Frightened of needles, syringes or injections?

Doctors refer to fear of needles as needle phobia and it’s more than just an aversion to feeling a pinprick.  Fear of injections and hypodermic needles can cause people to faint and even to die, and for many sufferers it makes them choose to avoid medical help altogether.  So understanding and finding solutions to this phenomenon is critical – it  affects at least 10% of all adults to some extent.  Other names to describe the fear of sharply pointed objects are aichmophobia and belonephobia or even trypanophobia.

About 80% of sufferers point out that they have a near relative who shares their fear of needles and this shows the strong genetic element to needle phobia.  At its simplest this maybe because stone-age man would have increased his chance of survival by avoiding pierced flesh so genes survived which transmitted this strong inclination to avoid anything that could create a stab wound.  Another response which may have evolved in order to increase survival is the vasovagal type where a patient suffers acceleration in heart rate and blood pressure followed by a rapid fall in both, often leading to unconsciousness or fainting.  This is sometimes accompanied by convulsions and rapid hormonal changes.  Perhaps in societies where violent conflict was common this might have been a way for a person to avoid becoming a combatant and therefore increasing their chance of survival.

This sort of vasovagal needle phobia can be promoted by the sight of needles or even the thought of needle-like objects.  Often people who faint at the sight of a needle don’t actually report any conscious fear of needles but they can even suffer when they see others receiving injections.   The symptoms can also include sweating, nausea, and severe anxiety.   A groundbreaking article on the phenomenon of fear of needles was written by Dr James Hamilton in 1995 and he observed that in some cases the loss of blood pressure can result in death: he identified over 20 fatality cases.

Usually the best treatment is desensitisation through progressive exposure to increasingly frightening stimuli allowing patients to become less affected by seeing needles and similar objects.  There are also a range of technical measures which can help such as EMLA (an anaesthetic cream), Ametop (a gel), patches, or jet injectors which can introduce substances to the body with high pressure gas rather than a needle.  But the measures which avoid physical intervention are behavioural therapy and the use of orally taken tranquilisers such as benzodiazepines (eg Valium).

Whilst fear of needles is not an issue for 90% of the population, for those who do suffer from the condition it can be life-threatening.  As long as doctors are sympathetic to this and employ the (less sharp) tools at their disposal they may help those with needle phobia to overcome it permanently or at the very least find ways to benefit from modern medicine.

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