Allodynia
Allodynia is a type of pain. People with allodynia are extremely sensitive to touch. Activities that aren’t usually painful (like combing one’s hair) can cause severe pain. Many conditions and injuries cause allodynia. To relieve pain, providers treat the condition that’s causing it. Treatments may include medications, PT, and therapy.
What is Allodynia?
Allodynia refers to a form of neuropathic pain, characterized by heightened sensitivity to touch. Individuals experiencing allodynia are exceptionally responsive to stimuli that would not typically cause discomfort. Such stimuli might include cold temperatures, brushing hair, or wearing a cotton t-shirt.
Allodynia can stem from various conditions. Among the most prevalent causes are diabetes, shingles, fibromyalgia, and migraine headaches.
To alleviate allodynia, healthcare providers typically address the underlying cause of the pain. They may also suggest a pain management strategy, which could involve medications to relieve pain and therapeutic interventions aimed at altering the way the patient responds to pain.
How common is allodynia?
The exact prevalence of allodynia is not definitively known. Approximately 10% of people in the United States experience some form of neuropathic pain, and within that group, around 15% to 20% are affected by allodynia.
What are the types of allodynia?
Allodynia can be categorized into three types:
- Dynamic (or mechanical) allodynia, where pain arises from an object moving across the skin.
- Static (or tactile) allodynia, triggered by gentle touch or pressure.
- Thermal allodynia, resulting from minor changes in temperature.
What are the most common causes of allodynia?
Allodynia usually emerges when the nervous system’s communication network, responsible for transmitting signals between the brain and skin, muscles, and organs, malfunctions. This breakdown in communication can arise from various injuries and conditions, including:
- Diabetes: Nerves can become damaged and dysfunctional due to diabetes-related neuropathy.
- Disorders and conditions: A wide range of health conditions and disorders, such as trigeminal neuralgia (TN), complex regional pain syndrome (CRPS), amplified musculoskeletal pain syndrome (AMPS), multiple sclerosis (MS), and fibromyalgia, can contribute to allodynia.
- Fibromyalgia: This condition is characterized by widespread pain, fatigue, and cognitive issues.
- Medications: Certain opioids can increase sensitivity to pain, a condition known as opioid-induced hyperalgesia. Additionally, chemotherapy drugs used in cancer treatment can lead to allodynia.
- Migraine headaches: Allodynia can accompany migraines in up to 70% of cases.
- Nutritional deficiencies and diet: Severe deficiencies in vitamins D or B can contribute to allodynia, and excessive alcohol consumption can cause nerve damage.
- Shingles: Allodynia may persist even after the shingles rash disappears, a condition referred to as postherpetic neuralgia.
- Trauma: Allodynia can develop after nerve injuries resulting from events like deep cuts, amputations, radiation therapy, or strokes.
How will my provider determine the cause of allodynia?
Healthcare providers will conduct an examination and inquire about the nature of the pain, including its frequency and exacerbating or alleviating factors. They will also gauge the pain’s intensity on a scale and assess its characteristics, often described by patients as sharp, stinging, or burning, similar to a severe sunburn.
To pinpoint the cause of allodynia, providers will gather information about the patient’s medical history and medication usage. They might perform various tests, such as blood tests, urine tests, MRI or CT scans, electromyograms (EMG), nerve conduction studies (NCS), and quantitative sensory testing (QST), to identify diabetes, neurological disorders, or other contributing factors.
Care and Treatment
How do healthcare providers treat allodynia?
Treatment of allodynia typically centers on addressing the underlying condition causing it. If the cause is unknown or untreatable, efforts focus on pain reduction. Treatment options within a comprehensive pain management plan may involve:
- Oral medications: Different types of medications, including anticonvulsants and certain antidepressants, may alleviate allodynia. Pregabalin (Lyrica®) is a common prescription for fibromyalgia-related pain, while triptans are used for migraines associated with allodynia.
- Topical medications: Creams, lotions, and patches containing medications such as capsaicin or lidocaine can be applied directly to the skin.
- Counseling and therapy: Given the emotional toll of chronic pain, counseling, cognitive behavioral therapy (CBT), mindfulness training, and biofeedback can help individuals manage pain and respond differently to it.
- Physical therapy (PT): A PT plan may focus on desensitization techniques, gradually exposing the patient’s skin to pressure until it is no longer painful.
- Nerve blocks: For targeted pain relief, nerve block injections may be recommended.
- Surgery: In cases where other treatments prove ineffective, spinal cord stimulation through the implantation of a device may be considered.
How can I prevent allodynia?
While preventing allodynia directly may not be possible, certain steps can help reduce the risk of conditions that contribute to its development:
- Engaging in regular exercise: Exercise helps manage stress, reduce the risk of migraines, and play a significant role in managing fibromyalgia.
- Being aware of family history: Individuals with a family history of conditions like fibromyalgia, MS, stroke, or diabetes should maintain regular check-ups.
- Maintaining a healthy weight: Obesity and excess weight increase the risk of diabetes, a potential precursor to allodynia, and contribute to chronic migraine development.
- Staying up-to-date on vaccinations: The shingles vaccine can provide protection against the viral infection.
- Adopting a balanced diet: A diet rich in fruits and vegetables can prevent vitamin deficiencies and promote overall health.
When to Call the Doctor
When should I reach out to my doctor about allodynia?
Contact your healthcare provider if you exhibit signs of allodynia, especially if the pain interferes with daily activities or sleep. Seek medical attention promptly if allodynia emerges suddenly or causes severe pain. An evaluation by a provider is essential to determine the cause of the pain and formulate an appropriate response.
In summary, allodynia is a form of neuropathic pain marked by an increased sensitivity to typically non-painful stimuli. Allodynia can result from conditions like diabetes, fibromyalgia, and migraines. Treating allodynia involves addressing the underlying cause and may include medications, therapy, and lifestyle changes. It’s essential to consult healthcare providers for proper diagnosis and management of allodynia.