Fibromyalgia and Tactile Allodynia

When Your Skin Hurts From a Simple Touch

Tactile allodynia is one of the characteristic symptoms of fibromyalgia. It is a neurological condition in which the sensation of pain—sometimes severe—can occur with a simple touch.

With this condition, the body perceives pain to otherwise harmless physical (tactile) stimuli.

senior with neck pain
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Fibromyalgia involves multiple pain types, including hyperalgesia (the overamplification of pain) and paresthesia (abnormal sensations like burning or tingling in the absence of stimuli). In addition to fibromyalgia, tactile allodynia can occur with peripheral neuropathy, postherpetic neuralgia, trigeminal neuralgia, and migraine.

Tactile Allodynia Symptoms

Tactile allodynia can range from mild to severe. It can affect areas all over the body or only certain areas. It can be constant or come and go with symptom flares. Sometimes, allodynia may be set off by a trigger, such as scratching or stepping on something sharp.

Allodynia comes in two forms:

  • Mechanical allodynia (associated with physical stimuli)
  • Thermal allodynia (triggered by changes in temperature)

Common descriptions of tactile allodynia include:

  • Burning pain from waistbands, bra straps, socks, and other pieces of constricting clothing
  • Pain from tags in shirts or stitching on clothing
  • Pain from fabrics bed sheets, towels, or blankets that are not abrasive
  • Pain when rubbing against objects
  • Pain with hugging or even a firm handshake
  • Pain when grabbing something cold from the refrigerator or freezer
  • Pain when stepping out into extreme cold

Causes

Tactile allodynia is a form of pain that arises from a malfunction of nociceptors, which are specialized nerves. Nociceptors sense information about your environment, such as temperature, pressure, and conditions that could cause you harm at the cutaneous (skin) level.

Do you know how your hand will pull away from a hot burner before you even realize that you're about to burn yourself? This is due to the unique action of nociceptors, in which a reflexive response is triggered without the need for a separate signal from the brain.

With fibromyalgia, nociceptors may perceive normal sensations as painful. Researchers believe that this is the result of central sensitization. Rather than pain being triggered locally in the peripheral nervous system, fibromyalgia pain is caused by an overall amplification of pain in the central nervous system.

Treatment

Many of the treatments that lessen your fibromyalgia symptoms can help alleviate symptoms of tactile allodynia. Treatment options include:

  • Tricyclic antidepressants
  • SNRIs like Cymbalta (duloxetine) and Effexor (venlafaxine)
  • Seizure drugs, especially Lyrica (pregabalin) and Neurontin (gabapentin)
  • Topical lidocaine

Some people also get relief from topical pain creams, including Tiger Balm, Aspercreme, BioFreeze, and capsaicin-containing ointments and patches. You may also want to identify and avoid triggers that incite allodynia flares.

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