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When It Hurts to Be Touched

Our sense of touch is one of our most basic and fundamental aspects of the human experience. We use our ability to feel as an integral tool to discriminate and better understand our environment, almost without thinking about it, because we do it all day long. Likewise, being touched by others is a critical part of human communication, whether it is through a handshake, a hug, or a pat on the back. Human contact can be considered a key component of positive communication, and it can boost a sense of general well-being.

Unfortunately, living with chronic pain can interfere with your ability to touch, feel, hold, or be held by others. One of the most challenging examples of this occurs when we develop extreme sensitivities to touch from things that aren’t usually painful. The medical term for this is allodynia and it means that something is painful from a non-painful stimulus. Imagine lightly brushing the back of your hand with a cotton ball. That should not hurt in the least, but now suppose doing so is all of a sudden associated with the feeling of intense pain in the hand. That would be an example of allodynia. Having extreme sensitivities to touch can have a dramatic effect on a person’s life as it often leads to activity avoidance as a coping tool to try to prevent pain. As a result, a person may completely avoid using an affected body part, like a hand in our example, or not want to even leave the house out of fear that being around others may risk contact with the sensitive body part.

One of the most common types of pain that can lead to something like allodynia is nerve pain, also known as neuropathic pain. Changes in the normal flow of information through the nervous system, from the peripheral nervous system all the way through to the brain is a hallmark of nerve pain. Sometimes this aberrant processing occurs because of actual nerve damage but not always. One nerve pain syndrome, in particular, that is often associated with cantankerous forms of allodynia is complex regional pain syndrome, or CRPS. CRPS can be a debilitating pain problem that usually involves an extremity, like an arm or leg, after some type of tissue injury has taken place. One of the features of something like CRPS that makes it so difficult to treat is the severe pain that can be experienced from trying to use a body part that is hypersensitive.

Allodynia can be associated with other types of chronic pain problems, as well, including fibromyalgia, migraine headaches, TMJ, painful surgical scars, and skin damage from ultraviolet radiation. In fact migraine sufferers have been reported to have pain with hair combing, shaving, and putting in contact lenses. What all of these syndromes seem to have in common is what is known as central sensitization, where there is an amplification of pain signals going on in the brain. It is still unclear what causes all of this, but research is looking at the effects of inflammatory mediators on nerve cells inside the brain as well as the role of the supporting glial cells which form the brain’s white matter.

Fortunately, allodynia can be successfully treated under the right circumstances, so it is important to find health care providers who understand this problem and can help. Desensitization techniques are one way of reducing the hypersensitivity of the skin or tissues, and you can even learn how to do some of this at home on your own. For example, placing a sensitive hand or foot into a bowl of uncooked rice or lentils is one tool we use with some of our patients. Other topical treatments include things like contrast baths, paraffin wax, and clay. Because desensitization can be a painful process to start, it helps to have as much support and guidance from your treatment team as you can get.

So, if you are struggling with hypersensitivities and it is interfering with your quality of life, then talk to your health care team about it to get help.

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