The Least Painful Insulin Injection Sites: Not Just About Location

The four most recommended sites for insulin injections were chosen because they share two qualities: They have a generous fat layer just beneath the skin into which the insulin is injected, and they have fewer nerve endings than many other areas of the body. None of the four sites – abdomen, back of the upper arm, upper buttocks, upper/outer thigh – is nerve-free, though, so some injection discomfort is normal.

The factors that seem to most influence the pain level of insulin injections are a person’s perception and anticipation of pain, the sharpness and maybe the size of the needle, and injection technique.

Needle Sharpness and Size

A study published about 20 years ago showed the one factor most responsible for increased injection pain was the bluntness of a needle. The needle diameter and dose size had significantly less effect on an insulin users’ experience of pain.

Those who reuse needles are injecting themselves with dulled and possibly bent needles. This can do more than just increase pain; a separate study showed that reuse raises the risk of developing lipohypertrophy, a lumpy buildup of fat under the skin at injection sites.

Many people today, children and adults, report less pain when using short, narrow-gauge needles – those typically used in insulin pens (4 to 5 mm x 32G). Insulin pen needles also have the advantage of not being dulled by piercing the membrane of an insulin vial or getting accidentally bent since there is no needle cap to remove.

Minimizing the Discomfort

Besides using each needle only once, there are other ways to minimize pain at the injection site:

  • Use insulin that is at room temperature.
  • Remove all of the air bubbles from a syringe before injecting.
  • Let the site disinfectant (usually alcohol) dry before injecting.
  • Keep the direction of the needle steady when inserting and removing it.
  • Have relaxed muscles at the injection site.
  • Penetrate the skin quickly.
  • Twist the needle cap and pull it off straight to avoid bending the needle.
  • Review your injection technique with your diabetes care team.

Some individuals numb the injection site with an ice cube or a topical numbing cream. Numbing cream takes 20 to 30 minutes to work, but if you want to try one discuss it with your doctor. After injection, applying steady pressure with your palm for a few seconds (no rubbing) may lessen the sting.

Testing Your Sensitivity

The different insulin absorption rates of the injection sites and the type of insulin being used are of primary importance in choosing a site. However, if you are curious, there is a way to compare the nerve sensitivity of injection sites on your body.

Open a paper clip and bend it in half; touch your skin simultaneously with the two endpoints. Start with the points very close together and gradually widen the gap between them. Notice how wide the gap is when you start to feel both points. The closer the points are when you can feel both, the more sensitive the area.

If you are wondering, the most sensitive parts of the human body are the lips, face, hands, fingers, feet, toes and tongue. The least sensitive is the back, buttocks, and backs of the arms and legs.

Sources: Diabetes Educator, Children’s University
Photo: Pexels

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