swelling in my right arm; I have lost a lot of strength in my right arm and hand; Circulation is not what it used to be; extreme pain in my shoulder area neck back and my whole arm; I haven't had a decent nights sleep since all of this started; It feels like hot Sharp needles are digging deep inside; extreme pain in my shoulder area neck back and my whole arm; extreme pain in my shoulder area neck back and my whole arm; extreme pain in my shoulder area neck back and my whole arm; It started with just a knot where I received the shot; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (extreme pain in my shoulder area neck back and my whole arm), NECK PAIN (extreme pain in my shoulder area neck back and my whole arm), BACK PAIN (extreme pain in my shoulder area neck back and my whole arm), PERIPHERAL SWELLING (swelling in my right arm) and PAIN (It feels like hot Sharp needles are digging deep inside) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 041B21A and 030B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concurrent medical conditions included Penicillin allergy and Drug allergy (codiene).   On 06-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 04-May-2021 at 3:15 PM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 11-May-2021, the patient experienced PAIN IN EXTREMITY (extreme pain in my shoulder area neck back and my whole arm), NECK PAIN (extreme pain in my shoulder area neck back and my whole arm), BACK PAIN (extreme pain in my shoulder area neck back and my whole arm), PAIN (It feels like hot Sharp needles are digging deep inside) and INSOMNIA (I haven't had a decent nights sleep since all of this started). In May 2021, the patient experienced VACCINATION SITE INDURATION (It started with just a knot where I received the shot). On an unknown date, the patient experienced PERIPHERAL SWELLING (swelling in my right arm), ASTHENIA (I have lost a lot of strength in my right arm and hand), POOR PERIPHERAL CIRCULATION (Circulation is not what it used to be) and ARTHRALGIA (extreme pain in my shoulder area neck back and my whole arm). The patient was treated with Manual therapy (Ice and Heat) for Pain in extremity; Manual therapy (Ice and Heat) for Neck pain; Manual therapy (Ice and Heat) for Back pain; Manual therapy (Ice and Heat) for Pain and Manual therapy (Ice and Heat) for Arthralgia. At the time of the report, PAIN IN EXTREMITY (extreme pain in my shoulder area neck back and my whole arm), NECK PAIN (extreme pain in my shoulder area neck back and my whole arm), BACK PAIN (extreme pain in my shoulder area neck back and my whole arm), ASTHENIA (I have lost a lot of strength in my right arm and hand), POOR PERIPHERAL CIRCULATION (Circulation is not what it used to be) and ARTHRALGIA (extreme pain in my shoulder area neck back and my whole arm) had not resolved and PERIPHERAL SWELLING (swelling in my right arm), PAIN (It feels like hot Sharp needles are digging deep inside), INSOMNIA (I haven't had a decent nights sleep since all of this started) and VACCINATION SITE INDURATION (It started with just a knot where I received the shot) outcome was unknown.            No concomitant medications were reported.  The patient reported that it started with just a knot where she received the vaccine and experienced quite a bit of swelling in her right arm. It just kept getting worse, and experienced constant pain in her shoulder and back that travelled up her neck and down her arm. She lost a lot of strength in her right arm and hand. She could no longer hold her arm straight up over her head any longer. It was swollen under her arm. She had to be very careful about picking something up with this arm. The pain woke her up in the middle of the night. She tried ice and heat to help relieve the pain, but nothing helped. She described the pain as like hot, sharp needles that dug deep inside. At times it felt like nerves were affected because it almost wanted to go to sleep. She stated that it was hard to explain because it seemed like it changed all the time.  She had not had a decent nights sleep since all of this started. She had not seen a doctor because she had no insurance and could not afford it.   Most recent FOLLOW-UP information incorporated above includes: On 06-Aug-2021: Significant follow-up received. Added patient demographics, patient not pregnant, Dose 2 details, added Start Date and updated outcome of event 'extreme pain in my shoulder area neck back and my whole arm', new events added, and added non drug treatment for some events.