Does your skin burn like it has a sunburn on it? Does contact with your clothes aggravate you beyond belief? Does even the lightest touch make you want to jump out of your skin? That sounds like Allodynia.
Allodynia is a type of pain associated with Fibromyalgia and Multiple Sclerosis. I knew it was associated with fibromyalgia but I had no idea it had anything to do with MS. And now, I am wondering about the more severe cases of Allodynia I have had. Whether they were Allodynia at all or more of a nerve pain situation.
In fact, with migraines, allodynia is common in the scalp, although it can occur anywhere. I have had the scalp allodynia from migraine attacks more than once. It used to happen in clusters with migraine attacks for me. And if you talk to someone with migraine disease and they say their ‘hair hurt’ that would be why.
The conditions it can be associated with:
- Multiple Sclerosis (MS)
- Fibromyalgia (FM)
- Migraine disease
- Shingles
- Vitamin D deficiency
- Trigeminal neuralgia (TN)
- Diabetes-related neuropathy
- Complex regional pain syndrome (CRPS)
- Amplified musculoskeletal pain syndrome (AMPS)
What is it?
With allodynia, there is a triggered pain response from stimuli that doesn’t normally cause pain. It is a type of neuropathic pain and is a symptom of an underlying condition. In this case, it causes a great deal of skin pain. The skin burns to the touch and is often described as a sunburn sensation. Clothes will hurt against the skin. Even the slightest of breezes will feel painful against the heightened and tender skin.
There is no exact cause for allodynia, but it is considered to be from central sensitization where there is an increase of excitability in the neurons of the central nervous system. As such, harmless stimulus – like a light touch – activates the nociceptors which are usually activated only in response to intense stimulus causing damage to the tissue and thus causing pain where there should be none.
“One theory is that certain nerve fibers are crossed, leading to unusual reactions.” Medical News Today
The pain caused by touch is called tactile allodynia (Gentle touch or pressure); when caused by movement, it is mechanical allodynia or dynamic (like when clothing brushes against your skin) and thermal allodynia is related to temperature.
Allodynia can range from mild to severe and can be all over the body or only in certain areas. It can be continuous or come and go. It can become more severe as time goes on, or not.
My personal experiences
My personal experience of allodynia has varied. I have had mild bouts of it in precise locations similar to a mild sunburn. In these cases, it is just a mild irritation – noticeable, but easy to ignore. Very tender. And patches of it. Like a large patch on the arm or calf muscle. A brush with the fingertip and it hurts. Very similar to a moderate sunburn.
Then I have had severe bouts in large patches of skin, like on my back and thighs, that was aggressive and hard to have clothes touching me. I even found it hard to just handle being in my skin, with showers being immensely painful experiences. Movement itself is an ordeal. Touch was out of the question. That one lasted weeks and was excruciating. I needed Tramadol for it which barely touched the pain.
And there is in the middle where it is more like a bad sunburn. Sharper and quite sensitive against clothing and touch.
It is a fairly frequent occurrence and usually happens in both my arms and legs at the same time. So a patch on my calf and the arm, same side. And in batches with migraine attacks, then months without it at all. I haven’t had it with a migraine for quite some time though, thankfully. I have had some mild bouts on my arms and legs recently though.
However, I have not had it continuously. It comes and goes.
When it strikes, it lasts for weeks and then simply fades. During an episode, Tramadol is the only thing that has ever managed the pain, although not very well, instead only slightly dulling the edges of the pain.
For the severest of bouts I had, I tried topical Lidocaine. It didn’t even dent it. But that bout was intense and basically my entire back as well as parts of my arms. I think it may help with the milder ones but the the scheme of things, the milder ones are just a drop in the ocean of pain- more tolerable than the rest of my pain and easier to ignore. I am not sure it would help with the moderate bouts since it failed with that one, I just never tried it again. And I am on Tramadol, so I figure there isn’t a point.
Clothing is a common problem with allodynia. There can be a burning or constricting feeling from waistbands, even if they are not tight. Bra straps can create a lot of discomfort. Any clothing closely pressed to the body can seem to be putting ‘pressure’ on the burning sensation, including tags and stitching. Generally, fabric choice can be a real issue as some will seem quite aggressive against the tender skin, but when it is severe, all fabrics will be equally aggravating.
Things to consider for allodynia
- This goes without saying, but dress in loose clothing with little contact with the skin.
- Heat can aggravate allodynia, especially thermal allodynia. If you find this to be the case, stick to the shade or wear a hat and/or sunglasses when outside. Consider bringing a cooling product with you like a cooling pad for travel (instant ice bags you squeeze to trigger a chemical reaction and they become cold instantly). Sometimes, even consider heat avoidance. The same goes for really frigid conditions.
- It’s best to avoid hot showers and baths; keep the water warm or cool. When allodynia is severe, showers can be particularly painful, and I find baths are a better solution.
- Strong winds will also cause pain with this condition because the skin is extremely sensitive when hit with wind. It brings a whole new meaning to a biting and stinging wind.
- Capsaicin has been shown to help with allodynia; however, it can cause a burning sensation in itself so use with caution. Capsaicin is the only topical cream that has ever provided relief for me for FM pain, but I have never tried it for the allodynia. Many people also reference Tiger Balm.
There are medications that some people find helpful for allodynia:
- Antidepressants
- Tramadol
- Anti-seizure drugs such as Lyrica (pregabalin) and Neurontin (gabapentin)
- Topical Lidocaine
- Nerve block
- Botox
- Capsaicin
Chronically Nikki 