This is a spontaneous report from Non clinical study program IBCC (Inbound Call Center for HCPs) for a contactable consumer. A 52 years old female patient received PREVNAR 13 in Sep2014 at single dose. The patient medical history included on going osteoarthritis knees, ongoing back pain since 1995, ongoing gout since a couple of years back, ongoing thyroid problems for 3 years, ongoing high blood pressure for 3 years, pyelonephritis and an automobile accident causing lumbar back pain L5-S1 (some lady hit the patient from behind and she was twisted). Concomitant medications included oxycodone 5-325mg, tablet, twice a day, by mouth, have been on medicines for 14 or 15 years for back pain; levothyroxine 0.05mg daily, tablet, by mouth, for thyroid; lisinopril 20mg, one table, every morning, by mouth, for blood pressure; Allopurinol 300mg, 1 tablet by mouth every day, for gout; LASIX and unspecified antibiotic both in hospital at unknown dose. The patient was hospitalized from 22Sep2014 to 27Sep2014 for pyelonephritis. The patient started getting sick in early Sep2014, 7 or 8 days before the hospitalization. During hospitalization, on the second or third day, the patient received the vaccine. Within 12-24 hours the patient experienced swelling around bicep, and warm raised bump. The swelling started going up to the right shoulder joint heading into the fourth day. The raised bump starting going away by the fourth day and by the 5th day it was gone. 3 or 4 days afterward the pain started going into the right shoulder. After 5 days it went toward the left shoulder. It was starting to work downwards now. The knee pain was popping, but this was like a sharp pain. The pain went down arm to right elbow. The patient was transported form the hospital to home and that was when she noticed pain in the right shoulder. Progressively it was going into her fingers. As time went on, it just started getting worse. Now it has gotten to the point it wasn't going away. The patient kept telling her doctor about it and they were not really listening. When she was lying down at night she had to prop the arms up. Just the regular weight from the arms were tugging on the joints and increasing the pain. She had to prop them up equal to the level of the chest so that it would stop pulling and to get some relief from the pain. She did take some of the pain away from the arms when they were propped up. Before she went into the hospital she didn't have any of this. The pain it was creating was still with the patient. When she wake up in the morning she can barely move. She had a limited range of motion. The patient could barely lift the right arm up, so she had to reach over and grab the arm and pull it over with the left arm, just so she could try to get rolled off the bed to get to the bathroom. The doctor and nurses said it was just related to the side effects and she had an appointment on the fourth and she was going to talk to them. She had a back injury and she was on pain medicine. It was not even stopping it from hurting. She had been on it for a long time so it had nothing to do with the pain medicine. When it weared off for the day, it was worse. The patient underwent lab test on unknown date: blood pressure 160 something/90 and 120/80, fever at 100.4 a week before the patient was in the hospital.