Nerve damage can lead to an unusual and often painful sensation known as dysesthesia. Possible causes include multiple sclerosis (MS), diabetes, and shingles.
Dysesthesia is a type of chronic pain triggered by the central nervous system (CNS). It’s commonly associated with multiple sclerosis (MS), a chronic condition that causes damage to the CNS, but it can also be a symptom of other conditions.
Dysesthesia often involves sensations, such as burning, electric shock, or a general tightening around the body. It generally occurs in the legs, feet, arms, and hands, but it can affect any part of the body.
Dysesthesia can be mild to intense and may include:
- aching or throbbing
- skin crawling
- burning or stinging
- shooting, stabbing, or tearing pain
- electrical shock-like sensations
These sensations might be constant or only pop up every once in a while. Sensations can also vary based on the type of dysesthesia you’re experiencing
Types of dysesthesia
There are several distinct types of dysesthesia, including scalp, cutaneous, and occlusal dysesthesia. However, not all cases of dysesthesia fall into these categories.
Scalp dysesthesia, also called burning scalp syndrome, involves pain, burning, stinging, or itching on or under the scalp. There’s usually no rash, flaking, or other visible irritation.
Cutaneous dysesthesia is characterized by a feeling of discomfort when your skin is touched.
The symptoms, which can range from mild tingling to severe pain, may be triggered by anything from clothing to a gentle breeze.
Occlusal dysesthesia (OD), also called phantom bite syndrome, is discomfort in the mouth when biting, usually with no obvious cause.
The underlying cause of OD isn’t well understood. Sometimes, it’s diagnosed as a psychological condition, but it can also be related to jaw misalignment.
Dysesthesia vs. paresthesia vs. hyperalgesia
It’s easy to confuse dysesthesia with paresthesia or hyperalgesia, both of which can also occur with MS.
Paresthesia describes sensory symptoms, such as numbness and tingling, “skin crawling,” or a “pins and needles” feeling.
Hyperalgesia refers to increased sensitivity to painful stimuli.
While dysesthesia and paresthesia have their own definitions, some consider dysesthesia to be a type of paresthesia. In some cases, you might hear the terms used interchangeably.
Dysesthesia is caused by nerve damage. When nerves are damaged, they can start to send mixed signals to your brain, resulting in unusual (and often painful) sensations.
For example, you may have painful sensations in your leg even though it’s not injured. It’s a communication problem between your brain and the nerves in your leg, which stimulates a pain response. And the pain is very real.
According to the National Multiple Sclerosis Society, more than half of people with MS experience pain as a significant symptom, and about 1 in 5 people who report continuous pain describe it as a burning pain that mostly affects their legs and feet.
MS causes the formation of scar tissue, or lesions, in the brain and spine. These lesions interfere with signals between the brain and the rest of the body.
One common type of dysesthesia experienced by people with MS is the MS hug, so called because it feels like you’re being squeezed around your chest. It can be described as a crushing or vice-like grip causing pain and tightness in your chest and ribs.
Here are some other reasons a person with MS might have strange sensations or pain:
- spasticity (muscle tightness)
- injection site reaction or side effects of medications, including disease-modifying medications
- bladder infection
Of course, your symptoms could be completely unrelated to MS. They could be due to injury or another underlying condition.
Like other symptoms of MS, dysesthesia can come and go. It can also completely disappear without treatment. Also like many other symptoms of MS, when you and your doctor find the right treatment, you’ll experience dysesthesia less frequently.
Dysesthesia isn’t unique to MS. Other conditions that affect the nervous system and may cause dysesthesia include:
- diabetes, due to nerve damage caused by chronic high glucose levels
- Guillain-Barré syndrome, a rare neurological condition in which the immune system attacks and damages part of the peripheral nervous system
- Lyme disease, which can cause neurologic MS-like symptoms, including itching and burning sensations
- HIV, due to resulting peripheral sensory and motor nerve disorders
- shingles, when tingling and pain occur near lesions
There are a variety of potential treatments, but it may take some trial and error to find the right one for you.
Over-the-counter pain relievers such as acetaminophen (Tylenol) and ibuprofen (Motrin) usually aren’t effective for treating neuropathic pain, like dysesthesia, according to the National Multiple Sclerosis Society.
Dysesthesia is usually treated with the following medications:
- antiseizure agents, such as gabapentin (Neurontin), pregabalin (Lyrica), carbamazepine (Tegretol), and phenytoin (Dilantin), which can alter nerve activity
- certain antidepressants, such as amitriptyline (Elavil), nortriptyline (Pamelor), and desipramine (Norpramin), to change your body’s response to pain
- topical pain-relief creams that contain lidocaine or capsaicin
- the opioid tramadol (Ultram, ConZip, Ryzolt), rarely prescribed and usually only for people experiencing severe pain
- the antihistamine hydroxyzine (Atarax), for people with MS to relieve itching and burning sensations
Your prescriber will start you out on the lowest possible dose and adjust upward if needed.
Before starting on a new medication, ask your care team about all the potential short-term and long-term side effects. To avoid dangerous medication interactions, be sure to tell them about all the medications you take, including supplements.
They may also recommend a topical treatment if dysesthesia causes you to scratch your skin to the point of breaking the skin.
The following natural remedies may provide some relief from chronic pain associated with dysesthesia, especially when combined with medication:
- applying a warm or cold compress to the affected area
- wearing compression socks, stockings, or gloves
- performing gentle stretching exercises
- using lotion that contains aloe or calamine
- taking a bath before bedtime with Epsom salts and colloidal oats
- using certain herbs, such as Acorus calamus (sweet flag), Crocus sativus (saffron), and Ginkgo biloba
If you’re interested in using herbs and supplements to help manage dysesthesia, check with your healthcare professional first to ensure the supplements won’t interact with any medication you take.
Persistent dysesthesia can interfere with your life in a number of ways, such as:
- skin or scalp irritation or infection due to scratching or rubbing
- daytime fatigue due to poor sleep
- inability to perform everyday tasks due to pain or being distracted
- isolation from avoiding social outings
- irritability, anxiety, or depression
If your dysesthesia symptoms are interfering with your life, you should see your primary care physician or a neurologist. Other causes for your pain should be examined and ruled out.
Dysesthesia doesn’t always require treatment. But if you seek help, there are a variety of options to manage it and improve your overall quality of life.