• Self-injecting biologic drugs for spondylitis can be a convenient alternative to getting injections in a clinic or doctor’s office.
• When you first start self-injection, you will be trained by a nurse or doctor.
• Following these tips can make self-injection easier and more comfortable.

Many biologic drugs used to treat spondylitis (also known as spondyloarthritis) can be self-injected conveniently at home, and there are tips to help make administering injections easier. It’s common to be nervous about self-injection initially. “I hate needles so badly,” one MySpondylitisTeam member wrote. But many people with spondylitis find that self-injection has advantages over injections in a clinical setting.

In recent years, self-injected biologic medications have become increasingly popular as a treatment option for people with autoimmune conditions such as ankylosing spondylitis (the most common form of spondylitis), rheumatoid arthritis, Crohn’s disease, and psoriatic arthritis. Biologics work by blocking pro-inflammatory proteins in the immune system and must be taken by either subcutaneous (under the skin) injection or IV infusion.

Self-injection can help reduce visits to the doctor’s office and provide more self-reliance with managing treatment, which can help improve quality of life. Many people with spondylitis appreciate the flexibility and comfort of self-injection at home.

There are several biologic drugs that are currently approved by the U.S. Food and Drug Administration (FDA) for the treatment of spondylitis and available for self-injection. These include anti-tumor necrosis factor (TNF) drugs and interleukin (IL)-17 inhibitors such as:

• Cimzia (a formulation of certolizumab pegol)
• Cosentyx (secukinumab)
• Enbrel (etanercept)
• Humira (adalimumab)
• Remicade (infliximab)
• Simponi (golimumab)
• Taltz (ixekizumab)

Learning more about self-injection may help you determine if this mode of treatment is right for you. Always follow medical advice from your health care team on how to properly administer self-injection. The following tips can help make the self-injection experience better. As always, discuss any problems or concerns around self-injection with a health care professional.

1. Get Proper Training for Self-Injection

Ask your health care provider for training on self-injection by a trained clinician. The nurse or doctor should supervise your first self-injection, and you’ll have a chance to ask any questions. It is also important to get clear information about how to store self-injectors, which require refrigeration.

A one-on-one training session and supervised first self-injection can help you build confidence about injecting your spondylitis medication. One MySpondylitisTeam member described their experience with learning how to self-inject. “I never thought I could do an injection on my own,” they wrote. “You will have [a registered nurse] assigned to you, who will be there for you as you learn how to do the injections.”

Read more about three types of self-injection.

2. Prepare Everything You Need To Inject

Before injecting, prepare a clean, uncluttered area. Wash your hands and have an alcohol swab handy to disinfect the injection site before administering the injection. Some people like to have a family member, friend, or caregiver with them, especially when first starting self-injection.

Some syringes and auto-injectors can be removed from the refrigerator for an hour or two before they’re used to bring the medication to room temperature. Cold, refrigerated medication may be uncomfortable when injected. Some syringes and auto-injectors can also be warmed with one’s hands before use. Be sure to ask your provider about specific protocols for your particular medication before warming it to room temperature.

3. Choose the Right Injection Site

Self-injections are usually administered to the arm, abdomen, or thigh. Many people find that the thigh is both easy to reach and the least sensitive to pain. Talk to your doctor about rotating injection sites to avoid any one area becoming sore over time or building up scar tissue.

One MySpondylitisTeam member shared their experience: “I have the new injection pen, so I don’t even see a needle. I also inject into my stomach. So far, all has been easy-peasy.”

4. Use Ice To Numb the Site

An ice pack or ice cube can help numb the injection site before self-injecting to reduce any pain or swelling. Pinching up the skin around the injection site before and during the injection is also recommended to reduce pain.

5. Recognize and Manage Injection Site Reactions

Like any medication, even those purchased over the counter, injected medications have a risk of side effects. Common side effects at the site of the injection include pain, redness, itching, or swelling. For some people, injection site reactions stop after a few injections.

Here are a few tips for managing injection site reactions:

• Use an ice pack after injecting to help minimize swelling and pain (as well as before to numb the site).
• If itching at the injection site is a problem, ask your doctor whether topical or oral antihistamines (anti-allergy drugs) such as diphenhydramine (Benadryl) may be helpful before or after injecting.
• Apply warm compresses, which may provide comfort to the irritated area.
• Ask your doctor whether over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil) would be safe and effective for pain and swelling at the injection site.

If your injection site reactions are bothering you, talk to your doctor about more ways to manage these discomforts.

Allergic Reactions

Rarely, injected medications for spondylitis can lead to serious allergic reactions. Unlike injection site reactions, allergic reactions can affect your whole body and may be life-threatening. Symptoms of an allergic reaction can include:

• Shortness of breath
• Itchy eyes
• Full-body rash
• Fever
• Chills

If you experience an allergic reaction to a self-injection, contact your rheumatologist immediately.

Talk With Others Who Understand

On MySpondylitisTeam, the social network for people with spondylitis and their loved ones, more than 87,000 members come together to ask questions, give advice, and share their stories with those who understand life with spondylitis.

Do you have tips for easier self-injecting you’d like to share? Add your thoughts in the comments below, or start a conversation with others on your Activities page.