Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine
No, your pain is probably not exaggerated. Allodynia is real, and can greatly affect pain perception.
What is allodynia, exactly? Where does it come from, and how do you recognize it? Is it related to back pain? And above all, what are the ways to treat it?
This popularized article explains everything you need to know about allodynia, emphasizing simple and practical notions.
Definition of allodynia
Before talking about allodynia, we must understand that pain is a mechanism from the brain to the periphery.
In the presence of a painful stimulus (like putting your hand on a hot plate), a message is sent to the brain which analyzes the situation and perceives a danger.
The answer is therefore to send a message of pain to the hand so that it can be removed immediately, and tissue damage prevented. We therefore understand that pain can sometimes be useful in certain situations.
On the other hand, in certain rare cases, it happens that the pain message is altered. This can cause abnormal and exaggerated reactions.
Essentially, allodynia refers to experiencing pain from stimuli that normally do not cause pain. For example, painful skin when touched, or gestures as innocuous as brushing your hair, can seem unbearable.
It's like an exaggerated response, whereas allodynia causes symptoms to stimuli that normally wouldn't cause pain.
Symptoms of the disease
In terms of symptoms, they vary depending on the individual. Some people may experience an intense burning sensation, while others experience mild discomfort.
Besides pain, allodynia can affect quality of life and cause:
- Sleeping troubles
The diagnosis is issued by a doctor after he has carried out several clinical tests. In fact, there is no single test that can be used to conclude that allodynia is present. Rather, it is a combination of factors that leads to this diagnosis.
Clinical tests also make it possible to clarify the type of allodynia from which the patient suffers:
A doctor can observe his patient's reaction to various temperatures. For example, drops of cold water on the skin can cause an intense painful reaction. This is called thermal allodynia.
By applying mechanical pressure (such as applying friction to the skin), the pain response can be observed. If normal friction is painful (such as the contact of the sheets being pulled towards you in bed), we are in the presence of mechanical allodynia.
Tactile allodynia occurs following light touch or pressure on the skin. If we induce a light tap on the shoulder, or if we touch the affected person and it provokes an excessive painful reaction, it is a tactile allodynia.
Causes of allodynia
At present, the exact cause of allodynia is unknown. We know, however, that it is a dysfunction of the nociceptors (pain receptors).
Certain conditions can increase the risk of developing allodynia:
- Peripheral neuropathy
- Post-herpetic neuralgia
- Complex regional pain syndrome
Link to back pain
On the other hand, if the back pain is caused by a fibromyalgia, it is possible to experience associated symptoms of allodynia.
Allodynia and stress: what is the link?
Recent preclinical studies have shown that exposure to a chronic stress can lead to an exacerbation of pain sensitivity.
The effects of stress on the processing of nociception and pain can depend on a multitude of factors, including the type of stress (physical or psychological), its intensity as well as its temporal characteristics.
Several biochemical pathways and mediators known to be involved in stress processing may play a major role in the regulation of neuropathic pain.
Personalized stressors such as release of catecholamines related to stress have, for example, been described as leading to neuro-inflammatory reactions encompassing peripheral and central release of pro-inflammatory cytokines.
These substances have been shown to play a crucial role in enhancing nociceptive processing that can induce allodynia.
Another major player in the context of this article is the glutamate, the main excitatory neurotransmitter of the central nervous system (CNS). Glutamatergic transmission is significantly modulated by stress-related corticosteroid release.
Indeed, stress can exacerbate neuropathic pain and therefore promote the onset of allodynia through the activation of specific receptors of the glutamate and thus send excitatory signals constantly to the origin of a allodynic neuropathy.
Treatment: How to Treat Allodynic Pain
Unfortunately, there is no treatment to combat allodynia at its source. Rather, the goal will be to reduce the symptoms caused by this condition, and improve the quality of life of the affected patient.
Here are different treatments to relieve allodynia:
Medications like lidocaine or prebagalin can be effective in relieving symptoms of allodynia. The same is true for certain antidepressants such as amitriptyline.
Sometimes, anti-inflammatories or painkillers are also prescribed by the doctor. CBD is increasingly popular in the treatment of chronic pain.
All of these medications can be taken by mouth, or given as a cream.
TENS (or other electro-stimulation machines) is often used in physiotherapy to modulate the sensation of pain.
Because it comes to stimulate the A-beta fibers (which provide sensation), it can inhibit the A-delta and C fibers (the fibers which transmit the message of pain).
Thus, TENS may mask the pain message going to the brain, which may mask the symptoms of allodynia.
Certainly, allodynia is caused by touch. But not all pressure, or even intensity of touch, reproduces the symptoms.
Thus, it is possible to use a gradual approach aimed at desensitizing the central nervous system, and thus reducing allodynia.
For example, you can start by touching hypersensitive skin with a texture as soft as silk. When this pressure is tolerated, you can either increase the pressure, or change the texture.
Cardiovascular exercise has several health benefits. Whether it's biking, brisk walking, swimming, the goal is simply to increase your heart rate (within a safe and progressive framework, of course!).
As it increases blood circulation and tissue oxygenation, one can hope for desensitization of the brain and better nerve conduction.
When we suffer from migraines for example, it is possible that certain elements aggravate our symptoms.
With this in mind, we can try to identify these factors in order to limit them. It may be a particular food, a social or professional context, lack of sleep, particular foods, light, etc.
If in doubt, it is possible to use a logbook to monitor your symptoms, and note certain elements that can then be shared with your doctor.
Additionally, changes in clothing can help reduce the discomfort caused by allodynia. Sleeveless or light textured clothing may be used.
In conditions like fibromyalgia or migraines, stress typically worsens pain and allodynia symptoms.
It is therefore relevant to find natural and medical strategies aimed at reducing stress, anxiety, and depression.
Professionals like psychologist or the psychiatrist can also help manage stress through cognitive behavioral therapy (CBT).
Finally, online and in-person discussion groups can help people feel understood and share their experience.
In addition to medical treatments, there are natural methods aimed at relieving the symptoms of allodynia.
- Reiki (as traditional massage is often poorly tolerated)
- Anti-inflammatory diet
- Acupuncture (if tolerated)
It should be noted that these approaches have generally not been subjected to robust scientific studies. This means that their effectiveness is mainly based on an empirical approach.
Allodynia: natural treatments
The application of heat or cold directly to the affected area can sometimes be one of the best ways to relieve symptoms associated with a joint sprain or muscle injury, and is most often the first treatment professionals recommend immediately after such an injury.
It can be one of the most effective ways to relieve the symptoms ofallodynia, especially when directed to the most affected area.
Since some cases of allodynia are related to temperature sensitivity, the effectiveness of heat or cold (or its effectiveness at all) can vary from person to person.
New research shows that theanandamide may help relieve nerve pain and discomfort that accompaniesallodynia. This compound can be found in some supplements and foods, but most often in substances rich in other cannabinoids, such as CBD.
If you think you are suffering fromallodynia and some of the other treatment options have not helped, talk to your doctor about dietary supplements containinganandamide and bring him some of the research that supports them.
Although it is not considered a cause ofallodynia by itself, a lack of minerals in your diet can aggravate many muscle and nerve conditions such asallodynia.
Two of the minerals known to cause cramps and pain most often when you don't get enough of them in your diet are magnesium and salt. Increase your intake of foods rich in magnesium and salt, or add them to your diet as supplements.
Remember to watch out for salt and magnesium if you have been diagnosed with heart problems or high blood pressure issues – too much magnesium is also dangerous and can increase your risk of heart attack or stroke cerebral.
How can I prevent allodynia?
You may not be able to prevent theallodynia.
But you can reduce the risk of certain conditions that causeallodynia.
- Exercise : Regular exercise can help you manage stress. It also helps reduce the risk of migraines. Exercise also plays a major role in managing the fibromyalgia.
- Know your background : if you have a family history of fibromyalgia, SEP (Multiple Sclerosis), dstroke or diabetes, talk to your doctor. You may need to have regular checkups so that your doctor can monitor your condition.
- Maintain a healthy weight : People who are overweight or obese have a higher risk of diabetes, which can lead to allodynia. Excess weight is also a risk factor for the development of chronic migraines.
- Stay up to date on your vaccines : ask your doctor if it is possible to receive the vaccine against area to protect you from this viral infection.
- Watch your diet : A balanced diet rich in fruits and vegetables can help you avoid vitamin deficiencies and stay healthy.
Allodynia refers to feeling exaggerated pain for a stimulus that usually does not cause pain.
It is important to know the factors that contribute to allodynia in order to set up an appropriate treatment plan.
Several modalities can be used to relieve symptoms, although there is currently no treatment that can resolve allodynia.
A healthcare professional is your ally of choice if you experience symptoms that may be similar to allodynia.
Good recovery !
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