What is the problem?
With widespread rollout of vaccines, it was noticed that there has been increase in complaints of shoulder pain following vaccines. Initially it was dismissed as a chance finding, but over the last 2 years papers have been published to confirm there is a correlation between vaccine administration and shoulder pain in some patients. While we still do not know what triggers this pain and who is at risk, we do know that symptoms can vary from aching pain in shoulder to a full blown frozen shoulder type of picture causing significant pain and stiffness. This group of symptoms has been labelled as SIRVA (shoulder injury related to vaccine administration). It is thought that incorrect placement of needle or accidental injection of the vaccine into capsule of the joint instead of deltoid muscle bulk can generate this response but evidence is not clear on this aspect.
What happens if you develop Frozen shoulder:
If a frozen shoulder cycle sets in following SIRVA, the treatment approach should focus on physical therapy and injections initially, but Hydrodistension can be quite useful in resistant cases. It is important to remember many cases may need more than 6 months to resolve. Proper counselling and treatment suitable for the particular time frame is important. Remember, vaccines will need to be given for the foreseeable future. It is important for patients to be aware of this particular condition so they can seek treatment in time, and also do not panic about the pain!
How to treat such pain:
Initially rest, icing and NSAID (ibuprofen type medication) can be tried for symptomatic treatment. However, prolonged rest or splinting is not recommended since it can promote stiffening of the joint. Occasionally steroid injections may be necessary to control pain. Symptomatic treatment using modalities like Interferential therapy has also been tried with some success.