What is desensitisation and who is it for?

It is an important treatment technique for people with Complex Regional Pain Syndrome (CRPS) who may exhibit abnormal sensation throughout all or part of the affected area. This often includes increased sensitivity to particular stimulation, such as touch, pressure or temperature.

Desensitisation can be an effective way to treat hypersensitivity, especially when used in combination with other medical or therapeutic interventions.

Desensitisation is used to modify how sensitive an area is to particular stimuli. This technique is used to decrease, or normalise, the body's response to particular sensations.

How does it work?

A desensitisation programme is designed to provide consistent stimuli to the affected area for short periods of time, frequently throughout the day. These small bursts of therapeutic activity shower the brain with sensory input. The brain responds to this demand by getting used to the sensation, thereby gradually decreasing the body's pain response to particular stimuli. It involves the use of a variety of materials applied to the painful body part.

Texture kit

Many materials used for desensitisation can easily be found around the house and used to make your own portable texture kit.  Here are a few examples of some of the materials you might want to include in your kit.

• Fabric – scraps of silk, denim, cotton, cord, tulle and/or felt.
• Kitchen scouring pad which is soft on one side and coarse on the other.
• Cotton bud.
• Toothbrush with soft bristles, progressing to one with harder bristles.
• Warm water and soapy water.
• Bowls of pasta, rice, sand and any grains which can be used to immerse your painful body part.

Will desensitisation get rid of pain?

Desensitisation may minimise the body's painful response to various stimuli, however, the affected area may still feel uncomfortable when in contact with particular stimuli.

Guidelines for desensitisation

• Find a quiet space where you will not be distracted or interrupted.
• Position yourself comfortably with the painful limb well supported.
• Select two or three textures from your texture kit for each session – you should ideally rotate through all your textures each day. You could try keeping a diary to help you keep track of session times and textures used.
• At least four, short, five-minute sessions of desensitisation are required daily to achieve progress.
• Start by stimulating the same portion of skin on the non-painful side.
• Look at what you are doing and focus on the qualities of the texture, for example, what you are experiencing.
• After one minute of stimulation, move across to the affected side and begin the process again.
• Work around the border of the sensitive area using inward strokes but not working over the whole area.
• While you are doing this, look at what you are doing and recall how the texture felt against the non-sensitive limb.
• Repeat the technique with the second and third texture, but the whole session should be restricted to about five minutes.

Reproduced with permission from Lewis, J.S. Coales, K. Hall, J. and McCabe C.S. (2011). ‘Now you see it, now you do not’: sensory-motor re-education in complex regional pain syndrome.  Hand Therapy 16: 29-38.

Are there any side effects?

No specific side effects have been reported from using this technique, however, you might initially experience a slight flare-up of your symptoms, especially if you exceed the recommended five minutes treatment time.

To minimise this you can:

• swap frequently between the affected and non-affected side, but with practice the process will become easier
• start at a shorter time and gradually increase the stimulation time as it becomes easier.