Flu shots are more important than ever this year so I hope you’re all scheduling yours, if you haven’t gotten one already. But when you do, you might have a sore shoulder for a couple of days. A reader asks if there’s a good way to prevent that soreness:
You should do an article on how to avoid flu shot pain as much as possible, cause I always forget how damn much this thing fucking hurts. Up at 4 in the morning hurts. Good lord.
Not everyone gets a sore arm after a flu shot, but it’s pretty common. The pain is because your immune system has to react to the antigen in the vaccine (priming your immune system is the whole point of getting the shot), and that process involves inflammation, and inflammation tends to involve soreness, redness, and swelling. These are the most common side effects of almost every vaccine.
The amount of inflammation from a flu shot is fairly minimal, and for many of us the pain is mild, but everybody experiences it differently. Some people have a better pain tolerance than others, for example, and pain also has a lot to do with expectation: If you expect the shot to hurt, and spend a lot of time thinking about how much it hurts, you may have a harder time than someone who gets distracted and forgets to even think about it.
The pain can also vary from shot to shot. Some vaccines have a reputation for being more painful than others, probably because their contents provoke a more pronounced immune reaction. If I’m ever getting more than one shot in the same visit, I always ask if one tends to cause more soreness than the other, and I choose which one goes in which shoulder accordingly.
Ways to reduce the pain of your flu shot
First, recognize that there might be some soreness, and plan for it. Get the shot in your left shoulder if you’re right handed, for example. If you’re often sore after a flu shot, consider not scheduling the shot right before arm day in the gym.
Next, ask your provider if it’s okay to take a pain reliever like ibuprofen before or after the shot. Sometimes that helps. (For the immediate pain of the injection, you can also try any of the tips we’ve written about for kids, like using ice or a topical anesthetic, or distracting yourself with a video, or chewing on some candy. Communicate with your provider about these things, too.)
Relax your muscle before the needle goes in. Injections tend to hurt more if a muscle is tensed.
Finally, move your arm around after the shot. This may help because it moves the injected liquid around your arm a bit, so that when that inflammatory reaction occurs, it’s not as concentrated in one place. Also, it’s important to recognize that it’s just soreness, not a serious injury, and you can move around and use your shoulder. Don’t baby it. Whether a few arm circles after the shot could actually reduce late-night pain, we aren’t sure, but in general the muscle soreness tends to feel better with movement.
Seek help if it’s extreme
This is all assuming you have a normal amount of pain, which is anything up to a few days’ worth of the same feeling of soreness you might get from a hard workout.
If it feels like something beyond that, get back in touch with your provider. Serious complications from a flu shot are rare, but possible. For example, if the needle misses your muscle and hits one of the fluid-filled sacs around your shoulder joint, you could experience pain, weakness and possible nerve damage in your shoulder. (This is rare because the people who administer shots tend to be good at their jobs, but we know about it as a medical condition because, well, it does happen sometimes.)
If the pain is so bad you can’t sleep, I’d check in with your doctor, or if you don’t have a primary care physician just call the clinic where you got the shot. But a little bit of soreness is normal, and you can use the tips above to reduce your chances of feeling it next time.