Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2023; 11(15): 3637-3642
Published online May 26, 2023. doi: 10.12998/wjcc.v11.i15.3637
Atypical progress of frozen shoulder after COVID-19 vaccination: A case report
Hyun-Seok Jo, Hyeong-Min Kim, Jae-Young Han, Hyeng-Kyu Park
Hyun-Seok Jo, Hyeong-Min Kim, Hyeng-Kyu Park, Department of Physical and Rehabilitation Medicine, Research Institute of Medical Sciences, Heart Research Center, Chonnam National University, Chonnam National University Medical School & Hospital, Gwangju City 61469, South Korea
Jae-Young Han, Department of Physical and Rehabilitation Medicine, Regional Cardiocerebrovascular Center, Center for Aging and Geriatrics, Research Institute of Medical Sciences, Heart Research Center, Chonnam National University, Chonnam National University Medical School & Hospital, Gwangju City 61469, South Korea
Author contributions: Jo HS, Kim HM, Han JY, Park HK investigated; Jo HS, Park HK conceptualized the report; Jo HS, Park HK wrote the original draft, reviewed and edited the draft, wrote and edited the draft; all authors approved of the final manuscript.
Informed consent statement: All study participants, or their legar guardian, provided informed consent prior to study enrollment.
Conflict-of-interest statement: All the authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hyeng-Kyu Park, MD, PhD, Doctor, Professor, Department of Physical and Rehabilitation Medicine, Research Institute of Medical Sciences, Heart Research Center, Chonnam National University, Chonnam National University Medical School & Hospital, 42 Jebong-Ro, Dong-Gu, Gwangju, 61469, South Korea. phk1118@naver.com
Received: February 5, 2023
Peer-review started: February 5, 2023
First decision: March 14, 2023
Revised: April 3, 2023
Accepted: April 18, 2023
Article in press: April 18, 2023
Published online: May 26, 2023
Processing time: 109 Days and 9.2 Hours
Abstract
BACKGROUND

After vaccination was mandated worldwide, various adverse effects associated with the coronavirus disease 2019 (COVID-19) vaccination, including shoulder pain, have been reported. Here, we report a case of new-onset shoulder pain after BNT162b2 (Comirnaty, Pfizer-BioNTech) mRNA vaccination.

CASE SUMMARY

A 50-year-old man visited our rehabilitation center with left shoulder range of motion (ROM) limitation that had persisted for more than 5 mo. The history included no specific noteworthy events, except vaccination. The pain in the patient’s left deltoid muscle appeared 1 day after the second BNT162b2 vaccination and intensified to severe pain. The patient self-administered aspirin, with which the pain subsided immediately, whereas ROM limitation persisted. At the first visit, the patient complained of dull pain and ROM restriction of the left shoulder (flexion 130°, abduction 110°, and external rotation 40°). Among the diagnostic studies conducted for the evaluation of the shoulder, magnetic resonance imaging showed a thickened coracohumeral ligament. Nerve conduction studies and needle electromyography showed no electrodiagnostic abnormalities. The patient received comprehensive rehabilitation for 7 mo and had an overall improvement in pain and ROM of the left shoulder.

CONCLUSION

In this case of severe shoulder pain after COVID-19 vaccination that subsided immediately with aspirin treatment, the exact cause and mechanism of pain are unclear. However, the clinical symptoms and diagnostic workups in our report suggest the possibility that the COVID-19 vaccination triggered an immunochemical response that resulted in shoulder pathology.

Keywords: COVID-19; Vaccination; Adhesive capsulitis; Frozen shoulder; Mechanism; Case report

Core Tip: In this case, the patient experienced severe pain immediately after coronavirus disease 2019 (COVID-19) vaccination and was diagnosed with a frozen shoulder. Pain resolved immediately after taking aspirin. The pain of frozen shoulder is associated with inflammatory mediators, such as cytokines. Although the pathogenetic mechanisms of frozen shoulder after COVID-19 vaccination are unknown, an association between some cytokines and frozen shoulder after COVID-19 vaccination likely exists.