Hi folks, today marks the 1-year anniversary of my shoulder injury due to a mis-adminstered flu shot (SIRVA) which hit the bone right about where one of the rotator cuff tendons (the teres minor) attaches. I see my orthopedist again next week, am planning to request a 3rd MRI to follow up on the bone damage, and am dealing with some relapse of pain (probably from pushing it too much) after previously reporting good improvement.
I’ve gotten a lot of emails from people through this site, and I always really appreciate hearing from other folks and giving advice to the best of my ability based on my experiences. I have found that the most common thing I end up writing about to people in emails is what to expect and how to deal with doctors, nurses, and other health care practitioners who have never heard of Shoulder Injury Related to Vaccine Administration and who are skeptical that it is even a real injury. I’m not a doctor, but I am a scientist, and I am doing my best to try to navigate the world of health care as a patient with SIRVA.
This post will describe my advice for you going into your medical appointments. As always, please let me know in the comments below if you have any other suggestions or advice or would just like to share your experiences as well.
Doctor Finder
First of all, I’ve started making a webpage to collect information about doctors who ARE knowledgeable about SIRVA so that people don’t have to be afraid of seeing someone who belittles their problem or tells them it’s not possible. This is going to require your input—please submit comments (on that page) if you have a positive experience with a doctor, and I’ll add them to the map; if you have a negative experience, say so too, and I WON’T add them to the map. Check it out here.
My Experience
I know firsthand how devastating it can be when the people who should be the best equipped to help you are instead unfamiliar and skeptical. So do you guys—in the SIRVA Survey, nearly 100% of respondents have seen a doctor who had never heard of it and were dismissive. Here is my experience, in chronological order (this might be kind of boring, skip ahead to recommendations if you’d like):
- Urgent care doctor: never heard of it, said I didn’t have an injury related to the flu shot, but gave me a referral to an orthopedist (shoulder specialist)
- Orthopedist #1: Boy, I got really lucky here–he had heard of it AND treated several cases of it (“one or two per year,” he even said.) He ordered an MRI. But he didn’t accurately locate the injured structures in my shoulder (told me at first it was subacromial bursitis, and not damage to the rotator cuff and bone.) In fact, I think because he had previously treated cases that were primarily bursitis, he assumed it was the same, but SIRVA cases can be very different from each other.
- Primary care doctor: she had never heard of it, but she had actually been briefed by the urgent care doctor prior to my visit and did some research on her own, and was prepared when I came in to the visit. (She’s extraordinary, I know!). There wasn’t much she could do but say to keep seeing the orthopedist.
- Physiatrist: I chose Dr. Bodor because he was an author of a journal article about SIRVA (in fact, the first person to describe it in the medical literature, although he wasn’t the one to coin the term “SIRVA”). Of course he was quite familiar with it and my visits with him were wonderful. He’s the first doctor I added to the Doctor Finder Map. He was the one who pinpointed the location of the shot (using ultrasound), identified the rotator cuff and bone damage.
- Orthopedist #2: When my husband went in for knee surgery, I mentioned it to the surgeon, who also specializes in shoulders. He’d never heard of it, and was quite skeptical. I actually went back to him for my own appointment later when considering surgery because he was such a hot-shot well-known shoulder surgeon to top athletes. After a 45-minute appointment in which I showed him journal articles, he came around 180 degrees to the point that I would have felt comfortable having him operate on my SIRVA shoulder. However, he had a very busy schedule and couldn’t book me very soon, so I didn’t end up going with him after all.
- Orthopedist #3: Yeah, I know, it may seem like overkill to see so many doctors, but I am desperate to rock climb again so I will do anything for the sake of my shoulder. Orthopedist #1 also had a busy surgery schedule this summer, so once we decided surgery was the path forward, I saw #3 and ended up having shoulder surgery with him. I would consider him SIRVA-skeptical, had never treated any and had some definite gaps in his knowledge about it. Interestingly, the gaps in his knowledge may have been ultimately helpful (he “thought outside the box” when it came to the bone damage on my MRI), but there’s no way to know for sure.
The summary of all that experience above is this: I got very, very lucky that Orthopedist #1 had heard of SIRVA, because that gave me great comfort and hope, strengthened my resolve to learn everything I could about it, and made me feel less alone and misunderstood. Then, when I went to other doctors who knew nothing about it, I knew what I was talking about and could speak to them with confidence. In some cases (Orthopedist #2) I was even able to change the mind of a skeptic.
My Recommendations to You
Not every doctor, like Orthopedist #2 above, is willing and able to listen to a patient and learn something from them. It’s just a fact of life that SOME practitioners (in any profession!) have an ego that prevents them from absorbing new information from people who are supposed to know less than them (i.e., patients). Orthopedist #3 is like that. I wish you the best of luck at finding doctors who, if they have not heard of SIRVA, are ready to learn and help you. I bet that in a decade or two, every doctor and nurse will have heard of it and learned about it in school.
So here is the advice I have. In my experience (particularly with Orthopedist #2), a doctor is more likely to listen to you if you can show them medical journal articles. But which articles? You may only have a short window of time to catch their eye and get them engaged in skimming the papers. Also, not all of the papers on my Resources page are publicly available, and in some cases all you can bring is the abstract, but that is enough. So here are a couple that I would recommend you try to print and bring, along with why:
- This one is good, is freely available, and gets to the point quickly: “A “Needling” Problem: Shoulder Injury Related to Vaccine Administration”
For appointments with your primary care/urgent care doctor:
- This is the first article to really describe SIRVA and suggest some options for treatment (but I don’t recommend you get cortisone shots at your primary care doctor, have them refer you to an orthopedist): “Vaccination-related shoulder dysfunction”
- This article is quite important, because it comes from the U.S. Department of Health and Human Services, but you can only access the abstract. It covers 13 cases and first presents the term “SIRVA”. It is too bad that it is not freely available: “Shoulder injury related to vaccine administration (SIRVA)”
- Here is another good abstract: “Risk of bursitis and other injuries and dysfunctions of the shoulder following vaccinations”
- I would also consider providing information that makes it clear to your doctor that the CDC recognizes SIRVA as a real and true adverse reaction and is (slowly, not quickly enough) trying to do something about it. I don’t love this poster for reasons discussed here, but here is a poster you can print out and show your doctor from the CDC that clearly warns about the risk of severe shoulder injury from vaccines (even if your vaccine was not a flu shot): “Intramuscular Influenza (Flu) Vaccination Infographic”
- Finally, at an appointment with a primary care or urgent care doctor, make sure you get a referral for an orthopedist. If you don’t know which one in your local area is considered best for shoulder injuries, definitely ask around.
For an appointment with your orthopedist/shoulder specialist:
- An orthopedist might like this one because it’s in an orthopedic journal, as opposed to a Vaccine journal (abstract only): Here
- This is in a Radiology journal, but is very good and descriptive and makes the case for getting an MRI: “Radiological Case: Shoulder injury related to vaccine administration”
- This case is EXTREMELY bad, and hopefully most of us don’t have anything this horrible, but at least one well-known shoulder surgeon is a co-author (Joseph Iannotti) and it also makes the case for getting an MRI, and it is also fully available: “Progressive Osteolysis and Surface Chondrolysis of the Proximal Humerus Following Influenza Vaccination”
For later visits with your orthopedist:
- If you need to talk about bone damage, print these abstracts: Here and here
- If enough time has passed and you need to talk about surgery, make sure your surgeon is aware of this excellent article: here
Spread the word!
Finally, spreading the word about SIRVA throughout the health care profession is very important to me. There’s no excuse for how little-known it still is, when so many people have suffered from it. It may be exhausting and emotionally draining, but please talk to your doctor/nurse/physical therapist friends and family about SIRVA, and point them to the peer-reviewed medical journal articles listed here to help them understand that this isn’t some conspiracy theory. It may help someone else out when your medical friend then sees a patient with this problem in the future.
After completing an annual physical in October 2017 my doctor suggested a flu and Dtap vaccination and me being caught off guard I agreed, Both vaccines were administered to my left arm by pulling my collar down and me standing in the doctor’s office lobby; all three a negative. It was my first and last vaccine as it has altered my life as I knew it. Doctors are in denial and never heard of SIRVA. Prognosis 1.5cm complete tear of rotator cuff, impinged muscles and tendons, bursa fluid and a left arm I refer to as a hanger; painful range of motion and no strength. Life as I knew it pretty much gone – sleepless nights – simple procedures can’t do – and riding my Harley no longer an enjoyable past time. Those that suffer the bad jab will feel alone as your injury is not visible and nobody – especially the doctors really care – their concern is to remain held harmless. Being able to file a SIRVA claim takes the anger felt and neutralizes it; other wise a malpractice lawsuit would be justified. Without the SIRVA trust a lot of doctors and nurses would be getting sued!
I hear ya. The incentive system is screwed up; the people who administer the vaccines have no incentive to do better because they’re not going to be sued for malpractice—they suffer no liability for their incompetence.
Sorry to hear your SIRVA is so severe, and I hope you can find a good doctor who can help. There are many who can’t help and also some who, like you say, don’t seem to care, either.
I am almost 18 months in since onset of injury. Vaccine was administered way too high on my shoulder. I had rotator cuff surgery almost 9 months after onset because the doctors wouldn’t believe it was from the flu shot. Said take ibuprofen and ice. It sometimes takes a few months. 10 out of 10 pain. Had to sleep in a recliner for months. Because surgery was so long after injury (and I’ve had a previous rotator cuff surgery), atrophy had set in and my tissue was thin. The surgery was not 100% – part of the tendon was not repairable. And still nobody believes me.
I am so sorry Tracy! The feeling of not being believed by anybody can be somewhat relieved by eventually talking to a doctor who is knowledgeable about SIRVA—they are out there. But they are hard to find and it takes so much time and money to keep seeing doctors. I can only imagine how awful it must feel to have your surgeon find irreparable rotator cuff damage. Wishing you the best healing possible in the coming months.
I am not only losing sleep because of the shoulder/arm pain, I also lose sleep because of the lack of knowledge the medical community has about SIRVA and where you can go for treatment. I did not receive a vaccine, I received a B12 shot; and immediately had a dull ache in that area. Usually, it is just that “pinch” and gone. Within 48 hours I had pain and weakness from my shoulder through my elbow and hand. All the additional pain and weakness left me questioning… what did I do to my arm that it is killing me like this?? (I never associated it to the shot) I didn’t fall, didn’t lift anything very heavy, didn’t bang it etc.etc.etc. After a couple of weeks, I went to an orthopedic group to get an x-ray; which didn’t reveal anything. A few days later I had a pre-scheduled appt. with a neuromuscular doctor for my leg. I told him about my shoulder / arm. He sent me for an MRI, which revealed the multi tears in the rotator cuff. (I have never had any shoulder injuries) He sent me to a shoulder dr. who basically identified the tears and offered a cortisone shot. He didn’t know what he was treating. (I refused the shot because I had recently started googling “pain from B12 shot ?” and discovered exactly what was wrong with my arm. I certainly didn’t want another shot in my arm; and I didn’t want someone trying to treat me without knowing what is was he was treating.) And that is where I am at ! I cannot find a doctor in the New Haven,CT area who has even heard of SIRVA, never mind treating it. I got the B12 shot on March 29, 2019. The extreme pain that I experienced for the first 6 to 8 weeks is about 40% better, but my arm and hand remain weak and the aches flare-up out of nowhere. There is a constant ache in that area where the shot was administered. I have felt that I should have been getting “treatment”, but so far can’t find someone to go to. My last statement I would like to make is, I do not believe that any of those government pay-outs that people have received for “vaccine shots” had anything to do with the vaccine itself, but it is the incorrect administering of the shot in the arm; NOT “what” was in the shot.
I’m so sorry. I have been wondering if other types of shots can cause this. So far one other survey respondent also got it from a mid-administered injection that was not a vaccine either.
I think it would change what people say in the literature about the cause and mechanism of the injury but it wouldn’t surprise me. There’s still so little that’s understood.
I really hope you can find a decent doctor in your area eventually. A few people have been happy with Dr. Strauss in New York if that’s an option.
Where in Ny is Dr Strauss?
Jean,
I know your post is from almost a year ago and wondered if your pain has gotten better. I have been having problems since October 2020 and my pain is better but still not good. I think my pain is a lot like yours it goes from my shoulder all the way down my arm especially where I received the flu shot.
I’ve had SIRVA for a little over 2 years now. It’s actually getting worse as time goes on. I filed a SIRVA claim but I’d much rather have full use of my arm again. Got a flu shot at my Drs office from her nurse. Ten minutes later I knew something was wrong. Nothing helps. What scares me is what will it be like in 5 years? Will I lose all use of my arm? Everyone in the medical profession needs to learn about SIRVA. Its not fair for people to get this and suffer with it and have no medical professional they can talk to because the medical professionals dont know anything about it. It can also cause alot of misdiagnosis. Makes me angry.
I hear you, Michelle, I’d give anything to have the past 2 years back without shoulder pain.
Yes, it is so true, I’m angry as well; the medical profession needs to catch up on SIRVA. Nothing adds insult to injury (literally) like being dismissed and having your injury downplayed or misdiagnosed by doctors who are uninformed.
I’ve been suffering since I got my flu shot at the end of November. I honestly just thought I slept on my shoulder wrong. I went back to my dr. 2 weeks after the shot and he never heard of SIRVA and didn’t want to hear about it. My chiropractor has been working on it ever since and it was getting much better. Then in the past week I had a flair up and the pain is worse than ever, can’t even lift my arm above my shoulder. I’m so disgusted.
He says an orthopedist won’t help either. I’m not sure where to turn next.
I’m sorry you’ve had that experience….a lot of us have faced negative reactions from doctors, for sure. It’s the number one thing I see in the survey. I hope it starts to change as more practitioners become knowledgeable. You do want to try to find an orthopedist, but it is possible that you will run into the same reaction as the first doctor. That’s what the advice on this page is all about….bringing in the published, peer-reviewed papers to try and change a doctor’s mind…not an easy task, but I have personally seen it happen. It depends on the orthopedist’s attitude. Good luck and I very much hope you find someone who has heard of it, and if you do, please add them to the Doctor Finder so we can fill out this map:
http://sirvasurvey.org/sirva-doctors/
My experience with SIRVA pain was also a flare-up after a couple of months. Went from kind of “present but tolerable” to constant and very strong after a few months. I don’t know what happens physiologically to cause that, but it was the same for me, sorry you’ve had the same.
Amy
Thanks Amy, it certainly is frustrating. My chiprporator, who has helped me with many issues, also does not really seem to care what caused this. He just wants me to go 2-3 times a week to have it worked on. He says an orthopedist won’t really be able to do anything for me and that I respond well to his treatments. But I am now in pain again after overdoing it lifting some things at work this week, not even a lot or very heavy things.. The problem is, I’ll feel good and before I know it, without thinking…. I can tell I’ve overdone it. Then I’m back to suffering again.
Heidi,
I got my flu shot in October but have not been back to the doctor because after reading everyone’s responses I know the doctors we have wouldn’t know anything about SIRVA. I have pain everyday and can’t raise my arm above my head. It is so frustrating. The only thing I am thankful for is that I got the shot in my left arm.
Hope you are feeling better, Lisa
I had a flu shot at work about a month ago. I felt no pain whatsoever. About two weeks later i suffered from severe shoulder pain and also noticed weakness in my arm. My partner was massaging my shoulder and gave me a massager for my shoulder as well. As i was aiding my shoulder with the device i went down my arm and as hit the approximate needle sight i felt so much intense pain and then the penny dropped, “My problem was needle related” OMG, i thought. I researched effects of immunisation and lo’behold i found “SIRVA “. I am a nurse and i know the immunisation that was administered i has damaged the use of my arm . SIRVA is real but nobody has heard of it or wants to know about it. Thats the nursing world these days!
I had a flu shot at work about a month ago. I felt no pain whatsoever. About two weeks later i suffered from severe shoulder pain and also noticed weakness in my arm. My partner was massaging my shoulder and gave me a massager for my shoulder as well. As i was aiding my shoulder with the device i went down my arm and as hit the approximate needle sight i felt so much intense pain and then the penny dropped, “My problem was needle related” OMG, i thought. I researched effects of immunisation and lo’behold i found “SIRVA “. I am a nurse and i know the immunisation that was administered i has damaged the use of my arm . SIRVA is real but nobody has heard of it or wants to know about it. Thats the nursing world these days!
Hi Adrienne, thanks for the comment and for the perspective on the nursing world. Yep, that matches my experience talking about SIRVA with friends in the medical community and with my own doctors and nurses!! “Getting the word out” is a really important step here and is so difficult when there is backlash and immediate assumptions made when a vaccine injury is brought up by somebody. It was hard for me to talk about it but I felt it was always very important to have a conversation about it to anyone in the medical community so that they might be made aware, and to root the conversation strongly in the peer reviewed medical literature and CDC acknowledgement of SIRVA as a causally related injury following misadministration of vaccines. Best of luck to you!!
Thank you. About 4 hrs after 1st Covid 19 shot 1/22/21, my R shoulder began to really hurt. Then arm and finally hands. Told person how I felt at 2nd shot 2/19/21, she wrote it down. Can’t sleep on R side, turn knobs, open jars, cans or completely close either hand, and difficult to grasp wheel of car. Sleep deprived as I wake up nightly with terrible pain in both hands. Nothing I have tied quells the pain. See my Dr. 4/7. I am 79, single female and on Medicare. I am frightened, in pain daily.
Thank you for this site. I for sure thought I was crazy thinking my flu shot still hurt months later. I just booked an appointment with a Dr from your site. I happen to be in that city (4hours away) next month and he’s able to see me. Thank you again – others still think I’m crazy but with your site I am armed (haha)!
Haha, love the pun Michele!!! 🙂 I am sorry you’re in this boat though. Good luck with the Dr appt; please keep me posted. I hope your injury resolves with a minimum amount of more pain and difficulty.
I live in Canada.. I received the flu vaccine in October 2020. Six weeks later I continue to have excruciating pain in my arm.. I am also a nurse.. I went to the occupational health nurse who said its a coincidence, I went to the emergency room, the ER physician said it’s a coincidence, my family doctor have never heard of Sirva or any other health care physician I know.. Canada does not offer compensation from this injury.
I had an MRI and an appointment to see a ortho doc.. I am worried he will not know of Sirva either.. I feel so alone in this because no one seems to know of sirva in Canada.. The pain is consistent and I’m a nurse.. How do I get my job done, this is so frustrating..
I’m so sorry, Kim…it is such an isolating feeling when no one believes your injury even exists. I hope you’ll find that your ortho has either heard of it or is receptive; I really recommend bringing a few of the journal articles listed above (at least, I got lucky and it worked for me). I really feel for you with the way the injury is interfering with your job. I remember hearing another nurse describe not being able to hang IV bags and that’s just awful. I wish I knew more about Canadian law. Here in the US, there is a push to take SIRVA off the compensation table, and the argument is that people will have to fight for SIRVA compensation through traditional medical malpractice, which many of us with SIRVA think will be an uphill battle considering so many doctors don’t believe it exists. With all that said, you might consider getting a lawyer and working on it through the medical malpractice route; at a minimum, I think fighting to increase visibility of the injury is important. But right now I just hope you can get good info from the ortho and get better. Best wishes.
I believe I have Sirva. Did my body absorb the medicine at the time of vaccination?
Thank you !!
Hi Pat,
I don’t think anyone can say for sure how protected you are from a vaccine that gave you SIRVA. The effectiveness of a vaccine does typically depend on where in the body it is injected, which is why it’s important to hit the right spot (e.g., deltoid muscle). The year I got my flu shot that gave me SIRVA (2017) it was a very bad flu season and I actually masked up (ahead of my time!) while traveling through airports because I was afraid I was not protected against the flu. For the Covid-19 vaccine, at least you get 2 shots, so maybe you will be protected. I wish someone would do some research on this and find out more.
Best,
Amy
Well I may not be crazy after all. After my second Covid vaccine shot (Moderna) January 26, my upper arm was more more sore than with the first shot. A month later and it’s actually worse. I cannot put any side load on my arm or lift it up without feeling pain and feeling no strength at all. And it feels like the constant ache is spreading to my elbow now. Even typing this is causing pain. Advil doesn’t really help. A heating pad helped. I tried massaging but that just hurts. I tried reporting it to the CDC and they were no help. I finally started researching online and found a bunch of vaccine lawyer sites and your site. From what I see described, SIRVA sounds exactly like what I am experiencing. I am in the Baltimore area so I guess I will try to make a doctor appointment. I’m not happy at all. I knew something was off with the way that second shot felt being administered. Do I have to have a lawyer to file a claim with that national vaccine injury program? Thank you for having this website.
Hello all
I’ve just found this website after not knowing what do do for almost 4 weeks of searching and trying to find out if a vaccine can cause injury which I’ve never heard of before but having read and read the symptoms makes sense . When I had my 1st covid-19 vaccine it was really quick and I was anxious so probably didn’t relax my arm and it took seconds but pinched when the needle came out and it hurt
I didn’t think anything of it
Until the next morning a Sunday I felt like I had layed on my arm all night
I still over 3 weeks later can’t lift anything can’t lift my arm up
Everyday tasks are painful and the tingling, numbness and weakness and pain is very frustrating if it’s not better the nurse said I’ll need physical therapy
I’m hoping it’s not an injury but it’s definitely worrying .
Thank you so much for your website and all the great information!! I got SIRVA from my second Covid vaccine a week and a half ago, saw a gaslighting ortho yesterday, but just now made an appointment with Dr. Natanzi from the map you have!! I hope you and everyone here heals rapidly!!
Been all over looking for doctors who perform sir a surgery with tenex closer than dr. Bodor in napa. I live in Chicago. NO ONE. Not even mayo clinic. Do you know it dr. Bodor’s surgery is covered by medicare and do you know how much he charges??
I can’t live this way for the rest of my life… thanks for any info u can share.
Best
Grace e.
Good, middle of the night…..2/20/2021 is the date that…as a 48 year old woman…always vaccinated, changed. I know, you think it was the Covid vaccine. Nope. Tetanus in my right shoulder after a cat bite…& seen at a local emergency clinic.
I went to the ER today…after attempting to get a ct scan or MRI two weeks ago through my own primary failed. 10/11 weeks now if it hasn’t gone away.
Listening to a medical student deny it. I swear, listening to other patients lose their minds from pain after the Covid vaccine.
Wonder if I chose the wrong time to go in asking for help.
Not a single doctor on Long Island deals with this.
They referred me to one affiliated with the hospital. I don’t see this getting better anytime soon.
Hi. I am 28 weeks pregnant with my third & final child, & I do believe I may have SIRVA from the Dtap/Whooping cough vaccine. I noticed when the nurse administered the vaccine it was much higher on my arm then I’m used to, but I also wasn’t aware that any adverse effects could come of it. I’m about to approach my primary doctor about & she’s always heard me out before so I’m hopeful she will be receptive. I am going to bring the info & talking points I found here.
Just found this website and good to learn of others with similar issues. I am about 2 weeks out on getting by booster shot. My arm started hurting as soon as the injection and continues to cause problems. Aching tangling all the way to my fingers. Loosing sleep from the pain. Will need to call my primary care provider who I just had my yearly physical and he said it should be fine in a few more days. I will need to re address this issue with him this coming week. Thank you for posting this. I am located near kansas city if anyone has any recommendations.
I just posted something about Dr. Bodor and the ultra sonic debridement procedure he’s used to treat SIRVA, but the link was incorrect. The correct link is below (napamedicalresearch) and I’ve quoted a section from the article as well.
Here, also, is a very informational article/blog post by someone who was treated by Dr. Bodor (http://sirvasurvey.org/a-new-treatment/)
https://www.napamedicalresearch.org/ultrasound-guided-surgery
“Methods: Dr. Bodor used high-frequency ultrasonography, sonopalpation and precise local anesthetic blocks to identify the suspected location of vaccine deposition in the infraspinatus and teres minor tendons of the rotator cuff in 5 patients with long-standing symptoms. He subsequently performed percutaneous ultrasound-guided ultrasonic debridement and aspiration of these tendon locations and in some cases the underlying bone hypothesizing that we’d be able to flush out the vaccine. Following the procedures, each of the patients experienced rapid resolution of symptoms and restoration of shoulder function.”
I have been suffering with shoulder pain since my TDAP vaccine in August ‘21. I still do not have a diagnosis but I am meeting with an orthopedic dr tomorrow. I wanted to recommend acupuncture as it has significantly reduced the pain level I feel. However it does seem to wear off and I need to go every 2-3 weeks but it is worth it. My insurance doesn’t cover it, but I think some do. I still go because it helps. I wanted to throw that out there in case anyone is considering trying acupuncture. I think it’s worth a try.
I have been in pain since October of last year I’ve had four MRIs and nobody can figure out what is wrong with my shoulder and my arm where I got my email where where I got my flu shot is where it hurts but there’s no doctor here in Shreveport that treats SIRVA can you possibly tell me where I could go close to get my arm checked out I can’t do this pain much longer