Is there any risk with regular IM injections?

Is there a potential for muscle damage with very regular IM injections? (Genuine question—I’m not sure.) I know we all have to be careful to not get scar tissue with sub-q injections, so I wonder about the risks with IM. I’m intrigued about IM and keep meaning to get my hands on some longer needles to try it, but I think I would have them as occasional injections only, since I already have difficulties with my muscle tissue and fascia. I would think at the very least, if you’re doing them regularly, you’d want to be very careful to rotate your sites considerably, since longterm effects probably haven’t been studied.

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I’ve set off on gathering a little info on this since I’m doing them so frequently now, and I’m glad to be doing the reading. I am not terribly worried that I’ve done any damage with what I’ve done so far, but there are definitely some good techniques that are worth learning, and it looks like there are also some risks that these good techniques can help one to avoid. For one, there is a very popular injection site that seems to carry the lowest possibility of any kind of injury, and I haven’t even tried it. Whereas the top of the glutes, which is where I used to get shots during pregnancy, carries quite a bit of risk with the presence of the sciatic nerve. And don’t I know I don’t want to mess with that thing.

Anyway, I’m thankful for the discussion in here because I will learn more about proper technique and will continue to use them as I am— but more cautiously.

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I am a bit surprised, actually, I did not think there was any, but I find there are some risks. Here is the best link I found:

https://opentextbc.ca/clinicalskills/chapter/6-8-iv-push-medications-and-saline-lock-flush/

Intramuscular injections must be done carefully to avoid complications. Complications with IM include muscle atrophy, injury to bone, cellulitis, sterile abscesses, pain, and nerve injury

A big surprise, for me, is:

The length of the needle is based on the patient’s age, weight and body mass index. In general, the recommended needle length for an adult is 25 mm to 38 mm

I thought we were thinking big when we went from 8mm to 13mm :slight_smile:

Rotate IM sites to avoid complications.

There appears to be an interesting 1983 reference, but I am not able to find the text for the article (Adverse effects of frequent intramuscular injections)

It appears that the most significant risk for PWDs using much smaller needles may be nerve damage, and that it is most significant in the neighborhood of major nerves, particularly, for us, gluteal and sciatic.

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I imagine this is why results can be inconsistent!

And yes, when I looked up IM shots, my impression was one had to be relatively careful about locations, and that there are reasons you tend to get them at the doctor’s in very particular spots. There’s a lot more stuff you can hit when going deeper than with sub-q, where at worst you nick a capillary or a tiny nerve ending. I do wonder about the cumulative effect of injecting very regularly into muscle, which I’m guessing is simply not studied, because few injections designed to be given IM are given multiple times a day for an indeterminate period of time.

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@Michel, I plan on doing some reading on this. I really like the IM shot, and I plan on using it wherever possible. With that kind of frequency though, I definitely need to learn a very good technique. Just in the little reading I did the other day, I have picked up a few things including to only use a rectangle area of my thigh, to use my shoulder (and now know the precise location) only for smaller doses, and to avoid my backside—- for now. I have enough lower body issues right now that I don’t need to mix in a sciatic nerve injury. Anyway, it’s very interesting stuff, and I do also wonder about the needle length information and what it would then mean for us. I know the IM shots they’re talking about, having done huge ones during pregnancy, and this hardly feels like I’m at risk for the same kinds of complications. I don’t think these needles are big enough to put us at risk for all of the most common injuries, but I’m going to take my time and learn about them all anyway. I believe I have hit a nerve twice now while injecting into my calf, and although I’m not worried I’ve caused injury, I do want to prevent that as much as possible in the future.

Thanks for splitting the thread. :wink: I look forward to passing back through with whatever I come across and hearing back from @Eric and crew on the accuracy and relevance of it.

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Are you currently using 13mm for the IM injections?