ALLERGY BRIEFS

Painful injections -- what to do?

May 20, 2003

Some physicians I've worked for added a minute amount of a corticosteroid medication in the same syringe with shots made from alum precipitated extracts. This helps prevent the inflammation that is particularly noticeable with the alum precipitated product.

However, for most extracts simply adding a tiny amount of lidocaine (a numbing medication) after drawing up the allergy extract into the syringe helps remarkably. We use lidocaine for almost all our injections for children, and for adults who experience pain with the injections.

It is important, though, to determine if the patient has ever had a reaction to local anesthetics such as the numbing medication given for dental work or minor skin surgery. Local anesthetics (numbing medications) can cause serious reactions in a minority of people.

Those of our patients who prefer lidocaine in their shots are quick to remind me if I forget to add it. I used to quip with them, "Oops, I almost forgot the good stuff. Let me add it!" Then I became worried someone might overhear our conversation and wonder what sort of "good stuff" I was adding to patient injections. I decided it best to just refer to it as "numbing stuff" rather than "good stuff" lest anyone get a wrong idea!

If an injection does cause a painful, hot, swollen area, we recommend ice packs, tylenol, antihistamines, and cortisone cream. Notify your doctor and follow his advice.

Your allergist may have other recommendations for your comfort. Ask the nurse who gives your injections what may be most beneficial for you.

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