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7,8 Degeneration also results in degradation of the extracellular matrix and loss of hydrophilic matrix molecules, which can lead to structural and biomechanical changes 9 and is a leading cause of increased inflammation, nerve ingrowth 10,11 and release of pain factors

J Earth Syst Sci 130:53

Overexpression of the heme oxygenase gene in renal cell carcinoma

The injection delivers methylcobalamin or cyanocobalamin active forms of B-12 directly into muscle tissue, where it is quickly utilized by the body

Solution : Use 1-2ml water for 5mg vial

this is not very common, but if it happens, sitting or lying down for a few minutes post-injection can help