Are HUMIRA shots painful? Understanding and Managing Injection Discomfort

October 13, 2025 •

4 min read

According to clinical studies, injection site reactions, including pain, are one of the most commonly reported side effects by people using Humira. This often leads many to wonder, are Humira shots painful? and what can be done to make the experience more comfortable? The discomfort is typically a temporary stinging or burning sensation that can be managed effectively with proper technique and preparation.

Quick Summary

Humira injections can cause a temporary stinging or burning sensation at the injection site, but the pain is often manageable. Factors like medication temperature, formulation, and injection technique influence discomfort. Patients can utilize techniques such as warming the medication, rotating injection sites, and using cold packs to minimize pain and anxiety.

Key Points

Pain is common but manageable: Humira injections often cause a temporary stinging or burning sensation, which is a common and usually mild side effect.
Citrate-free formulations reduce pain: The newer, citrate-free Humira formulations were developed to minimize injection discomfort.
Temperature matters: Letting the medication warm up to room temperature for 15-30 minutes before injecting can decrease the sting.
Technique and site rotation are key: Proper injection technique and rotating between abdomen and thigh sites help reduce irritation and pain.
Anxiety can increase pain perception: Addressing injection-related anxiety through relaxation or distraction techniques can help lower perceived pain levels.
Numbing the area helps: Applying an ice pack to the injection site beforehand can provide temporary numbness and relief.

The Science Behind the Sting: Why Humira Injections Can Hurt

The pain experienced during a Humira injection is typically a burning or stinging sensation that occurs at the site of administration. As a subcutaneous injection, the medication is delivered into the fatty layer of tissue just below the skin. While generally less painful than an intramuscular injection, several factors related to the medication's formulation and the injection process can cause discomfort.

One significant factor in the past was the presence of a citrate buffer in the original Humira formulation. Citrate is an excipient used to stabilize the drug, but it can activate pain-sensing nerves (nociceptors) in the tissue. The subsequent introduction of a citrate-free Humira formulation has resulted in less discomfort for many patients. Additionally, other formulation-related elements like pH, injection volume, and viscosity can influence the intensity of injection-site pain. The temperature of the medication is also a key variable; injecting cold medication straight from the refrigerator can cause a more pronounced sting than when it has been allowed to warm up to room temperature.

Techniques to Minimize Pain and Anxiety

Numerous strategies can be employed to make Humira injections less painful and reduce associated anxiety. Following these steps can help improve the overall patient experience and adherence to treatment.

Before the Injection

Warm the medication: Take the Humira pen or syringe out of the refrigerator 15 to 30 minutes before injecting to allow it to reach room temperature. Never use a microwave or hot water to speed up the process.
Prepare the site: Choose an appropriate injection site, such as the front of the thighs or the lower abdomen (avoiding the 2-inch area around the navel). Wipe the area with an alcohol swab and let it air-dry completely before injecting, as injecting through wet alcohol can cause a sting.
Numb the area: Applying an ice pack wrapped in a cloth to the injection site for about 15 minutes before the injection can help numb the skin and reduce pain.
Relax: Tensing your muscles can increase pain perception. Try deep breathing exercises or other relaxation techniques to calm your body and mind before and during the injection.

During the Injection

Rotate injection sites: Consistently rotating injection sites prevents sensitivity or scar tissue from building up in one area, which can increase pain. The stomach is often reported as less painful than the thigh.
Pinch the skin: Gently pinching the skin at the injection site can create a firmer surface and help ensure the injection is subcutaneous, away from muscle tissue.
Control the speed: If using a prefilled syringe, injecting the medication more slowly can sometimes reduce discomfort. Humira pens deliver the dose at a controlled speed to minimize pain.
Distract yourself: Focus on something other than the injection, such as music or a video, to help manage anxiety and perception of pain.

After the Injection

Press gently: After removing the needle, press a cotton ball or gauze pad over the site for 10 seconds. Do not rub, as this can cause bruising or irritation.
Rest: Take a few moments to rest after the injection before resuming your activities.

Comparison with Other Biologics

Comparing injection site pain among different biologics can be complex, as individual experiences vary. Factors like formulation and delivery device play a role. A study published by the National Institutes of Health (NIH) highlighted that multiple factors influence injection-site pain, and perceptions can differ from patient to patient. However, some comparisons can be made based on user reports and research.


Feature	Humira (adalimumab)	Enbrel (etanercept)	Cimzia (certolizumab pegol)
Injection Pain	Users, especially of older formulations, reported stinging and burning; newer citrate-free versions are less painful.	Historically less injection site burning and pain reported in some studies compared to older Humira formulations.	Injection site reactions may occur but are reported less frequently than with Humira.
Formulation	Reformulated to be citrate-free and with smaller injection volume to reduce discomfort.	Available in both prefilled syringe and autoinjector.	Often uses an autoinjector pen to deliver medication.
Frequency	Typically administered once every two weeks.	Often administered once or twice per week, depending on the condition.	Typically administered every two or four weeks after initial loading doses.

Managing Injection Anxiety

Needle anxiety, or fear of injections, is common and can exacerbate the perceived pain of a Humira shot. Several strategies can help address this anxiety:

Desensitization: Gradually confronting your fear can make it less intimidating. This can involve starting by looking at pictures of needles, then watching videos, and eventually handling the injection pen yourself.
Deep breathing: Techniques like box breathing can help calm the nervous system and reduce pain perception.
Distraction: Engaging your mind with something else, like listening to a favorite podcast or talking with a friend, can help manage anxiety during the injection. Some people find that focusing on the flavor of a sour or sweet candy also helps.
Therapy: For severe cases, a behavioral health therapist can provide coping strategies through exposure therapy.

Conclusion

While the answer to are Humira shots painful? is often yes, they typically cause only temporary discomfort that is manageable. Factors like medication temperature, formulation (especially the move to citrate-free options), injection technique, and anxiety levels all play a role in the pain experience. By following simple preparation and injection techniques, such as allowing the medication to warm up and rotating sites, patients can significantly reduce discomfort and minimize injection anxiety. For most patients, the therapeutic benefits of Humira in managing chronic conditions far outweigh the brief, manageable sting of the injection. If persistent pain or serious side effects occur, it is essential to consult a healthcare provider.

Disclaimer: Always follow your doctor's or pharmacist's specific instructions for administering your Humira injection.

[Disclaimer: The comparison table is for illustrative purposes based on general information and should not be used to choose between medications. Consult a healthcare professional for advice.]

Frequently Asked Questions

The burning or stinging sensation can be caused by several factors, including the temperature of the medication if injected cold, the volume of liquid, and the properties of the formulation, such as the buffer used.

Yes, many patients report that the citrate-free formulation of Humira causes less discomfort or stinging compared to the original formulation that contained citrate.

Yes, allowing the Humira pen or syringe to sit out for 15 to 30 minutes to reach room temperature before injecting is a highly recommended way to reduce the potential for a painful sting.

The lower abdomen, avoiding the area within two inches of the navel, is often considered less painful than the thigh for most people due to more adipose (fat) tissue and less muscle.

Relaxation techniques, such as deep breathing or listening to music, can be effective. Seeking support from a family member, or using distraction methods like talking or enjoying a candy, can also help.

Yes, applying an ice pack wrapped in a towel to the injection site for about 15 minutes before the shot can help numb the area and reduce pain. Be sure to clean the area with an alcohol swab after icing and allow it to dry completely.

If injection site pain is severe, persistent, or accompanied by other symptoms like a spreading rash, worsening swelling, or fever, contact your doctor immediately. For mild discomfort, over-the-counter pain relievers or a cold pack may help, but discuss this with your doctor, especially if you have an inflammatory condition like IBD.