Pain at buttonhole sites

I am hoping you could assist me with trying to figure out why many of my patients are reporting pain at buttonhole sites during palpation as wwll as upon initiation of needle into buttonhole site. Once the needle is placed, there is no issue but it is a common problem amongst my patients. I am looking for some answers and solutions.
Thank you

Ok first is the pain in upper arms are lower arms. Is the pain in the tunnel track are when the needle goes in to the vessel?

The pain is at the buttonholes itself. Once the needle is in the vessel, the patient reports no pain until it is time to pull the needle out and the buttonhole is touched. This is a common report from my patients with lower arm fistulas. At first it seemed to be with my diabetic patients so I thought it could be related to neuropathy that nerve endings were overactive in that area of healing but I now have 1 non-diabetic patient complaining of sensitivity in venour buttonhole, almost reporting it as pain.
I do not know many people who are knowledgable about buttonholes and am trying to reach out to anyone ho can give me insight as to why this is occurring and what I can do to assist patient. 1 patient abandoned the BH and now is doing rope and ladder and feels imprved but she has a nurse doing her treatments. Most of my patents will refuse to go to sharps.

call me at 576-826-8237 I will be able to explain after 500 pm to nite

Thank you for your assistance, I will give you a call after 5pm. If it is easier for you to contact me I am at 631-484-5676.