Beginner's Guide to MS: Subcutaneous Injections, 7 Tips for Reduced Pain and Skin Irritation

Patient Expert

For subcutaneous (under the skin) self-injections, these tips should help eliminate some pain and lessen site reactions.

1. Room Temperature Medication.   Drugs which must be kept in the refrigerator for storage are often much less painful upon injection when at room temperature.   I choose to use the travel container provided to me by the drug manufacturer to store a 5-day supply of medication in the bathroom.   Or remove one syringe from the refrigerator and, while still in the wrapper, hold it in your armpit to bring it to body temperature.

2. Warm Skin is Soft. Cold skin can be hard.   I choose to inject after a warm shower when the skin is soft and supple.   Or apply a warm compress to the injection site for 5 minutes before injecting.   Take caution in any area where sensation of temperature is impaired.

3. Alcohol or No Alcohol? Wet alcohol on the skin burns too often.   Since I choose to inject after a shower, the skin is already clean and I skip the alcohol step.   If you use the alcohol, let it dry before injecting to avoid the sting.   Then after the injection, quickly apply a cotton ball to prevent medication from leaking and irritating the skin.

4. Set Auto-injector Depth. Every body is different.   Depending upon how much extra cushion (ie. fat) or lack there of you have, set the auto-injector depth accordingly.   Deeper is usually better, but not so deep as to risk hitting a muscle - OUCH!     Adjust the depth somewhat for each site location.   More fat, more depth, higher number.   Less fat, less deep, lower number.   Count to ten (slowly) before removing needle to insure complete injection.

5. Rotate. Rotate. Rotate. Help keep your skin healthy!   Rotate injection sites, moving between different areas of the arms, legs, abdomen, and buttocks.   Do not inject in the same place twice in a row, and be sure to wait at least seven days before using a particular spot again.   This helps to limit injection site reactions and the break down of skin tissue (Lipoatrophy).

6. Gentle Massage.   Post-injection, gently massage the area.   For Rebif, Avonex, and Betaseron, you may do this immediately.   For Copaxone, wait at least 24 hours before massaging any lumps.   For those lumps and bumps which stick around, apply Arnica Gel to the area to increase circulation.

7. Special No-Drip Needle Option.   To limit the amount of medication which leaks from the needle before injection, and which can cause burning and irritation, try the following:

(a) Do not use the Needle Cap Remover (red for Copaxone, Gray for Rebif). Discard.   Use the Syringe Housing to push the yellow plunger in the Injector Body until it clicks.   Now the spring is locked and loaded.

(b) Prepare the medication.   Take the room temperature pre-filled syringe and gently twist and rotate the Syringe plunger a little, pull the plunger outward just a bit, and manually remove the gray needle cap.   Do not attempt to eliminate the air bubble.

(c) Drop the syringe, needle first, into the Syringe Housing.   Then attach the Syringe Housing to the Injector Body. Hold the Syringe Housing against your chosen injection location.   BE CAREFUL NOT TO TOUCH THE TRIGGER BUTTON UNTIL YOU'RE READY TO INJECT.

So those are my tips for a reduced-pain subcutaneous self-injection.   What tips do you have? ** Lisa Emrich is author of the blog Brass and Ivory: Life with MS and RA and founder of the Carnival of MS Bloggers.**