How do I improve my tolerance for touch?

Living with Complex Regional Pain Syndrome (CRPS) often means dealing with significant pain and discomfort, particularly when touching or using the affected body area. However, avoiding touch and movement can exacerbate the condition. Sensory training, also known as desensitization or body-relearning, plays a crucial role in managing and improving CRPS symptoms. This blog post explores the importance of sensory training, how to handle the pain associated with it, and the latest advancements in this therapeutic approach.

Should I Avoid Using or Touching My Painful Body Area? It's natural to want to avoid touching or moving the affected area when it hurts. However, too much avoidance can worsen CRPS. It’s crucial to use the affected limb within your limits. Therapists can teach you techniques and strategies to gradually use and touch the limb, making it more tolerable. This process is called “desensitization” or “body-relearning.”

How Do I Handle the Pain If I Use the Limb? The key to using the limb is reassuring yourself that, despite the pain, you are safe and in control. Using relaxation and breathing techniques while you move or touch the affected area can help train your mind and body to recognize that you are safe. Your therapist will guide you to work gradually, starting within your limits and expanding them over time.

If It Hurts, Does That Mean I Am Damaging Myself or Making the Condition Worse? In CRPS, your body can make you feel pain even when there is no actual damage. For example, gentle touch or movement might cause real pain but does not harm your body. Feeling pain does not necessarily mean you are causing damage or worsening the condition. Your therapist will guide you on how to safely use your body without causing harm.

Introduction: The Goal of Sensory Training The primary aim of sensory training is to help your body become more tolerant of touch and movement and to increase comfort. Initially, the idea was that experiencing a touch or movement repeatedly would help your body adapt (a process called "habituation"). Traditionally, this involved either you touching different objects or having a therapist or family member apply touch using various items like feathers, sponges, or massagers.

Active Discrimination: The New Approach A new method that emerged in the early 2000s requires your active participation in identifying sensations. In this approach, you are not just a passive receiver but an active participant in interpreting sensations. For example, you might close your eyes and try to:

• Distinguish between a sponge and an eraser touching your skin.
• Identify if you were touched with one or two fingers.
• Determine the exact part of the arm that was touched.

This approach involves interaction, mental processing, and you playing a part in your healing.

The Science Behind It This new way of sensory training engages special nerve pathways (called "inhibitory circuits") that naturally turn the volume down on sensations. With repetition and practice, the sensations begin to feel less unpleasant.

Pioneering Research: The Lancet Study of 2001 A game-changing study published in The Lancet in 2001 found that an active approach to sensory training, initially tried on patients with phantom limb pain, led to lasting pain reduction and measurable improvements in brain function monitored with brain scans (fMRI).

Extending to CRPS: 2008 Breakthrough In 2008, this new approach was applied to CRPS for the first time, compared against the traditional passive stimulation method. The results showed that the active approach was more effective. Subsequent studies in 2009 and 2017 further demonstrated its efficacy.

How Can You Do Sensory Training at Home? Despite these promising research findings, the new sensory training approach can be hard to implement in daily life. It requires frequent daily practice and a trained family member or therapist to deliver the sensory exercises while you close your eyes or look away. The amount of repetition required can also make the practice tedious and boring.

This challenge inspired the creation of TrainPain. TrainPain uses technology tools to empower people to perform sensory training at home. It makes training accessible and delivers it through video games, using algorithms to adjust the exercise difficulty for a personalized experience.

Conclusion The journey with CRPS is extremely challenging, but advances in scientific research are giving rise to new helpful approaches. Sensory training is a promising and empowering self-care technique. By embracing sensory training, you can gradually increase your body's tolerance to touch and movement, improving your overall quality of life.