Allergy shot muscle loss

[agutierrez]

I had an allergy shot done in my right deltoid on June 1, 2009. At first everything was fine and I just had a small bruise where the nurse gave me the shot, but it never went away. Three weeks after the shot I started to feel sore and stiff in my right shoulder and realized that a hole or dent had formed underneath the bruise (which is still there). It looks like the muscle literally slid down my arm leaving my collar bone jutting out of my shoulder and an empty gap between the muscle and the collar bone. The hole is about 2 inches wide, 1 inch tall, and 3 centimeters deep- and getting bigger slowly everyday. I went back to the doctor totally freaked out and he said it was very strange, but muscle dystrophy can happen with steroid injections. He told me to just exercise the muscle and hope it fills in but if it doesnt to come back in and he would do an x-ray, mri etc. I have been exercising my arm and the deltoid is getting stronger but the hole is not filling in at all. I dont think my doctor has any idea what he is doing but my arm looks completely deformed, though it is still totally functional and I do not feel impaired- though it is sore when I sleep. I did some internet research and it sounds like I am not the only one to have this side effect, but that this could possibly be a permanent deformity. Is that true? I am pretty thin so this hole is very noticeable. Is there anything I can do to fix it or a treatment i should be looking at? I am at a loss and I feel like my docotr is wasting my time and money. Please help.

[National Jewish Health]

The temporal relationship of the injection quickly followed by painless muscle atrophy suggests a cause and effect relationship between the two.  Fortunately, such atrophy following deltoid injection is most uncommon.  However, atrophy of one or more (of the 3) heads of the deltoid muscle, following an intramuscular injection of that muscle has been described in the medical literature.*   It has been postulated that the atrophy is secondary to injury to the axillary nerve, either from the needle and/or the material injected.  The same investigators suggested that the presence of voluntary motor units (nerves) in the middle head of the deltoid muscle, might “portent a favorable prognosis” for continued re-innervation of the other two muscular “heads.”

The best advice I can give is that you ask your doctor to refer you to a medical specialist in Physical Medicine, called a Physiatrist, who can perform diagnostic studies (nerve and muscle function) to further define the presence and extent of muscle atrophy and recommend appropriate physical therapy, in response to which muscle function and size may or may not respond.

Good luck,


* Davidson LT, Carter GT, Kilmer DD, Han JJ: Iatrogenic axillary neuropathy after intramuscular

injection of the deltoid muscle. Am J Phys Med Rehabil 2007;86:507–511.