Injection pain

[jjstraining]

Hello I am new to this forum. I am writing on behalf of my mother who has to inject insulin 5 times a day.

She is in pain each time despite trying smaller needles as suggested by her nurse.

Can anyone suggest any remedies to decrease the pain of an injection. She has tried injecting into her stomach but gets bruised really easy. She cannot easily inject herself into the arm so she tends to use the thighs.

We have looked into EMLA cream but that is not recommended for continued use? :(

Please, any suggestions would be greatly appreciated.

Thank you

[Jan B]

I don't use needles very much anymore (pumping), but I discovered something a while back. When I touched the needle to the place I was about to inject into, and it stung - I chose another site, even very closeby. When I touched the needle to a place that doesn't sting or cause any special sensation, it didn't hurt there! Also, injecting cold insulin can be uncomfortable. Room temperature is better.

Also, you can pinch harder and the pinch hurts and not the needle!

[shiftzor]

The sweet spot for thighs is between your waist and your knees, at least that’s what I found. We all get bruising; I think the only way around that is to inject 2 in stomach and 3 in thighs in this case. Reduces the bruising in one place, tell her to keep trying different spots on her thighs until she finds the right spot that doesn't draw blood or hurt on her thighs. It takes time to perfect and I can’t say I have it perfected. ;)

I just did a thigh injection and I think it’s a bit lower (towards the knee) than half way point for me. Its worth experimenting with.

[Mich]

Is it the needle sting or the insulin being injected that causes your mom's pain? Some people have trouble with very fast injecting of the insulin and the answer is to slow it down.

I found that doing a "one-two-three" count and getting it over with was the best for the needle sting. If your mom waits for about five seconds, she may experience the pain lessening due to release of endorphins and then can release the insulin.

The sting might be due to muscle tension. Be sure she is injecting into fatty areas because insulin injected into muscle works much faster than it should. The little needles used for insulin are rarely long enough for injecting into muscle, so this probably isn't the problem.

As a last resort, sometimes new diabetics find the use of an automatic injector (look up Busher Automatic Injector) to be a comfort. It always gets the angle and depth correct and lessens the anticipation of injecting oneself.

Mich

[UpNorth]

This is some tricks i've heard about, but never needed to try, exept for one of them....

1. Cool down the site with ice just before the injection- the ice will numb the skin. Costs less than Emla, and can be used as frequently as needed :T

2. "poke around" until finding a painfree place (something i used to do a lot until i learned where my good areas are) It's a great way to do painfree injections and also learn where the good and bad spots are...

3. Make sure to be RELAXED when putting the needle in and injecting. Take a very deep breath in, and breathe out then put the needle in- this is especially for stomach injections. I've never needed to try this, but my friend Elina use this technique all the time and think it's great- she's rather skinny...

[UpNorth]

Another possibility could be using an Insuflon, and then it's possible to use EMLA too. The insuflon is a small needle you can leave for 3 days and just inject into that one. Bit like a pump infusion set. The Insuflon needle is rather big compared to the pen needles though... Or look into a pump.

[Eddy]

I hunt for an acceptable injection site. Sometimes moving but a couple millimeters does the trick; other times, I need to try half a dozen places all over my abdomen. Being relaxed is helpful, as is getting a good pinch of skin.

Hope this helps.

[jjstraining]

My mother is 70 years old and recently had to rely soley on injections for insulin (prior to this she was on tablets). She takes novorapid 3x pday and lev_? 2x pday.

I cannot believe that nothing has been created to relieve injection sting?

She absolutely dreads the injections so your suggestions are very helpful. She says she cannot inject in the same sites often due to sometimes getting a lump. She also says she has to use both hands to hold the pen as it is very stiff to press and keep steady. This means she cannot pinch the skin whilst injecting.

Would a different pen be less stiff enabling her to just use one hand and pinch the skin with the other?

I think she is doing everything wrong which is increasing the pain. Please keep your suggestions coming as they are very helpful in identifying options to improve her suffering and lift her spirits alittle better.

Thank you so much for your advice.

I too thought of ice to numb the area but was concerned about its ability to reduce blood flow to the applied area? Anyone use this or similar on a regular basis?

[shiftzor]

My mother is 70 years old and recently had to rely soley on injections for insulin (prior to this she was on tablets). She takes novorapid 3x pday and lev_? 2x pday.

I cannot believe that nothing has been created to relieve injection sting?

She absolutely dreads the injections so your suggestions are very helpful. She says she cannot inject in the same sites often due to sometimes getting a lump. She also says she has to use both hands to hold the pen as it is very stiff to press and keep steady. This means she cannot pinch the skin whilst injecting.

Would a different pen be less stiff enabling her to just use one hand and pinch the skin with the other?

I think she is doing everything wrong which is increasing the pain. Please keep your suggestions coming as they are very helpful in identifying options to improve her suffering and lift her spirits alittle better.

Thank you so much for your advice.

I too thought of ice to numb the area but was concerned about its ability to reduce blood flow to the applied area? Anyone use this or similar on a regular basis?

You mean Levemir? ;) What pen is she using? I usually hold the pen in one hand and hold my clothes or something with the other. I know with the Autopen24 you could get attachments to make the plunger easier to push and the dial easier to turn. However I wouldn’t recommend the Autopen24 as it’s not that great and it’s a Lantus (different type of insulin) only pen. Maybe a Levemir user knows a better pen?

[JoanW]

I am 74 years old and do 5 injections a day, and have been doing them for almost 10 years now. Yes, I get bruises, I don't think that can be avoided, but I agree with the folk who say 'touch the needle to the skin gently, and if it feels picky, move it over a little to another spot'. This works for me. I also use Levemir twice a day, morning and evening. Tell your mother to get a Novo-4 pen, it has a very easy pushing motion, much easier than the Novo-3 pen which I used to use. That pen can also be used for her novorapid. I take Humalog for my bolus, so I use a Huma pen Luxura which again is a very nice pen to use. She will relax when she gets used it it, and will be able to do it with ease. Make sure the pen is kept at room temperature and not in the fridge as this makes the insulin too cold and might sting when injected. Hope some of the hints you read here will help. I have plenty of fat around the waist area, and tend to do my bolus (mealtime) injection just above the waist and my Levemir lower down on the abdomen.

[TenderVittleS]

There are a few things I can suggest which may or may not help:

1) use the short needles
2) inject the insulin slowly
3) use fattier areas of the body
4) rotate injection sites
5) make sure there is no blood in the syringe before injecting

Sometimes pain is unavoidable no matter what you do but these techniques should help lessen the frequency.

[UpNorth]

Definitely give the Novopen4 a go! I've been using it for a couple of years or so now, and it's brilliant :D So easy to use! Much better than FlexPens (disposable pens). I've never used Novopen 3, but from what i've heard, they need more force to inject the insulin.


As for using ice for numbing, this is something i've heard some doctors recommend even. But with your mum's problems with both pain and not being able to pinch and inject at the same time, i'd still suggest she tries the Insuflon. Then she'd be able to use EMLA for the insertion, and would only need to have needles every 3 days or so.

[jjstraining]

Thank you all so much. I now have a number of suggestions to make to my mum.:)

She is unsure what pen she is using but we are going to find out from the phamacy. We will also find out about the other recommendations when she next visits the diabetic nurse.

Again, I find it really hard to believe there is no cream/topical applications that can be used to numb the frequent use of injections.

I heard they were developing an insulin patch?

[Tattoo azz]

I don't mean to be rude, but would she be able to inject into her ahem 'butt'? i do and it hurts less and you don't really need to pinch, although i only inject novorapid in there as Lantus tends to sting for me if i inject it in my butt. Again i don't mean to be rude but as no one has suggested it i thought i would.
Azz

[SuzySushi]

You might also want your mom to try the Junior pen, which is designed for children. My daughter (age 11) has been using it by herself for over a year and finds it very easy to handle. It doesn't require a lot of strength to deliver thee insulin dose so she can hold the pen and push the button with one hand while pinching her skin with the other.

[KCP]

Again, I find it really hard to believe there is no cream/topical applications that can be used to numb the frequent use of injections.

Yea i guess part of teh reason for this is that after awhile you do get used to the feeling of having to inject yourself everyday.
Can you imagine: injecting 6+ and having to use that cream all the time? Man ! Id never be NOT covered in it :cool:

[condensr]

Can she go to syringes/vial? It's a little more work up front drawing it up, but for someone with hand problems or struggling with the pen, they're a lot easier to use during the actual stick/injection part. I rather prefer them for home use.

[Lizzie G]

Hi, Id agree with the 'poking around' approach....i didnt realise at first that the intense pain i would on occasion experience was due to hitting blood vessels (which would of course then bruise). i dont know how it works on other people, but i seem to have a 'strip' along the bottom of my stomach that doesnt hurt at all, really low down below my hits. i actually have less fat here than further up but for some reason it works the nicest.

Iv never used any creams or anything but im sure pharmacies sell creams contain a mild topical anaesthetic, the sort of thing they sell you for cuts and burns? its worth asking. also, if you get some aloe vera gel (if you're in the US you can probably get this in walmart, in the UK body shop does it) its really good for soothing the skin, it wont stop the injections hurting but will repair the damage more quickly.

[shades9323]

Hi, Id agree with the 'poking around' approach....i didnt realise at first that the intense pain i would on occasion experience was due to hitting blood vessels (which would of course then bruise). i dont know how it works on other people, but i seem to have a 'strip' along the bottom of my stomach that doesnt hurt at all, really low down below my hits. i actually have less fat here than further up but for some reason it works the nicest.

Iv never used any creams or anything but im sure pharmacies sell creams contain a mild topical anaesthetic, the sort of thing they sell you for cuts and burns? its worth asking. also, if you get some aloe vera gel (if you're in the US you can probably get this in walmart, in the UK body shop does it) its really good for soothing the skin, it wont stop the injections hurting but will repair the damage more quickly.

Doesn't "poking around" potentially increase the pain? The best way I have found is to just jab it in there. Don't put the needle in slowly, a swift jab does the trick for me.

[shiftzor]

Doesn't "poking around" potentially increase the pain? The best way I have found is to just jab it in there. Don't put the needle in slowly, a swift jab does the trick for me.

I do the same, I guess jabbing about is good to find the "good" spots. After that jabbing becomes a bit pointless, sure every once in a while its painful but thats life.

[gobbly2100]

Hey, I really feel for your mother, I am not sure how practical this is but I had major issues with injections and as a result went for an insulin pump and I now never have any anxiety what so ever about the next injection which is every 3 days and it also does not really hurt, it is such a short pinch when it go's in you don't feel it.

As I said, I don't know if it is possible for you but I highly recommend it.

I hope your mother finds a way to make it better for her.

Feel free to PM me if you have any questions!

[PepsiLvr]

Make sure that after she has the needle in that she doesn't apply pressure in any direction (e.g. up, down, sideways) while injecting. I've found myself doing this once in a while and it does make it hurt more. Just inject straight in and try to "hold" the needle as little as possible.

Like others have said, it does help if you are relaxed. Is she new to injecting? I use the 31 gauge pen needles and it really doesn't hurt too much. Everyone is different though.

[HollyB]

I think pinching up the skin could make a big difference. Hopefully the suggestions for a different pen -- Novo 4 or children's Flexpen will allow her to use it with one hand and pinch the skin with the other. That way, you're pretty sure of getting just into the fat. And you get a little resistance in the skin so the needle maybe pops in more smoothly.

I was surprised to find what a range there is in needle sizes. If your mom is thin, make sure she has the shorter needles in the thinnest gauge available (higher number = thinner needle). I can't figure out why they even make those fatter needles.

And then, as was suggested, use room temp insulin and inject it bit by bit, slowly. My son almost never found the needle itself to hurt much but the insulin will sting going in if you shoot it in too fast.

I hope you find something that helps.

[Lizzie G]

Doesn't "poking around" potentially increase the pain? The best way I have found is to just jab it in there. Don't put the needle in slowly, a swift jab does the trick for me.


i guess when i say 'poking around' i mean, i ease the tip in gently, so that if i hit a piece of skin that is sensitive or tough (you know how some skin breaks really easily whereas some bits need a bit of a 'pop') i withdraw the needle and try again....lovely....

[jjstraining]

Wow you guys are really helpful here, thanks so much for your advice. My mum is really touched by all your help.

We have to wait for a needle/pen change and to discuss possible alternatives like the pump (:nurse: next nurse appointment). The other tips in the meantime make it much easier to find what works for her.

I have printed out your comments to take to the appointment and will let you know the outcome, hoping this might help others in a similar situation.

Thanks again!:)

[nono87]

Hi,

i had the same problems and i have been recommended Autocover Novofine Needles they come in 8mm but they are sooo much gentler on the skin. try and see if your doc will prescribe them ad i'm told they are more expensive than ordinary needles so some docs refuse to prescribe them.

[Eddy]

i seem to have a 'strip' along the bottom of my stomach that doesnt hurt at all, really low down below my hits. i actually have less fat here than further up but for some reason it works the nicest.


I almost never inject in my central belly fat these days. Current favorites: abdominal area straight down from nipples, most anywhere along the bottom of my ribcage, or occasionally the "waistband strip". All lower-fat areas, and all hurt less than central belly or love handles. *shrug*


The best way I have found is to just jab it in there. Don't put the needle in slowly, a swift jab does the trick for me.


Aiyee! Works okay for a "good" spot, but not fun if hitting a vein or the vagus nerve. After a few blue spots on my belly, and blue streaks in the air, I picked up the "hunting" technique. I've not looked back.

[Lizzie G]

[QUOTE=Eddy;331967]I almost never inject in my central belly fat these days. Current favorites: abdominal area straight down from nipples, most anywhere along the bottom of my ribcage, or occasionally the "waistband strip". All lower-fat areas, and all hurt less than central belly or love handles. *shrug*



im the same, the belly hurts! i get bruises if i go too high, and when i gain a little weight on my tummy it hurts way more than when im thin which is opposite to what i expect. i havent tried the higher areas below ribcage etc, maybe i will give it a go, im currently on loads of shots as my A1c a bit higher than i wanted last time and im scared to take a lot of insulin in one go...

[Eddy]

when i gain a little weight on my tummy it hurts way more than when im thin which is opposite to what i expect


Same here. I found the central-belly shots hurting more and more. I moved to the "love handle" area. Then, when I began adding fat there, those started hurting. Perhaps it has to do with new tissue growth to support the swollen fat cells?

[jjstraining]

Thanks for all that help guys :)

She told me to ask also about the pain when the insulin is going in, she said it is so painful she wants to pull the needle out. She describes it as a long sting? For the needle pain I am hoping your suggestions will help. But with the insulin going in also causing the pain I wondered if this is common? I forgot to mention this as I was focusing on needles :o

(The days injections are kept at room temperature as this was previously suggested).

Anyone know what might be the cause and if it can be overcome?

[Stuboy]

Insulin can sting if it's COLD when it goes in. It helps if you dont keep the insulin cartridge currently in use in the fridge, it's fine at room temp for 28 days, most people use a couple or few cartridges in that time anyway so it's ok.

Try injecting room temp insulin and see if that lessens the sting.

[HollyB]

And push the plunger SLOWLY. My son says it stings if he shoots it in fast -- much less if he injects bit by bit -- about a unit at a time.

But he's never used Lantus, which I understand stings for some people no matter what.