Injection pain

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UnexpectedDiagnosis

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Relationship to Diabetes
Type 1.5 LADA
I've read the tips of injecting through this forum and even purchased a "tickle flex" in the hope that I can try new places to inject.

This is only my 3rd month of injecting, some days its fine and I barely feel the needle penetrate the skin, but then I have other days where its like my skin is tough and I have to force the needle through the skin.

I've gone back down to 4mm needles (from 5mm) so I've got the smallest needles I can get really. Last night everywhere I put the needle it was like it just didn't want to go in, and once through the first layer of skin I could feel every push of the needle. I've tried pinching and stretching the skin but neither seem to help.

I rotate my needle site daily, is it typical to have days where they all hurt? I know needles will never be pleasant but it's starting to give me some anxiety before I inject which isn't helping. Usually the needle does much of the work, I start to pressure and it just slides into the skin, but recently it's just not been as easy.

I feel like a right wuss complaining about this but it's just getting worse so I thought I'd ask
 
What make of needles are you using.
some have a more gradual profile than others.

Using the shortest needles possible for you is a good plan.

I found BD microfine were Brilliant. I got switched to GlucoRX needles and they gave me bruises every time. I got switched back. If you look at the profile of the needles you can see what there is such a difference. Have a chat with your nurse and see if they can help you switch.
 
I'm using the 4sure 4mm 32G needles so I would have thought they would be ok, normally they are but the past couple of weeks it's like they just don't want to go in.... like I say some days it's totally fine but I have days where it's like my skin is tough! I will try my previous 5mm needle again later to see if it's any better

Thanks for your reply @SB2015
 
I too use the BD needles without issue but don't have experience of others to compare.

Where & how are you injecting? I use the abdomen with a short, gentle "stab" at 90 degrees to the skin & rarely feel the needle. The only time I do is if I'm unintentionally a bit tentative & the needle goes in slower.
 
RBZ5416 said:
I too use the BD needles without issue but don't have experience of others to compare.

Where & how are you injecting? I use the abdomen with a short, gentle "stab" at 90 degrees to the skin & rarely feel the needle. The only time I do is if I'm unintentionally a bit tentative & the needle goes in slower.
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90 degrees against the skin, I don't pinch the skin as I don't usually need to, I rotate from right leg to right stomach to left stomach to left left on rotation and I've even started moving round to my bum. Most of the time the needle goes in without trouble and tbh isn't painful.... but I am having more days where I'll pressure against the skin but it just hurts and doesn't breach without me having to pressure further, and then it hurts as I am pushing in.... Usually I can almost leave the needle pressured against the skin and it's almost like the skin does the work and it slides in no trouble but lately it's like my skin is tougher. I must sound mad but I can't explain it any other way.

I just don't know why I am getting such a big difference, either no pain or it's a very unpleasant experience and I have to try a couple of areas. But I think I inject the same way each time. It's just getting me down a little at the moment as at first it didn't really hurt, now I am a little anxious each time I am about to inject.

I will try to just do it quicker and see if that helps too, maybe I am being too tentative now it's started hurting
 
I experience a very similar thing but what I find is that there are definite areas which don't hurt at all and I don't feel the needle go in and others where I sometimes even get so far in and take the needle out again because it is so painful. It is very tempting to go for the areas that don't hurt every time but obviously that is risky long term so I avoid doing that except with my occasional evening basal injections into my thighs. (I often don't need an evening basal dose if I have been very active, so doses into thighs are rare and morning basal goes into my buttocks.

Sometimes I do think that just jabbing it in is the answer and part of the problem is touching the needle to my skin looking for a less painful spot and perhaps being too reticent. Sometimes I just think to myself, "relax" it will only hurt for a few seconds and I know it won't get to the point of being unbearable and it doesn't deter me from injecting.... I regularly inject corrections between meals, so my need for good management overrides the concern about pain, but I know mostly where the painful areas are, so if that is my chosen spot I am prepared for it to be painful although sometimes I get a pleasant surprise. I don't think it is psychological in that I expect it to hurt so it will hurt.
I have tried pinching to make the skin more taught in the hope that it will slide in more easily. I have tried deep breathing to relax before pressing the needle through the skin. I have had other makes of needles like BD before my current ones GlucoRx and it doesn't seem to make much difference. I can move the same needle to a different spot and it goes in painlessly so it isn't the needle, so I agree that it is to do with the texture of the skin/tissue. It hasn't got appreciably worse over the last few years so I don't think it is deteriorating. My waist band area and above seems to be the worst area, but below waistband is much less sensitive so maybe having tight clothing in that area over the years has thickened the skin/tissue.
I think the best answer is probably to just jab.... the same as ripping a sticking plaster or Libre off. Don't hesitate, just do it, but I understand that mentality isn't always easy to achieve when you are poised with the needle expecting it to hurt. I mostly just go for it now, and accept the pain if it happens. I breath and I know it will soon subside.

Sorry that my post probably isn't that helpful in solving the problem but just wanted you to know that you are not alone in this and I can totally relate to what you are describing. I also sometimes have the additional problem of my insulin stinging occasionally and then sometimes I will also have a bleeder that bruises and if I am really unlucky I will have the triple whammy of pain from the needle, stinging from the insulin and a bleed and bruise, but to balance it out I sometimes get none of the above and it is totally painless. You gotta love diabetes.... nothing with it is consistent!!
 
rebrascora said:
I experience a very similar thing but what I find is that there are definite areas which don't hurt at all and I don't feel the needle go in and others where I sometimes even get so far in and take the needle out again because it is so painful. It is very tempting to go for the areas that don't hurt every time but obviously that is risky long term so I avoid doing that except with my occasional evening basal injections into my thighs. (I often don't need an evening basal dose if I have been very active, so doses into thighs are rare and morning basal goes into my buttocks.

Sometimes I do think that just jabbing it in is the answer and part of the problem is touching the needle to my skin looking for a less painful spot and perhaps being too reticent. Sometimes I just think to myself, "relax" it will only hurt for a few seconds and I know it won't get to the point of being unbearable and it doesn't deter me from injecting.... I regularly inject corrections between meals, so my need for good management overrides the concern about pain, but I know mostly where the painful areas are, so if that is my chosen spot I am prepared for it to be painful although sometimes I get a pleasant surprise. I don't think it is psychological in that I expect it to hurt so it will hurt.
I have tried pinching to make the skin more taught in the hope that it will slide in more easily. I have tried deep breathing to relax before pressing the needle through the skin. I have had other makes of needles like BD before my current ones GlucoRx and it doesn't seem to make much difference. I can move the same needle to a different spot and it goes in painlessly so it isn't the needle, so I agree that it is to do with the texture of the skin/tissue. It hasn't got appreciably worse over the last few years so I don't think it is deteriorating. My waist band area and above seems to be the worst area, but below waistband is much less sensitive so maybe having tight clothing in that area over the years has thickened the skin/tissue.
I think the best answer is probably to just jab.... the same as ripping a sticking plaster or Libre off. Don't hesitate, just do it, but I understand that mentality isn't always easy to achieve when you are poised with the needle expecting it to hurt. I mostly just go for it now, and accept the pain if it happens. I breath and I know it will soon subside.

Sorry that my post probably isn't that helpful in solving the problem but just wanted you to know that you are not alone in this and I can totally relate to what you are describing. I also sometimes have the additional problem of my insulin stinging occasionally and then sometimes I will also have a bleeder that bruises and if I am really unlucky I will have the triple whammy of pain from the needle, stinging from the insulin and a bleed and bruise, but to balance it out I sometimes get none of the above and it is totally painless. You gotta love diabetes.... nothing with it is consistent!!
Click to expand...
Tbh you've helped loads! Knowing it's not just me is the biggest help, I thought I was just being a wuss lol

The insulin does sting sometimes but it's usually fine, I did hit a nerve last week though and that was not fun. Diabetes is the gift that keeps on giving! I was getting fairly heavy bruising at first but swapping to the 4mm needles seems to have helped with that.

I thought Diabetes was simple at first but there's quite a lot to it 🙂
 
rebrascora said:
I experience a very similar thing but what I find is that there are definite areas which don't hurt at all and I don't feel the needle go in and others where I sometimes even get so far in and take the needle out again because it is so painful. It is very tempting to go for the areas that don't hurt every time but obviously that is risky long term so I avoid doing that except with my occasional evening basal injections into my thighs. (I often don't need an evening basal dose if I have been very active, so doses into thighs are rare and morning basal goes into my buttocks.

Sometimes I do think that just jabbing it in is the answer and part of the problem is touching the needle to my skin looking for a less painful spot and perhaps being too reticent. Sometimes I just think to myself, "relax" it will only hurt for a few seconds and I know it won't get to the point of being unbearable and it doesn't deter me from injecting.... I regularly inject corrections between meals, so my need for good management overrides the concern about pain, but I know mostly where the painful areas are, so if that is my chosen spot I am prepared for it to be painful although sometimes I get a pleasant surprise. I don't think it is psychological in that I expect it to hurt so it will hurt.
I have tried pinching to make the skin more taught in the hope that it will slide in more easily. I have tried deep breathing to relax before pressing the needle through the skin. I have had other makes of needles like BD before my current ones GlucoRx and it doesn't seem to make much difference. I can move the same needle to a different spot and it goes in painlessly so it isn't the needle, so I agree that it is to do with the texture of the skin/tissue. It hasn't got appreciably worse over the last few years so I don't think it is deteriorating. My waist band area and above seems to be the worst area, but below waistband is much less sensitive so maybe having tight clothing in that area over the years has thickened the skin/tissue.
I think the best answer is probably to just jab.... the same as ripping a sticking plaster or Libre off. Don't hesitate, just do it, but I understand that mentality isn't always easy to achieve when you are poised with the needle expecting it to hurt. I mostly just go for it now, and accept the pain if it happens. I breath and I know it will soon subside.

Sorry that my post probably isn't that helpful in solving the problem but just wanted you to know that you are not alone in this and I can totally relate to what you are describing. I also sometimes have the additional problem of my insulin stinging occasionally and then sometimes I will also have a bleeder that bruises and if I am really unlucky I will have the triple whammy of pain from the needle, stinging from the insulin and a bleed and bruise, but to balance it out I sometimes get none of the above and it is totally painless. You gotta love diabetes.... nothing with it is consistent!!
Click to expand...
Yes, I recognise and agree with all of that.

Couple of related thoughts, @UnexpectedDiagnosis.
I, now, never reuse a needle, since they come with a lubricant that both aids skin penetration and provides an element of sterilisation. Now, knowing that, I don't feel the possible economy by me for the NHS is worthwhile. Using even a slightly blunted needle and without any residual lubricant is much more likely to cause damage and below skin problems.

According to the DSN on my recent DAFNE course areas where there is absolutely no pain or discomfort are more likely to be areas that are already compromised by being used too frequently and may well hinder the full release of insulin into one's blood. She said (my paraphrase) if a zone is completely senseless (ie no discomfort at all) check it very thoroughly for any swelling and bruising and if you can't see that zone ask someone to check it for you. If in doubt avoid that zone. So I always expect a small amount of sensation or discomfort; sometimes injections are a little more painful - no reason why as far as I can tell.

You are already experimenting with needle lengths; if this difficulty continues for you, ask your GP (or the surgery Nurse who generally deals with diabetes I the Practice and might be more familiar with options - or at least able to give you sufficient time and attention to help) to let you try a different needle brand. There are differences in needle profiles, as well as diameter and length, plus different lubricants. Since you are going to be injecting for the foreseeable future (unless technology overtakes this) it is perfectly reasonable to ask your GP Surgery to help and allow you to experiment.
 
I have to be honest and admit that I still reuse my needles and I don't find that the problem. The same needle will go in very painfully in one spot and be absolutely fine in another even if it has been used 6 or even 10 times before.... I am really naughty 🙄 . For me it absolutely doesn't make a difference and a brand new needle is as likely to be painful as a multiply reused needle. I should say that I am absolutely not encouraging people to reuse needles, but just refuting that this is the issue for me. I have had the conversation with my nurse several times and she has been unable to convince me of the arguments based on my own experience.

Also the painless spots, particularly on the tops of my thighs, are my absolutely least used areas so I don't agree with that comment from the DAFNE nurse either for me and I get normal absorption from them. I appreciate it may be the case for some people, but I can't see that being the situation for myself or @UnexpectedDiagnosis who is relatively newly diagnosed.

I think there may be a bit of cellulite in the problem areas which perhaps thickens the skin/tissue. Certainly the areas which are least painful appear to have the thinnest, smoothest, softest skin.
 
Like @rebrascora I disagree with the comment from your DAFNE course @Proud to be erratic.
After nearly 20 years (12 of them on up to 10 injections per day), I have no "compromised areas" but do know if it hurts, it is a hint to avoid that area, especially as it often results in a bruise. Most of the time, I barely feel the needle.
I usually inject in my abdomen as I have muscular legs which I find more sensitive (and the exercise I do significantly reduces the absorption time).

Like rebrascora, I was not always a good girl in terms of single usage of needles. The additional uses resulted in unsightly bruising rather than pain inserting the needle.

I have noticed that GPs seem to favour cheaper needles which do not "glide" as easily. Now, I am on a pump, I rarely use the needles so I accept the added friction for the occasional jab. However, if I was on MDI, I would be requesting/demanding the more expensive better lubricated needles.
Unless you have tried the lubricated and less lubricated needles, it is hard to understand the impact the cost saving can have.

I have not used 4sure needles but @UnexpectedDiagnosis I would recommend requesting to try a different brand if you are having problems with them. Please don't suffer in silence - make it your GPs problem.

My other thought if you are finding your skin is tough, is it worthwhile moisturising it? The massaging is likely to loosen the skin a little. But stay away from areas that are sore or bruised.
 
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Hi. I don't believe it has been mentioned but I also use the upper arm as suggested by my DN. Works well in conjunction with stomach, thigh, backside etc
 
Have you tried different locations? I only inject in my stomach if I’m out and want a discreet jab as I find it too painful. I mostly use arms and legs at home.
 
DaveB said:
Hi. I don't believe it has been mentioned but I also use the upper arm as suggested by my DN. Works well in conjunction with stomach, thigh, backside etc
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Upper arm cannot (easily) be used if you have limited fat.
My arms are muscley (probably something to do with my climbing exploits). Where I have less fat, I need to pinch. Unfortunately, I run out of hands when I pinch my arm and try to inject.
I did once read a suggestion about pinching your arm against the back of a chair but I decided that was just too much trouble and, knowing me, liable to unintentional stabbing :D
 
@rebrascora - never, never, NEVER EVER re-use needles. I most certainly used to do it - but regretted it A LOT when it completely destroyed the fat layer on both my outer thighs which I suddenly realised I'd done in the early noughties, getting dressed one morning to go somewhere on the pillion of one of the motorbikes and being winter had donned my M&S thermal leggings prior to my leathers, just happened to glance in the floor length mirror in our bedroom - two huge hollows in my outer thighs!! and since then many many spots on my belly and my bum which simply refuse to absorb insulin.

Since then one of my missions in life is to try and scare folk as much as I can, never to do it. In an emergency - OK. Otherwise - NOT.
 
Oh and PS - drink plenty, keep the flesh well hydrated and moisturised well whichever gender you happen to be.
 
helli said:
Like @rebrascora I disagree with the comment from your DAFNE course @Proud to be erratic.
After nearly 20 years (12 of them on up to 10 injections per day), I have no "compromised areas" but do know if it hurts, it is a hint to avoid that area, especially as it often results in a bruise. Most of the time, I barely feel the needle.
I usually inject in my abdomen as I have muscular legs which I find more sensitive (and the exercise I do significantly reduces the absorption time).

Like rebrascora, I was not always a good girl in terms of single usage of needles. The additional uses resulted in unsightly bruising rather than pain inserting the needle.

I have noticed that GPs seem to favour cheaper needles which do not "glide" as easily. Now, I am on a pump, I rarely use the needles so I accept the added friction for the occasional jab. However, if I was on MDI, I would be requesting/demanding the more expensive better lubricated needles.
Unless you have tried the lubricated and less lubricated needles, it is hard to understand the impact the cost saving can have.

I have not used 4sure needles but @UnexpectedDiagnosis I would recommend requesting to try a different brand if you are having problems with them. Please don't suffer in silence - make it your GPs problem.

My other thought if you are finding your skin is tough, is it worthwhile moisturising it? The massaging is likely to loosen the skin a little. But stay away from areas that are sore or bruised.
Click to expand...
Thanks I will certainly try different brands, naively and being new to diabetes I didn't even realise the needles were lubricated lol! I will try to moisturise too, it can't do any harm.

My legs used to be the best for me to inject in with no pain, now my stomach seems to be easier. I'll also try to log better where I've injected... i have just bought a "tickle flex" so I can reach places I can't usually, I find it a bit awkward in some places tbh so I thought that would make it easier.

Thanks all for the replies
 
I too would never re-use needles. They are so fine nowadays that they can bend easily. The bend isn't always obvious, but it can affect insulin delivery.

We don't want the NHS bean-counters getting ideas!
 
You are certainly not alone in this! I don't have problems with the needle going into the skin, I use BD Viva 4mm and seems to slide quite easily but it is a bit of a lottery wether it will hurt or not. This not knowing made me take a longer time to inject in the early days, could stay a long minute looking at the needle trying to gather the courage. Now after 15 months or so I have accepted that most times it doesn't hurt, but sometimes it does, and generally just go for it so I can continue with my day. Have to admit I still have days where I need a deep breath, count to 3...maybe count to 3 again... :D no shame in that, pain is not something I look forward too.
 
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