Hyperalgesia describes an increased response to pain; this is caused by the ‘super activation’ of pain pathways, resulting in increased sensitivity to pain. Signals from pain pathways can be amplified due to the suppression of natural pain relieving pathways e.g. discontinuation of pain medication can result in a poorly or non-functioning natural pain-relieving system, resulting in heightened sensitivity to pain.
Hyperalgesia can occur in damaged and undamaged tissues; the amplification of pain signals can be caused by irritation, inflammation and disease of the peripheral nervous system, or it can occur in the spinal cord itself.
Treatment
Physiotherapy treatment can provide hyperalgesic patients with effective pain relief whilst increasing functional ability. Physiotherapy treatment often focusses on functional activities in order to make rehabilitation effective and useful.
Hydrotherapy is used to reduce weight bearing through the lower limbs whilst providing an effective treatment for strengthening and increasing range of movement in an environment where pain is more easily controlled.
Transcutaneous electrical nerve stimulation (TENS) is also a treatment commonly used for pain relief. Studies have shown the benefits of TENS in reducing inflammation patterns in the peripheral nervous system, as well as in the spinal cord and descending inhibitory pathways.
Other treatments include:
- Mirror therapy
- Desensitisation
- Gradual weight bearing
- Stretching
- Motor control
