Injecting medication manually is best, rather than with the automatic devices. It is important to warm the syringe to body temperature first by holding it in your clenched hand for a few minutes. It is also important to pinch a piece of skin and lift it up before injecting into it.
Medicine injected with the skin flat often goes too deep. To avoid site reactions with sub-cutaneous injections, it is important to use the correct injection technique.
In the video below, Professor George Jelinek shows how to inject correctly. Many people injecting sub-cutaneous (SC) medication for MS develop site reactions, like lumps, weals, itching, redness or bruising.
This is usually due to injecting too deep (into muscle) or too shallow (into the skin itself). The right place for the medication to go is just below the skin, in the space between the skin and the underlying muscle.
This space is hard to find reliably if the skin is stretched out during injection. Pick an area where there is some fat under the skin such as the abdominal wall, the skin needs to be grasped between thumb and middle finger and lifted.
The needle is then introduced perpendicular to the top of that wad of skin and inserted all the way to the hub. If using an autoinjector, set the depth at maximal depth, as lifting that piece of skin guarantees the injection will not go too deep with a standard needle like the one on the Copaxone injection.
Inject relatively slowly, as rapid injection causes pain, and once injected, remove the needle quickly, and then let go of the skin.
Dispose of the syringe and needle safely.
Most people do not require heat or cold packs with this technique, and very few develop any site reactions.
This video demonstration below was performed at one of the Gawler MS Retreats and shows the correct technique: