Why treat adult injection pain? Insulin, arthritis injections, or flu shots protect us... so why make such a big deal about a little shot?

Some pain in life is unavoidable. Pain is a valuable way the body alerts us to danger. For many people, being able to overcome or ignore pain can build character, make them feel stronger, and give people sense of control coping with life.

Treating chronic illnesses with daily insulin injections, blood thinning medicines, or arthritis or psoriasis shots reflects very recent medical advances. Coping with daily repeated pain is different than infrequent, unexpected pain. Scientists haven't done much research to find out the effects of chronic painful injections, but work in children indicates that preventing pain is important.

Sharp pain for tiny babies and children too young to understand is not a natural state. The philosophy used to be that infants don't feel pain. We know now that pain in young children is interpreted as punishment, and causes stress responses in the body that can decrease healing.

The first proof that pain can damage infants came in 1989, when Dr. Anand published a paper (1) looking at the effects of pain control for heart surgery. He followed 16 children who had surgery to tie off a duct leaking blood from the heart. Eight had standard care – nitrous oxide and a paralyzing drug. Eight also got Fentanyl, a potent pain medication, during the surgery.

The patients that did not have pain control had hugely increased inflammatory and stress hormones, as well as differences clinically.

Adverse events	Fentanyl N=8	No Pain control N=8
Increased time with mechanical ventilation	1	4
Hypotension	0	2
Spontaneous bradycardia	1	4
Acidosis	0	2
Intraventricular hemorrhage	0	2

In non-medical terms, having a painful event without pain management caused inflammation, acid in the blood, low blood pressure, drops in heart rate, and brain bleeds. While heart surgery isn't the same as a needle prick, the concept is the same. The body's natural response to stress isn't beneficial when the stressor isn't what we're designed to handle.

No one has researched the effects of daily shots in adults. Until we know it's not a problem, there's no reason to stand by the belief that pain builds character.

No needless pain. For anyone.

References:

1. Anand KJ, Sippell WG, Aynsley-Green A. Randomised trial of fentanyl anaesthesia in preterm babies undergoing surgery: effects on the stress response. Lancet 1987;1(8524):62-6.

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