Understanding Hyperalgesia


Hyperalgesia brings an increased awareness of pain. Normal pain will be amplified. Things that may not have been painful will be to someone with this condition.

This condition may be caused through the use of opioids, which can cause changes in the nervous system. This may amplify your perception of pain and make you feel more uncomfortable. This discomfort can be identified as Hyperalgesia.

Hyperalgesia however, is not only brought on by opioids. It can result from an injury to part of the body. It is considered OIH [opioid-induced hyperalgesia] when it is a side effect from medication. This condition is becoming more of a concern because of the increased usage of narcotic drugs.

“There are two types of hyperalgesia—primary and secondary. Primary hyperalgesia occurs at and around the site of the injury. Secondary hyperalgesia occurs when the pain feels as if it’s spreading to a non-injured site of the body.” [2]

Increased sensitivity to pain with no additional injury and/or worsening of another condition is the key symptom to hyperalgesia.

OIH’s main symptoms:

· The pain you feel over time is intensified

· Your pain spreads to other areas beyond the original injury site

· Sensitivity to external stimuli increases

Increasing the dosage of drugs does not take away the pain. It increases in spite of the extra medication. OIH is not opioid tolerance. When you have a tolerance for a drug increasing the dosage will decrease the pain. Increasing the dosage with OIH will not decrease the pain. In some cases it will actually make the pain worse.

Hyperalgesia can develop from conditions such as fibromyalgia or shingles. The nerves become hyper-sensitive to many types of tissue damage or trauma [surgery] and outside stimuli.

There are options available for treatment of hyperalgesia. The treatment itself can be very challenging. Changing to a different prescribed medication in smaller dosages can sometimes bring relief to this condition. Gradually stopping the medication altogether is an option even though it can be quite challenging.
In severe cases a NMDA receptor antagonist may help block the nerves that are over sensitized in hyperalgesia. It is a painful condition to live with no matter how it is treated.

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