Hyperesthesia refers to increased sensitivity to touch and sensory stimuli, which often manifests as pain. It is closely associated with other sensitivity disorders that represent either hypersensitivity or decreased sensitivity.
What is hyperesthesia?
The term hyperesthesia is used in both neurology and psychology. In neurology, it is often associated with an increased sensitivity to pain when touched. Psychology refers to a pathologically increased excitability as hyperesthesia, where the excitation is triggered by touch stimuli. The concept of hyperesthesia is inextricably linked to other sensitivity disorders, which differ only by a few nuances. For example, allodynia refers to a disorder that elicits a sensation of pain from stimuli that do not normally produce pain. Dysesthesia defines abnormal unpleasant sensory perceptions to normal stimuli, and may result in increased sensitivity to pain, decreased sensory perceptions, or hypersensitivity. Hyperalgesia refers to increased sensitivity to pain, while hyperpathia, in turn, represents hypersensitivity to sensory stimuli when the threshold is elevated. This enumeration shows that these terms can also be used in part as synonyms for hyperesthesia.
Causes
The causes of hyperesthesia are not at all easy to determine. For various reasons, there is an increased transmission of stimuli in the nervous structures. There are both organic and psychological reasons. For example, permanent hypersensitivity to touch stimuli can occur in mono- and polyneuropathies, CNS lesions, nerve compression in the case of a herniated disc, postoperative conditions or in Sudeck’s disease (sympathetically maintained pain). However, there is also the phenomenon of phantom pain. In this case, the body has acquired a so-called pain memory from previous traumatic pain experiences. Although the cause of the pain has disappeared and even corresponding limbs are missing, the same pain is still felt there. Regardless of its causes, hyperesthesia is manifested by intense sensations as a result of increased transmission of stimuli in the nerve structures.
Symptoms, complaints, and signs
Hyperesthesia is primarily noticeable through hypersensitivity. Affected individuals react very sensitively to stimuli such as touch, cold or heat. As a result, a markedly increased sensation of pain develops over weeks or months. This can be accompanied by a number of other symptoms. Typically, there are sensory disturbances or signs of paralysis, and occasionally there are also nerve pain and cramps. Sometimes bleeding or inflammation occurs, which can cause further symptoms if left untreated. The hypersensitivity causes severe discomfort in the affected person and considerably limits the quality of life. The symptoms of hyperesthesia often occur at night or during periods of rest, causing sleep disturbances. Affected persons are quickly irritated and often suffer from concentration problems. In the long term, hyperesthesia can cause psychological problems, for example anxiety disorders or depression. Hyperesthesia usually occurs in conjunction with another disorder, but it can also occur as an isolated feature. Regardless of the form, symptoms usually appear quite suddenly and increase in intensity as they progress. Without treatment, the hypersensitivity persists and causes further complications. If the hyperesthesia is based on a traumatic pain experience, phantom limb pain may develop.
Diagnosis and course
Whether hyperesthesia occurs as a symptom of an underlying disorder, or as an isolated feature, requires differential diagnosis. There is the question of whether there is an organically traceable disorder of the nervous system or whether the increased transmission of stimuli occurs because of previous trauma. Among the organically related causes are nerve root compression in the case of intervertebral disc damage, the existence of neurinomas (benign tumors of the nervous system with involvement of the connective tissue) or polyneuropathies. For differential diagnosis, a medical history is first taken. By means of the anamnesis, it is already possible to differentiate between organic and psychological causes.Imaging procedures, such as CT and MRI, can detect any disc damage or neurinomas. Furthermore, sensitivity tests, nerve conduction measurements, reflex tests and other examinations are performed. Often, however, the existing hyperesthesia is not pathological, but only a norm variant that manifests itself in a more sensitive reaction to environmental influences.
Complications
Hyperesthesia results in greatly increased sensitivity and sensibility. Even no touch or stimuli can cause the patient to experience severe pain and a burning sensation on the skin. In some cases, however, hyperesthesia also manifests itself in the form of reduced sensitivity. In both cases, the patient’s quality of life is reduced by the disease and everyday life is made very difficult. It is not uncommon for sleep disturbances to occur when rest pain is experienced at night. A general irritability of the patient can also occur. In many cases, certain activities of everyday life can no longer be carried out without further ado, and it is not uncommon for the patient’s movements to be restricted. The treatment of hyperesthesia is always causal and depends on the underlying disease. Complications do not occur. However, nerve damage may have occurred that cannot be reversibly treated. In this case, the affected person suffers from the symptoms and limitations for the rest of his or her life. The treatment can influence certain stimuli and reactions again through therapies. However, a positive course of the disease does not occur in every case. Life expectancy is not affected by hyperesthesia.
When should you see a doctor?
A visit to a physician is necessary as soon as pain is experienced to the touch for reasons that cannot be understood. If there are no injuries and the touch can be classified as light, the pain is an indication of a serious illness. If the affected person reacts hypersensitively to touching people or when wearing clothing on the skin, he or she needs an intensive examination to clarify the cause. Of particular concern is an increase in the intensity of the symptoms. If the affected person experiences severe suffering, he should consult a doctor. Help is needed in case of malaise, irritability, sleep disturbances or an impairment in coping with everyday tasks. If the physical discomfort results in emotional distress, a persistent experience of stress, or behavioral problems, a visit to the doctor should be made. If there is anxiety, aggressiveness, or outbursts of anger, a doctor’s visit is needed. Consultation with a doctor is also necessary if there are other symptoms such as headaches, itching, weight loss or discoloration of the skin. If the affected person avoids social contacts, withdraws from the usual environment or if there is a depressed mood, a doctor should be consulted. In the case of depressive phases, the use of narcotics or changes in personality, a visit to the doctor is advised.
Treatment and therapy
Treatment of hyperesthesia depends on its cause. If there are traceable organic causes, the underlying disease must be treated. For example, neurinomas can be surgically removed. Nerve root compressions due to intervertebral disc damage must be treated by physical therapies or, in exceptional cases, surgically, depending on their severity. Polyneuropathies, in turn, have various causes that must first be determined by differential diagnosis in order to be able to treat them. Sometimes certain viral infections also cause nerve damage that triggers hyperesthesia. In many cases, however, there are no organic causes. Here, the body has learned, so to speak, to react to certain stimuli with overexcitability or pain. Then psychological care is often necessary to learn a more relaxed reaction to these stimuli. This sometimes requires a lengthy psychological treatment. A prerequisite here is the identification of any traumatic experience that may have triggered the hyperesthesia.
Prevention
It is very difficult to give recommendations for prevention from hyperesthesia. Both organic and psychological causes are so varied that the development of this symptom cannot be predicted.Only when tendencies toward the development of hyperesthesia are already apparent should the course of the disease be stopped by timely initiated therapy.
Aftercare
Aftercare of hyperesthesia focuses on palliative and preventive measures. However, depending on the cause of the condition, it is not so easy to initiate the appropriate follow-up treatment. Patients should discuss the situation with their physician and possibly combine medical methods and self-help measures. A trusting relationship with the treating physician is helpful for successful improvement of the condition. If illness was triggered by psychological complaints, psychological or psychotherapeutic treatment is an option. In addition, patients often receive strong support from family and friends. This psychological reinforcement is particularly important if a traumatic experience is responsible for the onset of the disease. In long, open conversations, those affected can share their fears and complaints, which reduces the symptoms caused by the illness. Such follow-up treatment can take a long time. To avoid depression and discouragement, relaxation exercises and gentle physical activities also help. Yoga and tai chi are particularly popular. Long walks also make people feel better and thus help them to progress positively. In some cases, cold or heat applications are used, which serve to limit the typical symptoms.
What you can do yourself
The possibility of self-treatment for hyperesthesia depends very much on the exact cause of the condition, so no general prediction can be made about it. However, in many cases, patients rely on medical treatment to manage the symptoms of the condition. If the hyperesthesia occurs due to psychological discomfort or upset, treatment with a psychologist or with a therapist is necessary. In most cases, this treatment can also be strengthened by talking with other sufferers or with friends and family. Especially in the case of a traumatic experience, detailed and clarifying discussions about the experience should take place in order to limit the symptoms of this disorder. Sufferers should not be discouraged if treatment has to be given over a very long period of time. This is common in many cases of hyperesthesia. Furthermore, relaxation exercises or light sports can also have a very positive effect on the course of the disease. Yoga is particularly suitable for this. Furthermore, heat or cold applications can also be helpful. In many cases, this can limit the symptoms of hyperesthesia.