Under ordinary circumstances, your nervous system tries to regulate the intensity of the signals it sends and relays. The signals have to be strong enough for you to notice and process, but not so strong that they overwhelm your brain’s processing abilities. It tries to reserve more intense signaling only for when absolutely necessary (like the pain of touching something hot enough to burn you). An example of hyperesthesia is feeling unusually strong temperature sensations. If you have hyperesthesia and touch a warm cup of coffee or tea, you’ll feel a flood of sensations related to the cup’s warmth.
Exercise and Physical Therapy for Desensitization
Treatment involves treating underlying conditions and symptomatic support. A multidisciplinary approach that is able to provide timely diagnosis and treatment has the best outcomes. This activity outlines the evaluation and management of hyperesthesia and reviews the role of the interprofessional team in evaluating and treating patients with this condition. Hyperesthesia commonly happens along with neuropathic pain and other pain- or nerve-related conditions.
How is visceral hypersensitivity diagnosed?
These disorders exhibit the same symptoms as inflammatory diseases, such as GERD, peptic ulcer disease and inflammatory bowel disease. The only difference is that with functional disorders, healthcare providers can’t detect any organic cause for them — no ulcers, no acid reflux, and no chronic inflammation. It’s not the same, but visceral hypersensitivity is often involved in IBS. People with IBS are the ones most often evaluated for visceral hypersensitivity.
What causes visceral hypersensitivity?
Thus, in addition to decreased analgesia, opioid tolerance may also decrease opioid side effects including nausea, respiratory depression and sedation 44. Thus opioid cessation results in increased NE levels and elicits the symptoms of opioid ‘withdrawal’ including muscle spasms, abdominal cramps, anxiety, palpitations and hot flashes 45. Withdrawal symptoms for short-acting opioids (e.g., heroin, oxycodone and hydrocodone) typically occur within 12 h of cessation, peak at 36–72 h and taper over 4–7 days 46. This timeline highlights another critical difference between tolerance/withdrawal and OIH, as OIH potentially has much longer-lasting effects. Opioid-induced hyperalgesia (OIH) occurs when opioid medications worsen rather than decrease pain. Although mechanisms of OIH are thought to primarily start in the brain or brainstem before traveling through the spinal cord to the area of pain in the body, there are likely many causes.
When to call your healthcare provider
Your provider’s job is to diagnose and treat conditions you have; they won’t judge what you’re experiencing or how it’s affecting your life. The goal of diagnosis and treatment is to help return your senses to how they should be working and keep them from drowning out the things you want to experience. These nerves send pain signals to the part of your brain that registers pain, which signals to your brain regions that process the emotional part of the pain. An emotional response is part of your body’s way of teaching you to avoid whatever injured you.
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- While the term may refer to any heightened sensitivity to a stimulus, doctors often use the term to describe increased pain sensitivity from a stimulus.
- A thorough history should be performed, as this should be sufficient to make a diagnosis of hyperesthesia.
- Many people with visceral hypersensitivity are also diagnosed with functional disorders, especially gastrointestinal ones.
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- It is a type of hyperesthesia and refers to an exaggerated response to a painful stimulus.
- For example, an injury or infection or severe stress may have caused acute pain and inflammation in one of your organs.
- Hyperesthesia could happen when some part of the sensory process becomes dysfunctional.
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- As prevention may serve as the best treatment, patient risk factors for OIH, decreased opioid use, and both medication and non-medication strategies are discussed.
However, neuropathic pain, such as hyperesthesia, tends to be chronic. While a doctor may initially prescribe one medication at a time, nearly half of individuals with the condition are on two or more medications. A 2019 study found that sleep shortage increases a person’s risk of postherpetic neuralgia, or a lasting pain in the areas of skin following shingles.
In other words, with hyperalgesia, there is increased pain response to a painful stimulus. A neurologist (a physician who specializes in disorders of your brain, spinal cord and peripheral nerves) should be able to localize the area of dysfunction and perform tests to find the root of the problem. They may get blood work, electrophysiologic studies (electromyography EMG and nerve conduction studies), neuroimaging studies (magnetic resonance imaging MRI), neuromuscular ultrasound and more. The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.
Some interventional treatments currently being practiced lack robust trials to be recommended by the guidelines. Some of the interventions that require continued research are radiofrequency denervation of the dorsal root ganglion, adhesiolysis for FBSS, TENS, spinal cord stimulation, and motor cortex stimulation. Briarwood is dedicated to facilitating a healthy and safe environment that empowers people to make significant and lasting changes in their lives.
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The education of the patient early on during the treatment is necessary to establish realistic pain goals. A psychiatrist and psychologist evaluations are recommended as many patients suffer from mood disorders. Healthcare providers have been able to measure the visceral pain threshold in certain patients with tests that apply small amounts of internal pressure to some of these organs. Most people don’t experience discomfort from these tests, but those with visceral hypersensitivity do. They also may feel discomfort from the normal functioning of the organs that other people wouldn’t notice. There are many valuable opportunities for improvement of screening, prevention and treatment in OIH.
We provide a suggested clinical definition and a pathway for clinical differentiation of OIH from other diagnoses to help with management. Finally, we discuss prevention including patient education and medication management choices. As prevention may serve as the best treatment, patient risk factors for OIH, decreased opioid use, and both medication and non-medication strategies are discussed.
Psychotherapy, including cognitive behavioral therapy and mindfulness, can be add-ons to other treatments. If a doctor hyperalgesia: causes, symptoms, treatment, and more suspects a specific underlying condition, they may perform diagnostic tests, which may include lab and neuroimaging tests. Hyperesthesia can exist on its own or as a symptom of another related health condition. Whichever applies to you, your doctors will try to diagnose the root cause so it can be treated effectively.