On the other forum I wrote several times about the sunburn like rash I get. Well I got it again this morning. It follows exactly, the pathways of where there is pain from my TOS. It turns bright red, feels like it is on fire, is sensitive to the touch, and the joints are hard to bend. My DH said it is almost as if it is my lymph system flaring up. I know it isn't RSD because it is intermittent, and RSD is present all of the time. I have never been able to show it to the Dr. so of course he thinks it is all in my head. I also know it is not an allergy. I had testing done, and was told by my allergist that allergies do not present themselves in this way. She at least got the opportunity to see the rash. My DH took photos of it this morning, so hopefully I can show them to the Dr. and he will have some idea of what to do. Anyone have any ideas?
Tracy

hi trix-
how long does it usually last?

so it seems to follow a lymph pathway {if there is such a thing} vs a nerve pathway?

oh can you post the pic of it?
maybe somebody else will recognize similar sx if they see a picture.

Tracy, I get this too... it's wherever the pain is. it looks like a cat clawed my shoulders or chest and there are red spots from it. I'll try to get a pic and post here later, but am on my way out for a day. For me it's almost always there around my shoulder capsules and is very tender to the touch. and frequently goes across my chest above the collarbones.

The way it was explained to me (can't remember who: Dr or PT) is that when you have pain in the same place for so many years, acids build up in the tissues that kind of attack your body. Make sense? Am I wrong? Comments?

Hang in there - it's all we can do.
Anne

Hi Trix,
On the old forum I had posted a similar mylay. At times I also got a tiny scabbs like along the path. Just liek wa said a cat scrath.
It reminded me of when my son had shingles, the aggrivated nerve path.
I found that Valtrex, and bynadryl cream, or something with lidcain in it, like a preperation H product, perianal, or insect releif, calmed it down.

For prevention, I found a small dose of Topomax has helped the best.
I also think when you see the doctor mention Allodynia. It is a hyper nerve reaction to long term chronic nerve activity. The nerves travel to the brain and send messages. When you feel something instead of a pin prick, it seems a stabbing. Or if someone touches your arm in an attention getter, it feels like a painful pressure point remains.
I will look for some literature for you to print to take.
Di

Hi,

Just a suggestion but it could be an immune reaction to the pain the nerve cells are damaged and then the body tries to heal which causes redness inflammation and sometimes puss. Think of what happens when you get a cut. the body reacts by sending immune cells white cells and other important cells. perhaps this is what is causing the problem. And yes there is most definatly a nerve pathway and a lymph pathway.....all systems are interconnected. One thing goes wrong......and then all flares up. Not sure if this helps or hinders........GREAT idea for pics make sure to document every little thing. Do you keep a pain journal when you take your meds with your symptoms.....is a very valuable tool to take with you to your docs so they understand just how awful you feel and how painful things are.

Take care

Victoria

it last anywhere from 2-3 hours where the pain is out of control, burning and nothing can touch it. After that, the redness stays for about 4-5 hours. It prickles like a sunburn, that is how I know it is starting. That and I get REALLY hot. I get so hot that I have to pull off as many clothes as I can. I am then HOT for the rest of the day. I went to a wedding on Saturday when it happened, and it was about 10c and everyone else was wearing jackets, and as the sun went down people were wearing parkas and I was standing around in a short sleeved dress sweating like a pig. Everyone thought I was nuts. I hope my Dr. can figure out what this is and get rid of it. I hate it!

Trix,

RSD often DOES flare up and then go away, especially the color changes, swelling and stiffness, at least early on, that's why it can be really hard to get a dx cause it never seems to "act up" during a Dr visit

And RSD shows up in lots of different ways, it's not the same in every person, which makes things harder to figure out!

But there are usually other sx in common besides the burning pain: pain when touching or being touched (it would hurt to pick up my car keys!),
pain from AC or wind on your skin, a deep, achy bone pain, abnormal sweating, abnormal hair loss or growth on the limb, abnormal fingernail growth (fast or slow). Not every person will have ALL of these though.

There are some really helpful people on the RSD forum here that you may want to ask about this.

I'm hoping it's not RSD, in some ways it doesn't sound like it, but if it is it's important to get an early dx and treatment as there's a chance of putting it into remission if caught early enough.

The best Dr to see for this is probably a neurologist or a Pain Mgmnt/Anesthesiologist, they do a really poor job of educating Drs about this in med school, which is a crime as it is SO important to catch it early!!

Feel free to PM me if you have ANY questions.

(((hugs)))
beth

i was having knee pain (from overdoing it on the eliptical walker). at one point it was similar to the pain i had when the knee was infected, and i had a big red spot and red streaks.

i have read that herpes infections can manifest as red streaks and nerve pain. i had chicken pox as a kid and i think it recurs similar to this.

i was fortunate, i waited and it went away with the high pain. guess i am just living well. but i did beef up on yogurt and wonder if that is what did it. anyway, it is worth a try.

here is my yogurt recipe. i have a melitta coffee maker, but u can use cheese cloth or any other coffee filter. i spoon the yogurt into the coffee filter and put it in the fridge. this makes the yogurt really thick and it tastes "sinful". it takes an hr or so but i usually give it overnight. i use stevia and concentrated cherry juice to flavor it.

I think what you are thinking of is shingles. I am definetly up on that yogurt recipe. It is better than ice cream! So far my Dr. calls it hyper-algesia. He says it could be RSD, but he wants to wait on that until my next nuero appointment. All I know is that it is the worst part of this so far. I can deal with unrelenting pain. I can deal with not having any fine motor control, I CANNOT deal with the burning fire, the swelling and the absolute horror of being touched in any way. How do you tell your beautiful children that you love them, but don't touch mommy, it hurts?

Trix,
Do some web research on the allodynia. It has to do with the c-nociceptive and non-nociceptive primary afferent neurones, and A-beta low threshold mechanoreceptors...Dr. Togut's meeting explanations.....

Allodynia
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Allodynia, meaning "other pain", is an exaggerated response to otherwise non-noxious stimuli and can be either static or mechanical. Allodynia is not referred pain and can occur in other areas that are not stimulated; it is also dysesthetic.

For example, a person with Allodynia may perceive light pressure or the movement of clothes over the skin as painful, whereas a "normal" individual will not feel pain.

One explanation of the mechanism for Allodynia is that the associated nerve damage results in decreased firing thresholds of nociceptive fibres.

Alternatively, it has been postulated that peripheral nerve injury could induce collateral sprouting of non-nociceptive primary afferent neurones, such as A-beta low threshold mechanoreceptors, into the superficial (nociceptive) laminae in the dorsal horn of the spinal cord. These collateral branches could form functional contacts with nociceptive second order neurones, normally innervated by C-fibre nociceptive primary afferent neurones and transmit an innocous input as noxious.
There are different kinds of Allodynia:

Mechanical allodynia (also known as tactile allodynia) - Pain from light touch/pressure applied to the skin in the area of the damaged nerve.
Thermal allodynia - Pain from normally mild skin temperatures in the affected area.

PainFrom Wikipedia, the free encyclopedia
(Redirected from Nociceptive)
Jump to: navigation, search
Look up Pain in Wiktionary, the free dictionary.For other uses, see Pain (disambiguation).
Pain is an unpleasant feeling which may be associated with actual or potential tissue damage and which may have physical and emotional components. According to the International Association for the Study of Pain (IASP), one should distinguish between pain and nociception[1]. The word "pain" comes from the Latin: poena meaning punishment, a fine, a penalty.

The term "pain" is a subjective experience that typically accompanies nociception, but can also arise without any stimulus, and thus includes the emotional response. Nociception, on the other hand, is a neurophysiological term and denotes specific activity in nerve pathways. It is the transmission mechanism for physiological pain, and does not describe psychological pain. These pathways transmit the nominally "painful" signals, though they are not always perceived as painful. Although pain can be associated with tissue damage or inflammation, this is often not the case.

Despite its causing suffering, pain is a critical component of the body's defense system. It is part of a rapid warning relay instructing the motor neurons of the central nervous system to minimize detected physical harm. Lack of the ability to experience pain, as in the rare condition Congenital insensitivity to pain or Congenital Analgesia, can cause various health problems.

The two most common forms of pain reported in the U.S. are headache and back pain. Pain is also a term specifically used to denote a painful uterine contraction occurring in childbirth.


An example of touch allodynia is pain from the touch of clothing. Thermal allodynia occurs from a draft of warm or cold air on the skin. The March 17, 1997 issue of Newsweek describes a patient who dreaded the breeze from a ceiling fan because it felt like razors cutting his flesh.

A good example of location allodynia is pain in the right ulnar forearm from a rough scratch on the patient's palm from whiskers on the right side of the face. If a physician demonstrates or presumes physical relocation of the pain signal, it is also proper to use the term ephapse, so literature may refer to this as either location allodynia or as ephapse.

Clinicians report ephapse in perhaps one percent of patients with Central Pain. Diligent testing may demonstrate ephapse or location allodynia in many patients that are unaware they have it. The quickest way to test for ephapse is to rub the palm of the hand (glabrous skin) against something rough, such as whiskers or a piece of sandpaper. Demonstration of an ephapse often requires prior sensitization by heat, followed by vigorous prickly scratching, or having the patient rub a dysesthetic hand or limb against something rough-textured.

Thermally-sensitized skin more dramatically and more easily demonstrates ephaptic phenomenon. Many Central Pain patients tested carefully this way demonstrate an ephapse or location allodynia. Almost no patients volunteer it on their own. One patient with very marked and reproducible ephapse did not recognize its presence after five years with the disease. Because there is such poor localization of sensation distally, the patient tends not to pay much attention to such matters.

Anatomically, it is unclear to what extent Devor's work on the ability of injured sensory neurons to humorally induce firing in surrounding fibers encompasses the phenomenon of an ephapse. Devor discovered crossed afterdischarge; the capacity of injured sensory neurons to induce passive autonomous firing in uninjured neighbor neurons. In such injury the entire axon may gain the power to behave as if it were a nerve ending. This earthshaking discovery ran contrary to long held theories of neurotransmission. Researchers believe that crossed afterdischarge is a humoral phenomenon, while ephapse refers to postulated physical phenomena involving proximity or direct contact between nerve fibers. (Wall 1994, Devor 1995)

Allodynic pain is dysesthetic, whereas hyperpathic pain is not. Ochoa reported a cold allodynia due to pure A-delta dysfunction separate from Central Pain. Since Central Pain involves transmissions from many different types of fibers, it is not clear whether the mechanisms are similar. Patients with Central Pain of the trigeminal area feel burning in the pulp of their teeth, but not in the dentin, which lacks C-fibers but does have A-fibers.