Seven Ways to Improve Injections

Many RA medications come in the form of self-injectables. Over the last 18 years I have heard many people complain that they cannot learn to give themselves injections or if they can, it is always difficult to do so. I never had this issue, but then again, I have been injecting myself since June 18, 1974. 

My history with RA self-injections

In fact, a rough estimate is that I have given myself about 37,000 injections give or take a few thousand. If anything, that number is likely a little less than I have given myself.

Mix in a few RA injections (roughly 40,000 finger sticks) and you might say I am something of an expert at how to stick sharp (and sometimes dull) steel wires into my skin.  In this time many have hurt, a few have really hurt, and most are completely unmemorable, including the six I have given so far today as I write this item.

Tips to safely inject RA biologics

1. Get to know the device

The first thing to do is get to know the device.  Next time you see your doctor, ask if they can spare an empty syringe and needle or better yet the sample of the device you will be using.  If they cannot spare it, ask for a prescription for a needle that is approximate length and gauge of the needle of the device you will be using.

After your next injection or with a practice syringe take it apart as best you can in order to examine the parts.  For the most part all devices have similar parts.  Plunger, barrel, needle hub (where the needle attaches to the barrel and of course the needle.  Most have a cap or guard that covers the needle.

After you have examined the parts then put the syringe aside but in a secure place.  Then pick up the syringe at least once a day for 20 days.  Handling the syringe is the number one best way to breakdown the fear.

2. Practice injections

Most RA medications come in a single dose pen or another device.  So, to do this, you will need the syringe and needle from your doctor that I describe above.

The best way to practice is to draw saline or water into the barrel of the syringe and inject the fluid into an orange.  An orange feels much like human skin, except it is a little more taught than piercing skin.  Practice each step of giving an injection, until you normalize the process for yourself. Take the alcohol swab and wipe the orange, let the alcohol dry then insert the needle and push the water or saline into the orange.  Do this over and over using rote learning to ease the fear of giving injections. One trick to remember: always allow the alcohol to completely dry on your skin before injecting yourself.  If the alcohol is still wet when you inject it is likely that the injection will hurt.

3. Pay attention to tip location

The injection needle tip has two sides.  The point and the flat part.  It is important for maximum comfort to insert the tip into the skin, not the flat end.  I never give an injection without first looking at where the point is located.  If I cannot see the point (the pen sometimes will not allow you to see this) then I imagine I am inserting the needle tip into my skin.  It may seem odd to think about pushing the sharpest part of a needle into our bodies, but that is exactly what makes insertion easier.  Think of the front of an airplane.  Fronts of airplanes are often pointed to reduce wind resistance.  The needle is shaped at a tip to reduce needle pain.

4. Apply Ice

One way to lessen the pain is to apply ice to numb the area before the injection.  Laying an ice cube directly on the site for about one minute will numb the injection site to the point where you will not feel the needle pierce the skin.  If you use a commercial product to numb the skin be sure and ask your doctor.  Sometimes chemicals in these sprays or creams can react with the medication injected.

Just as important is to warm the medicine.  Many RA medications require refrigeration before injection, so remove from the refrigerator 15 to 20 minutes before injection.  Doing this alone will improve injection pain.

5. Pinch the skin

Pinching a large amount of skin will assist you in placing the needle correctly.  Do not pinch too small an area.  The pinch is to offer control of placement.  So, use it this way.

6. Dispose of the needle properly

It is important to know the correct way to dispose of used syringes.  In my area, the local hazardous waste authority provides medical disposal boxes for in-home use.  I am careful to place my syringes and needles in this container and then to exchange it when it gets full.  If your area does not provide a similar service, contact a local hospital, pharmacy or your waste disposal hauler to ask for local rules.

7. Don’t eat the orange

The first injection I gave myself was done without practice.  Since I was 17, I was always hungry so when they brought me the orange to practice on, I ate it instead.  In fact, I ate it for three days in the row.  On the fourth day the nurse called my bluff and said the day had come.  In retrospect, I wish I practiced before I did it. Still, those oranges did taste good.

Taking these steps in addition to steps suggested by the medication provider and your doctor will improve your injection experience.  Especially number seven.

What are your tips for making injections less painful or stressful?