My Skin Hurts! Allodynia in Fibromyalgia & ME/CFS (2022)

Allodynia is a rare type of pain, generally on the skin, that's caused by something that wouldn't normally cause pain. This pain type is frequently associated with fibromyalgia. Some research suggests allodynia may be associated with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) as well.

Other conditions associated with allodynia includediabetic/peripheral neuropathy, postherpetic neuralgia(nerve damage from shingles), and migraines. Outside of these conditions, allodynia is a rare symptom. Knowing this term may help you communicate better with your healthcare providers and other healthcare providers as well as understand research about your illness.

My Skin Hurts! Allodynia in Fibromyalgia & ME/CFS (1)

Types of Allodynia

Allodynia comes in three different forms. It's possible for you to have one, two, or all three kinds. The different forms are:

  • Tactile allodynia: This is pain caused by touch. This can include clothing pressing against the skin (especially the tighter parts of clothing, such as waistbands, bra straps, or the elastic part of socks), a hug, or someone touching you lightly on the arm.
  • Mechanical allodynia: This type of pain caused by movement across the skin. This can be a towel as you dry yourself off, bedsheets brushing against you, or even the air from a fan moving over your skin.
  • Thermal (temperature-related) allodynia: This pain is caused by heat or cold that is not extreme enough to cause damage to your tissues.Your hands and feet may burn if they get chilled, or getting too hot may make them ache.

Note that you should talk to your healthcare provider if your hands and feet turn blue when they're cold. This may be a symptom of a different condition called Raynaud's syndrome, which can lead to tissue damage.

It's often hard for people, even those who experience allodynia, to understand how these otherwise harmless things can cause so much pain. However, it is real pain and doesn't mean that you're crazy or making too big a deal out of "normal" aches and pains.

Allodynia is different fromhyperalgesia, which is the mechanism that "turns up the volume" on pain in these conditions. Hyperalgesia takes your pain and makes it worse, while allodynia is an actual type of pain.

Causes

Allodynia is thought to be a hypersensitive reaction to stimuli. Research suggests it may result from central sensitization, which is believed to be an underlying mechanism of fibromyalgia, ME/CFS, and several other conditions. "Central" indicates the central nervous system (brain and spinal cord) and "sensitization" means that it's become extra sensitive.

In some conditions, research suggests allodynia may be caused by peripheral sensitization, which involves the nerves outside of your central nervous system.

The pain signals of allodynia come fromspecialized nerves called nociceptors. The job of nociceptors is to sense information about things like temperature and painful stimuli on the skin.

Most nerves have to send signals to the brain and wait for the brain to send a signal back before they respond. Nociceptors don't have to do that—they react immediately based on what they detect. This allows you to pull your hand away from something hot before you get burned, often before you consciously perceive the heat.

When these nerves become sensitized, they start interpreting all kinds of sensations as pain. Again, this is real pain that has just as much of an impact on you as any other source of pain.

No diagnostic test can identify allodynia. However, when you report this symptom to your healthcare provider, it can help them narrow down the possible causes of your pain and any other symptoms you may have.

How Fibromyalgia Is Diagnosed

(Video) Skin Sensitivity to Pain with Fibromyalgia and Chronic Fatigue Syndrome

Treatment

So far, it's unknown whether allodynia can be treated the same in every condition. Most of the common drug treatments for illnesses that involve this symptom can help alleviate allodynia and other types of pain. These include:

  • Lyrica (pregabalin): Often prescribed for fibromyalgia, neuropathy, and postherpetic neuralgia, and sometimes used off-label for ME/CFS
  • Neurontin (gabapentin): Often prescribed for postherpetic neuralgia and used off-label for fibromyalgia and neuropathy
  • Tricyclic antidepressants such as amitriptyline: Often used off-label for fibromyalgia, ME/CFS, neuropathy, postherpetic neuralgia, and migraine

Some people also get some relief with topical painkillers, such as lidocaine and menthol-based products like BioFreeze and Tiger Balm. While testing on humans hasn't yet been done, numerous animal studies support the use of ingested and topical cannabidiol (CBD), a hemp product that doesn't create a "high," for allodynia.

Most complementary and alternative treatments haven't been studied specifically for their effect on allodynia, but they have been investigated for central sensitization. As that's the suspected underlying mechanism of allodynia, it's possible that these treatments may be helpful:

  • Acupuncture: A 2019 review of studies on acupuncture for central sensitization concluded that the treatment can alleviate pain symptoms, including allodynia.
  • Mindfulness practices: Research published in 2020 suggests that practices involving mindfulness, including meditation and mindfulness-based stress reduction, are effective for alleviating pain in conditions that involve central sensitization.
  • Cognitive behavioral therapy (CBT): A psychological approach aimed at helping you make positive mental changes that impact your health, research has long shown that it may be of benefit in central sensitization.

Warning: Massage Therapy

It's possible for massage therapy and other hands-on treatments (such as Rolfing and chiropractic) to make allodynia worse, so it's important to find a massage therapist who understands your condition and knows how not to aggravate this symptom.

Does Myofascial Release Work for Fibromyalgia?

Lifestyle Changes

Allodynia can make your life difficult. Something as simple as wearing a shirt may become painful, or even agonizing. Many people who have allodynia find that they need to tailor their wardrobes to reduce the impact of this pain.

Thermal allodynia can play a role in another symptom—temperature sensitivity. To manage it, you may need to do things like dressing in layers or moving your workstation away from vents that blast you with hot or cold air. You may have to learn how to compensate for both cold and hot conditions.

Dietary Management

Some research has suggested that compounds in certain foods may alleviate neuropathic pain and the allodynia associated with it. While it's too early to say for sure, it may be that eating these foods or getting the active compounds via supplements could help ease your pain.

ALLODYNIA-FIGHTING FOODS
FOODSCOMPOUNDS
Hot chili peppersCapsaicin
CoffeeChlorogenic acid
Turmeric/curcuminCurcumin
SoyGenistein
TomatoLycopene
GrapesNaringin
Fish oilOmega-3s
Eggs and milkPalmitoylethanolamide (PEA)
SeaweedPhlorotannins
Red kidney beans, capersQuercetin
Grapes, nuts, berriesResveratrol

A Word From Verywell

The conditions associated with allodynia are often chronic and difficult to treat. You may not ever be completely free from the pain, but by working with your healthcare provider and making appropriate lifestyle changes, you may be able to minimize its impact on your life.

The 7 Types of Fibromyalgia Pain

Frequently Asked Questions

Fibromyalgia Doctor Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

My Skin Hurts! Allodynia in Fibromyalgia & ME/CFS (2)

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(Video) Allo, Allo...What IS Allodynia in relation to my Fibromyalgia?

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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  2. Yasui M, Yoshimura T, Takeuchi S, et al. A chronic fatigue syndrome model demonstrates mechanical allodynia and muscular hyperalgesia via spinal microglial activation.Glia. 2014;62(9):1407-1417. doi:10.1002/glia.22687

    (Video) Fibromyalgia and skin issues and pain

  3. Lolignier S, Eijkelkamp N, Wood JN. Mechanical allodynia. Pflugers Arch. 2015;467(1):133-9. doi:10.1007/s00424-014-1532-0

  4. Vale TA, Symmonds M, Polydefkis M, et al. Chronic non-freezing cold injury results in neuropathic pain due to a sensory neuropathy. Brain. 2017;140(10):2557-2569. doi:10.1093/brain/awx215

  5. MedlinePlus. Raynaud's disease.

  6. Cleveland Clinic. Neuropathic pain.

  7. Forstenpointner J, Binder A, Maag R, et al. Neuroimaging of cold allodynia reveals a central disinhibition mechanism of pain.J Pain Res. 2019;12:3055-3066. doi:10.2147/JPR.S216508

  8. Viana F. Nociceptors: thermal allodynia and thermal pain. Handb Clin Neurol. 2018;156:103-119. doi:10.1016/B978-0-444-63912-7.00006-0

  9. Prescribers' Digital Reference. Pregabalin - drug summary.

  10. Prescribers' Digital Reference. Gabapentin - drug summary.

  11. Prescribers' Digital Reference. Amitriptyline hydrochloride - drug summary.

  12. Baron R, Allegri M, Correa-Illanes G, et al. The 5% lidocaine-medicated plaster: Its inclusion in international treatment guidelines for treating localized neuropathic pain, and clinical evidence supporting its use.Pain Ther. 2016;5(2):149-169. doi:10.1007/s40122-016-0060-3

  13. Kocot-Kępska M, Zajączkowska R, Mika J, et al. Topical treatments and their molecular/cellular mechanisms in patients with peripheral neuropathic pain-narrative review.Pharmaceutics. 2021;13(4):450. doi:10.3390/pharmaceutics13040450

  14. Mlost J, Bryk M, Starowicz K. Cannabidiol for pain treatment: Focus on pharmacology and mechanism of action.Int J Mol Sci. 2020;21(22):8870. doi:10.3390/ijms21228870

  15. Lai HC, Lin YW, Hsieh CL. Acupuncture-analgesia-mediated alleviation of central sensitization.Evid Based Complement Alternat Med. 2019;2019:6173412. doi:10.1155/2019/6173412

  16. Pardos-Gascón EM, Narambuena L, Leal-Costa C, van-der Hofstadt-Román CJ. Differential efficacy between cognitive-behavioral therapy and mindfulness-based therapies for chronic pain: Systematic review.Int J Clin Health Psychol. 2021;21(1):100197. doi:10.1016/j.ijchp.2020.08.001

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  20. International Association for the Study of Pain. Hyperalgesia.

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FAQs

Can fibromyalgia make your skin hurt? ›

You may develop skin sensitivity or tenderness with the rash, or you may have itchiness without pain. In addition, a rash in fibromyalgia can cause a crawling sensation on the skin. If you also have dry skin, this can worsen itchiness and the rash.

Can fibromyalgia cause allodynia? ›

Tactile allodynia is one of the characteristic symptoms of fibromyalgia. It is a neurological condition in which the sensation of pain—sometimes severe—can occur with a simple touch. With this condition, the body perceives pain to otherwise harmless physical (tactile) stimuli.

What does it mean when your skin hurts to the touch? ›

When skin hurts to touch, it means your nerves are oversensitive or your brain is overreacting to stimulus. A number of pain conditions can make you hypersensitive to pain, like migraines, diabetes, shingles, and complex regional pain syndrome. There are medications and treatments that can help you cope with the pain.

What causes allodynia to flare up? ›

Allodynia can result from several conditions. The most common causes of allodynia include diabetes, shingles, fibromyalgia and migraine headaches. To relieve allodynia, your provider will treat the condition that's causing pain. They may also recommend a pain management plan.

Does fibromyalgia cause burning sensation skin? ›

tingling, numbness, prickling or burning sensations in your hands and feet (pins and needles, also known as paraesthesia) in women, unusually painful periods. anxiety. depression.

How do you desensitize allodynia? ›

How is it done? Through the controlled application of various textures (such as silk, towel, or cotton wool) or movements (for example tapping, stroking, or vibration). You must be free from distractions, so that you can concentrate on each texture or movement.

What helps with allodynia pain? ›

Currently, there is no cure for allodynia. Treatment is aimed at decreasing pain, using medications and lifestyle changes. Pregabalin is a medication used to treat nerve pain associated with conditions, such as spinal cord injuries, diabetes, fibromyalgia, and shingles.

Why is my skin sore to touch but no rash? ›

Allodynia is described as skin that hurts to touch or rub or unusually tender skin, caused from things that wouldn't normally cause any skin pain or discomfort. It can be caused by underlying conditions like migraines, fibromyalgia, diabetes, nerve conditions, past trauma to the skin or can simply occur on its own.

Why does my skin feel bruised when it's not? ›

What is allodynia? Allodynia is an uncommon symptom that can result from several nerve-related conditions. When you're experiencing it, you feel pain from stimuli that don't normally cause pain. For example, lightly touching your skin or brushing your hair might feel painful.

What is allodynia a symptom of? ›

It can occur due to a known medical disorder, be the result of past trauma or injury, or present idiopathically by itself. Anything that causes neuropathy may also have an association with allodynia. Allodynia is often due to diabetes, fibromyalgia, migraine syndromes, or postherpetic neuralgia.

What is the newest treatment for fibromyalgia? ›

Currently the two drugs that are approved by the United States Food and Drug Administration (FDA) for the management of fibromyalgia are pregabalin and duloxetine. Newer data suggests that milnacipran, a dual norepinephrine and serotonin reuptake inhibitor, may be promising for the treatment of fibromyalgia.

Why does my skin feel like it's on fire? ›

Burning Skin – feels like your skin has been burned, like a sunburn, yet it hasn't – is a common anxiety disorder symptom, including anxiety attacks, generalized anxiety disorder, social anxiety disorder, Obsessive Compulsive disorder, and others.

Does allodynia affect the whole body? ›

Allodynia may or may not be felt on just the head and some people compare it to having sunburn all over their body. It's also important to mention what allodynia is not. Despite the pain, allodynia is not an increased sensitivity to pain or the result of physical damage.

What is considered severe fibromyalgia? ›

Three cutoff points were established: absence of Fibromyalgia (FM), <34; mild, 34–41; moderate, 41–50 and severe, >50, with the following distribution of severity: absence in 0.4 %, mild in 18.7 %, moderate in 32.5 % and severe in 48.4 % of the patients.

How do you stop a hypersensitive nerve? ›

Here's how to get started moving again:
  1. Focus on breathing. Taking deep breaths from your diaphragm can quiet the nervous system.
  2. Start with small movements. ...
  3. Focus on one section of your body. ...
  4. Graduate to positions or thoughts of activities that previously would have triggered a pain response.
Sep 23, 2020

How do you test for allodynia? ›

Mechanical allodynia is often tested by quantifying tactile sensitivity, using a set of von Frey filaments (also referred to as Semmes-Weinstein [S-W] monofilaments, a series of nylon monofilaments of increasing stiffness that exert defined levels of force as they are pressed to the point where they bend; Stoelting Co. ...

How do you treat a hypersensitive nerve? ›

Treatment of Hyperesthesia

Your doctor may recommend lifestyle modifications, minor invasive surgery, and/or medications such as analgesics, antidepressants, topicals, or opioids. People with hyperesthesia will usually need to be treated by one or more of the following specialists: Physical therapist.

Is allodynia a disability? ›

Allodynia is associated with more disability when objectively measured by MIDAS (Migraine Disability Assessment Scale). The more years a person has migraine, the more likely they are to experience allodynia.

What is the difference between allodynia and hyperalgesia? ›

Allodynia is pain due to a stimulus that does not normally elicit pain. Hyperalgesia is increased pain from a stimulus that normally provokes pain.

Why is my skin so sensitive all of a sudden? ›

It can be caused by a wide variety of factors, including heat, over-bathing, not actively moisturising your skin or using harsh soaps too regularly. When the skin becomes too dry, cracked and damaged, it can no longer effectively protect nerve endings, causing sensitivity.

Why is my skin sore for no reason? ›

Allodynia is described as skin that hurts to touch or rub or unusually tender skin, caused from things that wouldn't normally cause any skin pain or discomfort. It can be caused by underlying conditions like migraines, fibromyalgia, diabetes, nerve conditions, past trauma to the skin or can simply occur on its own.

What causes skin sensitivity? ›

What causes sensitive skin reactions? Causes of sensitive skin reactions include: Skin disorders or allergic skin reactions such as eczema, rosacea, or allergic contact dermatitis. Overly dry or injured skin that can no longer protect nerve endings, leading to skin reactions.

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