Use of Osteopathic Manipulation for Treatment of Chronic Shoulder Injury Related to Vaccine Administration

An analysis of reported cases shoulder injury related to vaccine administration of after COVID-19 vaccination

To prevent COVID-19, the COVID-19 vaccine has been widely administered worldwide, but various complications accompany this vaccine. The aim of this study was to investigate the demographic patterns, clinical features, diagnostic findings, and treatment outcomes associated with shoulder injury related to vaccine administration (SIRVA). This study examined 22 patients with SIRVA following COVID-19 vaccination from the Web of Science (WOS) and PubMed databases. The patients were categorized based on sex, age, type of COVID-19 vaccine received, dose administered, latency of symptom onset, and the presence of specific clinical manifestations. Patients, evenly distributed by sex (12 females, 10 males), and aged 21 to 84 years (mean age 46.6), were analyzed. SIRVA cases were reported across all age groups. The Pfizer - BioNTech COVID-19 vaccine had the highest incidence (n = 8), followed by the Oxford/AstraZeneca COVID-19 vaccine (n = 4). Symptoms, primarily shoulder pain (n = 22) and shoulder mobility disorders (n = 18), occurred within three days post-vaccination. Some patients also reported shoulder swelling (n = 5) and fever (n = 2). Imaging revealed nonspecific X-ray findings, supraspinatus tendon calcification (n = 2), and shoulder edema and inflammation on MRI (n = 12). This study provides insights into the clinical aspects of SIRVA related to COVID-19 vaccination. Recognition and appropriate management of these complications are crucial for optimal patient outcomes.

Impact of Spencer Technique on Pain, Range of Motion, and Functional Disability in Patients With Frozen Shoulder: A Pilot Study

Background and objective The shoulder is the most flexible ball- and socket-type joint in the human body. The pathological condition that can commonly affect this joint is the frozen shoulder. This condition is marked by pain and stiffness in the area surrounding the shoulder complex. This leads to difficulty in doing the daily activities of living. Exercise and physical therapy are mostly recommended to decrease pain and improve and maintain the range of motion (ROM). Mainly traditional techniques such as Mulligans, Maitland, and Kaltenborn are used, along with electrotherapy and exercises, for the treatment of this condition. The effect of the Spencer technique is seen in baseball players' shoulder function. Thus, the purpose of this study is to determine how the Spencer approach affects patients with frozen shoulders in terms of pain, ROM, and functional impairment. Methodology This study included 20 patients aged between 40 and 60 years with stage 2 and 3 diagnosed frozen shoulder. This is a single-group pilot study that received the Spencer technique along with a moist heat pack and Codman's exercises on the affected shoulder for three weeks. Outcome measures used for assessment before and after treatment were the visual analog scale (VAS), shoulder ROM, and shoulder pain and disability index (SPADI). After the second, third, and sixth months, a follow-up was conducted. Two patients were lost to follow-up; consequently, statistical analysis was performed on the data from 18 patients. Results The current study's results suggested that there was an improvement in the mean values of VAS, ROM, and SPADI at post-three weeks, and a sustained effect was observed at the second, third, and sixth months. A statistically significant difference (P < 0.05) was found. Conclusions The study's conclusions demonstrated improved pain, ROM, and SPADI scores post-intervention. Treatment effects persisted, as seen by follow-up at the two, three, and six-month marks. As a result, the Spencer technique utilized in this pilot study on frozen shoulder patients proved effective. Also, the outcome effects were sustained, which suggests its utility in frozen shoulder rehabilitation.

Osteopathic Manipulative Treatment for a Chronic Rotator Cuff Tear: A Case Report

Rotator cuff tears, particularly involving the supraspinatus muscle and/or tendon, are highly prevalent among individuals engaged in repetitive shoulder motions. Occupations demanding constant and repetitive shoulder movements are especially susceptible to rotator cuff injuries, potentially leading to prolonged joint wear and tear and an increased likelihood of joint replacement. Considering the impact of social determinants of health, including access to healthcare and socioeconomic status, it is imperative to explore conservative treatment modalities that alleviate financial burdens and reduce lengthy recovery periods. In this report, we present a case of a 64-year-old female hairdresser diagnosed with a chronic partial thickness rotator cuff tear who remained unresponsive to physical therapy and chiropractic manipulation but exhibited improvement following osteopathic manipulative treatment. Additionally, osteopathic considerations and pertinent literature are reviewed to provide insight into the broader context of shoulder pain management.

An Integrated Physical Therapy Using Spencer's Technique in the Rehabilitation of a Patient With a Frozen Shoulder: A Case Report

A frozen shoulder is a painful condition characterized by pain and stiffness. In frozen shoulder, the capsule of the joint gets inflamed, leading to pain that limits shoulder movement and thereby affects shoulder functions. There are three stages of frozen shoulder, and the symptoms differ according to the stage. Physiotherapy plays an important role in the management of a frozen shoulder. The Spencer technique is a seven-step technique that is used to treat shoulder movement restrictions. In this case report, we present the case of a 57-year-old male shopkeeper by occupation with a right frozen shoulder with complaints of pain and stiffness around the shoulder region and reduced range of motion (ROM) for more than six weeks. Physiotherapy rehabilitation was given to the patient using Spencer's technique along with standard management for three weeks. Significant improvement in range of motion, decrease in pain, and functional disability, i.e., shoulder pain and disability index (SPADI), were seen post-rehabilitation and were sustained when evaluated at the end of the second, third, and sixth months.

Kuduz aşısı uygulamasına bağlı omuz yaralanması: bir olgu sunumu

Reactions at the vaccine injection site are usually mild and transient. Musculoskeletal symptoms, such as myalgia and arthralgia, are commonly seen following vaccination. Shoulder injury related to vaccine administration (SIRVA), defined as shoulder pain and limited range of motion in the shoulder after intramuscular vaccine administration into the upper arm, may occur due to incorrect vaccine administration. Using the appropriate injection technique in the intramuscular administration of vaccines will reduce the risk of SIRVA. In this paper, we report the clinical and magnetic resonance imaging findings of a 26-year-old female patient presenting with SIRVA after rabies vaccination and discuss this case in light of the current literature.

Lymphatic osteopathic manipulative treatment reduces duration of deltoid soreness after Pfizer/BioNTech COVID-19 vaccine

Pfizer-BioNTech BNT162b2 is one of the three U.S. Food and Drug Administration (FDA)-approved vaccines for the prevention of COVID-19. Its most common side effect, injection site pain, occurs because of locally recruited inflammatory mediators and is mitigated by the lymphatic system. Side effects may discourage individuals from receiving vaccines; therefore, reducing the duration of injection site pain can promote vaccination compliance. Osteopathic manipulative treatments (OMT) can directly affect the physiology underlying muscle soreness; however, there is currently no literature that supports the use of OMT in this scenario. In this case report, an otherwise healthy male presented with acute left deltoid soreness after receiving the Pfizer COVID-19 vaccine. The pain began 5 h prior to the visit. Three hours after being treated with lymphatic OMT, the severity of the pain was significantly reduced and was alleviated 8h after onset in comparison to the median duration of 24-48 h. He received his second dose 3 weeks later. This case report can provide future studies with the groundwork for further investigating the role of OMT in treating postvaccination muscle soreness, which can improve patient satisfaction and potentially promote vaccination compliance.

Influenza Vaccination Quality Improvement as a Model for COVID-19 Prophylaxis

Introduction: Many comparisons have been made on the effect and impact of COVID-19 on influenza pandemics of history. Therefore, it is reasonable to infer that the strategies utilized by healthcare providers to improve influenza vaccination rates can similarly be applied to the administration of a COVID-19 vaccine. The purpose of this study was to determine the rationale of low influenza vaccination rates in an urban allergy clinic and how to improve patient education and knowledge regarding the importance of influenza vaccination. A three-year comparison of interventions is presented as well as its application to future COVID-19 vaccinations.

Methods: This study was performed at an outpatient allergy and clinical immunology practice (MSBI) with hospital affiliation in New York City, New York. A quality improvement medical committee was formed to optimize influenza vaccination rates to greater than 71% and established standardized protocols regarding patient intake workflows, vaccine counseling, and documentation. Patient records from four providers were used for this study to compare pre-and post-intervention rates.

Results: 984 patients met inclusion criteria, with a normal distribution of ages (18-80), race, and sex. Average vaccination rates prior to the intervention were 9.25-13.60%. The average vaccination rate after the intervention was 91.34%.

Discussion: The MSBI quality improvement study identified key areas to address in improving influenza vaccination rates. Vaccine hesitancy, public misinformation, and ambivalence surrounding vaccination with egg allergies or during a subcutaneous immunotherapy injection were all topics addressed during the 2018-2019 intervention year. Additional attention was also put toward provider education and standardization of documentation. Shared decision making and intensive education/outreach efforts are needed by physicians and patients alike to overcome vaccine hesitancy. In comparing this to upcoming COVID-19 vaccine challenges, similar barriers will likely also need to be addressed. Greater research is needed to understand patient motivations regarding hesitancy specific to the COVID-19 vaccine.

Conclusion: As evidenced in the yearly battle with influenza and now the COVID-19 pandemic, it has become essential to identify and implement multi-level strategies to maximize vaccination rates, especially amid a global pandemic. With COVID-19 vaccines reaching emergency approval stages, it is important for healthcare providers to start creating workflows and strategies to address patient inquiries. The influenza vaccination quality improvement project presented here can be used as a guideline for future evaluations of COVID-19 vaccination efforts.

Osteopathic Manipulative Treatment in Tension Headaches

Tension-type headaches, associated with young age, poor health, sleep disturbances, anxiety, stress, and poor posture, account for 90% of all headaches diagnosed by healthcare professionals. Diagnosis and treatment of the various headache subtypes are often aimed at determining the underlying cause but commonly involve over-the-counter pain medication. Because recurrence is common in tension-type headaches, with a subsequent refractory response to over-the-counter medications, adjunctive and alternative treatment modalities should be further studied. Here we present a case of tension headache initially non-responsive to pain medication but resolved with osteopathic manipulative treatment and lifestyle modifications. Osteopathic considerations and literature are also reviewed in the broader context of headache management.