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To find the right zone of counterstimulation
I want to ask you about finding a zone of counterstimulation if the static mechanic Allodynia stage 4 is locatet at the palmo-radial middle joint of the middlefinger left side ( n. medianus n. digitalis palmaris). I couldn't find any gentle area to touch at the arm and belly, also not on TH12. Senstivity of the Allodynia is yellow. Thanks for your recomments!
Barbara Bretscher, Basel
Comments
Dear Barbara
If the stimulus with the fur is not comfortable and /or identical to the contralateral corresponding area at TH12, I recommend to try L1-S2 at the back.
If it is not working, Claude told me once, you could even try the n. iliohypogastricus area and further down the lateral part of the ipsilateral thigh.
Do you still do it that way Claude?
Once I had a patient who didn't like the touch of the fur on any part of her body, however she was comfortable with touching the defined zone with an artificial fur.
Perhaps even try different types of tissues.
If nothing is working, I would wait one or two weeks and try again, as the decrease of the allodynic region is 1/3 due to the distant counter stimulation and 2/3 to avoiding to touch the area. Your patient could start with avoiding stimulii in the region concerned.
Kind regards,
Ulla
Dear Barbara,
I agree what Ulla wrote.
It sometimes happen to have no comfortable zone of counterstimulation.
Count 3 weeks of avoiding the whole area of the Nerv. digitales palmares communes et proprii + cousins.
Therapeutic Patient Education is extremely important.
You will then check again if you can find one, starting as lower as possible (Co in the back).
About what else to use to do the counterstimulation with some patients, a makeup brush works well too
Best regards,
Florine