Imagine if a paper cut felt like a red, hot poker stabbed you. Imagine if a small bruise felt like a sledge hammer hit you. If you are able to imagine these examples or maybe have even felt this way, then you know what it is like to have hyperalgesia. This term means that the tissue involved has an increased sensitivity to painful stimuli. The small hurts hurt even worse. The minor injuries feel ten times worse. And it seems to hurt everywhere.
Where does hyperalgesia come from? And why does it happen? Increased sensitivity to pain can occur in damaged or undamaged tissue. Remember, pain does not necessarily mean that something is damaged. But pain does mean that the brain is interpreting signals from the body that seem threatening. Sometimes those signals are amplified because of the superactivation of the pain pathways. And sometimes those signals are amplified because of the suppression natural pain-relieving pathways in the body. Whether you have over-activity of pain pathways or suppression of pain-relieving pathways or both, all these roads can lead to an increased sensitivity to pain.
A classic example of hyperalgesia is felt when someone is experiencing opioid withdrawals. The sudden discontinuation of pain medications leaves a person with a non-functioning natural-pain relieving system while at the same time, the pain pathways deep within the nervous system become extremely active. This perfect storm of hyperalgesia causes a person to feel achy and sensitive everywhere. (1)
Another example of an increased sensitivity to pain is getting more and more notoriety because of the overuse of short-acting opioid medications for the treatment of chronic pain. This condition is called opioid-induced hyperalgesia. Pain medication can cause more pain if the user is experiencing a frequent cycle of withdrawals. As already mentioned, opioid withdrawals are well known to cause hyperalgesia. Furthermore, the frequent cycle of withdrawals sensitizes the nervous system. (2)
Nervous system sensitization is probably the most common reason for someone to experience an increased sensitivity to pain. Common conditions like fibromyalgia, headaches and sciatica are all conditions that typically have a component of hyperalgesia associated with that experience. Furthermore, each of those conditions is also related to a nervous system that has been altered in some way to be overactive and wound-up. The nervous system is your alarm system. When your alarm system overreacts to painful stimuli, all the little hurts feel HUGE.
And that might be the reason why you hurt everywhere. Hyperalgesia is not only an increased sensitivity to pain; it is also an indicator that someone’s alarm system might be dysfunctional because of the sudden withdrawal of medications, the overuse of medications or the sensitization of the nervous system. The hyperalgesia process can be reversed. It’s a matter of resetting the alarm. Allowing the body’s natural pain-relieving system to turn back on, eliminating the frequent cycles of withdrawals and desensitizing the nervous system are all ways to treat the increased sensitivity to pain. Unfortunately, resetting your alarm system is easier said than done.
- Pain. 2013 Jan 11. pii: S0304-3959(13)00011-0
- Cephalalgia. 2013 Jan;33(1):52-64
Specialist in Pain Management and Spine Rehabilitation