A Beginner's Guide to RA: Coping with Fear of Needles

Patient Expert

This post may contain triggers for those who have needle phobias.

Blood tests. Steroid shots. Injections with DMARDs and Biologics. Infusions. Self-injectors.

There is no getting around it. When you have RA, you will get in close contact with needles and syringes. While a small minority might enjoy getting poked with sharp things, most of us would rather not. And some of us are afraid of it. Finding a way to overcome this fear will make getting treated easier and remove part of the stress of living with RA.

Using logic to combat fear

Fear is a deep emotional and reflexive thing that has very little to do with your conscious mind. When you're afraid, you are all emotion and there is no room for thinking. Engaging your brain can make it difficult for the emotion to take over. One way to get ahead of the nerves is to pick the fear apart logically and start identifying ways of making injections easier.

Think about why needles bother you. Is it the pain associated with a shot, the needle itself, or the idea of getting an injection? Then approach them one by one.

Most shots do hurt a bit, but thankfully only a bit. The pain is largely associated with the needle penetrating the skin. It feels like a sharp sting that's over very quickly. Sometimes, the injection can be painful. For instance, the local anaesthetic that is often mixed with a steroid shot stings and often worse than getting a shot without it. Some Biologics sting so much it makes your eyes water. Leaving the syringe out of the fridge for half an hour and numbing the injection area with ice can reduce that.

Is your fear related to that sharp, pointy thing coming at you? On one level, that just makes good sense. We are taught from childhood to avoid sharp, pointy things because they can hurt you. The lesson sticks and persists into adulthood. However, in the hands of a medical professional, the meaning of the needle changes. It is no longer likely to randomly and seriously hurt you. Instead, it is a tool wielded by a professional who has received training in how to use it appropriately so it causes minimal pain without injury.

Does the thought of the injection itself freak you out? This could be related to, for instance, feeling ambivalent about the medication that is administered via the needle. It may be helpful for you to talk about your concerns in more depth with your rheumatologist and perhaps do some research about why taking medication can help your RA. Another reason may be that you have had a bad experience with getting a shot or blood test in the past. Keep in mind that some medical professionals are better at doing shots than others, but none of them set out to deliberately injure or hurt you.

As with so many other fears, talking about the feelings about needles and injections is an important part of overcoming it. Talk to your doctor, nurse, or phlebotomist (the person who does your blood tests) and ask them to help you through the procedure. Personally, I've found that it's helpful to ask   the medical professional to tell me what is going to happen and when. It gives me a sense of control by having the ability to predict what's happening. Also, not looking at the needle going into my body is very helpful, even after more than 40 years of RA

Needle Phobia

Ten percent of the population have a needle phobia, which is an intense fear of needles and other sharp objects. A phobia is very different than the kind of fear discussed above. It's defined as a "marked and excessive fear" and can cause extreme avoidance of all things medical, which is not a good idea when you have a chronic illness.

When faced with the feared object, such as needles or spiders, a phobia can cause physical symptoms, such as heart palpitations, high blood pressure, and fainting. Some phobias are so strong that even just thinking of an injection can cause these symptoms. As well, people with a needle phobia report intense pain connected with an injection or getting blood tested.

If you have a needle phobia, it's important to talk to your doctor about this. There are a number of techniques that can be used to help you through procedures involving a needle. They include using a topical anaesthetic so the injection doesn't hurt. Antianxiety medication prior to the shot can also be beneficial, as can body positioning, listening to loud music on your iPod, beta blockers, and a number of behavioural strategies that are worked out between you and your medical team.

A fear of needles doesn't have to get in the way of you and your RA. Knowing that a dislike of needles is a fairly normal thing can be a helpful first step in learning to cope and even overcome the fear. Even a needle phobia can be reduced. As with so many other things about adapting to RA, talking about it with your medical team and others in the community can be a huge help.

See More Helpful Articles:

Needle Phobia

DMARDs, Biologics for RA, and Needle-Free Injections

HealthCentral Anxiety Site

A Beginners Guide to RA: Biologics

Lene writes the award-winning blog The Seated View. She's the author ofYour Life with Rheumatoid Arthritis: Tools for Managing Treatment, Side Effects and Pain and 7 Facets: A Meditation on Pain.