Day 5
Gretchen Tietjen: Body pain, Allodynia & Fibromyalgia
Migraine & Body – Body aches & hair hurts
Allodynia
- Pain without painful stimulus
- “Central sensitization”
- Examples include; combing hair, putting on glasses or earrings and
pain whilst washing hair (sensitivity to heat or cold)
- Light touch can be extremely painful
- 80% will say they have experienced this with a migraine
Chronic migraine – can experience allodynia outside of an attack as well
Migraine comorbid conditions
1. Endometriosis (nerves to areas of endometriosis growths)
2. IBS
3. Interstitial cystitis
4. Chronic fatigue syndrome
5. Fibromyalgia (not problems with muscle itself – problem with nerves
to muscles)
Central sensitization – trigeminal nerves (sinus, face & head) –
explains why some people think they are experiencing sinusitis.
Allodynia sufferers
- More likely to smoke
- Higher BMI
- More than one pain condition
Migraine and body pain- is it fibro?
- Trigger points on the body;
back of shoulders, spine, hips, elbows, legs. Sensitive on specific body
points.
What can help?
1. Physical therapy
2. Exercise
3. Water therapy
4. CBT
5. Tai Chi
6. Mindfulness
7. Yoga.
8. Physio/ Psychologists
Medications
1. Fibro – duloxetine, pregabalin, Cymbalta (Approved by FDA)
2. SSRI (am) + Tricyclic antidepressant (amitriptyline) (pm) –
combination of two can work well together. Anti-depressants can work well for
migraine too.
3. Antivirals possibly for fibromyalgia
If you are able to stop the pain in your body – Allodynia usually calms
down as well.
Communication between different doctors is very important. Brief your
new doctor. Tell neuro what is happening with gynae for example. Accessing your
notes from different areas can be difficult.
Neuro can make referrals to other specialists where required for example
to a physio or rheumatologist.
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