As a massage therapist, I have been seeing more and more clients with shoulder issues. The complaints were the same… lack of mobility, reduced range of motion and overall achy and painful shoulder pain. I started doing some research. I realized the common denominator with each client complaining of this specific shoulder pain, was the covid vaccine! I discovered an underreported problem from the vaccine administration they are calling SIRVA. Also, I found a link for compensation at the end of this blog, so if this happens to you or you have seen this in your practice, read on!!

I want to be clear…I am not suggesting you allow this small risk to stop you from getting vaccinated, but it’s a good idea to learn about SIRVA , the cause, symptoms, treatment, and more importantly how to avoid it!. That way, you can get help if you need it.

SIRVA stands for shoulder injury related to vaccine administration.

What Are the Symptoms?

The main signs of SIRVA are serious shoulder pain and reduced range of motion, which gives you trouble with moving your shoulder normally. The symptoms usually show up within 48 hours after you get a vaccine shot in your upper arm and never really subside, or the person may notice a reduced range of motion in their shoulder. Research also suggests that over-the-counter pain meds don’t help the symptoms get better.

How Does It Happen?

It has nothing to do with the vaccine itself…. SIRVA can happen if a medical worker gives you a vaccine shot too high up on your upper arm. That could accidentally damage tissues or structures in the shoulder. At the onset of this global pandemic, the medical field wasn’t staffed adequately to handle millions and millions of vaccines that needed to be administered immediately all over the world. Volunteers and others were given a quick rundown on how to give a vaccine and turned loose to start saving the world from this killer virus. However…human error can create a mess in your shoulder.  The right place to give an intramuscular type of shot, such as COVID-19 vaccine, is in the middle, thickest part of the deltoid, a large triangular muscle that goes from your upper arm bone to your collarbone.

To prevent SIRVA and give these shots properly, many medical workers are trained to look or feel for specific physical “landmarks” on the arm that guide them to the deltoid muscle. Vaccine administration in the upper third of the deltoid area can have long-lasting consequences unrelated to the specific vaccine administered. Awareness of the potential for inducing a prolonged immune-mediated inflammatory reaction if a vaccine antigen is injected into synovial tissue structures underlying the deltoid muscle should be emphasized, as well as careful consideration given of proper injection technique when administering shoulder intramuscular vaccinations.

Why Does SIRVA Happen and How Common is it?

The symptoms of SIRVA stem from the shot going into the wrong part of your upper arm or due to trauma from the needle. Research suggests that this brings on inflammation and it could injure body parts inside your shoulder like:

  • Ligaments. These tough bands of tissue connect two bones in a joint.
  • Tendons. These thick cords connect muscles to bones.
  • Bursae. These fluid-filled sacs cushion bones, tendons, and muscles.

We really do not know how common SIRVA is at this time related to injections from the COVID-19 vaccine. Some researchers say SIRVA is rare but the truth is…it is seriously underreported because people are not equating their shoulder pain with their vaccine.  

But I did find this in a study…

All the patients were adults, 71.1% females, with a mean and median age of 53.6 years (range: 22-89). The most frequently involved vaccines were influenza and pneumococcal vaccines, respectively; followed by diphtheria-tetanus-pertussis, diphtheria-tetanus toxoid, human papillomavirus, and hepatitis A vaccines. The most frequent shoulder lesion was bursitis. Most patients required medical care due to severe local pain and arm mobility restriction. In a majority of cases, symptoms started 48h post vaccination. Subdeltoid or subacromial bursitis and other shoulder lesions may be more common than suspected. Such lesions predominantly affect women. The cause may be related to antigens or adjuvants contained in the vaccines that would trigger an immune or inflammatory response. However, they are more likely to be the consequence of a poor injection technique (site, angle, needle size, and failure to take into account patient’s characteristics, i. e., sex, body weight, and physical constitution). Therefore, vaccination-related shoulder injuries would be amenable to prevention.”

Massage Therapists Be Aware! 

Tightness in the shoulder and reduced range of motion are usually symptoms people bring to their massage therapist before their doctor. Shoulder pain that worsens with activities that require raising the arm overhead is characteristic of these injuries. Pain at night and having trouble sleeping on the side of the affected arm are also common.

Improper injection into the shoulder can cause inflammation and swelling, scarring, or other damage. The resulting conditions fall in the category of SIRVA. If you notice the symptoms within a week or two from when the person received a vaccine, encourage them to see their doctor. Deep tissue massage can agitate and aggravate their symptoms.

This youtube video is a great resource for you to understand!

What Types of Shoulder Responses Can Occur?

SIRVA does not refer to one single medical diagnosis, but refers to a broader category of shoulder injuries and conditions. Some of the shoulder conditions included in the SIRVA category are:

  • Adhesive Capsulitis (Frozen Shoulder)
  • Impingement Syndrome of the Rotator Cuff
  • Rotator Cuff Tear
  • Tendonitis
  • Bursitis

These injuries are generally reported by patients as pain and limitation of movement. For example, people suffering from Adhesive Capsulitis, also known as “Frozen Shoulder,” experience pain and a progressive loss of range of motion, making it difficult or impossible to raise their arm above a certain level. The shoulder seems “frozen”, unable to move beyond a specific point.

Impingement Syndrome of the Rotator Cuff and Rotator Cuff Tears, on the other hand, affect the muscles that come together at the top of the shoulder. Impingement Syndrome may present as the initial condition, then progress to a full Rotator Cuff Tear. 

How Is It Diagnosed?

Talk to your doctor if you have bad pain or trouble moving your shoulder weeks after you get vaccinated in the upper arm even if your arm felt fine then it started acting up.

They might do tests to rule out other conditions that could bring on similar symptoms, like an infection or a rheumatic disease like arthritis.

They may also recommend imaging tests like:

  • Ultrasound. This uses sound waves to take a picture inside your body.
  • MRI. This uses a magnet and radio waves to see inside your body.

The doctor might diagnose you with SIRVA if:

  • Your shoulder felt fine before the vaccine shot.
  • Your symptoms started within a certain number of hours of days afterward.
  • The symptoms are only in the arm and shoulder area where you got jabbed.
  • Tests don’t spot signs of another health problem that would explain the symptoms.

What Are the Treatments?

Talk to your doctor if you have serious pain or trouble moving your arm or shoulder after you get vaccinated. If the doctor thinks you might have SIRVA, they may recommend treatments like:

  • Physical therapy
  • Steroid shots
  • Anti-inflammatory drugs

You may need surgery if the injury is severe.

Some experts say more research is needed to figure out the ideal treatment for SIRVA. Massage is contraindicated until released by the doctor or physical therapist.

Does It Ever Go Away?

The little research available suggests that people with SIRVA who get treatment show “modest” improvements. But some have symptoms that never go away completely. For instance, it’s possible to have ongoing shoulder pain and less range of motion.

One study suggests that most people with SIRVA have symptoms for at least 6 months, and less than a third make full recoveries.

The research shows that diagnosis of SIRVA should be considered in patients with established symptoms of shoulder pain following a vaccination. 

Use Infused ReLeaf After Your Vaccine!

I am not suggesting Infused ReLeaf will prevent SIRVA, but customers say it helps reduce the pain and inflammation that comes with the vaccine. Rub it in as soon as you get jabbed for cooling relief right away. Keep it near you all the time so you can rub it in whenever you feel discomfort in your arm and shoulder and neck.

What is the National Vaccine Injury Compensation Program?

Medical appointments, treatments, medications, therapies, and other modalities associated with SIRVA can be expensive. Add other costly outcomes, such as lost wages and productivity due to prolonged pain and disability, and costs increase.

The National Vaccine Injury Compensation Program (NVICP) is a federal no-fault compensation program that was created, in part, to compensate individuals who suffer vaccine-related injuries. The NVICP draws on funds from the National Vaccine Injury Trust Fund to provide compensation for those who have been injured by a vaccine. Petitioning for compensation through the NVICP is a legal process.