Low-Pain Needles / Sports Wheelchairs

The fascinating stories and secrets behind hit Japanese products, plus parts and machines that boast the top share of niche markets. In the first half: the story behind needles which cause less pain during injection, developed by a Japanese company in 2005. In the second half: sports wheelchairs made by a Japanese company which have helped athletes win over 140 medals in the Paralympic events like tennis and wheelchair racing.

Nishikawa Hisao, involved with the development of low-pain needles
Ozawa Toru, involved with the development of racing wheelchairs
Racing wheelchair with a frame optimized to be lightweight and rigid

Transcript

00:09

"Japan's Top Inventions"

00:17

The behind-the-scenes tales of hit products and creations from Japan:

00:22

this is "Japan's Top Inventions."

00:28

On today's show:

00:30

needles, feared by people of all ages.

00:36

We explore a needle that was specially designed to make injections less of a pain.

00:44

Later on the show, wheelchairs designed for sports.

00:50

We introduce some impressive wheelchairs used by para-athletes!

00:59

Hello, welcome to "Japan's Top Inventions."

01:02

I'm your host, Jason Danielson.

01:05

In the first half of the show, we take you "Behind the Creation."

01:08

Today's topic is this: needles.

01:12

That prick of a needle can cause a lot of discomfort,

01:15

and many people have a fear of needles too.

01:18

This particular needle, released in 2005,

01:21

was made to reduce the amount of pain during an injection.

01:25

Development started with something an engineer saw during a visit at the hospital.

01:31

A medical equipment manufacturer's R&D building in the Greater Tokyo Area.

01:38

The company has been around for a century.

01:40

Over in this display area,

01:45

blood packs used at the hospital, and other devices like medical thermometers.

01:54

Lately, this has been a key product.

01:59

A low-pain needle.

02:04

Over 2.1 billion units have shipped in Japan

02:07

and to regions like Europe and China.

02:12

Our company has long been trying to help patients that need injections.

02:17

We've heard feedback from patients that our needles hurt less to use.

02:24

Our story begins back in the year 2000.

02:31

Men from the company made frequent trips to hospitals.

02:35

They were salesmen and product developers.

02:41

These employees would go around to client hospitals,

02:45

speaking with doctors to get ideas for new products.

02:51

Nishikawa Hisao was one of those men.

02:55

He went to the hospitals as a product developer.

03:00

As a developer, you had to go directly to the hospitals

03:04

and speak to the doctors yourself.

03:07

Otherwise, you wouldn't be able to make a good product.

03:11

From Hokkaido in the north to Kyushu in the south,

03:14

we visited hospitals across the nation to get insight.

03:21

It was during one of these trips, that something caught a developer's attention,

03:29

a child, holding an injector.

03:35

The child lifted his shirt,

03:37

steadied himself,

03:40

and jabbed the needle into his torso.

03:45

Pain clouded the child's face.

03:50

The injection was for insulin.

03:53

The child had type 1 diabetes,

03:56

meaning his body was unable to produce enough insulin,

03:59

requiring the hormone to be injected instead.

04:04

He needed to bear this pain four times a day.

04:11

Adults have a certain degree of fat under the skin.

04:16

But children, especially those in early elementary school,

04:20

have to inject into such a thin body.

04:26

I wanted to try and ease their pain, if only just by a little.

04:33

And so, the developers found their goal of making a low-pain needle.

04:41

They returned to the company to start work right away.

04:48

How could the pain be lessened?

04:53

Members of the development team were focusing on the thickness of the needle.

04:59

The skin is full of pain receptors.

05:05

The thinner the needle, the lower the odds of it hitting a receptor.

05:09

A thinner needle would reduce pain.

05:14

Of course, things weren't so straightforward.

05:18

A thinner needle meant more resistance as the insulin was pushed out.

05:27

When looking at the force required for injection,

05:31

a thinner needle means less pain

05:33

but it requires more force to push the fluid out.

05:38

We were trying to find a way around this issue.

05:42

That's what we were working on.

05:46

How could they make an extremely thin needle that didn't require a lot of force?

05:51

The team searched for days for an answer.

05:56

A member of the team that specialized in fluid mechanics had an idea.

06:02

"We could try tapering the needle."

06:07

"Even with a thin tip, if we make the base thick, the resistance won't go up."

06:15

There's a formula for calculating flow in fluid mechanics.

06:20

Running a simulation based on that formula,

06:23

if we connected a thicker section to the thin part,

06:26

the total resistance would go down.

06:29

It checked out on paper.

06:33

However, almost immediately, the team ran into a hurdle.

06:39

They had never created a needle with this shape.

06:42

How would they make it?

06:46

The way to make a conventional needle

06:48

was to roll up a thin sheet of stainless steel into a tube

06:53

and weld the gap.

06:58

Then, the tube would be evenly stretched and cut down to size.

07:04

Finally, the end would be sharpened to a point.

07:11

But their needle wasn't even like the older ones.

07:14

It had a special tapered shape.

07:19

The conventional method would not work.

07:25

With the conventional way, the whole thing has the same diameter.

07:30

You can't change the thickness partway through.

07:34

A tapered needle can't be made like this.

07:38

Honestly, we were worried whether it was possible.

07:43

While tapering the needle to reduce pain was a good idea,

07:46

there was the matter of how it could actually be manufactured.

07:50

But it wasn't long before the team got help from an unexpected source.

07:57

The tapered needle required a new method of manufacturing.

08:05

The team looked outside the company

08:07

to find places with the best metalworking capabilities.

08:14

We looked for metalworkers that could press a variety of shapes.

08:20

All in all, we had planned to contact about 100 different companies.

08:28

The team made an appointment to visit one of the manufacturers.

08:33

They showed them the tapered shape they wanted. Their response?

08:38

"Sorry, that can't be done."

08:44

The team continued to look for possible leads,

08:46

but all the places they visited turned them down.

08:55

Then one day,

08:57

they caught word about a small factory in old town Tokyo.

09:02

They only had six employees, but their skill was world-famous.

09:09

They had become quite famous in the industry

09:12

by making battery cases for lithium-ion batteries in mobile phones.

09:18

People called them saviors for metalworking,

09:23

so as a last resort, we asked for help.

09:28

A team member headed over.

09:32

He was greeted by this man.

09:37

Okano Masayuki, head of the company,

09:40

a master craftsman who had devoted over 50 years to metal press work.

09:47

The team member explained how everyone said the needle couldn't be made,

09:53

and how they wanted to help diabetic children.

09:59

Okano listened to their plea

10:02

and eagerly accepted.

10:08

Right away, Okano started prototyping.

10:14

He prepared a small sheet of metal with angled sides,

10:18

point-zero-five millimeters thick.

10:22

He pressed the sheet and rolled it into a tapered tube.

10:29

But there was a problem.

10:32

The edges needed to meet along the entire shaft.

10:37

If there were gaps, fluid would leak out.

10:42

Okano tapped into his years of experience,

10:45

repeating the process over and over while making fine adjustments.

10:51

After over a year,

10:53

he succeeded in making the tapered piece watertight.

10:58

Okano passed away in 2019.

11:03

He speaks about that time in this archival interview.

11:08

Is there any greater thrill than doing what other people can't?

11:12

Doing the impossible?

11:14

It's like mountain climbing.

11:16

Climbers live to scale impossible heights.

11:19

It's the same for us at a little factory like this.

11:23

Is there anything more fun than doing what no one else can?

11:28

Okano delivered this thin, tapered tube.

11:32

The last touch was to finish the tip.

11:40

It wouldn't be a needle without a pointy end.

11:46

A tube doesn't pierce.

11:49

It would hurt.

11:52

So we had to make the tip sharp in order to reduce the amount of pain.

11:59

Their goal was to create a low-pain needle.

12:03

Could they do something different about the tip too?

12:09

The development team carefully evaluated the possibilities.

12:15

They landed on the idea of making the tip

12:18

like a tiny knife for cutting the skin.

12:23

Here is a close-up of a real needle.

12:29

A conventional needle tip is symmetrical.

12:36

And here is the new design.

12:40

The tip is asymmetric and shaped like a knife.

12:46

This shape would allow the needle to slide into the skin rather than poking into it,

12:51

which should cause less pain to the patient.

13:00

By making it asymmetrical, the point becomes like a knife instead,

13:06

and cuts into the skin along its curved edge.

13:11

We thought this would reduce that painful prickling sensation that needles cause.

13:19

And so, the world's thinnest needle was finally complete.

13:26

But did the needle truly hurt less?

13:29

This required confirmation before the product went on sale.

13:36

Members of the team headed to hospitals across the country.

13:41

They asked the doctors to pilot their product.

13:48

"We want to help the patients."

13:52

"Please, can you ask them to try our needle?"

13:58

We really wanted to help the patients who needed insulin injections.

14:04

We asked them to try our new needles

14:07

and rate whether they hurt less than the old ones.

14:16

The team members visited hospitals, day after day.

14:23

In the end, a trial comparing the needles was arranged between six hospitals.

14:32

Two months later, the team members went to Tokyo

14:34

to attend a medical conference on diabetes.

14:41

Doctors from the hospitals that tested the new needles

14:44

were going to announce the results of the study.

14:50

If their new needle didn't cause any less pain,

14:54

then all their efforts would have been for nothing.

14:58

The team awaited the announcement with bated breath.

15:05

It was nerve-wracking.

15:08

We weren't sure if our product really lived up to expectations.

15:12

We were really nervous to hear what kind of feedback we'd get.

15:18

The session began.

15:20

Their sample needles had been used by 81 diabetic patients.

15:28

Among this group, how many people thought the new needle caused less pain?

15:36

What would the result be?

15:48

This paper contains the results of that announcement.

15:54

Fifty-one people felt that the new needle caused less pain,

15:58

over 60 percent of the group.

16:02

I was relieved to see our creation being accepted by others.

16:08

It was a wonderful thing.

16:11

It also made me excited to think about

16:14

how our needles might bring a bit of joy or comfort to patients.

16:23

And so, the low-pain needles were finally released.

16:29

This is from a survey the company did after.

16:34

It was filled out by a ten-year-old girl with diabetes.

16:37

(It didn't hurt!)

16:40

Afterwards, the needles were shipped to places around the world,

16:44

like in China and Europe, helping people take their medicine with less pain.

16:49

How do experts view this invention?

16:51

We're joined by Urakami Tatsuhiko,

16:54

who treats children with diabetes at a clinic in Tokyo.

16:58

Welcome to the show.

17:00

Thank you.

17:02

Does your clinic use these low-pain needles?

17:06

Yes, we do.

17:09

Insulin can't be taken orally. It has to be injected.

17:14

The low-pain needles are quite a bit thinner than conventional needles,

17:19

and they look less scary.

17:23

So when children find they don't hurt as much,

17:26

or it's nothing to be scared of,

17:29

they're able to take their injections without much trouble.

17:33

I see.

17:35

What would you say was groundbreaking about these low-pain needles?

17:40

I think of these needles like a hair.

17:44

They really don't hurt compared to needles for drawing blood or vaccines.

17:50

There's still a tiny prick,

17:52

but the patient can learn to pick a spot on their body

17:56

and inject without much pain or worry.

17:59

When you look at it that way, it's a great tool I think.

18:05

How much of an issue is the pain caused by needles with children?

18:10

Type 1 diabetes, when the pancreas isn't able to produce insulin,

18:14

is commonly found in children.

18:17

These children have to inject insulin four or more times a day.

18:22

They have to bear that pain thousands of times a year.

18:27

Low-pain needles reduce that discomfort and improve their quality of life,

18:32

so it makes a big difference.

18:34

Thanks for being here. Good talking with you.

18:38

Glad to speak with you.

18:41

"Top Niche Creations"

18:44

Our next segment is "Top Niche Creations."

18:47

Today, we're looking at these.

18:50

Sports wheelchairs, specially designed for use by para-athletes.

18:54

In 2021, Tokyo hosted the Paralympics.

18:58

Back in 1993, a Japanese company developed their first sports wheelchair.

19:03

Since then, their wheelchairs have helped athletes win 144 medals

19:08

over a span of just 28 years.

19:11

What kind of technology is packed in these wheelchairs?

19:14

We went to find out.

19:18

A wheelchair maker located in the Greater Tokyo Area.

19:23

Welcome!

19:26

It's a small company with 38 employees.

19:29

Their entrance is full of the latest sports wheelchairs.

19:35

One is for racing,

19:37

basketball,

19:41

and tennis too.

19:46

This type of wheelchair was used during the Tokyo Paralympics.

19:52

What makes these wheelchairs special?

19:55

Developer Ozawa Toru gave us an overview of this racing wheelchair.

20:02

The first thing to notice is the shape.

20:05

There's a front wheel.

20:08

The chair is 1.8 meters long.

20:14

The frame is made from carbon fiber and resin.

20:17

It's tougher and lighter than metal.

20:24

It's strong and light.

20:26

Usually, durability and lightness are opposing properties,

20:30

but carbon fiber lets us have both.

20:36

Another point is the handrim, used to spin the wheels.

20:40

Apparently, it's significant that it's around 40 centimeters in diameter.

20:48

It's certainly a lot smaller than one on a normal wheelchair, but why?

20:56

Gloves like these are used to spin it,

21:01

with this kind of paddling motion.

21:08

When the handrim is large, the hand can't reach to the bottom of the rim,

21:12

so it's been made smaller on purpose.

21:18

Just how fast can these wheelchairs go?

21:24

We asked wheelchair racing athlete Higuchi Masayuki for a demonstration.

21:35

He spins the wheels and picks up speed.

21:41

As he nears a corner...

21:49

he hits what's called the "compensator", which turns the front wheel.

22:00

The top speed was 31 kilometers an hour,

22:04

enough to do 100 meters in about 11 seconds.

22:12

Well, you're competing for speed and times,

22:16

so a faster wheelchair is better.

22:19

It makes me really happy to see the smiling faces of the athletes

22:23

when they win in a competition.

22:26

It keeps me motivated each day.

22:31

Athletes around the world appreciate the company's high-quality wheelchairs.

22:39

It was founded in 1976 and originally was a motorcycle shop.

22:46

However, the founder was involved in a motorcycle accident

22:50

which caused a spinal injury, and he shifted to making wheelchairs.

22:56

He used his expertise of making motorcycles lighter and more responsive

23:01

and applied it to sports wheelchairs.

23:06

Their first model was a tennis wheelchair in 1993.

23:12

To improve the design,

23:14

he worked closely with an athlete that had joined the company.

23:20

Their efforts have supported players behind the scenes.

23:24

In 2021, men's wheelchair tennis player Kunieda Shingo

23:29

won gold at the Tokyo Paralympics using a wheelchair made by this company.

23:39

This is our new tennis wheelchair.

23:44

What features does this tennis wheelchair have?

23:47

We were shown the latest model.

23:51

For one, it's incredibly light.

23:56

At seven kilograms, it's about half the weight of a normal wheelchair.

24:04

Next is the angle of the wheels.

24:06

It can be set at more of an angle than previous models.

24:14

This is the biggest angle we've put on it yet.

24:17

You turn after you swing when you chase the next ball.

24:21

You have to do a lot of turning, so we made the angle bigger.

24:24

That makes it easier to spin around.

24:29

Just how well does it turn?

24:32

Wheelchair tennis player Saida Satoshi demonstrates for us.

24:40

Two cones have been placed on the court.

24:46

Watch as he does a lap.

24:53

He corners them with ease.

24:58

When you compare with a normal wheelchair, the difference is clear.

25:08

Thanks to this feature, an athlete can quickly turn and reposition after hitting a ball

25:13

and be ready for the next return.

25:22

The company has their sights set on the 2024 Paralympics in Paris.

25:27

They're already working on improvements to their wheelchairs with athletes,

25:31

and hoping for a record medal count.

25:37

We're currently thinking about what kind of wheelchair to make for Paris.

25:43

Our purpose is to carefully consider the needs of the athletes

25:47

and address them by implementing improvements in our wheelchairs.

25:53

We're always hoping to come up with something new.

25:59

The company has developed other new products, like this one.

26:03

A new type of wheelchair for children.

26:06

It features a colorful design and is light and maneuverable.

26:10

Kunieda Shingo, who won gold for wheelchair tennis

26:13

at the 2021 Tokyo Paralympics,

26:16

helped oversee the design of the wheelchair.

26:19

It can be used for various sports, like tennis and basketball.

26:23

Hopefully, this wheelchair will help raise up future para-athletes!

26:28

That's all for this episode of "Japan's Top Inventions."

26:32

We'll leave you with what came next for the needles from the first half of the show.

26:36

See you next time! And stay inventive.

26:55

(Nishikawa Hisao helped develop the low-pain needle.)

27:01

(This new needle was created seven years after the initial design.)

27:08

(It set a new record for world's thinnest needle.)

27:14

(They were able to further reduce the pain of injection.)

27:22

In terms of diameter,

27:24

it's 0.02 millimeters thinner, and 1 millimeter shorter.

27:30

We want to do all we can to reduce the pain for patients.

27:34

We're going to keep chasing after that ideal.

27:36

Yes, we'll keep working at it.