Pain, Allodynia, and Desensitisation therapy

This leaflet explains how to carry out a desensitisation programme, as advised by your therapist.

What is desensitisation?

To reduce the sensitivity of your skin, your nerve endings need to be “re-trained” to identify different types of stimuli. A desensitising programme aims to bombard your sensitive nerve endings with different sensations. Desensitisation is the process where we retrain the nerves in your sensitive areas and brain to respond normally again.

How is it done?

• Through the controlled application of various textures (such as silk, towel, or cotton wool) or movements (for example tapping, stroking, or vibration).

• You must be free from distractions, so that you can concentrate on each texture or movement.

• The key is to ‘tune into’ what you know the sensation should feel like, rather than only focussing on your pain.

• It is important that you stay as relaxed as possible.

• Practice little and often, for example try a few minutes every hour or 10 minutes four to five times each day. Find a method that works best for you.

• If your pain is unbearable, stop the activity and talk to your therapist. They may be able to help you change things so that it is more bearable.

Desensitising programme

1. Massage

   • Using moisturising cream (E45, Diprobase, or aqueous cream), make small circles on and around the sensitive and scarred area with your thumb or finger.

   • Try this for five minutes without stopping.

   • Gradually increase the pressure over the next few days as the area becomes less sensitive.

2. Textured massage

   • Look at home for some textured fabrics / materials such as silk scarves, woolly gloves, rough towels, soft brushes, green scourers, rice, lentils, and twisty pasta. Arrange them in order of how bearable to unbearable you find them to touch.

   • To start with, use the texture on an unaffected area of your skin, so that you can use your memory to remember what the feeling should be like.

   • Always look at the texture or movement during the activity, this will help you to activate your memory of normal feeling.

   • Next, select a texture that is just about bearable to touch. Start on the edge of the affected area and work inwards, making a few circles over the hypersensitive area.

   • Choose a texture that is more comfortable and make small circles over the area for a minute.

   • Return to the first texture for a further minute, this should begin to feel more comfortable.

   • Over the next few weeks gradually work your way from the least to the most unbearable textures, only moving to a new texture when the previous one is no longer unbearable.

3. Immersion massage

   • Choose a number of dry ingredients (for example dry rice, pasta, or lentils) and put them into separate containers. Arrange them in order of the least to the most unbearable when your sensitive skin is immersed in them.

   • With your hand in the container, make small stirring movements, changing direction and speed. Do this for five minutes.

   • When this becomes bearable for three minutes, select another container of dry ingredients, that is almost unbearable, and repeat the steps above.

4. Tapping / Vibration

   • With your finger, gently tap the affected part of your hand or use a mini massager or vibrating end of a toothbrush. Gradually build up the intensity of the taps until they are at a reasonable level.

This sensitising can feel unpleasant, but the outcome of the treatment normally depends on how often you complete the above programme.

Is there anything else I can do?

Every daily activity you do using your affected limb is a chance to train your sensation. Once you understand the above steps you can be quite creative with this form of therapy.

• While dressing, stop to look at and feel the texture of the cloth against your skin. Try to think about what it should feel like.

• Whilst bathing, use different water temperatures that you can tolerate. Try to massage soap or cream up to and around the painful area with your hand, flannel, or sponge.

• When in the kitchen use different textures of food, or focus on the shape and feel of different utensils.

Further information

If you have any further questions, please ask your consultant or therapist.