“Hi this is Dr. Silvester. I’m going to talk a little bit about the first or second most common thing we see in our office: patients with ingrown toenails. We love those patients because most of the time, we can help them very quickly and very easily, and they’re always happy when they leave – at least 90% of them. If you’re afraid of getting the injection or afraid that it’s going to hurt a lot, I want to try to put your mind at ease a little bit, because we use about five different techniques that make the pain much less than it would otherwise be. We hear every week horror stories about patients who have had injections in their toes where they’ve been extremely painful – patients can’t tolerate it, they’re afraid to come in if they’ve been to other places and they come to see us, they’re usually very reluctant to come in because they’ve had bad experiences elsewhere, but you don’t need to have that fear. We use about five techniques to keep the shot painful.
First of all is the anatomy of the toe – if you know where to give the shot, it’s a lot less painful.
Second thing is the use of sodium bicarbonate and local anesthetics because local anesthetics are all acid based, so when you’re giving an injection, it hurts. If you use sodium bicarbonate, it hurts a lot less because it neutralizes the acid.
The third thing is that we use the smallest needle that’s commercially available (30 gauge needle) which costs about twice as much as other needles so it’s a little more expensive, but a lot more comfortable.
The other thing that we do is the technique of giving the injection. There are certain ways to make the injection a lot less painful by the technique of doing it. We train our staff in giving those injections in a painless way.
The last thing is that we use cold spray, which some argue that it stings, which it does, but it doesn’t allow you in general to feel the needle going into the toe. People prefer the sting of the cold spray to the sting of the needle.
Bottom line is that I’ve done that procedure to three and four year old kids, and they haven’t given me too much trouble if they’ll cooperate with us. So if a three or four year old child can take it, it should be okay for you to have it done and there’s no need to fear it too much. We’ll try to make it as pleasant an experience as possible. Everyone in our office has experienced that injection, which is part of our training, so we also have great empathy for the patients who are coming in to get the shot. We try to understand what they’re going through a little bit.