Table 1.

Factors contributing to subcutaneous injection-site pain

Product-related factors	Injection-related factors	Patient-related factors
• Formulation (ingredients, pH, buffers) [16, 17, 27, 28, 40] • Delivery volume [15, 32–34] • Needle gauge size [44] • Device type [49–54]	• Injection speed [55–58] • Fluid viscosity [55] • Injection angle/technique [59, 60] • Temperature of product [62, 63] • Allergens [65, 66] • Injection frequency [61] • Injection site [35]	• Low body weight [68] • Injection anxiety/‘needle phobia’ [69, 70] • Pain catastrophising [72] • Nocebo effect [73, 74] • Female gender [67] • Fibromyalgia [67] • Depression [67] • Severe rheumatoid arthritis [67] • Patient expectations [77, 78] • Patient movement (during injection) [87]