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Allodynia
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[[Allodynia]] refers to pain caused by what would normally be non-painful stimulation, for example brushing the skin.<ref name="Sandkuhler2009" /> The touch of clothing can trigger allodynia, for instance causing a painful burning sensation, or a slightly cool or warm temperature may be unbearably painful.<ref name="Jensen2014" /> ==Types== There are three main forms of allodynia: *'''Mechanical''' / '''Tactile''' **'''Dynamic:''' caused by movement across the skin such as a cotton bud, or brushing a painter's brush against the skin; or **'''Static:''' where pain is caused by pressure or touch such as clothing touching the skin *'''Thermal''', which is caused by heat or cold that is not extreme enough to cause damage to skin tissues. **'''Hot''' **'''Cold''' *'''Chemical''', caused by chemicals such as capsaicin (chilli extract), menthol (cooling sensation), histamine (itch)<ref name="Jensen2014" /> ==ME/CFS == Allodynia is not a diagnostic symptom of ME or CFS, although pain in general is, with multiple types of pain mentioned.<ref name="fukuda1994">{{Cite journal | last = Fukuda | first = K. | author-link = Keiji Fukuda | last2 = Straus | first2 = S.E. | author-link2 = Stephen Straus | last3 = Hickie | first3 = I. | author-link3 = Ian Hickie | last4 = Sharpe | first4 = M.C. | author-link4 = Michael Sharpe | last5 = Dobbins | first5 = J.G. | author-link5 = James Dobbins | last6 = Komaroff | first6 = A. | author-link6 = Anthony Komaroff | date = 1994-12-15 | title = The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group | url =https://www.researchgate.net/profile/Michael_Sharpe2/publication/247808895_The_Chronic_Fatigue_Syndrome_A_Comprehensive_Approach_to_Its_Definition_and_Study/links/0c96053201643bfc4b000000/The-Chronic-Fatigue-Syndrome-A-Comprehensive-Approach-to-Its-Definition-and-Study.pdf | journal=Annals of Internal Medicine | volume = 121 | issue = 12 | pages = 953–959|issn=0003-4819|pmid=7978722|via=| publisher = American College of Physicians}}</ref> Allodynia is not directly mentioned in the [[International Consensus Criteria]] primer for [[myalgic encephalomyelitis|Myalgic Encephalomyelitis]] but would fulfill the '''significant pain''' diagnostic criteria, which includes a number of types of pain including [[hyperalgesia]] and widespread pain that may meet the [[fibromyalgia]] criteria.<ref name="ICP2011primer">{{Citation | last1 = Carruthers | first1 = BM | author-link1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | author-link2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | author-link3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | author-link4 = Nancy Klimas | last5 = Broderick | first5 = G | author-link5 = Gordon Broderick | last6 = Mitchell | first6 = T | author-link6 = Terry Mitchell | last7 = Staines | first7 = D | author-link8 = Donald Staines | last8 = Powles | first8 = ACP | author-link8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | author-link10 = Rosamund Vallings | last11 = Bateman | first11 = L | author-link11 = Lucinda Bateman | last12 = Bell | first12 = DS | author-link12 = David Bell | last13 = Carlo-Stella | first13 =N | author-link13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | author-link14 = John Chia | last15 = Darragh | first15 = A | author-link15 = Austin Darragh | last16 = Gerken | first16 = A | author-link16 = Anne Gerken | last17 = Jo | first17 = D | author-link17 = Daehyun Jo | last18 = Lewis | first18 = DP | author-link18 = Donald Lewis | last19 = Light | first19 = AR | author-link19 = Alan Light | last20 = Light | first20 = KC | author-link20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | author-link21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | author-link22 = John McLaren-Howard | last23 = Mena | first23 = I | author-link23 = Ismael Mena | last24 = Miwa | first24 = K | author-link24 = Kunihisa Miwa | last25 = Murovska | first25 = M | author-link25= Modra Murovska | last26 = Stevens | first26 = SR | author-link26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf}}</ref> ==Fibromyalgia== Allodynia is a characteristic symptom of [[fibromyalgia]], which is a chronic condition of widespread pain<ref name="Watkins2006" />{{Rp|320}} A study of over 3,000 patients with [[fibromyalgia]] found that allodynia was "surprisingly common."<ref name="Baron2010">{{Cite journal | last = Baron | first = Ralf | author-link = | last2 = Tölle | first2 = Thomas R. | author-link2 = | last3 = Freynhagen | first3 = Rainer | author-link3 = | last4 = Brosz | first4 = Mathias | author-link4 = | last5 = Gockel | first5 = Ulrich | author-link5 = | last6 = Koroschetz | first6 = Jana | author-link6 = | last7 = Rehm | first7 = Stefanie E. | author-link7 = | date = Jun 1, 2010 | title = A cross-sectional survey of 3035 patients with fibromyalgia: subgroups of patients with typical comorbidities and sensory symptom profiles |url =https://academic.oup.com/rheumatology/article/49/6/1146/1790415 | journal = Rheumatology|language=en | volume = 49 | issue = 6 | pages = 1146–1152|doi=10.1093/rheumatology/keq066|issn=1462-0324|quote=|via=|pmc=|pmid=|access-date=}}</ref> ==Possible causes== Allodynia is caused by altered pain processing, but it is not yet clear exactly how this happens. Physical injuries including amputations and spinal cord injuries can cause allodynia, even if injuries have fully healed, but allodynia can also occur without a any injury.<ref name="Sandkuhler2009" /><ref name="Holdcroft2005" /><ref name="Jensen2014" /> Central pain sensitization (increased response of neurons) has been proposed as a possible cause, but this term has conflicting definitions and scientific evidence is unclear.<ref name="Sandkuhler2009" /> ==Allodynia compared to hyperalgesia == Allodynia is when pain is caused by a sensation that should not be painful, but [[hyperalgesia]] is significantly lowered pain threshold. People with hyperalgesia feel a greater intensity of pain, but do not find everyday sensations painful. ==Notable studies== *2005, Nerve damage and its relationship to neuropathic pain<ref name="Holdcroft2005">{{Cite book |chapter=Nerve damage and its relationship to neuropathic pain | first = N.B. | last = Finnerup | first2 = T.S. | last2 = Jensen | pages = 43-48 | title = Core Topics in Pain | publisher = Cambridge University Press | date = 2005|isbn=1139447025 |chapter-url=https://books.google.com/books?id=aJEmA8HmTCEC&lpg=PA45&dq=allodynia&pg=PA45#v=onepage&f=true |editor-first1 = Anita|editor-last1 = Holdcroft|editor-first2 = Sian|editor-last2 = Jaggar }}</ref> - [https://books.google.com/books?id=aJEmA8HmTCEC&lpg=PA45&pg=PA45#v=onepage&f=true (Chapter)] *2006, Contribution of glia to pain processing in health and disease<ref name="Watkins2006">{{Cite book |editor-first = Fernando|editor-last = Cervero |editor-first2 = Troels Staehelin|editor-last2 = Jensen| publisher = Newnes | date = 2006 |chapter=Contribution of glia to pain processing in health and disease |chapter-url=https://books.google.com/books?id=RVwM4f4WSfUC&pg=PA520&lpg=PA520&dq=allodynia&hl=en&sa=X | title = Pain | first = L.R. | last = Watkins | first2 = J. | last2 = Wieseler-Frank | first3 = E.D. | last3 = Milligan | first4 = I. | last4 = Johnston | first5 = S.F. | last5 = Maier |location=Boulder, CO. USA | pages = 309-325 }}</ref> - [https://books.google.com/books?id=RVwM4f4WSfUC&pg=PA520&lpg=PA520&dq=allodynia&hl=en&sa=X (Chapter)] *2008, Chronic widespread musculoskeletal pain—a comparison of those who meet criteria for fibromyalgia and those who do not<ref name="Coster2008">{{Cite journal | last = Cöster | first = Lars | last2 = Kendall | first2 = Sally | last3 = Gerdle | first3 = Björn | last4 = Henriksson | first4 = Chris | last5 = Henriksson | first5 = Karl G. | last6 = Bengtsson | first6 = Ann | date = 2008 | title = Chronic widespread musculoskeletal pain – A comparison of those who meet criteria for fibromyalgia and those who do not | url = https://onlinelibrary.wiley.com/doi/abs/10.1016/j.ejpain.2007.10.001 | journal = European Journal of Pain|language=en | volume = 12 | issue = 5 | pages = 600–610|doi=10.1016/j.ejpain.2007.10.001|issn=1532-2149}}</ref> - [https://doi.org/10.1016/j.ejpain.2007.10.001 (Full text)] *2009, Models and Mechanisms of Hyperalgesia and Allodynia<ref name="Sandkuhler2009">{{Cite journal | last = Sandkühler | first = Jürgen | author-link = | date = Apr 2009 | title = Models and Mechanisms of Hyperalgesia and Allodynia | url = http://www.physiology.org/doi/10.1152/physrev.00025.2008 | journal = Physiological Reviews|language=en | volume = 89 | issue = 2 | pages = 707–758|doi=10.1152/physrev.00025.2008|issn=0031-9333|quote=|via=|pmc=|pmid=|access-date=}}</ref> - [http://cbr.meduniwien.ac.at/fileadmin/db_files/pub_art_179.pdf (Full text)] *2010, A cross-sectional survey of 3035 patients with fibromyalgia: subgroups of patients with typical comorbidities and sensory symptom profiles<ref name="Baron2010" /> - [https://academic.oup.com/rheumatology/article/49/6/1146/1790415 (Full text)] *2014, Allodynia and hyperalgesia in neuropathic pain: clinical manifestations and mechanisms<ref name="Jensen2014">{{Cite journal | last = Jensen | first = Troels S | last2 = Finnerup | first2 = Nanna B | date = 2014-09-01 | title = Allodynia and hyperalgesia in neuropathic pain: clinical manifestations and mechanisms |url =https://www.sciencedirect.com/science/article/pii/S1474442214701024 | journal = The Lancet Neurology|language=en | volume = 13 | issue = 9 | pages = 924–935|doi=10.1016/S1474-4422(14)70102-4|issn=1474-4422}}</ref> - [http://www.myojin-kan.jp/wp/wp-content/uploads/2018/10/Jensen_Finnerup_2014.pdf (Full text)] ==Potential treatments== {{Main article|Analgesics}} ==Learn more== * [http://www.iasp-pain.org/Education/Content.aspx?ItemNumber=1698 Pain terminology] - [http://www.iasp-pain.org/ International Association for the Study of Pain] ==See also== * [[Fibromyalgia]] * [[Central sensitization]] * [[Chronic pain]] * [[Hyperalgesia]] * [[Analgesics|Pain relief (analgesics)]] ==References== {{Reflist}} [[Category:Signs and symptoms]] [[Category:Pain signs and symptoms]]
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