When Skin Hurts From a Touch: Allodynia and Fibromyalgia

Tactile allodynia is nerve pain that's 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 from something harmless. For example, your skin may hurt when clothes touch it, or you could feel pain when you lay down on a soft pillow.

Fibromyalgia involves multiple pain types, including hyperalgesia (the overamplification of pain) and paresthesia (abnormal sensations like burning or tingling in the absence of stimuli).

This article covers the symptoms, causes, and treatment of tactile allodynia. It also describes how fibromyalgia leads to allodynia, and what other conditions can cause it.

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.

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

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 action 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.

Other options may include cognitive behavioral therapy (CBT) and biofeedback to help modify your response to pain.

Other Causes of Skin Sensitivity

Fibromyalgia is just one cause of allodynia. Some of the other causes of skin sensitivity include:

• Migraines: Allodynia affects between 40% and 70% of people who experience migraines. You may be more likely to experience allodynia if you have migraines with auras.
• Diabetes: One of the complications of diabetes is peripheral diabetic neuropathy, or nerve damage in your legs, feet, arms, and hands. About one-third of diabetes patients experience pain from this nerve damage, including allodynia.
• Multiple sclerosis: Allodynia is a common symptom of multiple sclerosis. This includes not only tactile allodynia (pain with touch) but also cold allodynia (pain with cold temperatures).
• Shingles: Allodynia can persist in shingles patients even after the rash has cleared. This complication is known as post herpetic neuralgia.

Summary

Tactile allodynia is one of the symptoms of fibromyalgia. It's nerve pain that can happen with just a simple touch. It's caused by malfunctioning nociceptors, specialized nerves that sense information about your environment.

Treatment may include antidepressants, seizure drugs, and topical lidocaine. Cognitive behavioral therapy and biofeedback may also be options.

Other causes of allodynia, besides fibromyalgia, include migraines, diabetes, multiple sclerosis, and shingles.