Painful injection sites

[MeiChanski]

Hello Diabuddies! How are you?

I would to ask has anyone on MDI encountered painful injection sites? I do rotate my sites, however sometimes when I pick a spot to inject, the needle barely pierces the skin and I get a rush of pain. If I would to push the needle to inject, it would hit into a hard spot. I think I do have some hard areas that never really went away. If I had to rate the pain out of 10, it’d be 11.
Is there a solution? Is it worth mentioning it again to my new diabetes team? My new consultant did say use some moisturiser to get a good feel around to check for lumps. In the past everytime my previous diabetes team asked and I said yes, they weren’t able to give me any advice. I also did avoid that area for a number of years and it doesn’t feel like it has healed. Which is strange, right?
I usually don’t inject arms because that’s quite painful and muscly and apparently DSN in the past said to avoid arms. so I usually do belly rim area, buttocks and upper outer thighs and theres where I encounter the painful spots.

 

[Deleted Account]

Do you pinch when you inject?
This used to be the advice but the recent recommendation is that it is not needed because the needles are shorter.
However, when I inject into somewhere with less fat, I still need to pinch. Otherwise, I find the injection painful.

There are other techniques such as numbing the area (e.g. use a piece of ice) before injecting but this is not always possible.

 

[MeiChanski]

Do you pinch when you inject?
This used to be the advice but the recent recommendation is that it is not needed because the needles are shorter.
However, when I inject into somewhere with less fat, I still need to pinch. Otherwise, I find the injection painful.

There are other techniques such as numbing the area (e.g. use a piece of ice) before injecting but this is not always possible.

No, post 2010 I was told not to pinch. I use 4mm needles with my pens. Sometimes the area is so hard that the needle has trouble going in and other times its painful before the needle gets in.

 

[WuTwo]

A friend of mine was diagnosed T1 when she was 2, and managed her own injections from when she was about 10. Sadly no-one told her to rotate her sites and she used one site over, and over. Eventually she developed tissue breakdown, and she still had a sunken area of flesh in her upper thigh when we were in our 20's.

I use tummy during the day - swapping areas for each go - and thighs for basal. Left leg is mornings, right leg evenings and I vary the site. Her experience was a lesson for me that I didn't realise I was ever going to need but in retrospect I'm grateful.

 

[MeiChanski]

When you say "rotate your sites" do you pick an area and then use that for a bit?

I basically use my midriff so an area from one side to the other and always inject into a different place every time, sometimes I do hit something which is painful (not as bad 11) so I just move the needle an inch (2.5cm) one way or the other, usually solves it for me anyway.

Must admit I have not had lumps for like 30 years, used to get them when I injecting into my leg but I literally only used an area of about 4in x2in (10cmx5xm)

Yes a few inches away from the previous spot or last injection. The pain indicates “woman pls go else where with that needle”. I feel like I am running out of spaces. Current area is riding towards my midriff back. Outer thigh and centre midriff is off limits at the moment. I was thinking inner thighs but I cannot remember if that’s okay.

I remember as a kid I was given a paper injection site rotation sheet to encourage changing sites.

 

[Deleted Account]

I tend to use "rules" for injection. My left side is always used on odd numbered dates (1st May, 3rd May, .... 27th July, 29th July, ....) and my right side is used on even numbered dates.
I always injected in my tummy.
Breakfast injection was high middle, lunch out to the side and evening meal was lower middle ... I kind of drew a curve in my tummy.
Sometimes (who am I kidding, often), I would bruise which make it easy to know where I had recently injected and move a bit from there.

And as I said, regardless of recent advice and needle length, I always pinched to avoid the pain.

 

[MeiChanski]

Okay google showed that inner thigh is off limits.

 

[MeiChanski]

I tend to use "rules" for injection. My left side is always used on odd numbered dates (1st May, 3rd May, .... 27th July, 29th July, ....) and my right side is used on even numbered dates.
I always injected in my tummy.
Breakfast injection was high middle, lunch out to the side and evening meal was lower middle ... I kind of drew a curve in my tummy.
Sometimes (who am I kidding, often), I would bruise which make it easy to know where I had recently injected and move a bit from there.

And as I said, regardless of recent advice and needle length, I always pinched to avoid the pain.

I tend to save bum and thighs for basal and use midriff areas for novorapid for absorption purposes. That’s interesting about the pinching, it could work if the area wasn’t lumpy as well which contributes to the pain threshold. It’s like forcing a needle into a half riped avocado.

 

[O_DP_T1]

mine have become bloody painful recently. But then I'm using thighs, with allot of muscle and low body fat.

 

[porl69]

I always used to pinch, even when using the 4mm needles. Never noticed if there was a lump because the needle would be put in very quickly! Can remember when the needles were 1 1/2" long @Knikki will remember them well.....I used to just stick the tip in and cry my eyes out to my parents saying it was hurting (it probably wasnt hurting that much). When the needles eventually got smaller thats when the injecting got a lot quicker. I never rotated when younger, as it didn't hurt so much in a lump, but had terrible lipohypertrophy ie 2 huge lumps either side of my belly button

 

[evilclive]

I get it occasionally - my body goes "Ow, stop it" so I go and inject somewhere else.
I also very occasionally get a blunt needle - the Braun ones may be cheap, but their quality isn't as great as it could be. (less than one in ten boxes though, so not too often).

 

[O_DP_T1]

I always used to pinch, even when using the 4mm needles. Never noticed if there was a lump because the needle would be put in very quickly! Can remember when the needles were 1 1/2" long @Knikki will remember them well.....I used to just stick the tip in and cry my eyes out to my parents saying it was hurting (it probably wasnt hurting that much). When the needles eventually got smaller thats when the injecting got a lot quicker. I never rotated when younger, as it didn't hurt so much in a lump, but had terrible lipohypertrophy ie 2 huge lumps either side of my belly button

Yep remember those days well. Also remember having those thick metal needles with the glass syringes.

 

[Antje77]

I like inner thigh and the only reasoning I have found against it is "There are more nerves there SO it is more painful." I never counted my nerves but I KNOW it is less painful for me there. I also like sides of ribcage and upper belly right below my chest. And the little fatty spot right beside my inner knee.
I have enough padding about everywhere, but I figure if those skinny 7yr olds have enough fatty tissue too inject, most grown-ups have too.

 

[Deleted Account]

I also very occasionally get a blunt needle - the Braun ones may be cheap, but their quality isn't as great as it could be. (less than one in ten boxes though, so not too often).

Oooo - that reminds me. Some GPs have been prescribing cheaper needles recently and there have been a few threads about these not "gliding in" as easily and being more painful.
@MeiChanski if your needle brand has changed recently, it is definitely worthwhile asking if you can go back to the old brand.

 

[NinaB73]

@helensaramay has taken the words out of my mouth! Are you still using the same needles? I mean brand? a few years ago my G.P surgery tried changing over from BD to a cheaper alternative. You get what you pay for! I found these not only hurt but left me constantly bruised. I only insist now on the BD type, which I say I have earned by length of service! (that's just the brand I like but there obviously are other of a 'higher' quality). Finding another brand maybe kinder to you, just thought it worth a mention too! And gosh, I hope you get this sorted cos it makes life very difficult as a type 1.

 

[MeiChanski]

Is it?

I think I injected into my inner thigh all through my school years because I really did not want to get a dead leg in the area of where my injects would be if I used the outside of the leg. Those were the days when needles were way longer.

Well live and learn

I did a quick google search and the chart shows upper arms, outer thighs, mid riff front and back and buttocks are the areas to inject. I was thinking about inner thighs and never thought of asking.

 

[MeiChanski]

mine have become bloody painful recently. But then I'm using thighs, with allot of muscle and low body fat.

That’s understandable but I’m not too muscly and not extremely juicy. Juicy enough to wear sensors without discomfort

 

[MeiChanski]

I get it occasionally - my body goes "Ow, stop it" so I go and inject somewhere else.
I also very occasionally get a blunt needle - the Braun ones may be cheap, but their quality isn't as great as it could be. (less than one in ten boxes though, so not too often).

Oh I never thought of that, I’m guessing you wouldn’t know until you go to inject?

 

[MeiChanski]

I always used to pinch, even when using the 4mm needles. Never noticed if there was a lump because the needle would be put in very quickly! Can remember when the needles were 1 1/2" long @Knikki will remember them well.....I used to just stick the tip in and cry my eyes out to my parents saying it was hurting (it probably wasnt hurting that much). When the needles eventually got smaller thats when the injecting got a lot quicker. I never rotated when younger, as it didn't hurt so much in a lump, but had terrible lipohypertrophy ie 2 huge lumps either side of my belly button

There is conflicting information - back in 2001 I was always told to pinch and up until recently I was told it’s unnecessary to pinch because the needles are short -4mm. I guess I’ll found out if it’s helping soon I have to agree injecting is a lot quicker but due to us being diabetics, we could be lumpy in spite of a shorter needle?
Last year I was prescribed 8mm needles because the gp changed my prescription without telling me and 8mm was a nightmare to use. The needle kept bending and it was more painful.

 

[MeiChanski]

I like inner thigh and the only reasoning I have found against it is "There are more nerves there SO it is more painful." I never counted my nerves but I KNOW it is less painful for me there. I also like sides of ribcage and upper belly right below my chest. And the little fatty spot right beside my inner knee.
I have enough padding about everywhere, but I figure if those skinny 7yr olds have enough fatty tissue too inject, most grown-ups have too.

Thank you for letting me know, I was thinking somewhere on those lines. You are going further up than me - I can just about reach the furthest midriff spot.