PCOS Treatment How to Reduce Intramuscular and Subcutaneous Injection Pain By Nicole Galan, RN Nicole Galan, RN Facebook LinkedIn Twitter Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book." Learn about our editorial process Updated on February 24, 2022 Medically reviewed by Monique Rainford, MD Medically reviewed by Monique Rainford, MD Monique Rainford, MD, is board-certified in obstetrics-gynecology, and currently serves as an Assistant Clinical Professor at Yale Medicine. She is the former chief of obstetrics-gynecology at Yale Health. Learn about our Medical Expert Board Print Let's face it: Nobody likes getting injections and doing it yourself can be even tougher. The fear of pain and the sight of a needle, no matter how small, can be intimidating for many people. If you are undergoing treatment for infertility, you will likely have to give yourself daily injections. With some prior knowledge and practice, your daily injections can be made a lot easier. This article offers five tips to reduce the pain associated with at-home fertility injections. 1 Numb the Injection Site Buena Vista Images / Digital Vision / Getty Images If you are prone to bruising and pain, you can use an ice pack to numb the skin prior to injecting yourself. Limit the ice application to no longer than 15 minutes to avoid frostbite. If you still experience pain, you may be able to use an over-the-counter numbing cream containing lidocaine, either on its own or with ice application. There is also a prescription numbing cream called Emla that contains both lidocaine and prilocaine. Do not use a numbing agent without first speaking with your doctor. Recap You can numb the injection site by applying an ice pack to the skin for no longer than 15 minutes. If that's not enough, ask your doctor about an over-the-counter or prescription numbing cream. 2 Choose Big Muscles for Intramuscular Injections Clarissa Leahy/Getty Images An intramuscular injection is given into the muscle below the skin and underlying fatty layer. It can be a little trickier to give than other types of injections. Four sites can be used to give an intramuscular injection: The upper arm just below the shoulderThe outer or middle part of the thighThe muscular part of the hip just behind the hip boneThe upper muscular part of the buttock Choosing the right site is necessary to avoid injury and ensure the proper absorption of the medicine. Pick a site that has a large, definable muscle with little fat covering it. (For example, the lower part of the buttocks may be too fatty for a needle to reach the muscle.) If you notice bruising or pain, rotate your injection site. Rotating can help reduce pain when ongoing injections are needed. It may also reduce the risk of tissue scarring. Tensing up won't make injecting yourself easier, so position yourself in a way that reduces tension in your muscles. You may need to lie down or bend over a table, but a relaxed muscle will hurt a lot less than a tense one. Recap The best places for intramuscular injections are the upper arm, thigh, hip, and buttocks. Rotate the injection site if you experience pain or bruising, and avoid tensing the muscle during the shot. How to Give an Intramuscular Injection 3 Avoid Lean Areas for Subcutaneous Injections BSIP / UIG / Universal Images Group / Getty Images Subcutaneous injections are those delivered in the fatty tissue that lies between the skin and the underlying muscle. Choose a site that has a little extra fat rather than extra-lean parts of the body. The best sites for subcutaneous injections are those that provide an ample injection site and are well away from joints, nerves, and large blood vessels. These include: The upper outer area of the armThe front and outer sides of the thighsThe abdomen (except around the navel)The upper outer area of the buttocksThe upper hip You need to be able to pinch the skin for an ample injections site. If you can't, select another body part. As with intramuscular injections, try rotating your injection site if you experience pain or bruising. Recap The best subcutaneous injection sites are in places where the skin is not too lean and are well away from joints, nerves, and large blood vessels (such as the outer arm, thigh, abdomen, upper hip, and upper outer buttocks). How to Give a Subcutaneous Injection 4 Keep the Goal in Mind If your daily injections get difficult or tiresome, think about why you are taking the medication. If it is because you are trying to get pregnant or fight a disease (like diabetes or pernicious anemia), keeping the goal in mind may help ease any fear or anxiety you may be experiencing. Remembering the reason can also help you keep any discomfort you feel in perspective. When it comes to fertility treatments, remind yourself that the injections are not forever. Recap By reminding yourself why you need regular injections, you can keep your eye on the goal and reduce stress and anxiety. What Is Z-Track Method for Injection? 5 Know When to Ask for Help If you can't inject yourself or are having difficulties with certain injection sites, have someone else administer the shot for you. This can be a partner, spouse, family member, or friend. Certainly, with intramuscular injections, it is sometimes easier for a partner to inject you, say, in the hip or buttock than for you to do it yourself. Ensure that you or the person who is administering the shot gets appropriate training from your healthcare provider or another healthcare professional. Learning the correct way to inject yourself can make a big difference between a painful and possibly unsafe injection and a safe, pain-free injection. It is also important to remember that self-injection is not possible for all people. Don’t beat yourself up about if you can't; many people aren’t able to inject themselves. Recap If you have a hard time injecting yourself, have a friend or family member do it for you. You can also request a tutorial from your healthcare provider to ensure you are doing the injection correctly. Summary To reduce the pain and fear associated with regular injections, try numbing the injection site with ice and/or a numbing cream. Talk with your healthcare provider about the best sites for intramuscular or subcutaneous injections, and rotate the injection site if there is any pain or bruising. If you have problems injecting yourself, have a friend or family member do it for you. Frequently Asked Questions How do you give an injection without pain? There are some tips that can make giving an injection less painful:Allow the medicine to come to room temperature (but do not heat it).Always use a new needle. Used ones are not only unsterile but can be blunt.Position the needle at 90 degrees to the injection site.Stick the needle in quickly. How do you relieve pain after an injection? You can relieve pain after an injection by applying a cold compress to the injection site. If the injection is in the arm or leg, keep it moving throughout the day. If the pain is significant, you can take an over-the-counter pain killer like Tylenol (acetaminophen). What is the best position for an intramuscular injection? To avoid tensing up, find a position in which the muscle is relaxed. For example:If injecting the buttocks, lie on your side or face down.If injecting the thigh, recline back with the leg extended.If injecting the shoulder, let the arm hang loosely to the side. Learn More: How to Give an Intramuscular Injection? When should I worry about injection pain? Call 911 or go to your nearest emergency room if you experience any of the following after an injection:High fever with chillsWorsening injection site pain, redness, heat, or swellingA pus-like discharge from the injection siteSpreading redness, rash, or streaks (signs of cellulitis)Sudden severe rash and breathing problems (signs of anaphylaxis) Learn More: Injection Side Effects: When to Call a Doctor 5 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Hogan ME, Kikuta A, Taddio A. A systematic review of measures for reducing injection pain during adult immunization. Vaccine. 2010;28(6):1514-21. doi:10.1016/j.vaccine.2009.11.065 MedlinePlus. Giving an IM (intramuscular) injection. MedlinePlus. Subcutaneous (SQ) injections. Zijlstra E, Jahnke J, Fischer A, Kapitza, Forst T. Impact of injection speed, volume, and site on pain sensation. J Diabetes Sci Technol. 2018 Jan;12(1):163-8. doi:10.1177/1932296817735121 Polania JJ, Munakomi S. Intramuscular injection. In: StatPearls [Internet]. By Nicole Galan, RN Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book." See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit