Allodynia: A Rare, Distinct Type of Pain in Fibromyalgia and ME/CFS

Allodynia is a rare type of pain, generally on the skin, that's caused by something that wouldn't normally cause pain. This pain type is frequently associated with fibromyalgia. Some people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) have it as well.

Other conditions associated with allodynia include neuropathy, postherpetic neuralgia (shingles), and migraines. Outside of these conditions, allodynia is a rare symptom.

Knowing this term may help you communicate better with your doctors and other health-care providers as well as with understanding research about your illness.

Woman in pain
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Types of Allodynia

Allodynia comes in three different and distinct forms. It's possible for you to have one, two, or all three kinds.

The different forms are:

  • Tactile allodynia: This is pain caused by touch. This can include clothing pressing against the skin (especially the tighter parts of clothing, such as waistbands, bra straps, or the elastic part of socks,) a hug, or someone touching you lightly on the arm.
  • Mechanical allodynia: This type of pain caused by movement across the skin. This can be a towel as you dry yourself off, bedsheets brush against you, or even the air from a fan blowing moving over your skin.
  • Thermal (temperature-related) allodynia: This pain is caused by heat or cold that is not extreme enough to cause damage to your tissues. Your hands and feet may burn if they get chilled, or getting too hot may make them ache.

Note that you should talk to your doctor if your hands and feet turn blue when they're cold. This may be a symptom of a different condition called Raynaud's syndrome, which can lead to tissue damage.

It's often hard for people, even those who experience allodynia, to understand how these otherwise harmless things can cause so much pain. However, it is a real pain and doesn't mean that you're crazy or making too big a deal out of "normal" aches and pains.

Allodynia is different from hyperalgesia, which is the mechanism that "turns up the volume" on pain in these conditions. Hyperalgesia takes your pain and makes it worse, while allodynia is an actual type of pain.

Causes

Allodynia is thought to be a hypersensitive reaction to stimuli. Research suggests it may result from central sensitization, which is believed to be an underlying mechanism of fibromyalgia, ME/CFS, and other conditions. "Central" indicates the central nervous system and "sensitization" means that it's become extra sensitive.

The pain signals of allodynia come from specialized nerves called nociceptors. The job of nociceptors is to sense information about things like temperature and painful stimuli right from the skin.

Most nerves have to send signals to the brain and wait for the brain to send a signal back before they respond. Nociceptors don't have to do that—they react immediately based on what they detect. This allows you to pull your hand away from something hot before you get burned, often before you consciously perceive the heat.

When these nerves become sensitized, they start interpreting all kinds of sensations as pain. Again, this is real pain that has just as much of an impact on you as any other source of pain.

Living With Allodynia

Allodynia can make your life difficult. Something as simple as wearing a shirt may become painful, or even agonizing. Many people who have allodynia find that they need to tailor their wardrobes to reduce the impact of this pain.

Thermal allodynia can play a role in another symptom—temperature sensitivity. To manage it, you may need to do things like dressing in layers or moving your work station away from vents that blast you with hot or cold air. You may have to learn how to compensate for both cold and hot conditions.

Most of the common drug treatments for these illnesses can help alleviate allodynia along with other types of pain. These include:

Many people also get some relief with topical painkillers, such as lidocaine, BioFreeze, Tiger Balm, and Aspercreme.

It's possible for massage therapy to make allodynia worse, so it's important to find a massage therapist who understands your condition and knows how not to aggravate this symptom.

A Word From Verywell

The conditions associated with allodynia are often chronic and difficult to treat. You may not ever be completely free from the pain, but by working with your doctor and making appropriate lifestyle changes, you may be able to minimize its impact on your life.

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