Scientific article
English

Homotopic stimulation can reduce the area of allodynia in patients with neuropathic pain

Published inEuropean journal of pain, vol. 13, no. 9, p. 942-948
Publication date2009
Abstract

Allodynia is a common, troublesome feature of neuropathic pain conditions. In a previous study of postherpetic neuralgia we observed that repeated tactile stimulation appeared to reduce the size of the area of allodynia in some patients. We have undertaken a pragmatic clinical study to characterise this phenomenon in neuropathic pain patients with a range of different aetiologies. Neuropathic pain patients with a discrete area of tactile allodynia were recruited (n=20). We assessed the sensitive area using punctate and dynamic tactile stimuli, and thermal quantitative sensory testing. On two separate testing visits, the patients had repeated (10x over 1 min) noxious heat or cotton bud strokes applied to the affected site or contralaterally. Tactile stimulation of the affected area evoked pain (median 7 NRS) and a reduction (>30%) in the area of allodynia in 9/18 patients (maximum -48+/-9%, after 20 min), although the intensity of allodynic pain was unchanged. This effect persisted for over 1h and was present the following day in all patients tested (n=5/5). No subjects showed an increase in area after allodynic stimulation. There was no change in heat pain threshold at a distant site following allodynic stimulation, suggesting no activation of diffuse noxious inhibitory control. Repeated thermal noxious stimulation (median NRS 7) could also elicit changes (>30%) in the area of allodynia in some patients (reductions in 7/20, increases in 3/20). Thus, we have found that a brief period of homotopic painful stimulation can reduce the area of allodynia in around half of patients with established neuropathic pains.

Keywords
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Hyperalgesia/physiopathology/*therapy
  • Male
  • Middle Aged
  • Neural Inhibition/physiology
  • Nociceptors/*physiology
  • Pain Measurement
  • Pain Threshold/physiology
  • Peripheral Nerves/physiopathology
  • Peripheral Nervous System Diseases/physiopathology/*therapy
  • Physical Stimulation
  • *Physical Therapy Modalities
  • Skin/innervation/physiopathology
  • Touch/*physiology
  • Treatment Outcome
Citation (ISO format)
LOVE-JONES, Sarah J. et al. Homotopic stimulation can reduce the area of allodynia in patients with neuropathic pain. In: European journal of pain, 2009, vol. 13, n° 9, p. 942–948. doi: 10.1016/j.ejpain.2008.11.018
Identifiers
Journal ISSN1090-3801
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