Manage Pain through Desensitization

Have you had a recent injury or surgery and found yourself concerned with the amount of sensitivity the area around the injury has developed?

Does it feel like the skin at, or around, the site of injury has developed a heightened sensitivity or pain?  If so, you may have hypersensitive nerve endings that could benefit from a treatment known as desensitization training. However, if you are feeling abnormal hypersensitivity to touch, temperature, or pressure following an injury or surgery it is best to set up an appointment with your primary care physician immediately as you may be developing an uncommon condition known as Complex Regional Pain Syndrome (CRPS).

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CRPS is most commonly experienced after suffering a stroke, amputation, soft tissue injury, or surgery. It may affect a small area or an entire limb. CRPS is characterized by burning pain, swelling and stiffness of a joint or joints in the affected area, changes in hair or nail growth, changes in skin appearance (color, temperature, texture, and sweat), and increased sensation to stimuli that would normally not cause pain. www.RSDSA.Org is a website that provides support and education to those affected by CRPS. They report that CRPS occurs when the nervous system and immune system malfunction as they respond to tissue damage and result in a misfiring of nerves to the brain causing constant pain.

Unfortunately, CRPS is not fully understood and it requires a team of professionals working together to address pain management. A patient who is diagnosed with CRPS often sees a physician that specializes in pain management and also works with a physical therapist, massage therapist, or acupuncturist to help reduce their pain. Again, this is an uncommon condition but one patients should be aware of.

I work with many patients after orthopedic surgical procedures such as amputations, hip replacements, total knee replacements, and rotator cuff repairs who report hypersensitivity to touch.

Sometimes the patient will report a painful area of skin on or around the surgical site that they cannot stand having the bedsheets on, they can’t stand to have their bra strap touching, or they can’t stand to rub a wash cloth on the area in the shower because it is just too painful. This is the type of hypersensitivity that typically responds very well to desensitization training at home or in a PT clinic. In this blog, I’ll discuss one way we, as rehabilitation specialists, treat this chronic condition.

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A common method we use is a “desensitization” technique.

As defined in an article on www.physio-pedia.com, “desensitization is a treatment technique used to modify how sensitive an area is to particular stimuli. This technique is utilized to decrease, or normalize, the body’s response to particular sensations.” One patient we recently worked with after a total knee replacement had this to say.

“My knee was very hypersensitive along the incision and once Andy and Mike had me start to rub a wash cloth on it to reduce its sensitivity, the skin quickly became less sensitive. It wasn’t long until I could sleep with the sheets on my knee without them causing pain.”

If you are experiencing hypersensitive type pain, try these methods:

desensitizationStart with a soft material such as a dry terry or wash cloth. Gently rub the affected area back and forth, slowly, for a minute or two. Normally this should not cause any pain, but for someone experiencing hypersensitivity, this may be painful. The goal is to help the body adapt to the stimuli, helping to desensitize the painful area. If the soft material is not causing a painful response and becomes comfortable, you may try to use a small piece of scrub brush with a little rougher texture or apply more pressure. Just be careful, you don’t want to cause any skin breakdown.

Other methods for desensitization include:

  • Dipping your affected area into a bowl of dry rice, sand, kidney beans, cold water or warm water.
  • Allow cool or warm water to run over the area.
  • Using a TENS unit, make sure to ask your physician or physical therapist prior to using one.

If you choose to start with the method of dipping your affected area into a medium such as rice, sand, or water make sure to move the affected area around in the bowl until you cannot tolerate it or you reach one to two minutes, whichever comes first. Use a combination of these methods for 10 to 15 minutes, 3-4 times per day.

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Desensitization techniques are a natural form of pain management and can help reduce a patient’s need for pain medications. However, these techniques will not fix your pain overnight and desensitization will not work for everyone. Again, if you suspect CRPS or hypersensitivity consult a medical professional and see what options are available for you to help get your pain under control.

To learn more about these techniques be sure to book a free pain consultation at our Gorham, South Portland, or Portland, Maine clinics. We look forward to helping you.

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By Andy Broomhall, PTA

Back in Motion® Physical Therapy – Portland, Maine

 

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