Pain Service - Desensitisation Techniques

Desensitisation is a technique used to reduce the sensitivity of body parts to touch or other everyday contacts.

This leaflet aims to explain more about this technique to help you understand how desensitisation techniques may contribute towards your rehabilitation.

Why?

You may have painful abnormal sensations over a specific body part. The skin may feel more sensitive, unpleasant or even painful to touch, perhaps similar to the sensation you first experienced when the pain started. This may have followed an injury or surgery and the pain hasn’t reduced or it may be that your pain levels have increased over time.

This is because of changes within the nervous system, where the nerves which previously told the brain about touch sensations, are now constantly activated and continue to tell your brain about the acute pain you initially experienced.

This is caused by a fault within the protective part of your nervous system, rather like a broken car or burglar alarm. The tissues have healed as well as they are able to, but the nervous system hasn’t learned how to switch off.

This means you experience painful sensations as the nerves continue to misfire, rather than the normal sensations of touch you ordinarily feel.

Wearing clothes or bed sheets over the affected part may be unusually painful where you wouldn’t normally expect pain (this is called allodynia).
 
You may be fearful of pressure being applied to the body part or getting knocked. If this does occur, you may experience a heightened sensitivity to pain (Hyperalgesia). This may have led to you protecting the body part which may limit aspects of your life around other people that you previously enjoyed.

This increased sensitivity may now be a chronic (long-term) problem, which means there is no cure unfortunately, but desensitisation may help with managing it.

The nervous system is changeable and is constantly adapting to the environment and your experiences, one technique that may help to retrain this system to behave more like it used to, is called desensitisation.

By touching or applying pressure to the sensitive body part in a gradual way, using different materials (stimuli), it is hoped the body part will become less sensitive over time.

This is likely to be more successful if you can then begin to use and interact with this body part in routine activities throughout your day.

How?

This is done by gradually touching, stroking and massaging the affected body part whilst looking at it, starting with softer textures and moving on to rougher ones.

You will need to select some materials. Some softer examples include cloth, satin, make-up or paint brushes. Rougher materials may include towels, flannel, wool or Velcro.

Step 1: Get into a comfortable position. Gently touch a normal area of skin close but away from the abnormal sensation with the softer material, thinking about how it feels. Use gentle stroking and circular motions.

Step 2: Slowly move towards and then over the sensitive body part in the same way, trying to remember and focus on what the normal sensations felt like previously.

When you feel able to, move on to using rougher materials and then try applying greater pressure via massage using moisturising cream or oil before rubbing and tapping the skin.

How often?

Start these techniques for 5-10 minutes every few hours during your waking day.

Try to do this somewhere quiet away from distractions, as it should involve some concentration on the feelings experienced and the techniques applied.

The progression to different materials may take several weeks or months.
 
The approach should be ‘little and often’, with the focus on committed participation in order to challenge the nervous system in a manageable way on a regular basis.

What should I expect?

You should expect this technique to cause some level of discomfort or even pain, especially when you first start, whilst this doesn’t indicate damage, it should be done at a manageable level.

You may favour some materials more than others, so persevere with these until they feel more manageable, before moving on to the more difficult materials.

The response to the techniques will differ from person to person. Doing them episodically will only produce the same provocative response, but carrying these techniques out on a regular basis is likely to achieve better results.

You should expect that it takes a long time before improvements are seen and it may not be possible to normalise sensations fully to what they were like previously.

Any questions or concerns?

If you have any questions or concerns about the techniques or if you need more support, you should discuss this with your therapist.

Alternatively, you can contact the Pain Centre and leave a message with your contact details for the attention of the Physiotherapy team.

Contact

The Pain Centre - 0161 206 4002
Manchester and Salford Pain Centre, Salford Royal Hospital, Stott Lane, Salford, M6 8HD.