This Is MS Multiple Sclerosis Community: Knowledge & Support

I started my first treatment of Avonex yesterday. I had a nurse come and assist me because I was nervous doing the first administration alone. When I started inserting the needle into my thigh, I was able to feel the needle sliding in (it did not hurt); however, when I got closer to the bottom, I felt the needle puncture through something. It made me kind of jolt. It wasn't unbearably painful, but I could definitely feel it. Was this the muscle? Is this a normal sensation? Or did I puncture something I shouldn't be puncturing? Help! I don't think anyone can understand what I am saying unless they are doing IM injections themselves.

I started the Avonex in May and I am still trying to get used to being a pin cushion once a week. We've tried a couple different approaches to see what hurts less.

What size needle are you going to use? I myself have 1 in 1/4 and I do notice if my boyfriend is not careful and slides it all the way in it can be more painful or feel like he's hitting something. Basically it sounds like what you felt is normal. It is possible to hit a nerve when you do the injections although you'd definitely know as this is painful (it happened to me two weeks ago and I still have pain in the injection area).

Try searching for an area that has a lot more "meat" and slide it in at a slight angle and not the full way (perhaps only an inch instead of the full needle). Oh yes, some areas (like the arm) that have less "meat" might be slightly more painful. I have since tried icing my arm before swabbing it down and injecting. I did notice that this helps a bit.

I hope this helps.

Thank you Inquiz. Your information is helpful and comforting. I am using the 1-1/4" needle. First of all, just the sight of the length of that needle scared the daylights out of me; but I did it. It was smooth going in and then ooh I felt a little pressure and slight pain. It felt like my thigh was going to split in half and collapse. I know it wasn't bone because I guess I would have felt that. I guess what I felt was normal. I'll try again next week and see what happens.

The nurse also suggested that I could get a smaller needle for the arm (a 1" 25 gauge needle). I called my doctor to see if he can prescribe this for me. Maybe that can help for upper arm injections.

I just started my 9th year of Avonex. I inject into my upper thigh off to the outer side with the needle nearly vertical. Sometimes I barely feel the injection at all and there is no pain. At other times there is a little burning which one would expect with an injection. However, I've never experienced anything like you've described. What part of your thigh are you using? I've read that injecting into the top center of the thigh can be more painful since there are more nerves and more blood vessels. Anyways, one thing that I've found to be important is to keep my leg muscle as relaxed as possible. I lower my chair and make sure that my leg is bent at 90° at both the hip and knee and that there is no tension on my thigh muscle. I once had it undergo an involuntary contraction while I had the needle in it and that was particularly painful. Focusing on keeping my leg relaxed has helped to avoid a repeat of that experience.

NHE

Thanks for all the input. I will try moving the injection site over a little more to the right instead of center thigh. I'll see how it goes. I'm already having anxiety attacks before my second administration to be done on Sunday/Monday. What do you do if you hit a nerve? Do you pull the needle out slightly or keep injecting?

I can't remember ever hitting one. As I noted above, sometimes the injection is absolutely painless and other times it feels more like an injection. When I was initially trained to do the injection, I was taught to stick the needle in fast like I was putting a dart into an orange. Someone else was also getting trained at the same time and I remember that her needle went in and right back out since she did it so quickly. I usually push it in more slowly than described above. Once in a while there's more pain sensation than noted above and I just stop the insertion if it hurts too much, e.g., one time there was about ¼" of the needle to go in but I injected anyways. But then that was just one time out of many. I recall that Biogen approved the use of smaller needles for the IM injection so you may want to look into getting some of those from your local pharmacy if you continue to experience unusual amounts of pain with the injection.

NHE

Here's a link to our prior discussion of the smaller needles.

http://www.thisisms.com/ftopict-2578.html


NHE

Thanks again. I feel a lot better from your advice and suggestions and am no longer stressing. When I spoke to the nurse about the strange sensation that I felt upon injection, she said that my muscle may have been tense at the time and that it could have jumped when the needle hit it. She said that I could probably get away with the smaller needle in the thigh; definetely in the upper arm. I'll try the standard needle again during my next administration in the thigh and see what happens. I know that the concern is to make sure the Avonex goes into the muscle. It's already Thursday, my first day was Monday and my thigh hasn't turned purple or black or green and it hasn't fallen off so I guess I'm O.K. It's still a little sore underneath, but I suppose that is to be expected from having a foreign object inserted into your thigh.

I've been using Avonex for almost 4 years now, and I usually inject in my thighs because it's easier to self inject. I sit on the edge of my bed (I'm short and it's super-tall), surround myself with my *equipment*, pick a thigh and insert almost directly into the top. Usually it's very easy, but the last few times I've had the needle facing against the groove, so to speak, and had to stop and reinsert .
Like another poster, I don't jab the needle in (as I was also taught to do), I move slowly, get to my spot and depress the plunger. I keep my breathing very even and stay SUPER relaxed, and I get through just fine. Relaxation is the key, because I made the mistake of tensing once with the needle halfway to the goal ~ NOT FUN!
It's new to you now, but you'll get into it .
I can tell by your last post that you're probably not as belligerent as I was, swearing and flaring against the nurse ... who happened to be my mother!
Good luck!

Well, I administered my second treatment of Avonex and it was absolutely painless. I did not feel a thing. All went very smooth. Now I know for sure that I definitely punctured something the first time because today did not feel like the first. I was so unsure the first time that I was asking EVERYBODY what could have happened. I knew I hit something. I even asked the pharmacist about it and he said that it sounded like I hit a nerve. It figures. (I swear you all would have slapped me the first week.) Now I feel good about all of this. I was so nervous I was shaking with the needle in my hand. My husband put on some light jazz in the background to keep a calming environment, I breathed in and out and I did it! Yeah!!!!

See that! You'll be an old hand at this in no time.

Relaxation is always the key!

Hi Segan,

Just wanted to say, Thank You!

Hi Bewitched,

I have been injecting Avonex for about two years. In the first three months, when inserting the needle in my thighs, I would sometimes hit a nerve (maybe a bone?) that caused a sharp pain.

However, I now find that if I very slowly insert the needle, I can avoid this kind of pain. I rotate between my two shoulders and two thighs. I have never had the sharp pains in my shoulders.

I know the needle looks pretty scary at first! But if you realize that the pain usually only comes when you break the skin, Avonex isn't very daunting. Personally, I prefer Avonex over the other interferons, because you only have to inject it once a week.

Are you having chills and flu symptoms? I had serious flu symptoms over the first three or four months, but they subsided. I still feel a little stiff sometimes in the morning (I take the injections before I go to bed, usually on Friday night).

In any case, all the best to you. My guess is that you were only recently diagnosed and that you must be in a bit of a funk over the whole thing.

But multiple sclerosis is not the end of the world. In some ways, it has been a godsend for me. I work less, exercise more, drink less, and generally enjoy life more.

I had chills for about two to three hours straight the first time I administered Avonex with a slight headache the next day. My MS also flared up. The second time, I felt real sick. I had bad chills in the middle of the night, had excruciating muscle pain (where I felt muscle was going to rip off my bones), didn't get any sleep, felt real tired the next day and had an awful headache. My MS flared up three-fold. This lasted for a day. The third time, which was last night, I had slight chills, some muscle soarness and no headache. I slept real well and am feeling pretty good besides the muscle soarness. Go figure. I don't get it. But, I am used to the injections now and have not hit a nerve/bone since the first time. Hopefully, I won't hit one again. Thanks.

Hi Bewitched,
What are you taking to counteract Avonex's side effects? Biogen recommends Tylenol in their literature, but many people have found that ibuprofen actually works better. I take some ibuprofen a couple of hours after my shot and that seems to do the trick for me.

NHE