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SIRVA Treatment

Managing Vaccine-Related Shoulder Injuries

In recent years, the world has witnessed a remarkable effort to combat viruses and diseases by developing and distributing various vaccines.

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Our Founder Paul Brazil explains what a shoulder injury related to vaccine administration entails, how common it is, and more. SIRVA is the most common injury in the Vaccine Injury Compensation Program.

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SIRVA is known as Shoulder Injury Related to Vaccine Administration

You might have SIRVA (Shoulder Injury Related to Vaccine Administration) if you experienced severe shoulder pain after a vaccine. Some of the side effects can cause intense pain, and limited motion, and impact daily life. Treatment options include rest, steroid injections, pain medications, and physical therapy. Prompt medical attention is very important.

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Hear Cheryl's Vaccine Injury Story

Cheryl suffered SIRVA (shoulder injury related to vaccine administration) following a flu shot. Her vaccine injury claim was filed in the VICP by vaccine lawyer Max Muller where she obtained a large cash settlement for her pain and suffering, lost wages and out of pocket medical expenses.

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What are the Treatment Options for SIRVA?

SIRVA occurs when a vaccine is improperly injected too high or too deep in the shoulder. This can cause severe and prolonged pain and other shoulder injuries like rotator cuff tears or tendonitis. Typically, shoulder injections should be administered in the deltoid muscle. Still, if the needle used is too long or not inserted correctly, it can hit bone or puncture the protective bursa sac, leading to inflammation of the tendons and ligaments in the shoulder. SIRVA primarily affects the shoulder's mobility and often presents as sudden deltoid pain or limited range of motion within 48 hours of the vaccine injection. However, these symptoms can overlap with other conditions, including nerve damage.

The treatment options for SIRVA primarily focus on managing pain, improving range of motion, and promoting the overall recovery of the affected shoulder. Here are some commonly employed SIRVA treatment strategies:


Rest is a useful strategy for managing SIRVA as it allows the injured shoulder to recover and heal. Rest helps reduce inflammation, pain, and further damage to the shoulder by limiting movement and avoiding activities that strain the affected area. Resting the shoulder also allows the surrounding tissues, such as tendons and ligaments, to repair themselves and regain strength. Additionally, it can prevent aggravation of symptoms and promote a faster recovery, ultimately aiding in the overall management of SIRVA.

Steroid Injections

When administered directly into the affected shoulder joint, steroids can help reduce inflammation, alleviate pain, and improve mobility. The injected steroids work by suppressing the immune response and reducing swelling in the injured area. This treatment option can provide targeted relief, particularly for individuals experiencing persistent pain or limited range of motion. Steroid injections offer a non-surgical approach to managing SIRVA.

Oral Steroids

Oral steroids, such as corticosteroids, have potent anti-inflammatory effects. When taken orally, these medications are systematically distributed throughout the body, including the affected shoulder. Oral steroids help to reduce inflammation, alleviate pain, and improve shoulder function. This treatment option benefits individuals with widespread inflammation or those who may not be suitable candidates for localized steroid injections. It's important to note that oral steroids should be used under the supervision and prescription of a healthcare professional to monitor potential side effects and ensure proper dosage.

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Pain Medications

Pain medications like nonsteroidal anti-inflammatory drugs (NSAIDs) work by inhibiting the production of certain enzymes that contribute to pain and inflammation in the body. By taking NSAIDs, individuals with SIRVA can experience relief from the intense shoulder pain associated with the condition. These medications can also help to reduce swelling and improve the overall comfort and function of the affected shoulder. NSAIDs are easily accessible over-the-counter and can be an effective and accessible option for managing SIRVA symptoms. However, it's important to follow the recommended dosage and consult a healthcare professional if there are any concerns or if the pain persists.


Surgery becomes necessary for managing SIRVA when other treatment strategies fail to provide relief or when there is significant structural damage to the shoulder. Surgery aims to repair or reconstruct damaged tendons, ligaments, or other structures in the shoulder to restore proper function and relieve pain. It is typically reserved for severe cases of Frozen shoulder or Rotator Cuff tears with persistent impairment or evidence of significant tissue injury that cannot be adequately addressed through non-surgical means. The decision to undergo surgery should be made in consultation with an orthopedic specialist or healthcare professional who can assess the individual's condition and determine the most appropriate course of action.

Physical Therapy

Physical therapy is likely required when managing SIRVA due to its crucial role in promoting recovery, restoring range of motion, and improving shoulder function. Physical therapists design individualized exercise programs tailored to the specific needs and limitations of individuals with SIRVA. These programs typically include stretching exercises to improve flexibility, range of motion exercises to restore shoulder mobility, and strengthening exercises to rebuild muscle strength. Physical therapy also focuses on correcting postural or movement imbalances that may have developed due to the injury. Through targeted exercises and techniques, physical therapy helps reduce pain, inflammation, and stiffness while enhancing overall shoulder stability and function.

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What Are Some Exercises For SIRVA?

When it comes to SIRVA, specific exercises should be performed under the guidance of a qualified healthcare professional or physical therapist. They will assess your condition and tailor an exercise program to meet your needs. However, here are some general exercises commonly used in SIRVA rehabilitation:

Pendulum exercise: Stand or lean over a table with your uninjured arm for support. Allow your injured arm to hang freely and gently swing it in small circles in a clockwise and counterclockwise direction. This exercise helps improve shoulder mobility and flexibility.

Arm over the chest exercise: Start by extending your injured arm in front of your body near the waist. Place your unaffected hand behind the elbow of your injured arm. Gently pull your injured arm across your chest using your unaffected hand. Maintain this position for 30 to 50 seconds, then gradually release the stretch.

Neck release exercise: Assume a seated position with proper posture, ensuring your back is straight. Gently tilt your chin towards your chest, allowing the stretch to be felt in the back of your neck. Next, slowly lean your head to the right or left to extend the stretch to your shoulder. Maintain this position for approximately one minute, focusing on the stretch and relaxing any tension.

Is SIRVA Permanent?

In most cases, SIRVA is not permanent. With proper treatment and management, most individuals with SIRVA experience significant improvement in symptoms and functional recovery over time. However, the recovery duration can vary depending on the severity of the injury and individual factors. Some individuals may experience lingering effects or residual discomfort for an extended period, especially if the injury is severe or complications occur. 

A report from 2022 found that although the clinical evidence is limited, similar to any bursitis, typical SIRVA treatments appear effective, and surgery should rarely be performed. MacMahon A, Nayar SK, Srikumaran U. What Do We Know About Shoulder Injury Related to Vaccine Administration? An Updated Systematic Review. Clin Orthop Relat Res. 2022 Jul.
It is important to seek appropriate medical care and follow the recommended treatment plan to optimize the chances of a successful recovery. If you are experiencing SIRVA symptoms, it is advisable to consult with a healthcare professional for a proper diagnosis and guidance regarding your specific situation.

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What Do I Do If I Think I Need SIRVA Treatment?

If you suspect you may require SIRVA treatment, seeking medical attention from a healthcare professional is important. Here are the steps you can take:

  1. Contact a doctor immediately for treatment options. It's important to seek medical attention promptly to address your symptoms and begin appropriate treatment.
  2. Provide the doctor with a detailed account of the vaccination incident, including when and how the vaccine was administered and any symptoms or pain onset. This information will assist the doctor in understanding the specific circumstances surrounding your injury.
  3. Request that the doctor file a Vaccine Adverse Event Reporting System (VAERS) form or contact (800) 822 - 7967 to report the adverse reaction associated with the vaccine. Reporting to VAERS helps monitor and track vaccine-related injuries and can contribute to a better understanding of vaccine safety.
  4. Seek assistance from professionals familiar with the process to help file a claim in the Vaccine Injury Compensation Program (VICP). These professionals can guide you through the necessary steps and provide support in navigating the claims process.

What Happens If SIRVA Is Left Untreated?

If left untreated, SIRVA symptoms can manifest in various consequences. Individuals may experience persistent pain and discomfort without proper treatment, which can become chronic and significantly impact their daily lives. Untreated SIRVA can also lead to a limited range of motion, making it difficult to perform routine activities and tasks. Functional impairment of the affected shoulder can occur, affecting work, sports, and day-to-day activities. Additionally, untreated SIRVA may contribute to secondary complications such as muscle weakness, joint stiffness, and an increased risk of further shoulder injuries. The psychological impact of living with ongoing pain and limitations should not be overlooked, as it can lead to frustration, anxiety, and a reduced sense of well-being.

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What are the common symptoms of SIRVA?

Several common symptoms characterize SIRVA. The primary symptom is arm pain after the vaccine, often sharp and localized to the injection site, which can radiate to surrounding areas.  "Simple actions like lifting your arm to brush your teeth can cause pain," said Kelly Grindrod, PharmD, a professor at the School of Pharmacy at Waterloo.

SIRVA can also lead to a decreased range of motion in the affected shoulder, making it difficult to raise the arm or perform activities that require shoulder mobility. Shoulder stiffness, weakness, and swelling may also be present, along with signs of inflammation, such as redness and warmth around the injection site. Individuals may sometimes experience numbness or tingling in the shoulder, arm, or hand. It's important to remember that the severity and combination of symptoms can vary among individuals. 

Why do SIRVA incidents occur?

SIRVA incidents occur due to the improper administration of vaccines, specifically when the injection is too high or too deep in the shoulder. Normally, vaccines are intended to be injected into the deltoid muscle of the upper arm. If the vaccine is injected too high, it can impact the underlying structures such as tendons, ligaments, or the bursa (a fluid-filled sac that protects the tendons), according to a 2018 study published in the Canadian Pharmacists Journal. This can lead to inflammation, injury, and pain in the shoulder joint.

Several factors contribute to SIRVA incidents, including errors in the vaccine administration technique. These errors may involve using a needle that is too long for the individual's body size, injecting the vaccine too high up on the arm, or failing to locate the correct injection site within the deltoid muscle accurately.

It's important to note that SIRVA incidents are unrelated to the vaccine's contents. Instead, they result from the mechanical trauma caused by the injection technique. 

What are some ways to prevent SIRVA?

To prevent SIRVA, it is important to ensure proper vaccine administration techniques. This includes providing adequate training to healthcare providers on correct injection methods, verifying the injection site in the deltoid muscle before administering the vaccine, using appropriate needle lengths, maintaining open communication with patients, implementing quality control measures, and promoting reporting of adverse events. Adhering to these preventive measures can minimize the risk of SIRVA incidents, ensuring safer and more effective vaccine administration.

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Am I eligible for SIRVA vaccine injury compensation?

Determining eligibility for compensation under the Vaccine Injury Compensation Program (VICP) for SIRVA requires consultation with a qualified attorney or representative experienced in vaccine injury claims. To be eligible for compensation for out-of-pocket medical expenses, pain and suffering, and loss of earning capacity, you typically need to meet criteria such as timely filing, demonstrating a direct link between the vaccine and the shoulder injury, providing documented medical evidence, and showing significant impact on your daily life. Eligibility requirements and criteria can vary, and seeking legal advice is crucial for personalized guidance on your circumstances and assistance in filing a claim with the VICP.

When should I contact an attorney for a SIRVA injury?

It is advisable to contact an attorney experienced in vaccine injury claims for SIRVA as soon as you suspect you have sustained a SIRVA injury. It is best to consult an attorney promptly to understand your rights, assess the strength of your case, and ensure timely filing if you decide to pursue a claim. Attorneys specializing in vaccine injury claims can provide valuable guidance on the legal process, help gather necessary evidence, navigate the Vaccine Injury Compensation Program (VICP), and advocate on your behalf. They can also provide an initial evaluation of your case and advise you on the appropriate steps.

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Don't worry, we're here to help.

If you are undergoing ongoing SIRVA treatment, we understand the frustrations involved and are here to assist you in obtaining the compensation you rightfully deserve. Whether you or a loved one requires treatment for SIRVA, knowing there are avenues for seeking compensation is essential. Professional assistance is readily available to provide guidance and support throughout the process of pursuing compensation for your SIRVA treatment.