Understanding the Injury
A high‑pressure injection injury occurs when a fluid or gas is forcefully injected through the skin, often from equipment like paint sprayers, grease guns, or hydraulic tools. At first glance, the injury might look like a tiny puncture or a minor sting. But underneath, significant damage can be taking place. This is a medical emergency — not because of what you can see, but because of what’s happening deep inside.
Why It’s So Serious
- It Looks Harmless — But Isn’t
The entry wound may be no bigger than a pinprick. Pain might be minimal at first. This often leads to delays in seeking medical attention, which can make things worse. - Hidden Internal Damage
The injected substance travels rapidly beneath the skin, tearing through tissues, nerves, and blood vessels. It spreads along paths of least resistance and can reach far beyond the injury site, causing pressure build-up and cutting off blood flow. This can lead to compartment syndrome — where rising pressure within the body’s tissues threatens the survival of muscle and nerves. - Chemical and Infectious Danger
Some materials, like solvents or paints, are toxic to the body. They cause local inflammation, tissue death, and long-term damage. Others, like grease, may sit silently and form lumps or lead to chronic infection. Even seemingly harmless substances like air or water can cause swelling and pain.
Who’s Most at Risk?
- Manual workers, especially in construction, automotive, and manufacturing settings
- Those using or maintaining paint sprayers, grease guns, or pressure washers
- Most injuries involve the non-dominant hand — particularly the index finger, thumb, or palm
- Injuries often happen while cleaning nozzles or reacting to equipment leaks
What to Watch For
Early Signs
- Small puncture wound
- Mild or no pain at the start
- Swelling begins within hours
- Skin may become tight, pale, cold, or numb
What Happens Next
- Pain worsens as pressure builds
- Fingers may swell, become stiff or immobile
- Delayed treatment increases the risk of infection, tissue death, and even amputation
What to Do Immediately
Act Fast — Go to Hospital
Don’t wait to see if it gets better. Go straight to A&E or a trauma centre. Tell staff exactly what happened and what material was injected.
Avoid These Common Mistakes
- Do not apply ice or cold packs
- Do not squeeze or press on the injury
- Do not use tight bandages or try to clean deeply
- Avoid local anaesthetic injections into the area (they can worsen tissue damage)
What Doctors Will Do
- Examine the extent of damage using X-rays or other imaging
- Give tetanus protection and intravenous antibiotics
- Elevate the limb to reduce swelling
- Urgently consult a surgeon to explore and clean the wound in theatre
The Role of Surgery
Surgical treatment is usually needed to remove the injected material and relieve pressure. This often includes:
- Wide opening of the area to clean out harmful substances
- Cutting the tough tissues (fascia) to release pressure (fasciotomy)
- Flushing the wound with saline or antiseptic solution
- Leaving the wound open for further cleaning after 1–3 days
- In severe cases, early amputation may be considered to prevent spread of damage
Recovery and Long‑Term Effects
Even with prompt treatment, recovery can be slow. Common long‑term issues include:
- Stiffness, loss of motion, or difficulty gripping
- Pain or altered sensation
- Scarring and cold sensitivity
- Chronic infection or granulomas (small internal lumps)
- Loss of function or, in some cases, amputation
Rehabilitation includes physiotherapy, splinting, wound care, and — where needed — prosthetic training.
Prevention: Protecting Yourself
Workplace Safety Measures
- Always wear appropriate PPE: heavy-duty gloves, face shields, coveralls
- Maintain and inspect equipment regularly
- Shut off power before cleaning or repairing nozzles
- Never direct a spray gun or nozzle toward your body
- Be cautious around leaks — even if pressure seems low
Educate and Act
- Know that a “small” wound from high-pressure equipment is never minor
- Encourage colleagues and supervisors to take all such injuries seriously
- If in doubt, always seek emergency medical care
Key Points to Remember
- A high-pressure injection injury is a surgical emergency
- It may look harmless, but damage under the skin can be life-altering
- The sooner you receive expert care, the better the outcome
- Prevention and proper equipment handling are the best defence
- Speak up, act early, and don’t underestimate these injuries — even for a second
Call to Action
If you have pain, book an appointment to be reviewed by Prof Imam or another member of our specialist team at The Arm Clinic. Early specialist care helps prevent long-term issues. Visit www.TheArmDoc.co.uk or book your consultation today. Phone: 020 3384 5588 | Email: Info@TheArmDoc.co.uk
Disclaimer
This information is for general educational purposes and should not be used as a substitute for professional medical advice. Consult a healthcare professional for individual guidance on your condition and treatment options.
This page was last clinically updated in May 2025