Hyperalgesia

Hyperalgesia is a medical condition caused from the overuse and chronic use of opiate medication/drugs. This condition creates an increased sensitivity to pain which may be caused by damage to the nerves.

Hyperalgesia can cause pain in specific or more diffuse, whole-body induced pain. Studies have established that it is possible to experience a learned hyperalgesia, almost as if the body develops a memory for certain pain pathways.

There are 2 types of Hyperalgesia:

  1. Primary hyperalgesia is a created pain sensitivity that occurs directly in the area of the damaged tissues.
  2. Secondary hyperalgesia is a created pain sensitivity that occurs in surrounding undamaged tissues.

Hyperalgesia is induced by an inflammatory or allergic response by signaling an immune cell interaction with the peripheral nervous system, releasing pain producing chemicals. Long term opiate users may experience pain that is out of proportion to physical findings. This can be a common cause for loss of pain control over time causing the user to become tolerant and feeling more pain, therefore they increase their doses. Chronic overstimulation of opiate receptors results in hyperalgesia by increasing pain pathway sensitivity. The stimulation of pain fibers from inflammation causes a form of pain amplification in the spinal cord and throughout the body.

Opiate induced hyperalgesia may be a result of both long-term and acute opiate use. This side effect can raise enough serious concerns to warrant the discontinuation of opiates. Often, our patients are quite surprised that once they are detoxed off of opiate drugs, they find their levels of pain are drastically reduced and their health and quality of life is greatly improved.

What is Opiold Induced Hyperalgesla?

Have you taken opiate painkillers only to find that your pain has gotten worse? Opioid Induced Hyperalgesla, or OIH, occurs when the use of opioids reduces the pain threshold and can manifest as opioid tolerance. Pain can in fact become worse despite an increase in dose or escalation of use. The physiology behind this condition is not clearly understood and many medical personnel were initially skeptical of its origin. This paradoxical phenomenon poses a challenge for doctors, pain management specialists, anesthesiologists and other medical professionals trying to treat patients. It's often hard for people to wrap their heads around the idea that medication prescribed to relieve pain is having the opposite effect. It creates an issue for doctors who may not be sure whether an increase in pain is related to hyperalgesia or if the injury, disease or condition has worsened.

Chronic pain conditions are very common and provide quite a challenge for the medical community. Opioids such as hydrocodone, oxycodone and morphine are often the drugs of choice for doctors and specialists treating severe acute and chronic pain resulting from a number of conditions. The use of these narcotic pain relievers can produce hyperalgesia, or opioid-induced pain sensitivity. Use can also lead to opioid tolerance, where the body becomes accustomed to the drug and no longer responds to its intended effects.

Traditionally, it had been thought that a decrease of analgesic effectiveness was caused by the development of a tolerance or the progression of a disease or condition. Doctors are now coming to understand that increased pain can be caused by this opioid-induced pain sensitivity. In the case of OIH, it might make sense to increase the dosage to combat the pain, but the opposite is thought to be true. Tapering the dose may actually work to reduce pain.

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