Opioid-Induced Hyperalgesia: How Opioids Can Increase Pain

Thus, it is essential for anesthesiologists, pain management specialists, surgeons, and primary care physicians to regularly update their awareness and strategies for addressing this problem. This educational review of hyperalgesia provides up-to-date knowledge of the contributing mechanisms, differential diagnoses, and medical therapy. A particular focus is placed on common types of postoperative hyperalgesia and recent evidence that anesthesiologists and surgeons should be aware of. Hyperalgesia is a condition in which you develop an increased sensitivity to pain. Hyperalgesia is believed to be the result of an allergic or inflammatory response.

  1. You may also have withdrawal symptoms such as sweating, restlessness, anxiety, or cramps.
  2. When a person becomes more sensitive to pain as a result of taking opioid medication, it’s called opioid-induced hyperalgesia (OIH).
  3. They have an increased sensitivity to pain compared to a person without hyperalgesia.
  4. The chief symptom of hyperalgesia is an increasingly extreme reaction to painful stimuli without any new injuries or worsening of a medical condition.
  5. The most common types of hyperesthesia are allodynia, which involves experiencing pain from a stimulus that does not typically cause pain, and hyperalgesia, an extreme response to a painful stimulus.

Working closely with your healthcare team is very important, as is managing your pain during a weaning period. There are CDC guidelines available ketamine effects of ketamine to help your doctor safely taper your dose. Physical therapy has adopted several psychology techniques to help patients with neurologic pain.

What Is Myofascial Pain Syndrome?

There should be a further investigation for an underlying cause depending upon history and examination. Testing for coordination will often reveal subtle motor neuron deficits. If the patient is testing poorly on strength, try to ascertain if it is genuinely due to muscle weakness, or if it is due to pain leading to decreased effort. The symptoms of OIH typically develop despite an increase in the dosage or amount of opioid taken.

What are the symptoms of opioid-induced hyperalgesia?

Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight loss…from exercises to build a stronger core to advice on treating cataracts. PLUS, the latest news on medical advances and breakthroughs from Harvard Medical School experts. If we maintain our health, our bodies have resilient and elegant ways to do this for us.

That’s called “sensitization,” and it usually involves pain signaling. When this happens, the nervous system cells that handle pain signals become too responsive to pain signals. Pain signals can become more intense, easier to trigger or may happen without a reason. Hyperesthesia could happen when some part of the sensory process becomes dysfunctional. That can happen in the nerves themselves, your brain or your spinal cord. In effect, your sense of touch is dialed up to 11 without any regard for whether or not that level is necessary.

What Is Patellofemoral Pain Syndrome?

Lightly stroke the unaffected side, then the affected side, and then both sides. Sometimes patients are so sensitive that even a light breeze will elicit subjective pain. Document if the allodynia follows cutaneous dermatomes, if it is symmetrical and if crystal meth: signs of use and addiction it is bilateral. However, your doctor will rule out the progression of any preexisting condition before diagnosing hyperalgesia. Your doctor will evaluate your medical history as well as any medications before deciding on how to treat your hyperalgesia.

Create a file for external citation management software

OIH occurs when a person experiences worsening or new pain as a result of taking opioids, such as morphine, hydrocodone, or fentanyl for pain relief. This type of hyperalgesia is when the increased pain occurs in the tissue where the injury took place. An example would be when a person has surgery on their elbow, and the pain starts to worsen over time instead of improving. Your doctor will immediately suspect opioid-induced hyperalgesia if you experience extreme pain after increasing your opioid dose.