In our small series of 10 patients, all patients had prolonged (>1-month duration) and moderate to severe limitations of shoulder ROM and were diagnosed as frozen shoulder; thus, full-blown frozen shoulder may also develop after COVID-19 vaccination. -, Boonsri P., Chuaychoosakoon C. Combined Subacromial-Subdeltoid Bursitis and Supraspinatus Tear Following a COVID-19 Vaccination: A Case Report. If the condition is diagnosed in the inflammatory phase, Deu said a cortisone shot injected into the joint can help reduce inflammation and pain, allowing people to potentially start range-of-motion exercisessooner. Shoulder Injury Related to COVID-19 Vaccine Administration: A - PubMed 2012;112:447449. Twenty-five patients diagnosed as idiopathic frozen shoulder were seen in the shoulder surgeons practice center between June 1 and September 30, 2021. rosiewln Community member Posts: 6 Listener May 2021 Surg. The present study is a retrospective study on a small number of patients. National Vaccine Injury Compensation Program. 2023 Healthline Media UK Ltd, Brighton, UK. If a medical professional administers the injection improperly, this can cause injury to the shoulder joint, leading to pain and swelling. It is not the vaccine itself that causes the complication instead, it is the way a person administers the vaccine. 2022 Oct 15;15(1):63. doi: 10.1186/s40545-022-00459-3. -, Hesse E.M., Atanasoff S., Hibbs B.F., Adegoke O.J., Ng C., Marquez P., Osborn M., Su J.R., Moro P.L., Shimabukuro T., et al. Im still doing things to try to continue the recovery. The other possible reasons for SIRVA that have been described but largely unproven are that there may be an antigen-antibody reaction because of the injection of the antigen in the subacromial-subdeltoid bursa, thus leading to acute and prolonged hyperinflammatory reaction.5 Overpenetration, wrong site, and wrong vaccination technique have also been frequently implicated as possible mechanisms.1,13 A true explanation behind the causation may need a detailed scientific study and may be needed in the future, but a recognition of this possible etiology may at a minimum save the patient from a delay in diagnosis by an early recognition of the problem. Frozen Shoulder | Orthopedics & Sports Medicine - University of Connecticut and transmitted securely. The mean pain visual analog scale score was 6.5 1.9 (range, 2.5-8), and both active and passive range of motion were limited in all the patients at the time of presentation. -, Cagle P.J. Weisel B, et al. Two of the seven patients visited the orthopedic clinic after the persistent shoulder pain for 3 and 4 days and the other five patients 1-9 weeks following their injections. The hospital local Research Ethics Committee decided that no ethical approval is required. PMC Most of the time, this soreness is mild and will go away without treatment in a few days. Yet one of the most common complaints from people whove received a vaccination is soreness in the upper arm or shoulder where they receive the vaccination. The researchers suggested that both direct and indirect effects of having covid-19 may be involved in the development of frozen shoulder, with possible links to inflammation caused by the infection. Doctors can usually treat SIRVA, which will reduce pain and improve range of motion. Effect of nonoperative concomitant intraarticular pathologies on the outcome of arthroscopic capsular release for adhesive capsulitis of the shoulder. Most patients with SIRVA seek treatment from musculoskeletal specialists.21 Hence, a clinical description and data regarding shoulder injury after the COVID-19 vaccine is important for the education and awareness of physicians. An official website of the United States government. The https:// ensures that you are connecting to the Frozen shoulder, also called adhesive capsulitis, happens when the ligaments that hold the shoulder joint in place tighten due to inflammation and restrict the joint's movement. . Methods: sharing sensitive information, make sure youre on a federal Covishield is a nonreplicating adenoviral vector vaccine (ChAdOx1 nCoV-19) produced by Serum Institute of India in collaboration with AstraZeneca. Cassart EM, Vilas DR, Abe R, Cavanilles-Walker JM. An official website of the United States government. Federal government websites often end in .gov or .mil. Any vaccination can cause SIRVA. Once the inflammation clears up, people enter the frozen, or stiff, phase, Bishop said. -, Hexter AT, Gee E, Sandher D. Management of glenohumeral synovitis secondary to influenza vaccination. Vaccination process evaluation at COVID-19 vaccination centers in Lebanon: a national study. HHS Vulnerability Disclosure, Help Please enable it to take advantage of the complete set of features! However, Vaccine allergy is so rare that youre more likely to be struck by lightning this year than have an allergic reaction to a vaccine. They are part of the bodys natural process of building immunity. The impact of the COVID-19 pandemic on frozen shoulder incidence rates and severity During the COVID-19 pandemic, there was a significant increase in the incidence of patients with FS. In the present study, 10 patients (9 women and 1 man) with a mean age of 53 8 years (range, 43-68 years) who presented to the shoulder surgeon's practice center with painful stiffness of the shoulder after COVID-19 vaccination between June 1 and September 30, 2021, were retrospectively evaluated. Eight patients (80%) had a comorbidity during presentation (4 patients with hypothyroidism, 3 patients with diabetes mellitus, and 1 patient with prediabetes/hyperglycemia; TableI). It should be 2 to 3 fingerbreadths (the width of your fingers when held together) down from your acromion process the bony part of your shoulder above your deltoid muscle. It is an underreported and preventable event. (2022). Bulgen D.Y., Hazleman B.L., Ward M., McCallum M. Immunological studies in frozen shoulder. Keywords: Shoulder injury related to vaccine administration - Wikipedia Nat Rev Rheumatol. Doctors use the term SIRVA, which stands for shoulder injury related to vaccine administration, to describe this. Frozen shoulder after COVID-19 vaccination The musculoskeletal specialists who will see such patients with painful shoulder stiffness should be aware of the frozen shoulder diagnosis, which can occur after COVID-19 vaccination, so that such patients can be identified and treated early. Clinical relevance: Such severe reactions to vaccines are very rare, but they do occur. HHS Vulnerability Disclosure, Help However, improper vaccination technique can cause SIRVA, which can damage the shoulder joint. doi: 10.1177/1715163518790771. Federal government websites often end in .gov or .mil. There were 9 women and 1 man in our cohort with an average age of 53 years; our finding agrees with earlier reports that the average age is around 51 years,13 and women are more likely to be affected by SIRVA.1 The onset of symptoms after vaccination was immediate in 6 patients, at 48 hours in 1 patient, and at 10 days in 3 patients. Saudi Arabia Mental Health Surveillance System (MHSS): mental health trends amid COVID-19 and comparison with pre-COVID-19 trends. Sukhija S, Singh S, Saxena S, Ambwani S, Khera PS. Hence the vaccine can be safely given in the deltoid muscle in the shoulder, even if the same shoulder is affected by the frozen shoulder. PMC Careers, Unable to load your collection due to an error. Learn how long COVID-19 vaccines may protect you, including data from Moderna, Pfizer-BioNTech, Johnson & Johnson, AstraZeneca, and NovaVax vaccines. Clipboard, Search History, and several other advanced features are temporarily unavailable. Boonsri P., Chuaychoosakoon C. Combined subacromial-subdeltoid bursitis and supraspinatus tear following a COVID-19 vaccination: a case report. The https:// ensures that you are connecting to the Shoulder injury related to vaccine administration: Diagnosis and management. Patients are often diagnosed with inflammatory shoulder injuries (e.g., bursitis, rotator cuff tears, frozen shoulder syndrome, adhesive capsulitis) that do not appear to be any different than routine shoulder injuries, except that the shoulder symptoms started within days of an IM deltoid vaccination. Adhesive capsulitis; COVID-19; Frozen shoulder; SIRVA; Shoulder pain; Stiffness; Vaccine. Estimating the early impact of vaccination against COVID-19 on deaths among elderly people in Brazil: analyses of routinely-collected data on vaccine coverage and mortality. Often, SIRVA treatment includes one or more of the following: The exact treatment a person receives differs from person to person, depending on their symptoms. But they emphasized that a majority of frozen shoulder cases can be treated without surgery. All SIRVAs were from an incorrect injection technique and not actually the vaccination, so our series highlights the importance of ensuring all vaccinators understand the importance of taking proper care with the injection technique. and transmitted securely. Some studies have found that the symptoms of SIRVA may last at least 6 months. Localized autoimmune reaction has been investigated and stated as one of the etiological factors responsible for the development of idiopathic frozen shoulder in past reports.3,4 Vaccines are supposed to be absorbed locally and induce a local antibody response; However, any inadvertent systemic absorption of the vaccine and transfection to distant sites by the deltoid vasculature may lead to the rare autoimmune response against the transfected tissues.15 Autoimmune conditions such as Guillain-Barre syndrome and thrombosis with thrombocytopenia syndrome after vaccination have been theorized to occur as a result of similar systematic transfection of the vaccine and resultant autoimmune response to nerves and platelets.15 It may be possible that vaccine transfection to local capsular tissue or nerves may have elicited an autoimmune response leading to the development of a frozen shoulder. The most common side effects from vaccination, including the COVID-19 vaccines and boosters, are mild. government site. -, Boonsri P., Chuaychoosakoon C. Combined subacromial-subdeltoid bursitis and supraspinatus tear following a COVID-19 vaccination: a case report. Over-the-counter anti-inflammatory medications, such as Advil or Motrin, can also help people manage inflammation. A description of frozen shoulder after COVID-19 vaccination is virtually absent from the orthopedic literature.21. One year earlier, there were 898 initial consultations for a new shoulder problem; of these, 176 were for idiopathic FS. -. Cases also appear to bemoreprevalent among peoplewithcertain underlying health conditions, including diabetes,particularly Type 1 or insulin-dependent diabetics, and thyroid disorders, said Julie Bishop, chief of the division of shoulder surgery at Ohio State Universitys Wexner Medical Center. But experts cautioned against getting an MRI. A shoulder injury related to vaccine administration (SIRVA) is a vaccination complication that can affect daily life activities. doi: 10.5435/JAAOSGlobal-D-22-00156. 2022 Jun 30;95(2):217-220. eCollection 2022 Jun. Curr Sports Med Rep. 2022 Mar 1;21(3):78-83. doi: 10.1249/JSR.0000000000000939. A doctor may recommend one or more of the following options: Vaccine side effects, such as shoulder pain, usually resolve after a few days. Its also important for medical professionals to be aware of SIRVA so that patients may be treated in a timely, effective manner. Degenerative Disc Disease: Can Injections Help Relieve Back Pain? Overview. The .gov means its official. Millions of doses of vaccines for the prevention of COVID-19 have been administered to adults worldwide during the pandemic. Methods: (. -, Batra S, Page B. Would you like email updates of new search results? A misdiagnosis, Fu said, could be problematic for a persons recovery. All patients who were diagnosed with idiopathic FS were included. The second stage is the frozen stage, when the shoulder loses range of motion and "the capsule becomes thicker from inflammation ," notes Shubin Stein. The VAS pain score was similar in both groups: mean 6 2 and 7 2, respectively (P = .06). Vaccine. All 10 patients had normal radiographs and were diagnosed as frozen shoulder. Pfizer-BioNTech COVID-19 vaccine reactions & adverse events. (. report of 3 cases. Septic arthritis of shoulder joint following a COVID-19 vaccination: A case report. 1. (2020). For a very benign process that almost never ends up in surgery, it is miserable for the people that have a really severe case of it, she said. The Centers for Disease Control and Prevention (CDC) recommends a range of vaccines for most people to help prevent dangerous diseases. I knew it wasnt right, but because it would only happen at certain times at that point, I didnt think it was as serious as it was.. The site is secure. Accessibility The injection techniques. The aching is usually temporary and relieved by an ice pack, anti-inflammatory medications, and a few days of resting your arm. The shoulder capsule its a thin lining around the joint itself has to maintain a delicate balance between flexibility, pliability and also integrity, Fu said. government site. Six patients (60%) had no symptoms in their affected shoulder, and 4 (40%) patients had mild, intermittent shoulder pain before the vaccination (TableI). Shoulder Injury Related to COVID-19 Vaccine Administration: A Case Series. Vaccine. What causes frozen shoulder? That number is larger when factoring in all the various vaccinations beyond just the flu vaccine. Vaccines and summer travel what families need to know, Take an overnight trip with your two-wheeled vehicle. Epub 2022 Jun 8. Ibuprofen and ulcers: What Rep. Debbie Dingells emergency surgery can teach us. (, Ultrasonographic images of the right shoulder of Patient 7. Fu added that limitsto access to care, such as in-person physical therapy sessions, during the pandemic andchanges in peoples daily activities might also be possible triggers. Muscle soreness and achy joints are common symptoms among COVID-19 patients. Typically, shoulder injections should enter the deltoid muscle. Ministry of Health and Family Welfare; Government of India Indian COVID-19 vaccine tracker. How to release a frozen shoulder - Harvard Health Background: government site. Ann Med Surg. Earlier reports have also noted that diabetes and thyroid disorders are risk factors for developing idiopathic frozen shoulder.20 Hence, the possibility of frozen shoulder should be considered in a patient with comorbidity who develops painful stiffness after the vaccination. The site is secure. Scientists estimate that the first rounds of COVID-19 vaccines administered between December 2020 and December 2021 prevented 20 million deaths in 1 year. J Am Acad Orthop Surg Glob Res Rev. Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We spoke with researchers, physicians, and people with lived experiences of this effect to find, In this feature, we highlight the most common side effects of the Moderna COVID-19 vaccine. Bethesda, MD 20894, Web Policies -, Bancsi A, Houle SKD, Grindrod KA. But there have been earlier reports on shoulder stiffness and frozen shoulder after influenza vaccination.1,8 Furthermore, a recent increase in the presentation of frozen shoulder immediately after the vaccination, as seen in our series, should be an eye-opener and should lead to further research and improvement of our understanding behind the frozen shoulder etiopathogenesis. Med. Yildiz F, Sari A, Pulatkan A, Ucan V, Kochai A, Bilsel K. Acta Orthop Traumatol Turc. Credit: Northwestern University Imaging illustrates severity, long-term prognosis of COVID-19-related muscle, joint pain. We avoid using tertiary references. Zeitoun A, Hallit S, Helali M, Chehade S, Allam C, Ibrahim A, Dimassi H, Karam R. J Pharm Policy Pract. We excluded those patients who had significant shoulder pain and stiffness before the administration of the first dose of the COVID-19 vaccine. (2021). This site needs JavaScript to work properly. Risk of bursitis and other injuries and dysfunctions of the shoulder following vaccinations. Ten patients (9 women and 1 man) with a mean age of 538 years (range, 43-68 years) developed painful shoulder stiffness following COVID-19 vaccination. This site needs JavaScript to work properly. official website and that any information you provide is encrypted Risk factors in idiopathic adhesive capsulitis: a case control study. Frozen Shoulder | Johns Hopkins Medicine Keywords: 8600 Rockville Pike Corticosteroid Injections Accelerate Pain Relief and Recovery of Function Compared With Oral NSAIDs in Patients With Adhesive Capsulitis: A Randomized Controlled Trial. thought to occur as a result of unintended injection of vaccine antigen or trauma from the needle into and around the underlying Frozen shoulder after COVID-19 vaccination - PMC - National Center for doi: 10.1038/s41584-020-0448-7. Shoulder injury related to vaccine administration (SIRVA) after COVID-19 vaccination. Prevent shoulder injuries during COVID-19 vaccinations FOIA Frozen shoulder syndrome can be a severe manifestation of vaccination-related shoulder dysfunction. Correct intramuscular administration is crucial to prevent post-vaccination frozen shoulder and on the other hand, physicians' awareness is needed to recognize this feature early on. Epub 2022 Nov 12. Frozen shoulder cases can resolve on their own without treatment, experts said, but it can take a long time. Surgery cant get rid of inflammation or stop the conditions natural progression to stiffness, Bishop said. See this image and copyright information in PMC. doi: 10.1177/1758573214560258. Unauthorized use of these marks is strictly prohibited. (2022). In its proposed rule, the Trump administration argued that shoulder injurieswhich can happen when vaccines are administered too high on the arm were not caused by the vaccines per se and therefore were not compensable injuries under the National Vaccine Injury Compensation Program (VICP). Once you get into this cascade of a little bit of inflammation or microtrauma that leads to more inflammation, that just sets off the whole cycle of adhesive capsulitis, where the capsule, which is normally really thin like a piece of tissue paper almost, then becomes really thick and like cardboard, and thats how your shoulder gets tight and you lose range of motion.. In most cases, SIRVA pain emerges within 24 hours of receiving the vaccination. Can Pharm J (Ott) 2018;151(5):295299. A larger study and a longer follow-up will be needed and is currently underway to accurately define the prognosis and significance of the frozen shoulder after vaccination. Fathizadeh H., Afshar S., Masoudi M.R., Gholizadeh P., Asgharzadeh M., Ganbarov K., et al. Clinical features, follow-up, range of motion, and pain scores of 10 patients with frozen shoulder after COVID-19 vaccination. Bancsi A, et al. Background: A shoulder injury related to vaccine administration (SIRVA) is a vaccination complication that can affect daily life activities. All rights reserved. Less commonly, an individual may experience more extensive shoulder pain after getting the COVID-19 vaccine. Shoulder Pain and Injury after COVID-19 Vaccination.