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Nine Ways You Can Reduce the Pain and Fear of Needing a Needle

This is the second installment in a two-part series on what’s working to prevent and address needle fear. To learn more about needle phobia and what health care providers are doing, check out Part I: “A Shot of Courage for Those Who Fear Needles”. Click to view Amy Baxter’s TED talk on Pain, Empathy, and Public Health.

“Fear is the mindkiller. Fear is the little death.” – Frank Herbert, Dune

Amy-Baxter

Amy Baxter

In 1995, a scientific paper was published for the first time evaluating the prevalence of needle fear and its effect on accessing health care. Since then, studies suggest that the fear of needles is rising, afflicting a quarter of adults and two out of three children.

Needle phobia seems to be more likely in people who are sensitive to a light touch and sharp objects, particularly those with the “red head pain” MC1R gene. While most people acquire needle phobia around age four to six, about three to five percent of people have a genetic predisposition to become lightheaded or nauseated or even to faint.

But whether acquired or innate, fear not! Quite literally – here are nine ways to reduce the pain and fear of needing a needle at any age.

1. Pain Management.  When time permits, needle pain can be greatly reduced by using topical pain relief – specifically, topical anesthetic numbing creams and gels — which numb the skin in 20-60 minutes. Fun tip: use Glad® Press-N-Seal rather than the commercial medical covers. It is more comfortable to remove and much less expensive.

2. Let your brain do its thing.  Overwhelm other competing nerves with sensations that aren’t so painful. Studies have found that when someone’s hand is in ice water, they can handle more intense pain everywhere else in the body. This works both through something called gate control (e.g. cool water soothes a burn) as much as brain bandwidth. Vibration and cold have been studied together; when put between the brain and the pain (especially after numbing a shot area directly), they can decrease needle pain up to 80%.

3. Relax the muscles.  Pushing medication into taut muscles makes it hurt more, now and later. Even passively stretched muscles hurt. Rather than bending over and going for a gluteal stick, try lying on your side with the buttocks muscles relaxed. Do the same for thigh shots; sitting up causes the muscles to be active keeping you balanced, so go for a side position.

4. Distract your mind.  Counting and engaging in unrelated tasks can reduce pain by half. At a minimum, count corners, ceiling tiles, or holes in an air grate. Some studies have found that active engagement can be more effective at reducing pain for teens and adults. Drawing on an iPad game or finding items in “I Spy” apps, can work at any age.

5. Distract your senses.  The brain can only process so much at one time. Buy five packs of sugar-free gum, mix the sticks, pick one at random, and try to figure out the flavor. Drink a slug of a cold, sweet beverage. Taste and smell are great senses to counter paying attention to pain.

6. Focus on something you can control.  Whether you’re thinking about the health or life benefits of the shot, concentrate on that. Fertility shots, for example, can have an adorable payoff. Building an idea in your mind and mentally “going there” can help with pain.

7. Create a different sensation.  Pinching your own finger and focusing on that or forcing a cough have both been shown to decrease needle pain. Squeezing your toes, stretching your calf, or making any distant body part more noticeable to your brain will take attention away from the area of pain.

8. Be a scientist.  If you know you have multiple needle events coming up, keep records of what works best and what doesn’t. Being an observer, even of yourself, adds distance that can give you more control. More control = less fear. Less fear = less pain.

9. Speak up!  Let your care team know you don’t like needles, and let them know what you have found what works for you. “You know how some people pass out with needles? Shots and I don’t get along, so let me tell you what works for me. I really appreciate you listening to me; it makes everything go so much better for both of us. What seems to help me is this: “____.” Even if you haven’t ever gotten lightheaded or passed out, reminding care providers of people who have can help establish that you understand that procedural pain is important and you give them credit for appreciating it, too.

Do needles make you nervous? Have you found a strategy that reduces needle anxiety or pain? Post your experiences and tips to the comments section.

You can reach Dr. Amy Baxter at abaxter@mmjlabs.com.

A Shot of Courage for Those Who Fear Needles

This is the first of a two-part series on what’s working to prevent and address needle fear.

Most people don’t enjoy shots.

But for those with needle phobia, the fear of shots can be so severe that they actively avoid medical procedures involving injections, and in extreme cases avoid medical care more generally.

Jamie Elizabeth Rosen

Jamie Elizabeth Rosen

Needle phobia can arise from genetic and environmental factors, including experiencing pain during encounters with needles or seeing others uncomfortable or distressed by needles. Studies show that approximately two out of three children and one in four adults are afraid of needles, and 10 percent of adults have an outright needle phobia, characterized by avoidance behavior and physiological responses, such as increased heart rate or fainting.

The miracle of modern medicine has enabled us to protect ourselves from a range of dangerous or life-threatening diseases. In one recent study, seven to eight percent of adults and children reported avoiding potentially life-saving immunizations as a result of needle fear. Given the growth of vaccine-preventable outbreaks throughout the world (check out this interactive map), this is not only a concern for individual health but also for public health.

Preventing and Addressing Needle Fear

Fortunately, a growing cadre of empathetic health professionals is taking the prevention of needle pain, which can trigger needle fear, to the next level.

“In order to combat pain, vascular access professionals across the country are looking at creative ways to address patient pain and patients’ perception of pain,” said nursing leader and vascular access expert Lorelle Wuerz, MSN, BS, BA, RN, VA-BC. “Offering the patient options before you do any procedure is important.”

Wuerz said that she uses a variety of interventions to combat needle fear and pain in patients, including:

  • Ensuring patients know what to expect;
  • Deep breathing;
  • Guided imagery;
  • Distraction techniques;
  • Topical agents;
  • Warm compresses;
  • Involvement of child life professionals;
  • Pain control devices, such as Buzzy®;
  • Aromatherapy (“Anecdotally, this is something patients find soothing and calming during an uneasy time,” Wuerz said.).

Needle pain prevention extends beyond traditional health care settings. For instance, after discovering that 23 percent of Americans who skipped flu vaccination did so to avoid needles, Target Pharmacy began offering micro-needle flu vaccines. The needles are 90% smaller than those that have traditionally been used and reportedly result in less muscle ache and pain immediately following injection.

“Treating needle pain reduces pain and distress and improves satisfaction with medical care,” wrote pain researcher Anna Taddio in a chapter on needle procedures in the Oxford Textbook of Paediatric Pain. “Other potential benefits include a reduction in the development of needle fear and subsequent health care avoidance behaviour.” 

The 4 Ps of Needle Pain Management

In the Oxford Textbook chapter, Taddio outlined the four domains of interventions that can reduce needle pain for patients, known as the 4 Ps: procedural, pharmacological, psychological, and physical.

Procedural interventions involve bypassing needles altogether through the use of needle-free immunization or non-invasive sampling devices. Pharmacological interventions include local anesthetics, which have been shown to be effective and safe for reducing pain from common needle procedures, and sweet solutions for infants up to 12 months, which have been shown to reduce needle pain behaviors. Psychological interventions include coaching people to cope and providing distractions. Physical interventions – such as upright body positioning, tactile stimulation, and use of cooling agents or ice – can also reduce the perception of needle pain.

Empowering Ourselves

Many people will celebrate the day when shots are replaced with futuristic technology, such as a robotic pill or one of many other innovations currently in development.

In the meantime, what can patients do to help themselves? “A patient should never not speak up,” Wuerz said. “It’s okay to have all of the information before you make a choice.”

Stay tuned for Part II of the series, in which Dr. Amy Baxter, MD – pain researcher, CEO of MMJ Labs, and inventor of Buzzy® Drug Free Pain Relief – will outline how you can protect yourself and your family from needle pain. Dr. Baxter will appear on ABC’s Shark Tank Friday, February 28 at 9:00 pm EST.

How do you respond to needles? What works for you? Have you had a good experience with a health care professional? Post your experiences to the comments section.