What are the recommended immediate management steps for an adult with an acute shoulder dislocation?

Immediate management of an adult with an acute shoulder dislocation involves prompt clinical assessment to confirm the diagnosis and exclude associated fractures or neurovascular injury, followed by timely reduction of the dislocation to restore joint alignment and relieve pain NICE NG38. The reduction should be performed as soon as possible, ideally in an emergency or acute care setting, using appropriate analgesia or sedation to facilitate the procedure and minimize patient discomfort NICE NG38. Post-reduction, the shoulder should be immobilised briefly, typically in a sling, to allow soft tissue healing while avoiding prolonged immobilisation that may impair recovery NICE NG38. Early referral for physiotherapy focusing on pain management, restoration of range of motion, and strengthening exercises is recommended to optimise functional recovery and reduce recurrence risk Liew et al. 2021. Additionally, patient education on self-management strategies and activity modification is important to support rehabilitation and prevent further injury Liew et al. 2021. Imaging, such as an X-ray, should be performed before and after reduction to confirm successful realignment and to identify any fractures or complications NICE NG38. Overall, the integrated approach combines immediate reduction and immobilisation per UK guidelines with early physiotherapy and self-management interventions supported by recent research to enhance outcomes NICE NG38; Liew et al. 2021.