Question explored with the scientific record
Pain in both upper arms when I raise my arms
The short version: the evidence you retrieved is almost entirely about cervical radiculopathy and shoulder impingement, not about vaccine injury, and it does not answer the question of whether bilateral arm pain on elevation is a vaccine-related injury.
The evidence you have is a pile of studies on rotator cuff tendinopathy [1, 2, 20], calcific tendinitis [3], cervical radiculopathy [4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 15, 16], subacromial impingement [19, 21, 22], and one case of thalamic pain misdiagnosed as a disc problem [14]. None of these studies were designed to test whether a vaccine caused the pain. None of them compare vaccinated to unvaccinated people. None of them were funded by a manufacturer investigating a vaccine-safety signal. They are all about mechanical or degenerative causes of shoulder and arm pain.
The most common structural causes for bilateral arm pain on elevation are rotator cuff tendinopathy, subacromial impingement, and cervical radiculopathy. The evidence shows that exercise and physical therapy improve these conditions [15, 21, 22], that surgical options exist for refractory cases [3, 5, 11, 12, 13], and that the acromiohumeral distance has only a small association with symptoms [20]. But none of this tells you whether your pain is from a vaccine. To answer that, you would need a study that compared the rate of this symptom in vaccinated versus unvaccinated people, with a clear temporal relationship and a plausible mechanism. That study does not appear in your evidence.
My call: the evidence you retrieved does not support a vaccine-injury hypothesis for bilateral arm pain on elevation, but it also does not rule one out. The burden of proof has not been met either way. Confidence: low, because the retrieval is entirely off-topic for the vaccine question.
Sources examined 22
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Reduction of the subacromial space in athletes with and without rotator cuff tendinopathy and its association with the strength of scapular muscles
This study investigates the reduction of the subacromial space in athletes with and without rotator cuff tendinopathy and its association with the strength of scapular muscles, revealing significant differences in muscle strength and space reduction during arm abduction.
DOI: 10.1016/j.jsams.2016.03.011 -
A randomised controlled trial of long-chain omega-3 polyunsaturated fatty acids in the management of rotator cuff related shoulder pain
Two-month omega-3 PUFA supplementation plus exercise did not provide added pain/disability benefits over placebo for rotator cuff–related shoulder pain over 12 months, though a transient SPADI improvement at 3 months and some range-of-motion gains were observed with omega-3.
DOI: 10.1136/bmjsem-2018-000414 -
Functional Recovery of the Shoulder after Arthroscopic Treatment for Chronic Calcific Tendinitis
Arthroscopic removal of calcific deposits in chronic calcific tendinitis improves pain and shoulder function, with meaningful gains evident around six months and outcomes not dependent on cuff repair or complete versus incomplete removal.
DOI: 10.5397/cise.2018.21.2.75 -
Are Modic Vertebral End-Plate Signal Changes Associated with Degeneration or Clinical Outcomes in the Cervical Spine?
This study pooled two randomized multicenter trials (NECK and PROCON) to determine the prevalence of Modic vertebral end-plate signal changes in the cervical spine among patients with cervical radiculopathy and to assess associations with radiologic degeneration and clinical out…
DOI: 10.1016/j.wneu.2019.06.067 -
Degree of satisfaction following full-endoscopic cervical foraminotomy
This study evaluates satisfaction and pain outcomes after full-endoscopic cervical foraminotomy (FECF) for cervical radiculopathy in 109 consecutive patients, showing high satisfaction and significant arm-pain reduction with low complication rates over a 3-month follow-up.
DOI: 10.21037/jss.2020.01.02 -
Epidural steroid injections in the management of cervical disc herniations with radiculopathy
This prospective single-center interventional study evaluated the efficacy and safety of interlaminar cervical epidural steroid injections (CESI) in 33 patients with cervical radiculopathy due to disc herniation, showing significant long-term reductions in neck and arm pain, dis…
DOI: 10.3109/03009742.2014.992950 -
Operative treatment of cervical radiculopathy: anterior cervical decompression and fusion compared with posterior foraminotomy: study protocol for a randomized controlled trial
A multicenter randomized controlled trial protocol comparing anterior cervical decompression and fusion (ACDF) versus posterior foraminotomy (PF) for cervical radiculopathy, designed to test non-inferiority of PF to ACDF over 2 years using patient-reported outcomes (NDI, EQ-5D, …
DOI: 10.1186/s13063-021-05492-2 -
Reliability of diagnosis of soft cervical disc prolapse using Spurling's test
This study evaluates the sensitivity and specificity of Spurling's test in diagnosing soft lateral cervical disc prolapse in patients with neck and arm pain, finding it to have a sensitivity of 92% and specificity of 95%.
DOI: 10.1080/02688690400012350 -
Arthroplasty for cervical spondylotic myelopathy: similar results to patients with only radiculopathy at 3 years' follow-up
This study evaluates the outcomes of cervical arthroplasty in patients with cervical spondylotic myelopathy compared to those with radiculopathy, finding similar clinical and radiographic improvements in both groups over a mean follow-up of 36.4 months.
DOI: 10.3171/2014.3.SPINE13387 -
Predictors of Short-Term Outcome in People With a Clinical Diagnosis of Cervical Radiculopathy
This prospective cohort study identifies predictor variables from baseline examinations and physical therapy interventions that can forecast short-term outcomes for patients with cervical radiculopathy.
DOI: 10.2522/ptj.20060287 -
Posterior full-endoscopic cervical discectomy in cervical radiculopathy: A prospective cohort study
This prospective cohort study compares posterior full-endoscopic cervical discectomy (PECD) with conventional anterior cervical discectomy and fusion (ACDF) for single-level cervical radiculopathy, finding PECD reduces blood loss and hospital stay with similar pain relief and fu…
DOI: 10.1016/j.clineuro.2020.105948 -
Cervical disc arthroplasty for the treatment of spondylotic myelopathy and radiculopathy
This study evaluates the efficacy of cervical disc arthroplasty (CDA) in improving symptoms of cervical spondylotic myelopathy and radiculopathy, demonstrating significant improvements in pain and function over a median follow-up of 48 months.
DOI: 10.1016/j.jocn.2012.12.013 -
Results of posterior cervical foraminotomy for treatment of cervical spondylitic radiculopathy
This study evaluates the outcomes of posterior cervical foram inotomy for treating cervical spondylitic radiculopathy, reporting significant pain relief and patient satisfaction among the majority of participants.
DOI: 10.1080/02688690042898 -
Thalamic Pain Misdiagnosed as Cervical Disc Herniation
A 45-year-old man with thalamic infarction presenting as cervical radiculopathy was misdiagnosed as cervical disc herniation, and his thalamic pain (central post-stroke pain) improved with neuropathic pain–targeted meds after correct diagnosis.
DOI: 10.3344/kjp.2016.29.2.119 -
Cervical traction combined with neural mobilization for patients with cervical radiculopathy: A randomized controlled trial
This randomized controlled trial evaluated cervical traction with or without neural mobilization versus a wait-list control in patients with cervical radiculopathy and found that adding neural mobilization to traction significantly improved pain, disability, and function at 4 we…
DOI: 10.1016/j.jbmt.2020.08.019 -
Effects of Multi-modal Therapeutic Approach in Cervical Radiculopathy
A quasi-experimental study comparing two multimodal approaches for cervical radiculopathy—laser therapy plus isometric neck exercises versus mechanical cervical traction plus isometric neck exercises—found that mechanical traction yielded greater improvements in disability, pain…
DOI: 10.51253/pafmj.v73i6.6545 -
A meta-analysis of cervical arthroplasty compared to anterior cervical discectomy and fusion for single-level cervical disc disease
This meta-analysis of eight randomized trials comparing cervical arthroplasty with anterior cervical discectomy and fusion (ACDF) for single-level cervical disc disease finds similar neck disability outcomes but superior pain relief, higher overall and neurological success, and …
DOI: 10.1016/j.jocn.2012.03.046 -
P125. Growth rod spinal instrumentation to control progressive early onset scoliosis
This prospective clinical study compares ProDisc-C cervical total disc replacement with anterior cervical discectomy and fusion (ACDF) at a single level in patients with cervical degenerative disease, reporting similar short-term outcomes and preserved motion with ProDisc-C in a…
DOI: 10.1016/j.spinee.2005.05.340 -
Subacromial Impingement Syndrome: The Effect of Changing Posture on Shoulder Range of Movement
This study investigates the impact of changing thoracic and scapular posture on shoulder range of motion in both asymptomatic individuals and those with subacromial impingement syndrome, finding significant improvements in range of motion but no significant reduction in pain int…
DOI: 10.2519/jospt.2005.35.2.72 -
Does the acromiohumeral distance matter in chronic rotator cuff related shoulder pain?
A cross-sectional ultrasound study in adults with chronic rotator cuff–related shoulder pain found that acromiohumeral distance (AHD) has only a small, likely clinically negligible association with pain/disability and shoulder range of motion, while intrarater reliability of AHD…
DOI: 10.1016/j.msksp.2017.02.011 -
Pain, motion and function comparison of two exercise protocols for the rotator cuff and scapular stabilizers in patients with subacromial syndrome
This randomized clinical trial compares the effects of two eccentric exercise protocols on pain, active range of motion, and shoulder function in patients with subacromial syndrome, finding no significant differences between the protocols despite improvements in both groups.
DOI: 10.1016/j.jht.2017.11.041 -
Effects of Modified Posterior Shoulder Stretching Exercises on Shoulder Mobility, Pain, and Dysfunction in Patients With Subacromial Impingement Syndrome
Two modified posterior shoulder stretching methods added to a standard rehabilitation program improve activity-related shoulder pain, internal rotation range of motion, and function in subacromial impingement with glenohumeral internal rotation deficit, with similar benefits for…
DOI: 10.1177/1941738119900532