What is Hyperesthesia? : Causes, Symptoms, Risk Factors, Treatment, Diagnosis

Hyperesthesia is a heightened sensitivity to any stimuli that may affect senses and often involves increased sensitivity to touch, pain, and temperature sensations.

The name hyperesthesia is derived from the Greek word “hyper” which means over and “aesthesia” which means “feeling”.

According to the International Association for the Study of Pain, hyperesthesia is an increased sensitivity to stimulation excluding special senses.⁽¹⁾

Hyperesthesia may refer to the following sensations:

• Touch
• Pain
• Thermal sensation without pain

This term is often used to describe increased pain sensitivity to a stimulus.⁽²⁾ Allodynia (increased sensitivity to a stimulus that does not typically cause pain) and hyperalgesia (an extreme response to a painful stimulus) are the two most common types of hyperesthesia.

Neuropathic pain is the most common reason why hyperesthesia occurs. Neuropathic pain can occur due to various diseases affecting the somatosensory system. Its various causes include:

• Systemic diseases including diabetes, stroke, hypothyroidism, cancer, Guillain-Barre syndrome, nutritional deficiencies and multiple sclerosis.
• Infectious diseases including HIV, hepatitis C virus, and varicella-zoster virus
• Toxic drugs including immunosuppressants
• Mechanical causes including trauma, phantom limb pain, syringomyelia, radiculopathy, and complex regional pain syndrome
• Hereditary conditions including metachromatic leukodystrophy, and Charcot-Marie Tooth disease.

Any condition causing damage or injury to the nerves especially those relating to the somatosensory nerves may lead to neuropathic pain.

A study found that a shortage of sleep increases the risk of postherpetic neuralgia in a person in an area following shingles.⁽³⁾ This increases the risk of hyperesthesia and acute pain sensitivity.

In shingles, reactivation of the virus may lead to hyperesthesia in the affected areas.

The symptoms may vary in people and may depend on the area affected and the extent of the damage.

The pain is described as chronic burning type. It may be so severe that a person may not be able to tolerate it.

The pain also varies in terms of intensity, frequency, quality, and aggravating and alleviating factors.⁽²⁾

Hyperesthesia may also include the following symptoms:

• Changes in skin and hair
• Swelling
• Loss of range of motion
• Change in sensations
• Muscle spasms
• Redness or discoloration

Diagnosing the cause of hyperesthesia is very important for proper treatment. The following diagnostic process can be helpful in finding the cause:

• CBC or the complete blood count
• Fasting blood sugar
• Erythrocyte sedimentation rate
• Comprehensive metabolic panel
• Vitamin B12
• Thyroid stimulating hormone

A neurological examination may be carried out to assess a person’s neurological function. These tests can be helpful in identifying disorders of the brain, spinal cord, and nerves.

Hyperesthesia can also be identified with the help of the following special tests:

• Electromyography: A diagnostic test done to measure the response of muscles to electric signals in motor nerves
• Nerve conduction tests for large nerve fibers
• Punch skin biopsies for small-fiber neuropathy

In treating hyperesthesia, the aim of the healthcare team is to treat the underlying cause, address functional impairments, and provide mental health services.

Hyperesthesia may occur as a symptom of peripheral neuropathy due to hypothyroid, nutritional deficiency, and diabetes.

As hyperesthesia is a chronic condition, the following lifestyle changes can be helpful in reducing its effects on a person’s everyday life:

• Exercising regularly
• Maintaining a nutritious diet
• Eating healthy and a balanced diet
• Keeping blood sugar levels under control
• Drinking alcohol in moderation

Medication may be prescribed if the problem in the brain, spinal cord, or nerves is causing hyperesthesia. The medication may include antidepressants, anti-seizure medication, and pain relievers. Botox, epidural steroid injections, sympathetic nerve block, neurostimulation, and transcutaneous electrical stimulation may also be helpful.

Other treatment for hyperesthesia includes:

• Physical therapy
• Occupational therapy
• Pain psychology
• Patient Education

The outlook of hyperesthesia may depend on the underlying cause of it. Treating the cause may be helpful in resolving the condition. A person experiencing hyperesthesia should consult a doctor to diagnose the cause and get proper treatment for it.