Topical anesthetics are used to mitigate localized pain associated with a variety of superficial dermal irritation conditions. These medications are also used to reduce pain prior to many superficial dermal instrumentation procedures, such as needle stick numbing.
A subsection of the population suffers from a condition called, trypanophobia, the intense fear of needles. The fear is sometimes so great that some of these people become unwilling to seek medical attention when needed as well as avoid regular check ups and immunizations as a result. In these instances, needle stick numbing may be one method (among others) that may assist in easing some fearful individuals minds regarding the balance between standard healthcare visits and the fear of the visits derived from trypanophobia. Needle stick numbing may also help those whose fear may not be quite as intense, however, prefer that needle sticks be less uncomfortable.
Trypanophobia is a condition, formally recognized in the Diagnostic and Statistical Manual of Mental Disorders, affecting approximately 50 million Americans, making it a top-ten American fear.1 People who suffer from this often debilitating condition can experience symptoms including hypertension, rapid heart rate or heart palpitations followed by hypotension/bradycardia and even fainting or loss of consciousness.2 These physical manifestations of the phobia can also trigger feelings of anxiety and hostility toward the medical profession as a whole.
Not only are the symptoms themselves harmful to the individual’s health, but the fear associated with doctors, nurses and other medical professionals often prevents people from seeking treatment for serious ailments. Of those suffering from needle phobia, it has been reported that at least 20% avoid any medical treatment as a result.1 In a 2012 survey conducted by Target and Harris Interactive, out of the 60% of American adults who chose not to receive a flu vaccination, 23% stated the reason is a fear of needles. 3 Needle stick numbing may be an appropriate pre-treatment therapy in these instances.
According to the Centers for Disease Control and Prevention, each year as much as 20% of Americans fall victim to influenza and flu-related complications, resulting in approximately 200,000 hospitalizations and 36,000 deaths. 4 However, even in the face of such overwhelming statistics, sufferers of needle phobia will abstain from the flu vaccination.
Some cases of injection phobia are so extreme that even when directly faced with death, certain phobics will continue to avoid treatment. This has led to thousands of unnecessary deaths – statistics which are seldom related to phobias.5
Another reason why the trypanophobic is mistrusting of medical professionals is that the condition has long been dismissed by doctors — patients are encouraged to “just get over it.” For years, the fear of needles was considered simply an emotional response to a childhood fear rather than a serious illness.2 In reality, the condition can be due to a variety of factors including familial predisposition. In an effort to encourage phobics to seek medical treatment for preventative or reactive purposes, medical practitioners may choose to provide methods to ease pain and anxiety caused by injections to patients who harbor such fear. Improvement in patient comfort (needle stick numbing as one possibility) may be a pathway to reducing serious conditions, including death, caused by the avoidance of treatment due to the fear of injections, including immunizations.
Regardless of the origin or cause, needle phobia clearly presents a problem for both the medical profession and lay population. Doctors often fail to acknowledge the gravity of the condition, which further alienates those suffering from the phobia.
Needle phobia is not uncommon. Some researchers estimate that it is prevalent in as much as 10% or more of the population, combining both children and adults. (Kleinknecht, 1987; Mark, 1988; Craske, Antony, & Barlow, 1997).
The specific symptoms induced by needle phobia are directly related to its underlying cause, making it rather straightforward to identify the actual source and treat it.
1. Fainting. People who suffer from severe dizziness or fainting in response to needles typically have vasovagal reflex reaction, which often runs in the family.
2. Bad Memories or Ruminations. People who experience emotional reactions such as anxiety, insomnia, and panic attacks are suffering from emotions provoked by prior experiences (or imaginings). Their fears can be activated at any time, and they often have other medically-related fears as well.
3. Pain Intensity. Some people have a genetic condition that makes them extremely sensitive to pain. They cannot understand how other people can so bravely tolerate the enormous physical pain of a shot. They react to the pain with high anxiety, blood pressure and/or high heart rate, at some time during the procedure.
4. Fear of Being Restrained. People with this variety of needle phobia are actually afraid of being held down or controlled (restrained), even though they may think the needle itself is the actual issue. They typically develop a high heart rate, and may become physically or emotionally violent or may even try to run away.
5. Empathetic. Watching someone else receive a shot or medical care precipitates one of the above reactions.
Courtesy of Sclero.org (http://www.sclero.org/support/emotional-adj/needle-phobia/a-to-z.html)
What happens during needle phobia anxiety episodes?
• Feel intense fear and distress
• Increased heart rate and blood pressure (Willemsen, 2002)
• Sudden reflexive high drop in heart rate and blood pressure (Willemsen, 2002)
After the heart rate and blood pressure increases, the body then reacts by trying to reverse by slowing down. This reflex is called the vaso-vagal reflex, which causes the heart to slow down and blood pressure to drop. Sometimes this reflex is so pronounced that it causes fainting. (Willemsen, 2002).
Ways to handle the vaso-vagal reflex:
• Have the person (or yourself) lie down when getting an injection, IV, or blood test
• Apply a desensitizing agent (topical lidocaine) to assist in needle stick numbing), to the treatment area prior to the needle stick or IV insertion.
• Have the person continue to stay lying down for a few minutes after the needle, and get up very slowly
• Have the person (or yourself) tighten the muscles in the arm, legs and body, while relaxing the needle treatment arm.
Considering pre-treatment, by including needle stick numbing, prior to injections and blood draws may serve to improve patient comfort and ultimately reduce fear.