Migraine Allodynia: Top Reasons & What to Do When Touch Hurts

You will often hear Migraine Strong advocating to end migraine stigma by shouting from the rooftops that migraine is not just a headache. While head pain is a component of migraine disease for most, migraine actually causes many other multi-sensory symptoms. The whole multitude of symptoms migraine comes with make it a complicated neurological disease to manage.

The most common multi-sensory symptoms include sensitivity to scents, light and sound. But, those with migraine may also experience a hypersensitivity to touch called allodynia. If you are struggling with migraine allodynia read on to learn more about what allodynia is, if it’s a cause for concern and how to find relief from its discomfort.

**While Migraine Strong writes about the latest in migraine treatments, this is not medical advice. We are patient educators and all information you read should be discussed with your doctor.

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What is allodynia?

Allodynia is a symptom in which everyday touch sensations cause pain. It commonly occurs in those with migraine, but it occurs in other disease like diabetes, fibromyalgia & multiple sclerosis as well.

Allodynia is a type of pain, generally on the skin & scalp caused by touch that is not normally painful. Like most things migraine, allodynia is a perplexing symptom for researchers. But, it is thought to be a hypersensitivity or heightened response of our central nervous system. More on that later.

Migraine allodynia pain experiences can vary from mild to severe. The kind of touch that causes pain can vary too. Some people feel pain from slight pressure while others experience it just from hair brushing across their skin. Even the slightest feather weight touch can be painful for someone with allodynia.

Allodynia pain can even be experienced without pressure. Perceived touch like changes in temperature, vibrations and wind blowing across the skin can hurt in someone with allodynia as well.

Is migraine allodynia common?

Allodynia is not experienced by everyone with migraine, but it is fairly common.

Migraine allodynia is more common in women, in those that experience frequent & severe migraine attacks & in chronic migraine. Allodynia is also more common in those that experience migraine aura, in those that get motor and sensory symptoms during migraine attacks and in those with comorbid depression and anxiety.

One study found it occurs in approximately 65% of those with migraine although some estimate this number to be higher. For those who do experience this migraine symptom, it often lingers between attacks not just during the episode.

Types of allodynia

There are actually three different types of Allodynia. Tactile allodynia seems to be the most common in those with migraine, but it’s possible for you to have one, two, or all three types. The three different types of allodynia are:

• Tactile allodynia: Pain caused by hypersensitivity to touch. This can include brushing or washing your hair, tight clothing pressing against the skin such as straps & elastic bands, glasses resting on the bridge of your nose, a hug, or someone touching you lightly on the arm to gain your attention.
• Mechanical allodynia: This pain is caused from movement across the skin. Examples include clothing tags touching you, a towel as you dry yourself off, bedsheets brushing against you, vibration from a bass thumping car in traffic, a flowy dress or even the air moving over your skin.
• Thermal (temperature-related) allodynia: Is pain caused by heat or cold that is not extreme enough to cause actual injury or damage to your tissues. For example, your hands, face & scalp might hurt if it’s chilly. Or your skin & scalp might ache in warm temperatures.

What does allodynia feel like?

Imagine what it’s like to touch a bad bruise or a sunburn, that’s what allodynia feels like for many. A sunburn hurts even when you don’t touch it. It hurts worse when you do and it can feel excruciating when rubbed or pressed.

The same goes for migraine allodynia and it may last long after your migraine attack ends. Many people who experience migraine allodynia feel it’s discomfort between attacks not just alongside one. For me, it feels like bruising all around my face and scalp even though there is no injury present. Touching these spots feels exactly the same as touching a surface injury.

 People who experience migraine allodynia express pain from everyday activities like:

• Taking a shower
• Washing your hair
• Brushing your hair
• Wearing your hair pulled back
• Washing your face
• Laying your head on a pillow
• Putting makeup on
• Shaving
• Wearing glasses or contact lenses
• Tight clothing
• Wearing jewelry
• Carrying a purse, camera or backpack on your shoulder

Why does migraine cause allodynia?

Simply put allodynia is thought to be a heightened reaction of irritated nerve endings.

Why exactly are they irritated? Well migraine and especially high frequency & chronic migraine involves continual, repetitive attacks loaded with pain & a variety of other neurological sensory symptoms. These repetitive sensory symptoms & prolonged pain episodes create an agitated central nervous system.

An agitated central nervous system results in an excited nerve pathway called central sensitization. Research suggests allodynia results from central sensitization. “Central” is referring to our central nervous system and sensitization means it’s hyper-responsive, heightened & over sensitive.

Basically, what this means is that frequent migraine attacks may cause your nerve endings to be over stimulated & sensitive resulting in allodynia, hypersensitivity to touch, even touch that is normally pleasant or not noticed.

Should I be concerned if I experience migraine allodynia?

While the symptom itself is not dangerous, allodynia is not good. Any pain we feel is meant to serve a purpose, it tells us that there is a problem that needs to be stopped or treated.

Experiencing migraine allodynia can be a warning sign of migraine progression & needs to be treated. If you notice the presence of pain from touch, it’s likely that you also experience high intensity attacks, high frequency episodic attacks, chronic migraine or are headed in that direction. The presence of allodynia in the course of migraine attack also greatly increases the level of disability of migraine attacks you experience. This must be managed.

Not only is migraine chronicification a concern, According an American Headache Society Q&A With David Dodick, MD, those who experience allodynia have a harder time aborting attacks than those that do not. They also have a higher risk of medication overuse.

So the presence of allodynia is a sign that it’s time for your migraine attacks to be better managed. But don’t try to do this alone, talk with your doctor about treating & managing your migraine if you are experiencing this symptom. Early treatment is recommended for the most successful treatment outcomes.  

How to treat migraine allodynia

Because allodynia is a symptom and not a disease, it is best treated by addressing the underlying disease associated with it. So allodynia is best managed by treating your migraine disease alongside the help of a knowledgeable doctor. While not an exhaustive list, here are some strategies your doctor may suggest to make life with migraine allodynia a little easier.

Oral medications

• Migraine preventative medications
• Migraine abortive medications
• Migraine rescue medications

Topical Pain Relief Medications might include…

• Biofreeze roll on
• Capsaicin cream
• Lidocaine cream
• Tiger Balm
• Voltaren Gel
• Magnesium roll on
• Natural remedy lotion

Supplements- Migraine allodynia fighting foods and supplements

• Capsaicin found in hot peppers
• Turmeric/Curcumin & ginger
• Chlorogenic acid found in coffee
• Omega-3s found in fish oil
• Magnesium to calm that excited nerve pathway we talked about earlier. Calming forms of magnesium include magnesium threonate, glycinate & citrate.

Other treatment strategies

• Botox or Nerve Blocks
• Physical Therapy
• Cognitive Behavioral Therapy
• Mindfulness techniques- This one has the potential to sound hokey, but don’t overlook or underestimate this important strategy. Remember experiencing migraine allodynia is a sign of severe attacks, migraine progression & an excited central nervous system. So if touch feels painful to you, calming down your central nervous system should be on the top of your priority list. There are so many options for mindfulness techniques so do a little digging to find the strategies that you connect with the most. Deep breathing, biofeedback, yoga, grounding, creative experiences, acupuncture and so much more can help.

Next steps

If you are experiencing more frequent or severe migraine attacks and have been feeling more sensitivity to touch than usual, you are not alone. Many people with migraine disease are all too familiar with symptoms like painful touch that can make life difficult.

Because allodynia is a warning sign for migraine chronification, it is important to know if it’s the symptom responsible for your pain. If you experience migraine allodynia reach out to your doctor. There are treatments available to help lessen it’s discomfort and reduce your risk of migraine progression.

Because there is no one size fits all migraine treatment plan, working alongside a knowledgeable doctor to find the right combination of therapies and treatments perfect for you is key.