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occipital allodynia
Hello, I have a patient with an occipital allodynia. She has pain when the wind blows in her hair, a cap doesn't help for the problem, it aggravate the pain.
She suffers also in the night, when the affected areal touch the pillow. Are there any experiences how to help for this?
thank you
Comments
Thank you for your message and welcome to our moodle community.
First of all, could you please help us understand your patient's situation by telling us which is the Somatosensory condition with the exact nerve?
As a Somatosensory therapist, I kindly remind you that, after passing the McGill pain questionnary and defining the personalised VAS, we have to determine the Somatosensory condition and from there we can explore and propose the accurate treatment.
Thank you in advance for your answer that will help us bring you solutions.
Here we can find a great community of therapists (certified and non certified) that have a lot of motivation, experience and good ideas ?
Evangélia AGNESKIS
Somatosensory Rehabilitation Network President.
May I come with a suggestion?
The fact of having pain during the night lets me think that your patient suffers from an "incessant occipital neuralgia" (stage IV of axonal lésions) then you need to determin which nerve branch bas a lesion....
Is the mechanical allodynia on the territory of the greater occipital nerve?
Rebekah DELLA CASA
May I ask how are things going on with your patient?
We are waiting for more informations about the specific Somatosensory condition and nerve involved in here.
Not knowing what you already tried with her, and which is the width of the allodynia, did you consider wearing a helmet? Maybe an adapted hand-made thin helmet that would not touch the allodynic territory ?
For the night, maybe consider to sleep seated or in between the seated and horizontal position ? Did you consider creating some kind of silicone helmet for the allodynic territory so that the contact is lighter on the occipital area with less pressure from the weight of her head? Maybe combine the silicone and the half seated position to sleep?
Please give us more informations so that we can have enough keys to help you out.
Here we are a nice community, and as every community we need to communicate, both ways ?
Have a nice evening,
Evangélia.
Dear collegues,
Im sorry for the late answer, I was in holiday. Thank you for the support. Yes its on the territory of the greater occipital nerve. The patient has a mechanical allodynia, the rainbow pain scale is indigo. She has also a permanent headache. The Mc Gill pain score is 64, (if I have done in the right way, it was my first)
We have found out that she can sleep with a ring pillow. But the patient is very sceptic about the treatment.
Dear Carla,
About your patient scepticism, you might lead her to the patient's point of view on this page : http://blog.unifr.ch/e-NewsSomatosensoryRehabilitation/patients-point-of-view
You might also give her the article Neuropathic Pain: Myth or reality? that you will find on neuropain.ch
Feel free to ask some more questions !
Best regards,
Florine
Fribourg, CH
Somatosensory Rehabilitation Network