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Julie  Stachowiak, Ph.D.

Where Do You Inject Your MS Meds?

By September 30, 2011

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Okay, I'll go first. I admit it, I do not rotate injection sites like I should. I actually rotate them very little.

This is not good. I know that I would be better off if I rotated sites between the "approved" territories on the body for injecting my subcutaneous medication (Copaxone). These sites are:

  • Backs of both arms
  • Upper quadrants of hips/buttocks
  • Thighs
  • Stomach

I find myself sticking with the hips and upper buttocks area for many reasons: 1) this area is easier for me to reach; 2) this is the fleshiest area on my body, giving me plenty of room for that needle to go in without hitting muscle (I have nicked muscle before and had a pretty bad reaction with swelling, redness and bruising); 3) I already have lipoatrophy on my upper thighs and a little in my stomach/abdomen area that bothers me and I don't want it to get worse (I don't really care how bad it gets on my hips, as that is not an area that I have to look at); and †4) injecting into the other areas just really hurts.

I would probably be better off if I used an autoinjector, but I am not a fan of that device - although some of you love yours. (Read more: Do You Like Your Autoinjector?)

I can say that in a moment of honesty with my neurologist, I did share the fact that I did not rotate injection sites for all of the reasons above. He said, "Yeah. That's pretty common."

So, I am asking to hear from you, the real people with MS - not the smiling people in the MS drug educational videos who seem to enjoy injecting themselves in all of the places on their bodies - to give us all some feedback.

Where do you inject your meds? Why do you inject here? Do you rotate injection sites as instructed or do you have your own strategy? What else can you share about injection site rotation or location that can help some of us who may be looking for some real-life guidance? Leave your tips and experience in the comment section below and know that you are helping someone, somewhere by telling your story.

September 30, 2011 at 10:10 pm
(1) Bryan says:

I typically rotate my betaseron between my stomach and hips.

1. Right side of stomach
2. Left side of stomach
3. Right hip
4. Left hip

Rinse and repeat…

I am careful to shift each actual puncture point around so as to avoid sticking the needle into an area that might still be discolored. Sometimes the area is still slightly pink. Other times, I might nick a small surface blood vessel resulting in a little bruising.

October 5, 2011 at 1:55 pm
(2) Kathy says:

Thanks Bryan–I am on Betaseron and do exactly what you described because the marks on my arms and legs took a couple months to heal. I finally mentioned it to my neuro who told me it was fine and very common. Thanks for sharing….it really helps to know that others discover the same techniques, and I’m not so “different” after all.

October 1, 2011 at 12:10 am
(3) Judith says:

I have injected Copaxone daily for the last 3+ years. I rotate in the recommended way, including the 7 body locations, rotating weekly within each location, and document in a notebook. And I have visible lipoatrophy on both thighs and the back of both arms. I don’t think rotation of injection sites postpones lipoatrophy for more than a year or so. Like Julie, I can’t see my hips, I may or may not have lipoatrophy there, but then who cares.

I swim daily, so my bumps are visible to the world. Sometimes it bothers me. But most of the time I remind myself that I am giving feedback to the company on this drug, my injection methodology, reactions, and other effects, so that the next generation of MS patients will have better options.

October 1, 2011 at 1:29 am
(4) Daniel K says:

I put together a web page that I use to map my injection sites on a graphic that covers all the suggested areas except my arms (not fatty enough). I just enter a start date, and it maps out my schedule visually, rotating through the predefined locations over a 45 day period. I can then print that out and use it as my guide. My rotation ensures that I’m not injecting too close to a location I would have recently used, by bouncing from my left side to my right side, up and down.

I haven’t had lipoatrophy issues, but I can easily adjust to skip a location if need be, and have a few times because it wasn’t fatty enough.

October 5, 2011 at 2:00 pm
(5) Carolyn says:

Daniel .. Is there any way to share your webpage so that others can benefit from it? I think its WAY cool that you did that!

October 5, 2011 at 4:40 pm
(6) Marsha says:

Ditto to Carolyn’s post. I would be very interested in looking at your webpage, Daniel. The diagrams in the Copaxone booklet are not satisfactory in my experience since you have to flip back to see which sites you used in previous weeks. Your approach sounds like something that would be very useful for those of us who inject daily.

October 7, 2011 at 11:49 am
(7) Daniel K says:

[One more try to post this...]

I’ve considered building a site for mapping and tracking injection locations, but I’ve never found the time to do so, and there are technical details I don’t have easy solutions for to make it a really useful tool for anybody so one can pick a map and plot a sequence of preferred locations. I’ve also been too lazy. There are apps out there, however, but I think they all use the suggested location maps.

Still, if people are interested at what I did I’ve made a couple of screenshots. Basically it is just a web page backed by logic that renders content on a fixed graphical backdrop. This screenshot, http://www.imagegratis.com/hosting/uploads/baed7f1352.gif, shows the sequence of 90 locations I use over two 45 day periods. The map shows that I skimp on the thighs, and maximize my stomach area. No arms. The side areas are above and below my hips. This screenshot, http://www.imagegratis.com/hosting/uploads/1544a459e6.gif, shows how it renders after I’ve entered a start date and clicked Apply. Each location sequence number is replaced by a little calendar date box. I then print this out and I’m good to go for 90 days.

October 5, 2011 at 6:03 pm
(8) Cindy says:

I’d love to see a new “map” I have been on copaxone for 3 years, and rotate all 7 areas, but forget to mark the book faithfully. I have the atrophy worse on my thighs, but also on other areas. I’d love to find an easier way to keep track of the rotation within each site. I’m also going to ask my neuro about 4 times a week. That would help. Because of allergies I take a daily antihistamine which helps with the itch reaction. I found all of the comments very helpful, I don’t feel alone :)

October 6, 2011 at 5:55 am
(9) Karen Beth says:

Interesting on areas with “not enough fat”. I have flabby arms, tummy and hips, but my legs are very muscular. The Copaxone did fine on every area except my legs. I tried all over my upper leg at different angles and never could get it to not swell up. I even tried the autoinjector at different settings. The only thing I could figure was… not enough fat there.

October 1, 2011 at 4:16 am
(10) Marisa says:

I prefer not to use my autoinjector. I can’t inject in my thighs and back of my arms because I really don’t have enough “fatty tissue” for even an adjustment of a “4″ on the autoinjector. The trick of the trade I find helpful is to also use the sides of my stomach (left and right flank areas). A nurse from Copaxone had explained to me over the phone how to self inject and I have been doing it ever since. I only recommend it to those that call a shared solutions nurse at the 800 number and listen to them teach you. My method or “recipe” each day is to clean the area (buttox, abdomen, flank sides of stomach depending on the day) with an alcohol swab. Let the area dry for a second or two, then squeeze some of the fatty tissue (I only mean in the flank areas because you don’t need to squeeze fatty tissue in the stomach, buttox area) and SLOWLY begin to inject the needle. As the needle is going in, release the fatty skin you pinched with your other hand and begin to administer, counting 1-10. Once all the Copaxone is released into that area of your body, slowly remove the syringe and place a cotton ball with a bit of pressure to the area. Hope this helps!

October 1, 2011 at 4:56 am
(11) Lee-Anne says:

I use the autoinjector (set at 8), because I have had no reason to do otherwise. My neuro told me not to bother with the arms… because it’s hot in Australia, I wear a lot of sleeveless tops in summer and they are hard to inject. Therefore I inject stomach, hips/upper buttocks and thighs. I rotate left stomach, right stomach, left hip, right hip. left thigh, right thigh and just try to remember where I injected in those areas last. Thighs hurt the most. I mentioned this to my neuro and he suggested just injecting in the stomach and hips. I have found though that if I do not press the autoinjector into my skin on my thighs, ie just place it there, then injections hurt and bruise less. My nurse told me not to use alcoholic wipes and I have had no problems. Does everyone who uses copaxone get lipoatrophy? If this is the case then I might start injecting minus thighs.

October 12, 2011 at 5:08 pm
(12) Heather says:

When I was using copaxone (I just barely switched to rebif) I jad been using it for a year and a half. When I first started I found that I got some pretty spectacular bruising on my thighs. My skin also has a tendancy to overreact to any prick. One mosquito bite on me will swell to the diameter of a grapefruit and I’d find that that reaction would translate over to my injections. For the first few months there would be more bruises than “bug bite” swellings. I would still keep the full rotation, I would just make sure not to inject on an already existing bruise and by the time the next week would come around most of the outer edge of the bruising would be gone so I could inject in the spot next to it. I absolutely use my autoject (the thought of sticking myself with a needle still freaks me out and with the autoject I at least don’t have to see the needle go in) and when I do inject my thighs, I don’t press in hard. And that also really helped with the bruising. I still have slight discolorization even though it’t been a year since a spectacular bruise but I doubt that it is enough to really be noticed by anyone but me. I do think that inspite of all the bruises keeping the full rotation (except for the row just above my knees; hurt far too much) really helped that. I think that that is why I stopped having bruises within the first few months. I still do full rotation with the rebif. I do think that it helps prevent lipoatrophy. Hope this helps! : )

October 1, 2011 at 2:24 pm
(13) Cari says:

Like you, Julie, I stick to hips/buttocks, stomach and thighs. I originally thought neuros insisted on rotating to
Ensure Copaxone worked more effciently? And then my neuro said no- its strictly to prevent severe dents, etc. This
Month i will have been injecting 2 years. I just noticed my first spot where i can see a dent, etc and it made me
Sad- but it is what it is. I get lymphadenopathy in my right inguinal region if i over-inject my right hip so i try to take it easy on that side. Can you do an article about Copaxone and possible increased cancer risk? Saw the interferon one– but hace read a few things about breast ca and copaxone?

October 13, 2011 at 2:35 am
(14) Heather says:

It would be interesting to see if there is a link. I was diagnosed in 07 and have been on copaxone ever since. This year I was diagnosed with Breast Cancer. I know I have a family history of it, but wonder now if the Copaxone has something to do with it?

October 1, 2011 at 2:30 pm
(15) Daniel K says:

Lee-Anne brought up a good point about using the autoinjector, and that is to not press it into the skin, but rather just let it rest on the surface before triggering the injection. My guess is that some that don’t like using the autoinjector might be injecting deeper than they want because they are pushing the end of the device into the skin. You don’t need to do that.

Also, I usually inject at setting 6, but in my thighs I use setting 4. Another trick is to look for fatty tissue areas by pinching your skin and gauging how much is there. The areas with more are better areas to inject into, and I seek those out on my thighs.

I wouldn’t suggest not using the alcohol wipes. Surprising that a nurse would suggest not to. Just let the area you wipe dry for a few moments and you’re good to go.

October 2, 2011 at 12:06 pm
(16) widawn says:

I’ve been on copaxone since 1998 on and off (due to financial and insurance mostly) but mostly on, and I rotated religiously the first 5+ years but these days I stick to the stomach and hips, sometimes the arms but never the thighs, they have gotten so hard in spots and at times the pain is so excruciating that I just avoid them now, entirely – and I hate the autoinjector because I have, at times, pain so intense that I need to withdraw the needle and try another spot, don’t know if it’s the FMS or just wimpy but regardless it hurts.

October 5, 2011 at 12:16 pm
(17) Angie says:

I’ve got to where I only inject my Rebif into my abdomen area. My thighs have begun to show muscle degeneration and when I injected my arms, there was always someone who would grab my arm or playfully punch (nobody knew I was self-injecting anything). It was very painful to say the least!

October 5, 2011 at 12:20 pm
(18) Stacey says:

Seeing that I get huge whelts on my legs and arms.. I only use my belly (which is great because I had 3 c sections and its pretty numb) and my hips… Im a bad bad person LOL.. but hey.. it works for me.. I was on Avonex years ago like.. 11 years ago and seized with a needle stuck in my leg… so.. this seems like a cake walk compared to that…

October 5, 2011 at 12:27 pm
(19) Stacey says:

Oh I use the autoject set at 6 and I use NO prep… being a vet tech.. I learned a long time ago… swabs just make it sting and really have no benefit… just wash with anti bacterial and do the job… I do have dents on my thighs from when I used to inject there

October 5, 2011 at 12:22 pm
(20) Kim says:

I rotate between inner thighs, abdomen and buttocks. I don’t have enough fatty tissue in my arms–plus I like to wear sleeveless tops and got too bruised when I tried my arms. I’ve been injecting for 2+ years now and haven’t noticed any dents yet. Never had a bad reaction EXCEPT once–I injected too low in my abdomen and I think I hit a vein–the pain took my breath away and lasted for about 10 minutes. Obviously, I avoid that area now!

October 5, 2011 at 12:23 pm
(21) Aaron says:

Everywhere recommended except for the thighs. I’ve tried the thighs and it’s usually painful and/or goes badly. I use the autoject just because I can’t get my head around that pesky self preservation thing and just end up having a bad experience due to causing myself to tense up.

October 5, 2011 at 12:25 pm
(22) Kevin Burnett says:

Hi Julie,

I’m a regular reader. Thanks for the information you put out. Knowledge is power and your info contributes to empowerment.

I use rebif. I inject almost exclusively in my thighs and rarely in the stomach. I don’t use an auto injector choosing to control the speed of the needle entering into my skin.

I have no site reactions and only occassionally hit a little nerve. Initially used an auto injector but it broke and I decided to try manuary injection–which worked out better for me.

October 5, 2011 at 12:29 pm
(23) Dona says:

Sad to say–yes, I too do not follow the recommended rotations, and even skip from time to time. I am samll framed, and my arms get so bruised, they can’t take it….so I often skip the arms. And after 2 episodes of what I call the SHIVERS after injecting into a thigh & hip—I dread those areas expecting another shivering episode that lasts about an hour. My husband almost called 9-1-1 because of how I reacted. SOOO…..now I double up on my stomach because that is where most of my fat is. Yes, there are bruises….I joke & tell husband & my Dr. to call me Dot. But I do not know how much longer the health system will allow for these shots, so I do at least 6 a week…but my arms make me look like I got beat up! At least almost no one can see my brusied stomach!

October 5, 2011 at 12:39 pm
(24) Jessica says:

I have been on Copaxone on and off, mostly on, since 1998. I was very good about rotating spots for the first several years. But now, I stick to the stomach and buttocks….on my left side. I have an implanted Baclofen pump which is implanted under the skin of my abdomen on my right side with a tube running along my side to my spinal cord. I hate the autoject, don’t do my arms, it hurts my thighs, but I am not experiencing any muscle or skin breakdown. The pump has been in since 2010, so maybe I will get problems, but so far I am fine.

October 24, 2011 at 12:38 pm
(25) Jack says:

Jessica, You mentioned a baclofen pump. I take baclofen by pill form. I believe it is an antispasmatic drug. Was your prescription for spasms and does the infusion help? Thank you.

October 5, 2011 at 12:39 pm
(26) Lynda says:

I have been injecting Rebif for about a year now. I do use the autoinjector but have never used my arms for the site. I do rotate the other sites. My “nurse” has me using three arrows (the marking on the autoinjector) for all sites. I have bruised myself in the thighs sometime but have altered my pushing of the injector and that has helped. I prefer the hip area as i have no pain at all there but continue to use all sites (but the arms) just to be safe. Does it matter???

October 8, 2011 at 10:43 am
(27) Brenda says:

I have been injecting Rebif for about a year now befor it waas Betasaron and Avonex. I find Rebif works best for me. I try to rotate my sights but sometimes I bruse and I just cant use the back of my arms or my buttox so my tummy and thieys are where I inject and I could not do it without my autoinjector.I also found that if I push the injector down it helps not bruse the injection sight.

October 5, 2011 at 12:41 pm
(28) Colleen says:

Well, I’m on Avonex, so my issues are a little different. I alternate thighs for IM injections. Lately, after 3 years, I’ve felt my thighs were sensative (whatever) and have had my husband inject my buttocks. But that is causing large bruises, so I think I’m back to my thighs. It’s a rare treat when I can have a medical professional friend inject my arm!

October 5, 2011 at 12:44 pm
(29) Jasmine says:

I am on Avonnex (weekly) and I only auto inject into my thighs which I alternate every week. Anyone using Avonnex, where else do you inject?

October 5, 2011 at 2:00 pm
(30) Jody says:

Hi Jasmine,
I also use Avonex and have found that injecting into the thigh seems to be better for me. I have had my husband, my brother-in-law (a medical assistant), and had a couple nurses at different times give me the injection in the upper arm. I was super sick after each one and my arm muscle hurt really badly the next day.
Now, I’m just sticking with the thigh.


October 6, 2011 at 11:01 am
(31) Jasmine says:

Thanks Jody. I find that when I ice the area before the injection it doesn’t hurt and there is less bruising.

October 7, 2011 at 11:31 pm
(32) Carolyn says:

I use Avonex and rotate arms and thighs. I have less side effects when the injection is in the arms. My husband gives me the new Avonex Pen which I am still adjusting to. I also have a smoothie with fresh pineapple before the injection which also helps with the side effects.

October 5, 2011 at 12:45 pm
(33) Craig G says:

Hi Julie,

I use the AutoInject 2 Copaxone and rotate through all 7 sites. I always finish with a icepack on paper towel over the injection site. This numbs any pain and enhances recovery at the injection site. So far so good. I dread doing the arms mostly because sometimes I hit a muscle , getting better at it over time.

October 5, 2011 at 12:45 pm
(34) Sarah says:

Stomach…all the time…after 2 c-section babies my stomach is a write off anyways…so bring on the lipoathrophy! LOL

I sometimes use my hips also…but I have noticed denting there so I am doing it less and less.

I never do my arms or thighs…hurts way to much and don’t want to risk the denting in places that I frequently show!

October 5, 2011 at 12:45 pm
(35) jbd says:

I stopped injecting into my stomach. I take Copaxone and have had 4 bad “heart attack-like” reactions. They typically last 30-45 minutes but I have a headache and feel rotten the rest of the day. I pinpointed the reactions to the injections into the stomach so I am terrified to try it there again! I still use the other injection sites although the arms & thighs do hurt.

October 5, 2011 at 12:49 pm
(36) Kim Hahn says:

I was diagnosed with MS and began taking Copaxone injections daily in June of 2001 with a 30 day break for Betaseron that ended dismally and I went right back on Copaxone. Copaxone is side effect free for me except a little itchiness post injection which I can SO live with! Betaseron was another story all together!!
I am also a diabetic and I inject insulin 4 times a day, so talk about needing to be careful with my injection sites!!
I injected my thigh twice and both times it was extremely painful (not much subcutaneous tissue there) and I won’t inject there anymore. I use my stomach as I have plenty of subcutaneous territory there, but I do not stick to the little chart that says here, here and here on both sides. I start way around on my side and inject all the way around my abdomen. I mean adipose tissue is the same all around my abdomen why limit it to a small area??
When I was briefly on Betaseron I did have my husband inject me in the rump and that was fine. I do inject insulin in my arms but I would not inject Copaxone there. I have plenty of fleshy area and I’m doing fine. An occasional bruise, yes. And occaisionally a little bleed out but it’s not a problem. I don’t have any tissue damage from my injections but I sure can see how someone without much adipose tissue could get into trouble. Oh, and the autoinjector? I used to use it but it is just SO much easier for me to do the injection with the syringe as provided. I don’t pre-cool the injection site like I did at first. It’s not a big deal at all. What I wonder is, would it be better to inject at night or in the morning like I’ve done for a long time. My hubby would be here in the evening to do places I can’t reach well. Just wondering…

October 5, 2011 at 12:53 pm
(37) Brenda says:

I use an autoinjector for Rebif and use all 8 sites. I do a rotation of right thigh, stomach, hip and arm. Then I do the left side. I wish I could do my hip and arms myself. My husband does them most of the time, because I shake and can’t get those areas easily. He has been helping for several months and is still squeamish. I have large red spots until time for the next injection in each area and have started having welts on my legs. Enough complaining–at least with Rebif the blurred vision is much better so I can read.

October 5, 2011 at 1:43 pm
(38) Kathy says:

Brenda–Be brave for the first time and scrap the autoinjector. It hurts less to inject without it. Once I did that I could reach all the injection sites and I stopped being nervous about the shot, and my poor husband didn’t have to reach those hard to reach spots for me. Ihave been injecting Betaseron for 14 months now. I only use tummy and hips after severe bruising in the other locations.

October 5, 2011 at 3:01 pm
(39) Brenda says:

Kathy-I’m not sure how manual injection over the autoinjector will stop the tremors in my hands. When I inject my thighs and stomach, I only push a button. It is easy to keep the injector steady for 10 seconds. On occassion I can do my hips myself when my hands are steady, but that is occassional. If you have suggestions I would be more than willing to listen. At first my daughter was helping with injections and was very good at it, unfortunately she moved out.

October 5, 2011 at 12:55 pm
(40) Christa says:

I also use Avonex, so rotating isn’t too big an issue. Although, since I don’t have anyone else to help I only use my thighs. When I first started injecting (with the 1 1/4″ 23 gage needle) I only used the tops of the thighs, alternating every week.

Then I had a bad reaction and my muscle spasmed. So now I’ve gone to the smaller 1″ 25 gage needle and only use the sides of the thigh… it’s just more comfortable and I feel much more relaxed… although, after 2 years I have also noticed the muscles are more sensitive… but not bad.

October 5, 2011 at 12:59 pm
(41) Toni says:

Oh gosh. I’ve always been a rule follower. I have a chart and use it to remind myself of where to jab next. I use all the 4 sites, starting on the right thigh, move up and over and end on the left thigh. I have a little map showing the six areas in each site. The site I dread the most is the stomach and of course, that’s where I’m jabbing myself tonight. I use an injector and my son came up with a great visualization for me. There is a video game we both play and when the character needs to heal, he uses a product that looks like the injector…so my son said just pretend you’ve saved the world and need to heal after the battle. So, that’s what I do…I’m not someone with MS…instead I’m a hero! LOL

November 4, 2011 at 11:50 pm
(42) Donna says:

I really like your visualization…….you are a hero!

November 5, 2011 at 9:04 am
(43) Toni says:

Donna, thank you!

October 5, 2011 at 1:02 pm
(44) LuAnn says:

I take Rebif. In the beginning I used/rotated all the sites, then quit doing the legs because I would get a knot that wouldn’t go away very quickly, and then quit the arms during summer months because of the discoloration. Now I only do the stomach and hips/buttocks. The stomach is my fav. I also use the autoinjector. I love it. I self inject a vit. B12 shot once a month with a much bigger needle, so the small reibif needle is nothing. Thanks for the info you put out each week. Love reading others experiences.

October 5, 2011 at 1:06 pm
(45) karen says:

I am a newbie, so thought I HAD TO DO IT RIGHT!!! Now I am finding myself having to do it my way. I do rotate injection sites, except for thighs. They seem to get an enormously out of proportion reaction.

Beta nurse said try manual injection. I love it now that I got over the initial fear, but no diff in the thigh reaction.

Neuro said just don’t use thigh. So I stopped using the thigh. Still have reaction from 3 months ago there.

A bad side effect of doing things MY WAY, is that attitude is spilling over into every aspect of my life. When I wanted to stop the sleeping pills, and my pcp said “Oh No, you can’t do that…” I argued and then finally said, “do you want me to just lie to you? Cuz I am NOT taking that stuff anymore.” He was not happy with me.

October 5, 2011 at 1:09 pm
(46) FaithS says:

I inject Copaxone only 4x per week. I had major problems with pain and site reactions in my hips, thighs and arms. I contaced Shared Solutions by phone multiple times, and tried all of their injection tips. I even had someone from there come out to re-train me, in case I was doing it wrong.

I’d been injecting with correct techniques, and the pain was no less following my second training session. I needed to alternate Ibuprofen and Acetaminophen every 3 hours, day and night, to tolerate the injection site pain.

Talked to my MS Specialist and requested approval to inject only 4x per week, and rotate 4 sites in my abdomen only. Have been doing that for about 3 years. It appears to be just as effective. I have no lipoatrophy.

~ Faith

October 5, 2011 at 1:57 pm
(47) Marilyn says:

My neuro told me to inject 4x/wk also, but not because of lipoatrophy (which I do have). His told me that Copaxone users who have gone 3-4 years without a relapse do as well in the long run as those who inject daily. Was so glad to hear this that I forgot to ask him what research supports this. However, he heads the MS clinic at a Boston MS research and treatment center and I trust his judgment.

Will ask, next visit, for more details and pass info along through this forum. Hope your pain subsides.

October 5, 2011 at 3:24 pm
(48) FaithS says:


Here’s a link to a study. Actually, I’d read, in several places, about the efficacy of an every other day Copaxone injection, which is why I decided to ask my MS Specialist about it.

I didn’t have trouble with lipoatrophy either — not before, or after switching to a 4x per week injection. My reason for the reduced fx was pain and site reactions at other locations. The reason, though, that I requested going down to 4x per week is because Shared Solutions does not recommend utilizing the same site more than once per week, and, if I was only going to be using 4 abdominal sites, I wanted to reduce the fx.

It is actually very nice not to have to inject every day. I prefer the 4x per week schedule that I am on now to the every other day schedule that I was on, in the past, with Betaseron. I can inject on the same days every week, and it makes it very easy to remember.

~ Faith

October 5, 2011 at 4:45 pm
(49) FaithS says:

However, Marilyn.

I have not gone 3-4 years without a flare. That would almost be like heaven!

On Betaseron (for 5 years), I had severe flares annually, which usually required a 1-3 week hospitalization, even when caught and treated early.

On Copaxone (for the past 3 years), my flares have been much less severe, and I’ve been able to avoid hospitalization and avoid times away from my volunteer activities.

However, I have had 3-4 minor flares in the past 3 years. Some of them seemed very definitely related to stress events in my life (even “good stress”, such as a daugher’s wedding, and planning a 30-year reunion trigger MS flares in me). My MS Specialist is keeping a close eye on my flares. Although she is also encouraged by the decreased severity that I’ve experienced while on Copaxone, she remains somewhat concerned regarding the fx of the flares, and will consider medication options if that pattern continues.

~ Faith

October 5, 2011 at 1:15 pm
(50) peg says:

Thank you…thank you all for your honesty. I am just a 2 1/1 mo. newby and boy has this been hard. This last week I didn’t do my thighs and thought maybe the MS swat team would come take me away! The thighs after of 10 yr Avonex shots and now to the each day thing…my thighs are mush, scared and nasty. I thought maybe I would be dragged off into shot hell. Best to each of you and all who ‘tough’ out any cronic disease. Blessings pj

October 13, 2011 at 7:39 am
(51) DanaD says:

The treatments for this disease are so frustrating because they cause discomfort yet we don’t know for sure when they’re working. Keep on keeping on, Peg, and good luck.


October 5, 2011 at 1:25 pm
(52) Carolyn says:

I’ve been on Rebif for 4 years. I’m getting weary of the injections, especially if no one knows for sure if they are working to prevent progression. But, overall, it’s still worth a try, so I keep at it. I have evolved to using just stomach and hips..less discomfort. I want to try the oral medication but will wait a year or so since it just came out on the market…even though it has been approved by FDA. Onward!

October 5, 2011 at 1:26 pm
(53) Kathleen Shea says:

When I started injecting Copaxone I used a topical numbing agent, but have evolved to using one hip or the other, trying to find sites that are not hard.
Sometimes I will choose a likely spot, but I end up with a squirter, when the precious liquid sprays from the injection site.

October 5, 2011 at 1:30 pm
(54) Gerry says:

Hi, I have been on copaxion For 2 years and I try to use a different site. When I have problems with my arms I use the stomach area. I use the auto enject for it is easy and I can set the depth of the needle. My wife gives the shot in my arms and other places I can not get to. There are times i wished that I could use a pill, right now I store the injections in the fridge. I get 90 day supply. I look forward for a change to have a new treatment. I don’t have alot of fatty places to inject. So far it has been 2 years since my last relapse. gerry

October 5, 2011 at 1:33 pm
(55) Jody says:

I’ve been injecting with Avonex weekly for the past four years. For the most part I rotate between thighs, and on a few rare occations have had the injections given to be in the arm. Because I tend to get much sicker from the injection when given in the arm, I mostly stick with the thighs. I haven’t detected in problems with the sites thus far.

October 5, 2011 at 1:58 pm
(56) Carolyn says:

I am still a baby at this having injected less then a month so far with Copaxone. I rotate as recommended and have found that my thighs bruise and my abdomen hurts alot longer. But I still rotate. I did get a dent on my arm the first day of usage which panicked me as I didn’t know how I would look long term but no other dents have occured so I am breathing easier. Not that it makes a big difference. I already walk like I am drunk many days so why should I care what people think if I have a few dents as well? Bottom line is, I am thankful to be able to do something proactive for my MS. I have had Fibromyalgia for 10 years and the meds there only treat the symptoms. I am happy to be able to FIGHT a disease!

October 5, 2011 at 2:04 pm
(57) Holly Jocoy says:

I take intra-muscular Avonex once a week. Since Jan 2007, I have injected into my thigh muscle. I aim at the bruise that looks least fresh so I know I am hitting a different muscle each week, but that’s as rotated as I get. :-)

October 5, 2011 at 2:11 pm
(58) Amy says:

I am also guilty of this with Copaxone, I only do my stomach though, but the same thing – I rotate between each side and try to find new spots. My arms are to hard to do myself and I don’t have enough “fat” on my thighs so they hurt when I do my shot on them. I always felt guilty about this, but glad to know I am not alone!

October 12, 2011 at 2:27 pm
(59) FaithS says:

With Copaxone, lipoatrophy and necrosis are possible complications if you don’t rotate appropriately. Although I use only my abdomen, I made the switch only with my doctor’s approval. I inject less frequently, as well, to ensure that I am not injecting in the same site more than once per week.

~ Faith

October 5, 2011 at 2:19 pm
(60) Stan Arney says:

I do rotate sites, 8 in total (Rebif), then again, my Wife helps me with the difficult to reach spots (back of upper arms, back of hips), but I also keep a journal, so I know where I last did it, and where I should do the next one (memory thing, you know). It also helps that I use an auto-injector, since my Wife faints at the sight of a needle (no pun intended). Rubbing the site, after the injection, for about 30-60 seconds, seems to help. I have been doing this since January 2010, so almost 2 years now. I have seen bruising, at times, but seldom, and when the needle is inserted pain is felt, seldom, but also it rarely ever bleeds, at the site, after the needles removal. I was told to make sure to rub the site, after the injection, also to try icing the site or placing a warm moist cloth, on the site after an injection. If in a pinch, I could probably give myself injections in all area sites, but with tremors, the back of the upper arms, and back of the hips, is risky, so I thank God for my Wife.

October 5, 2011 at 2:25 pm
(61) bbabbaloo says:

What’s this about injecting 4 x a week? Have there been any studies about it? I am very thin, so have the autoinjector set at two. Been injecting for 3 1/2 years, and I do rotate, as recommended. Have occasionally hit a nerve in my arm which hurts for a few hours. My thighs are ravaged, like craters on the moon, and I’m very embarrassed about them. My stomach is starting to crater as well. I used to use a cold pack after injecting, but now I jump into a hot shower right afterwards and the sting dissipates very quickly. I still dread the injections as much as I did on Day One.

October 5, 2011 at 4:30 pm
(62) FaithS says:

The study is actually for every other day. I chose to ask about 4x per week. That way, if I’m not exact on times that i inject, I still know that I never go more than 48 hours between injections.

(I try to inject once every 42 hours: Sat eve; Mon supper; Wed noon; Fri breakfast. But, I’m not always consistent. If I’m a little later one day, I still don’t go more than 48 hours between injections.)

Here’s a link:

~ Faith

October 12, 2011 at 1:50 pm
(63) bbabbaloo says:

Thanks, Faith!

October 5, 2011 at 2:28 pm
(64) Pam says:

I’ve been on Copaxone since 2007. I used all 7 injection sites for years (with the auto-injector), but recently quit injecting my arms due to fat loss. My thighs also do not have much fat, so it’s harder to find a good spot to inject. I’ve been “cheating” by injecting the stomach area more often than recommended (lots of fat there!).

I don’t have much of a problem with the auto-injector. It does seem a little weaker in mechanical operation lately. The nurse at the 800 number told me that these devices do wear out, and many times they need to be replaced.

October 5, 2011 at 2:30 pm
(65) linda says:

Thank you so much for this information. I have been reading it for months, but this is my first post. I will be making some much needed adjustments to my rotation and I am thrilled! No more arms for me!!!

October 12, 2011 at 2:23 pm
(66) FaithS says:

Linda — I only made my adjustments after discussing it with my doctor and getting her approval.

~ Faith

October 5, 2011 at 2:40 pm
(67) Jeri says:

I’ve been on Copaxone for about 4 years, and from the beginning, I’ve followed the 7 sites thing. I used the diagram in the planner and marked off a whole year. I did go crazy for a while, complaining that I didn’t have that grid on my thighs so how would I know what to do? I realized later that it wasn’t very important. There are only 3 that I can really reach (thighs and abdomen) and my husband does the other 4. If he’s going away, we switch the days around so I do the sites I can reach while he’s gone. We just know to avoid any place where there’s still a lump from last week. I know a lot of people think the abdomen is the worst, but for me, I hardly feel it. I have lipoatrophy in all the other ones and it’s pretty plain. I decided that I don’t care, I’m more concerned with falling, stuttering and other physical things. If anyone’s looking that much at my thighs, Let them go at it. There are too many other things to want to hide!

October 5, 2011 at 2:42 pm
(68) Shirley says:

I rotate my Rebif injections. My arm, my stomach and my hip. I use the autoinjector and find it very easy to use. I have had some redness but found that putting ice on the site before and a hot compress afterwards helps.

October 5, 2011 at 3:00 pm
(69) Carol says:

I have been on Copaxone for about 2 years now and I actually do rotate as directed…I hate doing the thighs, arms, and stomach…but I use those spots anyhow. I have made sure that I always inject on my hips on Saturday and Sunday. Those are days to take it easy right down to using the easiest injection sites ;-)

October 5, 2011 at 3:07 pm
(70) Mary Beth says:

I was on Avonex for 8 years and I did rotate sites. I have been on Copaxone for 5 years and I do not rotate sites. I do not use my arms or thighs because it hurts. I use my stomach and upper hips and I am careful to avoid using the same site too often. I do not use alcohol preps. I inject clean skin and I have never had a problem with infection. I am an RN and I have had lots of experience giving injections, but I prefer to use the auto injector when I am self injecting. I originally chose Avonex because I did not want to think about a shot everyday, but I find that I don’t mind the daily Copaxone injection. I did not like the flu-like symptoms with the interferon. Taking ibuprofen before my interferon shot did lessen the symptoms, but I still had them with every shot (for 8 years). My Copaxone injection is just something I do every day, like flossing my teeth.

October 5, 2011 at 3:10 pm
(71) Joe says:

I do not rotate either. The legs stay lumped up the longest.

October 5, 2011 at 3:12 pm
(72) Laura B in KC says:

I’ve been taking Copaxone and Avonex for about 6 years and I am fanatical about rotating sites. I use a chart and mark it EVERY time. I did quit injecting in my arm about a year ago. It was just too painful. I have many dents in my arms but I notice them more than others who aren’t looking for them. I also decided around the same time to skip one injection a week so I only do 6 Copaxone shots. I’m glad to hear about the 4 times a week thing. I’ll have to research that. Also, I use the auto injector and even after 6 years I still have a lot of site reactions. I do change the depth when I inject my thighs. Stomach is the easiest and has fewer reactions. As far as the weekly Avonex, my neighbor does that for me and injects my hip area. Occassionally, a medical professional has injected my arm and in the beginning I used my thigh. No reactions to Avonex as long as I take ibuprofen throughout the day. I do all my shots in the evening before bed. Thanks everyone for sharing.

October 5, 2011 at 3:56 pm
(73) Colleen says:

You’re the 1st person I’ve heard of who takes Avonex and Copaxon. I thought it was either? You’re a strong woman!!

October 6, 2011 at 11:17 am
(74) Laura B in KC says:

I’m in a drug study that is combining the two to see if we get twice the fun! After more than 6 years the study is ending in January and I’ll need to choose which one I want to stick with.

October 5, 2011 at 3:26 pm
(75) Dee Dee says:

I use Rebif with the auto injector and I rotate left stomach, right stomach, left thigh, right thigh, left buttock, right buttock because that is what I was told to do. However if I could choose where to give my injections it would only be in the stomach. It is too painful in my thighs and buttocks, plus I have to have my husband inject in the buttocks which isn’t exactly a fun moment! I have been on injections for almost 2 years and have no injection site problems. Maybe a little bruising or redness every once in a while but normally you can’t tell I have ever injected anything. Once I read everyone’s comments I may choose to change my rotations as I dread the days I have to inject anywhere but my stomach, actually ruins me evening! Can’t wait to read everyone’s comments today!

October 5, 2011 at 3:36 pm
(76) Misty says:

I inject in my thighs and sometimes my buttocks…. I tried the stomach but it hurts REALLY REALLY bad! And I do not use the autoinjector so my arms are pretty much out of the question. I have found that it is more comfortable to inject my thighs…. So easy to reach! I am starting to get lipoatrophy though…. but I really don’t care!

October 5, 2011 at 3:45 pm
(77) Patricia says:

I only give shots in my arms and hips. I couldn’t give shots in my stomach cause it hurt to much. I had a bad reaction from Copaxone on my upper righ thigh that caused nerve pain so I stopped giving shots in that area. When I felt the same painful feeling in my left thigh, I stopped giving it there.

I have large dents in my upper thighs from the Copaxone shots. I always give shots in area where shorts or short sleeve tops would cover. Forget about a bathing suit.

So my shot areas where I try to rotate are:
1. Back of left or right arm
2. Sides of left or right hip

Since the Copaxone Daily Planner says to avoid injection sites if any of the following are present, then I’m all out of areas to give a shot:
redness, swelling, tenderness, scar tissue, tattoos, indentations, lesions, warts, hardness of skin (lumps) birthmarks, bruising and stretch marks.

I’m looking forward to when there is an MS pill that we all can take.

October 5, 2011 at 4:15 pm
(78) Claudia says:

I do not inject my arms! My arms where looking so bumpy and indented! I do like the Autoinjector and use it all the time. I inject my thighs, hips and stomach.

October 5, 2011 at 4:27 pm
(79) Erica says:

I’ve been on Betaseron for 6 years & I use thighs, arms, hips & stomach. In the summer months I inject in stomach & hips. In the winter I use arms & thighs. It gives each area about a 6 month break. It does sting in my thighs but I push through it. However, since I haven’t had a relapse in 6 years, I find myself “pushing the envelope” & instead of a shot every other day sometimes I do it every 3rd day. There…..I said it!

October 5, 2011 at 4:39 pm
(80) Ashley says:

I rotate my Rebif in the back of the arms, the thiegs (which i find to be less painful/brusing in the upper portion.), the stomach, the buttocks and the hips. I just try to find the fattest portion of meat and give it a whirl. I’ve been having a really hard time with brusing. It stays red for a long time and eventually turns brown. I look like a christmas tree when I get out of the shower because all of my patches turn bright red.

October 5, 2011 at 5:19 pm
(81) Cynthia says:

I don’t really rotate, but I do try to alternate. My shots are also limited to the fatty areas. I have given myself shots in the upper arm, but I’ve gotten it in a muscle and had a sore spot for weeks, and just last week hit a nerve, so now I’m back to trying to find clear spots. I’m running out of room as I’ve been doing them since 1996.

October 5, 2011 at 5:30 pm
(82) virgogal189 says:

I’ve only been injecting Copaxone daily for 10 weeks, but as a former Girl Scout, I follow the rules (boring…I know). But wasn’t there a badge for that? Anyway, I am very interested in knowing more about the “numbing creme” referred to by someone in the comments. I use ice after injecting, but find that no matter what, it’s just like a wasp or yellow-jacket (insect) sting for 15 minutes. I keep hoping there’s something else I could apply to the site besides ice. Any suggestions appreciated. Finally, I too would benefit from knowing about a way to track injections other than in the Copaxone booklet. Thanks!

October 5, 2011 at 5:41 pm
(83) Erica says:

You might want to ice the area before injecting. That might cut down on the pain.
Also, Lidecain (sp?) is a numbing cream. My son was given a prescription to put on his skin 45 before he had allergy testing done. I’m not sure if it’s the same strength over the counter but I know you can buy it at a drug store in the first aid section.

October 5, 2011 at 5:45 pm
(84) Erica says:

oops….45 minutes ….is meant to type!

October 5, 2011 at 6:19 pm
(85) kdm says:

I was using ice religiously after injecting Copaxone when I first started, but after talking to one of the Shared Solutions nurses stopped. She said that you could use ice after injecting but that you shouldn’t leave it on for more than 2 or 3 minutes. I had been going to bed with it on and leaving it there til it wasn’t cold anymore! She also advised me to try heating the area before injecting. I don’t know if I’ve just gotten used to it or not, but those suggestions seemed to help. I itch far less now and the stinging seems better, too.

October 5, 2011 at 5:33 pm
(86) sallyg says:

I was dx in 2009 at 49 yo, but am also a nurse. I don’t use the back of my arms because it’s hard to get to hurts…I do
rotate sites religiously because I really don’t want any prolems with Rebif

October 5, 2011 at 5:38 pm
(87) Barbara says:

I recently stopped Avonex, after being on it for 9 years I became allergic with a rash on my neck a day after doing my shot, so what to do now my Doc. said copaxone was the best choice as it has fewer side effects. Gilenya is still too new, but I would love to just take a pill a day. Avonex was once a week IM shot which did me well all those years, with no site reactions. But I am wondering if anyone does Copaxone every other day? or has anyone at least tried that. I always injected Avonex in my thighs & once a week is great, I have never had any site reaction with Avonex, and I would have never stopped it if I did not have to. I do not have an issue with injecting myself, but I do have issues with welts bruses & lumps & dents in my skin,I keep praying what to do, I have to do something I have been off Med for 3 months now.

November 12, 2011 at 1:43 pm
(88) Alyssa says:

Barbara, I have been injecting Avonex into my thighs and hips since 1997 and have had no problems with it. The first night I remember telling my parent’s I felt like I wanted to die. The next morning I walked into the kitchen where they were having breakfast and smiled and said, “Good morning”. I felt fine. I have never missed an injection and the only reactions I get are a headache which goes away after I take acetaminophen. I do not suffer any flu-like symptoms and thought I was very lucky. Over the past year I have been dealing with vertigo and suffering from over enhanced sensations… smells, temperatures in rooms, sounds, you name it… it’s bothering me. The only thing that helps me is coldness. I do not think this is from taking Avonex… I hope it’s not because I do not want to change to another shot. I need to make another appt. with my Doc…. not looking forward to it, but I need to do something.

October 5, 2011 at 5:53 pm
(89) Tina says:

I never use the auto-injector – I just didn’t like it. For my Rebif injections, I NEVER inject in my stomach (ick!). I rotate between arms, buttocks and thighs in a very loosey goosey manner…not a deliberate schedule as perhaps I should. I think part of it is that succumbing to anything else that regimens my life around MS makes me feel like it is controlling me rather than me being in control. Strange, I know, but I feel that if I’m gonna do this, I do it MY way.

October 5, 2011 at 6:19 pm
(90) Joe C says:

I use Rebif, I rotate all of my injections.
Right bicep
Left Bicep
Right stomach
Left Stomach
Right side just above my butt
Left side just above my butt
Right thigh
Left thigh
It’s alot of fun. I’m ready for the bone marrow stem cell transplant. Approximately 50,000 happen around the world each year, it’s over 86% effective. I asked my Doctor about this and he told me that “I am getting the best medical care in the world.” Well I tell ya what it’s the most expensive care in the world and we don’t live any longer on this side of the pond than they do on that side.

October 5, 2011 at 7:21 pm
(91) Lulu says:

I have been on Copaxone for 6 months and do follow the protocol of rotating sites. I have had minimal site side effects; just minor swelling, itching occasionally. In the beginning it was difficult for me to keep track of where I had injected the week prior, the paper grid just didn’t work for me. My solution was to always apply a bandaid where I injected and snap a photo with my smart phone. I file the photos in a separate folder on my phone and refer to it the following week when I am doing that particular area.
Very simple solution and has made the rotation of sites easier for me:)

October 5, 2011 at 8:13 pm
(92) ireneg says:

I have been taking Copaxone for two years. I rotate through seven regions as suggested in the materials I received when I started the drug. I remember where based on my usual repetitive activities. I have bumps when show when I swim. And I do use the auto-inject. On the occasions when I have lost the red top to the auto-inject, I have injected without it. Taking the disease modifying drugs is an act of faith, or maybe a crap shoot. I figure I might as well go along with the game plan. And hope.

October 5, 2011 at 9:02 pm
(93) Dana says:

What about injection sites for Avonex? I have the choice of top and side thigh….there are possibilities in the upper arms but I have no one to do them. I am assuming this is all different from the copaxine….as Avonex is inter muscular and once a week. I have a ‘map’ as well I look at, basically on one leg the top of the thigh 4 areas from knee to closer to body, and then 4 spots on the outer thigh and the same for the other leg. So ideally it leaves me with 16 weeks of not injecting the same spot. Ideally. But since its a certain area, I find myself just ‘trying’ to change spots but it ends up top right, top left, side right, side left.
I opened the article because I was curious about other Avonex users injection sites.

October 5, 2011 at 9:44 pm
(94) Dean says:

the auto inject is nice but I two knots at the top of my buttock from the auto injector.Also be carful when you inject I got cellulitise in my thigh.Three trips to family doctor & two trips to the hospital all told me to see my neurologist. Two roundds of antibodics & finally got releif that I could walk without a cane.

October 5, 2011 at 10:24 pm
(95) Yooper says:

I inject my Copaxone daily into only my stomach area. I made my own chart and use that. I’ve got 3 sets of “rings” going around my navel below my waistband, and 1 set above that. It’s a month. and then I rotate again. I heat first, do the injection, cottonball and ice…and then the cottonball gets gone, and I rub LAVENDER ESSENTIAL OIL on the injection site, and that pretty much takes care of pain, welts, skin issues, etc. The next day, IF there is an injection site issue, I’ll use PEPPERMINT EO on that. It draws the blood to wherever it’s used, and if you rub it there, the blood will run there, and eliminate the issue. LOVE my EO’s.

October 5, 2011 at 11:37 pm
(96) Tanya says:

Yeah, so…
I did the Copaxone thing. Lets just say NOT RIGHT FOR ME.
It never stoped sucking and it hurt, plus ddnt work for me at. all. I was so good about rotating my stupid injection sites, used the autoject and yeah.

Started Rebif in July (I think)
Left thigh
Right thigh
Left hip
Right hip
Left stomach
Right stomach
No Rebi-ject. I don’t always use the front of my thighs either. I haven’t been on it long enough to say much more. Except that it sucks less. So far.

October 6, 2011 at 12:49 am
(97) Tony Roach says:

Hi Fellow MS ers.

I did Avonex for about sixty weeks, intermuscular injections into the thighs every Friday, rotating left and right and up and down to give the are time to develop the red spot and settle down before hitting that area again. I was sick from it every time, Changed to Rebif and I now fair much better, up to my 200 Th shot this week, injections are easier but more frequent. I rotate locations like clockwork, but don’t do my arms. Belly, butt then leggs is my routine, belly is the best as there is a layer of thicker fat there. It’s a mental game as I too am not that fond of needles but am learnig to accept it now. It really does’nt matter what where or why you inject these drugs, as long as you get it done, the best possible outcome is your business, and if you struggle with it, it is a game of understanding. Understand that you have to do it for only your benefit, do whatever makes it easier and comfortable for you is up to you. This is a good thing we all do for ourselves and a big pat on the back to everybody who does. Dont stress about only doing it in one area, at least your having a go. Get it in you !
Keep up the good work (“,)

October 6, 2011 at 3:55 am
(98) Jayne says:

I too have in the past injected on my thighs, stomach and hips and buttocks.
The red bruise marks left seem to be permanaent on my thighs and stomach. I now just inject on my buttocks and hips which are fleshier and less painful. I alternate from one side to another and also alternate hips and buttocks.

October 6, 2011 at 4:42 am
(99) Aleksandra says:

I have been on Copaxon for 2,5 years. Because of planned pregnancy I decided to end my therapy next month.I donít have enough fatty tissue, so I inject only thighs and buttocks.
The next reason to stop injecting is lipoatrophy Ė I have many, many extensive dents..I was told by my docs that my tissue would regenerate, but it wouldn’t. Luckily I havenít injected in my stomach.. I donít know what could happen with my stomach (with all these dents) in pregnancy..
My legs look strange;)) But I donít care;)

October 6, 2011 at 7:45 am
(100) Valerie says:

I’ve been on Co for 8 yrs. and did at first do the rotation injections until I had rotator cuff surgery on my dominant arm. Then it was just easier to inject into my thighs and stomach. I don’t have a lot of fleshy areas on my thighs to begin with so I got creative and started injecting on the inside of my legs. Which I still do.
Unfortunately the next year I had to have the other shoulder operated on but at least my dominant hand was free and I could lean back on a table to hit my backside on the one side anyway and hit my one arm.
The tissue is broken down on my thighs so my Physical Therapist has me doing exercises to build up muscle and tissue mass and I do notice a different in only 2 months.
I was a nurse yrs. ago so injecting doesn’t bother me. I guess I could have used the auto-injector; but I just can’t stand the sound of that click.

October 6, 2011 at 10:30 am
(101) Terry says:

Copaxone for four and a half years now. For the first two years, I used the injector and did my own injections. I, too, found the journal maps insufficient, the flipping back pages to see sites previously used, and so after a month of that, I too created my own cumulative maps … on paper towels. I could get a full year out of one set of seven paper towels … I drew the maps life size, wrote the dates in each sub-site as they occurred. At first I tried staying two inches away and skipping around on each site map, but after a few months of that the paper towel was full of dates, and it became harder to skip around. I stopped worrying about the two inch separation and just started going in order at each site.

For the past two years, I have given up the injector (click!) and asked my husband’s help with hips an arms, manually. I do thighs, and we skip the stomach entirely… just keep on going with the six sites. At one point I was skipping the seventh day entirely, but my neuro said that was not the way the med was prescribed. So we just continue with our six site rotation over seven days, and for that, the journal comes in handy, but not the site maps. We record it as “right arm, top right” and so on.

I’ve always envied those who have Tysabri: they truly have a “treatment” by professional nurses and doctors, rather than having to learn to inject alone. Copaxone feels more of a burden than a treatment; a painful punishment for MS rather than a compassionate care. My husband is wonderful, but I feel that he is being punished, too.

I may ask this year for Tysabri, to relieve both him and me from the nightly injection.

October 6, 2011 at 12:30 pm
(102) Loralee says:

I take Rebif since 2005 & now only inject in my stomach. Very little pain just redness & mild bruising. Legs hurt like crazy & can’t reach my arms or hips properly without causing a tear or pain upon injection. I haven’t used my autoinjector for a few years caused more damage with it & I hated the snap & smack it made most unpleaseant. I can take my time going ‘freestyle’ and have no issues. Nice to read everyones comments I know I am not alone!!

October 6, 2011 at 1:55 pm
(103) Dorethea says:

I’ve been on Copaxone for just a little over a year. I’m proud to say that yes, I do rotate. Prior to copaxone, I was on Rebif for 2 years. While on Rebif I didn’t rotate as I should have, but since I have to inject daily, it is to my advantage to rotate. I started using the Shared Solutions website and set-up my own daily planner on-line and it lets you see where you’ve injected and where you should be injecting. I know that we each have to do what we feel is best for us, as well as, what works best for us. Rotating works well for me.

October 6, 2011 at 4:31 pm
(104) Dhreeves says:

Although over weight I still hit muscle on occasion. I have found that if I twist the arm flap to the side by resting it on the back of a chair or doorway, I can get the fatty part of the arm where I can reach it. I do a similar move on my thighs. They always hurt but not too much if I can stimulate the skin near the injection spot while injecting. Of course about 5 minutes later the reaction will usually hurt for 20 min. But that is usual for Copaxone. It almost always gets red and a bit swollen and about 12 hours later, very itchy. I rotate to all of the sites and use both the front and back of the hip as addition areas when rotating. I do arms, back of hips, front of hips, abdomen, and finally outer thighs.

October 6, 2011 at 4:33 pm
(105) dhreeves says:

I forgot to say that I don’t chart where I inject. I can usually find the sore spot so know where I injected last.
I always go from arms down so know where the next spot should be.

October 6, 2011 at 5:31 pm
(106) Janet McCallum says:

I have been do Beteseron almost 15 years. I don’t keep a log of where my shots are given. I do try to move around. I like the stomach but I get big red spots that take a long time to go away.I can’t use it until spots are gone. My second choice is the butt. I do use all the sites. Legs, arms, stomach, butt.

October 6, 2011 at 7:49 pm
(107) MAUREEN says:

ive got to say i pretty much stick by the book for injections. for a whole year ive been keeping record of all my shots. where and what time. i find that the rearend is the easiest. but i do rotate.what can we all say is that it just sucks period.

October 6, 2011 at 8:21 pm
(108) Susan Goldberg says:

I’ve been injecting Copaxone since 1998. I never felt okay injecting into my stomach – just doesn’t feel right to me. So after trying it twice, I decided I’d simply rotate the other six injection sights. I do have alot of dents and hardening of tissue around the sights. Also I occasionally hit a muscle in my leg and it is SO painful – takes about a week to calm down the area. I often get swelling and hardening, but it’ll disappear within a day. Not such a bad tradeoff given that the drug really works for me.

October 7, 2011 at 4:16 pm
(109) Susana says:

I don’t do the injector either…tried it at the beginning but it caused more bruises and pain…now I just do it directly and have gotten used to it. I do rotate from my buttocks, to hips and tummy…at times it hurts, others bleeds, others bruises and others ‘all of the above’
It’s now part of my daily morning routine while getting ready for work so I don’t have much time to evaluate the damage …LOL…since I’ve been part of a trial study with Copaxone and Avonex together for 5+ years I’m very used to it.
Avonex is very difficult and stressful to do on my thighs so I have someone do it on my buttocks.

October 7, 2011 at 7:09 pm
(110) Stephanie says:

Oh, I feel so much better hearing that I am not alone! I am on Copaxone and I have had trouble with injections in my arms. I do, however, rotate between my hips, legs and stomach. I only do my stomach once a week and that is the only site that I do not use my injector. For some reason my arms just seem to give me the most trouble. My arms aren’t huge but they are bigger and don’t feel comfortable in my shirts with short sleeves and having these huge red spots, and/or, whelps. Not to mention the slight pain that it causes too.

Something else that I have noticed is right before my injections my other injection sites from previous 2 days start to itch and turn red. It’s like my body knows the exact time that I’m about to give my shot. Weird. Thank you so much for sharing this article and all the others too. It really helps and gives great information!

October 12, 2011 at 1:50 pm
(111) Valerie says:

Stephanie, I also find, if you flatten your arm out on the back of a chair and pull if towards you so there is more flesh available and slightly angle your needle to 45%, that helps. I also do not fully insert my needle, enough to get it through the skin layer into the subcutaneous area. For me; it doesn’t leave any bumps or marks.
When I first had my shoulder operated on my husband offered to give me a shot. He line-drived it like he was throwing a dart. I didn’t ask him again. That”s when I got creative and used my inner thighs. Sigh…

October 7, 2011 at 7:18 pm
(112) Julianne says:

I rotate between thighs, stomach and hips. I do not do the upper arms. I am slender and have no fat there, since my arms are working all the time to walk with crutches, to propel the w/c and to do everything. I give my arms a break and a “thank you”. I think it is harder to do Copaxone when a person is slender – there is more breakdown and less cushion to inject into.

October 7, 2011 at 8:02 pm
(113) Candy says:

I don’t really rotate, either- just switch sides and general
injection sites on my hips. I have gotten painful lumps and have wondered how to treat them- any ideas?

October 8, 2011 at 7:39 am
(114) Carol says:

I’m very good about rotating injection sites on my body, but not very good about rotating within the prescribed areas withing the injection sites. I’m considering skipping the injections to my thighs because of the huge red lumps that occur and then turn into what I call permanent bruises. It has also become painful to inject into my thighs and I think this has to do with the fact that I used to use Avonex which is an IM injection. I’m also considering skipping my arms for the same red lump reason. Am I awful for considering this?

October 8, 2011 at 8:51 pm
(115) Anna says:

Dear Friends,

So nice to hear from so many brave and determined folks. wish you all very best.

I have been on avonex for 10 years, and my neuro says it suits me most, since I had few relapses all these years, and it seems like injection and related symptoms are also well tolerable/tolerated. it is only after so many years that I started experiencing injection site problems: i alternate between the thighs ( side thighs) and have never done upper arms. injection spots have become somewhat indented and the entire thigh is either in spasm frequently or just painful.
Can anybody tell me what the avonex pen is and if i wanted, where would I get the autoinjector?
What, besides ice pad, can be used to prevent the site injection redness, etc? I loved ddrinking the smoothie, would never think this would help:)
Many thanks and take care of yourselves,

October 8, 2011 at 10:39 pm
(116) Elizabeth says:

Greetings, gentle souls–
I have been taking Copaxone since December 22, 2009 (Dx 2009) after taking Avonex for a few months. I use the autoinjector and rotate sites as prescribed by Teva. I do have some lipoatrophy on the upper arms, thighs, and hip area–not so noticeable on my fluffy stomach. I otherwise consider myself lucky because the pain after injection has diminished over time (it really hurt like hell at first) and I haven’t developed rashes, though I do have lumps that hang around for a while.

October 9, 2011 at 7:24 am
(117) Quay says:

I have been on Copaxone for nearly 6 years. After injections in my thighs started to discolor my skin and my arms started to have lipoatrophy, I rotate hips and belly – also showing signs of lipoatrophy but easier to cover up. Sticking to therapy is most important to me. I live by my own MS motto: I get up, I walk, I fall down but meanwhile, I keep dancing!

October 10, 2011 at 8:07 am
(118) Martha says:

I don’t rotate as much, and if in a hurry the stomach is the way to go. The only site that does not sting or leave marks. I also cheat by must giving myself the injection without prior cleansing, etc. Bing, bang, boom. Done.

October 12, 2011 at 8:26 am
(119) ryan millsaps says:

I use actar gel every weak, I gues it works for a day or fwo . !

October 13, 2011 at 2:45 am
(120) Heather says:

I have been on Copaxone since 2007, for the first 3 years i used the auto injector until I finally lost parts and thought i would just give it a go without. I have been managing just fine, but i don’t rotate too much. I get terrible itching and a welt with every shot. I have lots of room on my belly for injections so i pretty much stick to that area. I used to think i needed to rotate but found it too cumbersome and since I have so much room on my belly figured it was just as good. Occasionally my belly gets sore so i either try my left arm or honestly I skip a day. I am sick of the shots, but try not to miss too many days. But no real rotation for me either!

October 13, 2011 at 7:30 am
(121) DanaD says:

Left/right hip
Left/right thigh

I double up on one of these areas on a rotating schedule. Thighs are the easiest because there’s more real estate. LOL

I have been taking Copaxone via autojector since my dx in 12/10. I injected according to the directions for a while but arm shots are more painful and leave bumps that take much longer than one week to heal. Most of my body fat sits below the waist and my arms are fairly muscular to begin with.

It is nice to see comments from real people who can relate to the realities of regular injections. My neuro is very “by the book” so he quietly disapproves of my decision not to inject my arms. Oh well. This is what works for me and the medicine is doing its job so far.


October 13, 2011 at 11:58 am
(122) Daniel K says:

Dana, just goes to shows that different doctors have different thinking. My doctor’s nurse, while instructing me on how to self-inject, simply said not to bother with injecting into my arms. Not only are they hard to reach, but they are not fatty enough. Different pokes for different folks!

October 13, 2011 at 12:03 pm
(123) Daniel K says:

In case anyone missed them, Julie was able to clear my previously blocked posting with links to a couple of screenshots showing the rotation map I use that covers two 45 day periods. Maybe others will find something like it useful.

Just search for “screenshot” above on this page to find the posting.

October 17, 2011 at 7:26 am
(124) Tom Niernacki says:

I am very fortunate and I have a loving wife who wants to keep me around healthy a possible. So, she give me my injections using the autoinjector. I used to take Copaxone, but my doctor changed me to Rebif when the MRIs kept getting worse. I haven’t had an MRI while taking Rebif, but I’ve only been taaking it for about 2.5 months. I also need to get blood work done to keep an eye on my liver functions.

OK, I ramble a lot. Sorry. : ) We use the autoinjector exclusively. It’s nive not have to see the darn needle! It works well for us!

October 17, 2011 at 10:59 pm
(125) Brenda2 says:

Copaxone going on year 3. Whoo hoo! I rotate each area but not like the chart. Mon-right arm, Tue-left arm, Wed-stomach, Thurs-right hip, Fri-left hip, Sat-right leg, Sun-left leg. It helps me remember what day it is by where my shot goes. I don’t mind most of the areas, but I HATE the leg! My husband tells me not to be a baby and get over it, but sometimes, the tears just roll even when I don’t want them to. I am so tired of this disease. I can’t wait to live in a time when there is no more sickness.

November 1, 2011 at 2:40 pm
(126) David Bruce-Casares says:

When I finally was forced off the denial train and started on treatment (Copaxone), I was very diligent about doing what I called ‘The injection Site Macarena” (left arm, right arm, left thigh, right thigh, stomach, left hip, right hip). Of course, I was using the Auto-ject, had a production (would lay out my ‘works’ on the dining table), etc.

That was beginning in 2004 (diagnosed in 2000, but promptly went into remission and denial). Eventually, my Autoject broke, and while waiting for a new one to be delivered, I simply began self-injecting, and never went back. In approximately 2009, my neuro suggested a change to Rebif (apparently, my body had adjusted to the Copaxone, and wasn’t nearly as effective). Since Rebif was injected only 3 times each week, I promptly lost track of location rotation, and began doing what I wanted (it’s my body, after all).

In the end, I do rotate, but not to any set schedule, plus I have completely stopped injecting anywhere on my arms). And, even though I don’t get ‘bumps’ as I did with Copaxone, I get red spots, which pretty much reminds me where I ‘shot up’ recently, and aim elsewhere.

I was a good and diligent boy at first, but not so much anymore (regarding location is all). Hell, I don’t always use an alcohol swab beforehand anymore — bad? maybe, but…

So, you’re not the only one who ‘cheats’ on rotation. I think most of us simply devise what works for us. Injections are still not what I’d ever have chosen for ‘fun’. At least, these are subcutaneous. :)


November 11, 2011 at 4:38 am
(127) Heather says:

Hi all,
I know my comment is late but I wanted to tell you that regarding my Copaxon reactions, here is something that works for me.
I use a Lidoderm Patch which I cut up into small patches to cover the injection site swelling or red area. It works to stop itch, swelling and pain. After a few times in an area my body doesn’t seem to need the patch for a time or two.
Oh also I warm up the needle before my shot (in my arm pit for a minute )Sometimes allergy pills (antihistamines) helps too.
I have been on Copaxon about 2 years. I take the shot at bedtime (everyday) and rotate sites.
I was on Avonex for 7 yrs. No probs with Avonex I used Ibuproben before the shot and after.

I had one major dent/scar from when I tried Betaseron. But that is almost gone after many years of creams and vitamins.

Thank you all for writing. You addressed many areas I worried about.
Thanks again,

December 21, 2011 at 12:31 pm
(128) Susan says:

I am needle phobic, plus my hands are numb.I try to do some with the auto inject if I am away but don’t rotate those sites. My husband does them everyday and rotates the sites.

December 21, 2011 at 12:34 pm
(129) Eileen says:

For many years I injected Avonex in the buttocks, which was very convenient as my husband could do the job, however 5 yrs ago I was told by an Avonex rep that this was never a recommended site. Injections are now in thighs and upper arms and administerd at a health centre, hubby is afraid of hitting bone! Much less convenient. Does anybody out there still use the buttocks as a site?

December 21, 2011 at 12:57 pm
(130) Faith says:

Hi all – newly dx 11/11 – am using Copaxone every day using the autoinject 2 – no problems using it. Site reactions is some burning after, use ice and it gets better. Then about 2 days later – reaction sets in – redness about 2″ roundish with itching. Lasts for day or two – put ice on it. Rotate using all sites, most likely will stop arms as I wear no sleeve shirts in summer in GA. Thanks Dan for the chart you use – I will try it and see how it works for me. Thanks to all who posted with info – it really helps to hear info from others as no one in my family has MS or really knew too much about it so I am having to educate myself at 56 – kinda scary. Hope all have a blessed Christmas and a very Happy New Year!!

December 21, 2011 at 2:44 pm
(131) Derek says:

Left thigh, right thigh, left hip, right hip, left back, right back, stomach. When I originally read your question I thought I inject my shot in my bedroom. And then I thought why does she care where I inject my shot at. Then I had to chuckle. Thank you for all of your wonderful advice and your stories, my auto injector broke yesterday. I’ve used it almost 2 years every day never missing a dose. I think that is pretty incredible that that thing has lasted so long. Have a happy holiday and thank you again for all of your work.

December 21, 2011 at 4:43 pm
(132) Dave in Idaho :-{) says:

Hello Everyone !!!

I am counting my blessings after reading all your stories about copaxone and rebif injections. I am on Avonex and have a much easier time … Thank You Jesus !!!

I tried to self inject in my thighs starting out. I was bruising myself. I also found it harder and harder to ‘stab’ myself each week. I began to delay my injections… a day… or two?!?! Not Good. Finally, when I was pulling my punch to the point on the sixth week, to the point of withdrawing half way through insertion… I said to myself, Enough !!!

I was developing a phobia to Big Long Sharp Needles being stabbed into my own flesh by my own hand.

I now have my nice and pleasant nurses at the VA inject into my buttocks every Friday. If I miss my trip on Friday, I may even go into the VA ER to get it done. I have a Veteran neighbor who will inject for me. There is a nurse at church who will do this for me as well. Amazing it is … how many people with medical training are available and will gladly stab my ‘cute’ butt.

I only inject in my right cheek right now due to a left side inflamed sciatic nerve. No problems so far.

I am seriously considering having two tattoos put on:

Left Cheek: A large Pirate’s map ” X ” with ” marks the spot ” underneath it.
Right Cheek: A large ” Bullseye ” target looking like a WW I allied insignia

Since I won’t see it… This will be for the benefit of my kind ‘stabbers’ to brighten their days.

Blessings Friends !!!

Dave in Idaho :-{)

December 21, 2011 at 5:23 pm
(133) Margaret says:

DX April Fool’s Day, 2 years ago. Thank God for my husband who gives me my shots (Copaxone) every day. Also thank God I have plenty of fat on my body, so no problem finding a place for the shot. He uses the auto-injector and it works just fine. Ice the area before and after. Rotate the sites, but don’t use the legs, just thighs, hips, stomach, arms. Place a little bandage over the area in case of a blood drop. I’m 70 years old and retired. No kids or job to take care of either. Things happen for a reason. Wish we could use a pill instead of the injections. I lie down for a about 15 minutes after in case of dizziness.

December 21, 2011 at 6:02 pm
(134) gale says:

I have using Copaxone for about 3months. I rotate, write in the book. Has anyone have any results with the copaxone. Do you feel any better or is it the MRI that will tell of any results.

December 21, 2011 at 9:38 pm
(135) Vanessa says:

I take Copaxone. I do not rotate my injection site often at all. My right hip and thigh is the side of my body with the most flesh and it doesn’t hurt. That’s where I inject most often. Before that, it was on the left side until the flesh got too scarred. I don’t know where I’ll go after my right hip scars up. Maybe my stomach, but am not looking forward to have itching welts on my stomach, especially in the warm weather.

Before the Copaxone, I injected Avonex into my thigh muscles. My thigh muscles were both the largest and easiest to reach. I had flu like symptoms all weekend after my injection on a Friday night.

Before that I was on betaserone and I injected on my thighs… then I had discolored spots on my thighs. I looked black and blue. I tried my arms, but was easily scarred. I stopped the ‘serone because I also had terrible flu -like side effects every night.

December 21, 2011 at 9:58 pm
(136) Susan Goldberg says:

I have used Copaxone since October of 1998, and I have rotated in the recommended fashion, except I don’t use the two stomach injection sites. I just can’t comfortably do it – it just creeps me out. I have alot of lipoatrophy on my legs, arms and hips, but I’m fine with it. I’d take that over ANY of my previous MS attacks.

December 22, 2011 at 8:54 am
(137) Eileen says:

Merry Christmas everyone,
Dave, this is for you. I’ve been looking at Avonex advice sites and they all recommend upper arms and thighs. Here’s a number I found that might be useful
1-800-2255. I live overseas so can’t call it. Good luck, I really hope they say that the buttocks are ok too. Keep me posted.

December 22, 2011 at 3:00 pm
(138) Kim says:

I have been using Avonex for almost 4 months. I rotate

L thigh
R thigh
L hip
R hip


I used Copaxone for awhile and never injected arms, even with the auto injector. We’ve got enough to worry about each day, the less we think about the shots or where they go, the better.

December 22, 2011 at 3:07 pm
(139) Kim says:

Also, a co-worker of mine who lives alone and uses Avonex, does 3 shots in one leg between hip and knee, and then 3 shots in the other. It works for her.

December 28, 2011 at 3:39 pm
(140) Dave in Idaho says:

Thank You Eileen,

There was a problem with your number… to short.

I probably oversimplify my description… more accurately the Avonex shots are not administered in the buttocks. It is administered high above the buttocks in the deep fleshy components of the hip. No one in my health care has wondered about this. I think the directions for the arm and thigh is for ease of self administration… although I find it hard to picture stabbing my tricepts. I think the important thing is to find large muscles not inhabited by very sensitive bundles of nerves and generally good blood flow.

My sight might be more accurately described as the hip I think… I still have to loosen the belt and drop my pants and slide my underwear down enough to expose that hip muscle.

Blessings and Thank You Eileen !!!!

Dave :-{)

January 23, 2012 at 11:53 am
(141) Sarah says:

I’ve only been on Copaxone for 3 months and I follow the recommended site rotation. I get red swollen marks everywhere I inject that sometimes bruise and they frequently itch. It’s January now and I’m already thinking ahead to summer when I go to the pool and my thighs and arms will show. I will soon probably just inject my stomach and hips, so I’m glad to see there are others who do not use each recommended site. My nurse recommended doing my injections directly out of the shower and I have found it stings much less doing it that way. I use the autoject for my arms & hips if my husband isn’t available to do the injection for me in those places. I wish everyone with MS the very best and hope you are doing well!

January 27, 2012 at 9:33 am
(142) Mike says:

After over 5 year on Avonex, I switched to Copaxone 8 months ago. I just couldn’t handle having flue like symptoms anymore. For most people on Avonex flue like symptoms end in less then 6 months, but not for me. Copaxone works better for me, I’m able to rotate between all 7 recommended injection sites. I use my Android app – MedNotesPlus to keep track of my injection areas. It works great for me.

March 14, 2012 at 12:53 pm
(143) Debbie S says:

I tend to agree I stick to my hips and buttocks and my stomach since I have a mommy pouch a few more dimples do not matter.
I use the autoject and I skip days I use the autoject because I cant seem to bring myself to do it without it. I am usually using my stomach and hips When I used my upper thighs and legs if leaves a very large lump and bruises easy I dont use hte back of my arms because it hurts even after 11 years. So all you guys dont feel bad between the shots and m cocktail of anxiety energy depression and vitamin d I feel like a walking pharmacy. Lately I seem to pacnic in large spaces and wonder if that happens to any of you. I ALSO LOSE THINGS all the time. YIKES I am not liking this MS monster

March 14, 2012 at 1:38 pm
(144) oSandi says:

Diagnosed in 1989 and started using Copaxone in 2000. I would rotate sites as best i could in the beginning but then relied solely on my ‘mommy pouch’ for a few years. Got a tummy tuck in 2007 and since then I have only ever used my upper buttocks. Because I am able to feel a slight tender spot beneath the skin even after 24 or 48 hours, I never inject in the same place twice in the same week. I’ve read that some people accidently hit a muscle but I’ve always associated that feeling with hitting a nerve because sometimes the funny ‘twinge’ feeling travels a length of 8 to 10 inches and it feels like a thread. For what its worth …

March 14, 2012 at 1:39 pm
(145) Rose says:

I use Rebiff and typically use;

Buttocks- both sides & thighs- both sides

Unfortunately i can’t seem to use my stomach as it hurts far too much and my skin seems hypersensitive there. Recently i have been having issues with hotting thew muscle or blood vessels maybe and the bruising has taken over 6 weeks to clear up and so sometimes i have to ignore a leg if it is sufferring too much!

The nurse told me not to use my arms and seeng how i like wearing short sleeves in summer and having seen the damage on my thigh, i am inclined to not give it a go!

March 14, 2012 at 3:20 pm
(146) Linda says:

I inject Avonex once a week, rotating between upper and side thighs. I take ibuprofen about half an hour before the shot, and ice the site for a few minutes before and after. The pain is minimal and I never have a site reaction other than an occasional tiny bruse.

March 14, 2012 at 3:59 pm
(147) Diane says:

I am not currently doing injections, but am supposed to start any day now with Copaxone and have received an AutoJect already. I am quite concerned with the lipoatrophy mentioned. Can someone please tell me more about this and, is there any way to avoid this?

March 14, 2012 at 6:47 pm
(148) JANET says:

HI All, I have been injecting Copaxone for nearly two months now.
I find for me injecting manually is easy. I use the autoinjector where i carn’t reach, like on the back of my hip, i have had the odd bruise. i use the compress hot or cold. i get a lump when the lump disappears then i rub with mosuriser. I am trying to inject first thing in the morning when i heard its the best time to inject, but i haven’t quite got their just yet.

March 14, 2012 at 8:24 pm
(149) Jayne says:

I have always had problems with injecting.
I seem to always get a bruise (redness) on my thighs after injecting. The area itches and swells and leaves a mark for what seems forever. My arms have the same result, also my stomach. On my stomach, if I get bruising this inhibits waisted clothes and I get quite sore.
I find the best place for me is on my buttocks and hips. If I bruise, I can’t see the marks and also the pain is far far less. Rotation? Well, this is a limited choice area and I can only move into different positions in the same area on both sides. I am really not keen to go back to marking my legs, arms or stomach now and will just stick with my rear!

March 14, 2012 at 9:22 pm
(150) Mac says:

I inject Copaxone daily and only into my stomach.(I have enough, trust me!) I made my own diagram that I follow, doing two “rows” under the navel and two “rows” above it. I use the heat first, for 5 mins, swipe w/the alcohol pad, inject while standing, w/the autoinject at almost 10, it goes deep, and I ice it. I can say, most everyday, there is no pain…unless I do it at the wrong angle….then after icing it a bit, I use LAVENDER Essential Oil…and if it stings again..it gets another dose. I’ve been doing this for the last year, and I honestly can say…this has gone from being one of the most heinous tasks for me…to being “just another thing”…..AND with the Lavender oil..the added aromatherapy benefit is awesome! I use Peppermint essential oil for the “flu-like” symptoms/side effects…rubbing a drop or two on my stomach as well..that works phenomenally. NOW products also have a “Peppermint Gels” that has peppermint, fennel and ginger oils in them, and they help immensely as well. Wintergreen EO stops muscle spasms for me too. GOD’S medicine!!!

March 15, 2012 at 8:57 am
(151) Jennifer Bell says:

At age 50, I am being diagnosed with MS. Neurologist said she is 80% sure but the 20% is referring me to Emery in Atlanta for 2nd opinion in a few weeks. 3 weeks ago was hospitalised for the steroids regimine and I don’t see much difference although this is all new to me so maybe it helped from getting worse. I begin the Athcar gel anyday now. (waiting for the med) My symptoms are on total right arm/hand and now I am getting spasms in my left arm. Legs are a bit numb but I am walking ok. Does being tired ever go away? I have been a health person my entire life and have amazing support but am so emotional trying the figure out what I need to do each day to take care of myself… Thanks for the blog…my sweet sister found it andm it’s helpful!

March 15, 2012 at 10:41 am
(152) Nancy T says:

Have been injecting Betaseron for the last 10 years., Injecting every second night, has always been painful so in August of 2011, I finally reached my pain limit and stopped the injections. Spoke with Neuro about oiral meds available, and he has requested a consultation with my MS Clinic in London to check on oral meds. Reading an article in the MS magazine mentioned anisthetic pads used to reduce painful injections. I contacted my local pharmacy and these pads are available in my small city so I tried using this as my symptoms grew worse after six months with no Betaseron. These medicated UBL pads work well. Pharmacy is ordering a tube as it costs less than the pads. Each pad costs $4.50. It is costly when injecting every other day. I’ll see if this stops the site reactions, bruising and sore spots. Because I rotate the injections as suggested, my stomach, legs, upper backside always hurt when touched. Anxious to see if pads help with this site pain.

March 15, 2012 at 1:03 pm
(153) karenintheatl says:

I went back to using avonex because of all the site reactions from Copaxane and Rebiff .I rotate 4different spots on my thighs with no problem

March 15, 2012 at 3:12 pm
(154) Sheryll says:

Its weird. Today you are hitting on everything that is a part of my daily make-up. I just left a post regarding Achtar. First time injecting. I take 1 ml for 5 days. I will definitely rotate. I feel like I got a booster shot. Its sore and I will not hit that spot again for a few days.

March 15, 2012 at 7:37 pm
(155) Sue W says:

I have been on Copaxone since I was diagnosed in 2007. I was trained with the autoinjector so thats what I use. After problems with my arms getting lumpy and sore I stopped injecting there about a year ago. Not enough flesh there. I hate injecting in my stomach so I quit that maybe after a month of injecting Copaxone. It hurt and made me nervous. So I use thighs and hips only. After taking this drug for so long, it doesn’t bother me to skip a dose every once in a while. Told my neurologist this and she told me it was better to inject every day, just in case. Whatever!

March 16, 2012 at 9:23 am
(156) Martha P. says:

This is a message for Daniel K.

I am so grateful to you for your sugestion on turning the autojet to 4 to give a shot in the thighs. I tried it and could not believe the results! There was no pain and no itch. I moved it to 5 to do my stomach and the same results. I am forever in your debt. Thank you as I was about to stop taking shots because I couldn’t stand the pain or the itch.


June 30, 2012 at 7:46 pm
(157) donna turner says:

I have been using Avonex for several years and last evening noticed and felt a rather large depression on my thigh where I have bee injecting. It is extremely noticeable when touched that there is loss of fat over the muscle. I can only inject in my thighs. I had breast cancer and a lymph node disection of all lymph in my left arm. I am right-handed. I guess now I need to find a different area in the right and left thighs so I do not lose any more subcutaneous fat over the muscle.
This is the first I have ever heard of lipoatry.

July 9, 2012 at 2:36 am
(158) read me says:

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December 28, 2013 at 11:03 pm
(168) Ivy says:

I’m a newbie, just diagnosed in early November 2013. Started Copaxone Dec 11/13, going well so far, moderate pain after injection usually lasting 30min to a few hours. I am rotating my injection sites (no help from the silly book they sent me). I will make a new book that I can properly track each area, in the meantime I’m using dots from a Sharpie marker. I find that for now, the Sharpie dots are a sure-fire way to see exactly where I injected over the past few weeks. I also take a pic from my phone that shows each dot. No skin dents yet, I am really worried about it though. I’m hoping that I can start using the 40mg dose/few injections.

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