma or injury. During pregnancy, your hormones also loosen ligaments, making your joints more mobile and at-risk for injury.

Diagnosis

If the injury causes some pain and swelling but doesn’t appear to be serious, make an appointment with your doctor to get evaluated.

During your appointment, your doctor will examine the injured joint to assess any visible damage, including swelling and bruising. In order to confirm whether you have a joint subluxation, your doctor will order tests, which could include an X-ray, magnetic resonance imaging (MRI), or computerized tomography (CT). This will allow the doctor to see where the joint is located, as well as the nature and severity of the injury.

Doctors will use these same diagnostic tools if you're seen in the emergency room. They'll also check for serious injuries that need immediate treatment, including artery and nerve damage.

Treatment

After examining your injury, your doctor will likely need to move the joint to put it back in its proper place through manipulation, which involves turning or pulling the limb. Once the joint alignment is confirmed and your doctor has ruled out any complications, treatment can be focused on reducing inflammation of the affected joint. Steps that can be helpful to reduce inflammation include:

  • Protection: You should keep your joint still to prevent another injury. Your doctor may suggest a splint or other device to help protect an unstable joint.
  • Rest: Limit activity and avoid putting weight on the body part to allow the injured joint to rest.
  • Ice and compression: This can help to relieve pain and swelling. Make sure you have a thin cloth between the ice and your skin. Apply the pack for 15 to 20 minutes at a time. Your doctor may suggest an elastic bandage to help provide some compression as well.
  • Elevation: Place the injured joint above the level of the heart while laying down to help inflammation subside.

Your doctor may also suggest nonsteroidal anti-inflammatory drugs (NSAIDs) to alleviate swelling and inflammation.

Once the acute inflammation has subsided, your doctor may suggest a long-term treatment plan. Most of the time, joint subluxations are one-time events, and you will be able to recover the full function of the joint. However, some other injuries can cause recurrent problems. If your symptoms of instability persist, then you should seek medical help to determine a long-term plan, which may include physical therapy to strengthen the muscles and ligaments around the joint.

Occasionally, surgery may be necessary if your doctor isn't able to realign your joint through manipulation. Surgery may be also be required to stabilize the joint or to treat fractures that occur along with the subluxation. 

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Article Sources
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