Vibration, Pressure, and Cryoanalgesia to Minimize Acral Injection Pain

Acral injections for conditions such as palmoplantar hyperhidrosis are associated with significant procedural pain, frequently limiting their use in pediatric populations. While nerve blocks, cryoanalgesia, and topical anesthetics can mitigate discomfort during palmar injections, each has practical limitations. This report describes a multimodal technique combining cryoanalgesia, pressure, and vibration using a handheld massager that substantially reduces injection-related pain and patient distress.