Hyperalgesia is a condition where a person develops an increased sensitivity to pain. What may not hurt most people can cause significant pain in an individual with hyperalgesia. Another kind of hyperalgesia is opioid-induced hyperalgesia (OIH). Hyperalgesia is an abnormally increased sensitivity to pain, which may be caused by damage to nociceptors or peripheral nerves and can cause. Hyperalgesia is an enhanced pain response. It can result from either injury to part of the body or from use of opioid painkillers. When a person.
Sign up for a free Medical News Today account to customize your medical and health news experiences. Although there are many potential causes associated with hyperalgesia, the condition is thought to be the result of changes to nerve pathways, which cause a person's nerves to have an overactive response to pain.
There are several nerve or "pain" pathways in the body where signals can start to miscommunicate with each other, resulting in hyperalgesia. Some scientists think that hyperalgesia occurs when chemicals known to reduce pain are disrupted.
Others propose that hyperalgesia happens when "crossed wires" in the nervous system prevent pain signals from transmitting accurately. Nociceptive and neuropathic are two different types of pain.
Nociceptive pain is acute and it usually has a specific cause, such as an injury. Neuropathic pain results from damage to the nervous system. It can happen even when there is no injury or outside stimulus. Hyperalgesia is considered a form of neuropathic pain. Doctors usually divide hyperalgesia into primary and secondary categories.
Both of these conditions are due to initial tissue trauma and inflammation. This type of hyperalgesia is when the increased pain occurs in the tissue where the injury took place. An example would be when a person has surgery on their elbow, and the pain starts to worsen over time instead of improving. Another kind of hyperalgesia is opioid-induced hyperalgesia OIH. OIH occurs when a person experiences worsening or new pain as a result of taking opioids, such as morphine, hydrocodone, or fentanyl for pain relief.
If hyperalgesia is opioid induced, a doctor may reduce the dosage. While a person may experience an initial increase in pain due to these changes, this frequently gives way to a reduced pain experience in those with hyperalgesia. There are also different classes of opioids a doctor could prescribe. One example is methadone, a medication that relieves pain, yet has been shown to prevent or reduce OIH.
Another medication is buprenorphine, which can help to reduce the incidence of hyperalgesia by blocking receptors in the brain and spinal cord. Ketamine, which also blocks certain receptors, is another option. All of these medications, as well as methadone, require close medical supervision. Another option is a muscle or nerve block, which uses a local anesthetic to numb or delay painful nerve impulses. Sometimes, treating hyperalgesia requires a trial-and-error approach, with frequent adjustments to medication until a person achieves a reduced pain experience.
The chief symptom of hyperalgesia is an increasingly extreme reaction to painful stimuli without any new injuries or worsening of a medical condition. An example would be a surgical incision that becomes more painful over time, yet the wound is not infected, and a person has not experienced any further injury. If a person develops a tolerance to a particular drug, it usually means that their body has become accustomed to the presence of the drug at the current dosage, and the drug is no longer working properly.
When a person has developed a tolerance to a drug, increasing the dosage will usually decrease a person's pain. Drug tolerance is different from hyperalgesia, where increasing pain medication will not reduce the amount of pain a person feels. Sometimes, increasing the pain medication makes the person's pain worse. Another similar medical condition is allodynia. This condition is where a person develops a significant pain response to non-painful stimuli.
Even brushing against a person's skin can cause pain. In hyperalgesia, a person has experienced a painful stimulus, such as cancer pain or pain following surgery, but their response to the pain is greater than the expected level of pain.
Hyperalgesia can present difficulties for a doctor to treat because a person may have developed OIH. A doctor may increase a person's pain medication to determine if hyperalgesia is the cause. If the additional pain medication does cause more pain, it is possible the condition is hyperalgesia. Article last reviewed by Sun 6 August All references are available in the References tab. Pharmacist , 37 5 , HSHS A comprehensive review of opioid-induced hyperalgesia.
Pain Physician , 14 , Remifentanil tolerance and hyperalgesia: This might be qualitatively and anatomically distinct from pain related to disease progression or to breakthrough pain resulting from development of opioid tolerance.
Pain associated with hyperalgesia tends to be more diffuse than the pre-existing pain and less defined in quality. Management of opioid induced hyperalgesia requires opioid dose reduction or changing to an alternative opioid preparation.
The effect of opioid dose and treatment duration on the perception of a painful standardized clinical stimulus. Regional Anesthesia and Pain Medicine ; Pain intolerance in opioid-maintained former opiate addicts: Effect of long-acting maintenance agent. Drug and Alcohol Dependence ; Pain Physician ; Opioid-induced abnormal pain sensitivity:
Opioid-Induced Hyperalgesia: An Emerging Treatment Challenge
Opioid-induced hyperalgesia (OIH) is defined as a state of nociceptive sensitization caused by exposure to opioids. The condition is characterized by a . Hyperalgesia and allodynia are frequent symptoms of disease and may be useful adaptations to protect vulnerable tissues. Enhanced sensitivity for pain may. Find out what hyperalgesia is and see how it's involved in fibromyalgia, chronic fatigue syndrome, and other sensitivity syndromes.