Allodynia: when caresses hurt

Can you imagine living in a world where caresses hurt, where the friction of clothing hurts you and human warmth is not possible? Unfortunately, it is not necessary for you to imagine it, since that world exists and is lived by people who suffer from allodynia.

Allodynia is an abnormal perception of pain that makes stimuli that are normally painless and even pleasurable become very unpleasant. The friction of clothing, the heat of the sun or a draft can be unbearable for these people. Even so, it is one of the most unknown and most difficult to treat disorders within chronic pain.

This disorder belongs to the group of neuropathic pain. A form of pain produced by damage or changes in the information-transmission mechanism of the peripheral and/or central nervous system whose nerves send pain signals without any real reasons for doing so. As Guevara-López (2016) states: “The degree of alteration will depend on the type and size of the damage or dysfunction of the affected structures”.

Types of allodynia

Although it is not well known, The little that is known about allodynia is that it can be of different types depending on the type of stimulus that causes it.:

Static mechanical allodynia: It occurs when pain is felt when applying a single stimulus or when pressing lightly, as can happen when holding a person’s hand.Dynamic mechanical allodynia: Pain is felt with the repeated application of soft stimuli or at the slightest touch, that is, caresses hurt.Thermal allodynia: when pain is felt when applying thermal stimuli. In this case, the degree of sensitivity is studied with the application of objects on the skin with temperatures between 20º and 40º.

One of the difficulties in the study of adolinia is found in differentiating this term from other related terms such as hyperalgesia or hyperpathy. Hyperalgesia occurs when stimuli are painful, although with a threshold higher than normal. Hyperpathy due to the repeated repetition of stimuli that initially did not cause any pain.

All of this produces a feeling of incomprehension towards these patients and their suffering that only prolongs the agony of living with such a degree of chronic pain that even breathing is torture. Thus, this situation produces innumerable unpleasant consequences and is, in turn, a source of negative emotions.

Emotional consequences of chronic pain

Pain is an essential function, it is adaptive and guarantees our survival since it warns our brain when something is wrong, both internally and externally. The problem occurs when it goes from being adaptive to being a chronic and unbearable pain that prevents people who suffer from it from leading a normal life. This causes suffering to such a degree that Up to 85% of patients with chronic neuropathic pain present depressive symptoms.

Depressive symptoms occur due to the constant fight they carry out to try to avoid pain and which often has no results.. This generates helplessness, which in many cases ends in depression: especially when the patient gives up due to how overwhelming the pain they are suffering is.

Anxiety symptoms also occur that intensify the physical pain itself. Faced with this, the body suffers and begins to generate bad habits to try to counteract this discomfort.

Treatment of neuropathic pain

From a medical point of view, pain treatment usually consists of the administration of drugs: both opiates and non-opioids depending on the degree of discomfort the patient feels. However, in the case of allodynia, such as neuropathic pain, this treatment is ineffective. Hencein cases where there is more frequent and intense pain, surgical intervention is recommended to eliminate some of the connections in the pain nerve pathways.

Authors such as Cruciani and Nieto (2006) highlight the use of antidepressants as pharmacological treatment for this type of patient. They state that selective serotonin and norepinephrine reuptake inhibitor antidepressants (e.g., duloxetine) appear to be of greater benefit than solely selective serotonin reuptake inhibitors (e.g., fluoxetine).

From a psychological perspective, work on pain acceptance is recommended., so that avoidance does not make symptoms worse. In addition, different biofeedback techniques accompanied by coping strategies are also recommended in order to have the best quality of life.

Although what they need, in general, is understanding from everyone. It is true that it is a pain that can be very difficult for us to imagine, since even the stimuli that bring pleasure to most of us, such as caresses, cause pain to them. However, this does not mean that we do not have to make an effort to understand that their pain is real and, in many cases, continuous.

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