Shoulder pain is quite normal after any vaccine. But persistent shoulder pain is not. Shoulder injuries associated with the administration of a vaccine (also known as “SIRVA”) are a rare but possible event when you receive a vaccine or booster injection. Injections into the shoulder should go into the deltoid muscle.
But SIRVA occurs when a healthcare professional injects the vaccine too high or too deep into your shoulder. When not given correctly, your next booster injection can scrape your bone or nerve, or even puncture your bursa (the fluid-filled sac that protects the tendons in your shoulder).
The pain from SIRVA can be really hard to distinguish from the normal pain that occurs after a shot in your arm. But it’s important to know what to look for. Because, if left untreated, SIRVA can cause long-term problems in your shoulder over time.
I’ve seen people end up with completely preventable rotator cuff tears, bursitis and tendinitis all because someone didn’t take their complaints of shoulder pain after a covid injection in the arm seriously enough.
Normal shoulder pain after a Covid vaccine or booster shot:
Mild skin tenderness and localized shoulder pain are quite normal after a Covid vaccine or booster shot. Some people experience what is now known as “Covid hand” – a mild rash and skin tenderness that can appear a few days to even a week after you receive the vaccine. You will experience skin tenderness and/or swelling that may look similar to cellulite.
Although annoying, the Covid hand is not considered dangerous or threatening. Symptoms usually go away after a week or two, and in the meantime, talk to your doctor or pharmacist about over-the-counter or prescription medications that can help with symptoms of itching or swelling.
Localized shoulder pain at the site of your vaccine or booster injection is also normal. The pain you feel is from a slight trauma caused by the insertion of the needle into the soft tissue (muscle) of your arm. It often feels like a bruise and you may feel some swelling. It usually disappears after 2-3 days. Although your hand may be quite sore, the important difference here is that you will still have full, normal function of your hand. In other words, despite the pain, you can still move your arm freely up and down if you need to, without restriction. The pain in your arm will go away with time, but gently massaging the area of pain and even some simple movements or exercises can help the pain go away faster.
Unusual shoulder pain after a Covid vaccine or booster shot:
The symptoms of SIRVA are different and usually more severe than what I just described above. If left untreated, some of these symptoms can lead to long-term shoulder problems or compensatory problems elsewhere.
As I mentioned before, one of the main differences between “normal” post-vaccination shoulder pain and SIRVA is how well your arm functions. If the needle was accidentally inserted into the joint capsule, for example, you will notice limited mobility and possibly limited strength. If not addressed, symptoms like this can manifest into more serious shoulder problems down the line, such as adhesive capsulitis or frozen shoulder.
If the needle was inserted too high or too deep and outside your muscle layer, it may have injured your bursa. This can lead to inflammation, turning into bursitis of the shoulder. Your mobility may or may not be affected when this happens, but you will notice lingering shoulder pain that doesn’t go away after 2-3 days like it should. Bursitis is actually a really easy injury to treat. But with SIRVA, this is often dismissed as normal post-injection pain. When neglected – shoulder bursitis can lead to compensatory movements due to pain – and cause problems later in places like the neck, shoulder blade or even the elbow.
One last common problem we see as a result of SIRVA is rotator cuff tendinitis. Like bursitis, you may have normal range of motion in your shoulder, but what you will notice with this is again that the pain will last longer than it should. But unlike bursitis, you’ll also have pain and weakness when you put force on this tendon — especially with overhead movements or lifting something with an outstretched arm. This is also not a difficult injury to rehabilitate, but if left untreated, it can develop into a more serious problem such as a rotator cuff tear or chronic tendonitis, conditions that are more difficult to treat.
To summarize – your shoulder will hurt after a vaccine. It’s normal. And you may even experience Covid hand. But these symptoms should go away, not stay. And you should still have normal function of your shoulder despite the pain. If you have shoulder pain that persists, and especially if you notice limited mobility, it’s worth getting checked out. The last thing you want is for these symptoms to last longer than necessary or develop into compensatory, more complex problems.
The good news is that even with SIRVA, your shoulder pain can be successfully treated naturally and without drugs or procedures. Don’t let a healthcare professional dismiss your concerns and blame your continued shoulder pain on your booster shot. Talk to a musculoskeletal expert who understands these things and get help.
Dr. Kari Jose, physical therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To contact her or request a free copy of any of her neck and shoulder pain guides, email her at [email protected] or call 603-605-0402.