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What And Where Are Dermatomes?

What and where are dermatomes?

Dermatomes are areas of skin that send signals to the brain through the spinal nerves. These signals give rise to sensations involving temperature, pressure, and pain.
The part of a nerve that exits the spinal cord is called the nerve root. Damage to a nerve root can trigger symptoms in the nerve’s corresponding dermatome.
Below, we show the locations of the dermatomes throughout the body. We also describe health conditions that can damage the spinal nerves and affect their dermatomes.

What are they?

A dermatome is an area of skin that sends information to the brain via a single spinal nerve.
Spinal nerves exit the spine in pairs. There are 31 pairs in total, and 30 of these have corresponding dermatomes.
The exception is the C1 spinal nerve, which does not have a corresponding dermatome.
The spinal nerves are classified into five groups, according to the region of the spine from which they exit.
The five groups and their points of exit from the spine are:
Cervical nerves: These exit the neck region and are labeled C1–C8.
Thoracic nerves: These exit the torso region and are labeled T1–T12.
Lumbar nerves: These exit the lower back region and are labeled L1–L5.
Sacral nerves: These exit the base of the spine and are labeled S1–S5.
A coccygeal nerve pair: These exit the tailbone, or coccyx.

Locations of the dermatomes
Each dermatome shares the label of its corresponding spinal nerve.
Some dermatomes overlap to a certain extent, and the precise layout of the dermatomes can vary slightly from one person to the next.
Below, we list the locations of the dermatomes that correspond to the spinal nerves in each group.
Cervical nerves and their dermatomes
C2: the base of the skull, behind the ear
C3: the back of the head and the upper neck
C4: the lower neck and upper shoulders
C5: the upper shoulders and the two collarbones
C6: the upper forearms and the thumbs and index fingers
C7: the upper back, backs of the arms, and middle fingers
C8: the upper back, inner arms, and ring and pinky fingers
Thoracic nerves and their dermatomes
T1: the upper chest and back and upper forearm
T2, T3, and T4: the upper chest and back
T5, T6, and T7: the mid-chest and back
T8 and T9: the upper abdomen and mid-back
T10: the midline of the abdomen and the mid-back
T11 and T12: the lower abdomen and mid-back
Lumbar nerves and their dermatomes
L1: the groin, upper hips, and lower back
L2: the lower back, hips, and tops of the inner thighs
L3: the lower back, inner thighs, and inner legs just below the knees
L4: the backs of the knees, inner sections of the lower legs, and the heels
L5: the tops of the feet and the fronts of the lower legs
Sacral nerves and their dermatomes
S1: the lower back, buttocks, backs of the legs, and outer toes
S2: the buttocks, genitals, backs of the legs, and heels
S3: the buttocks and genitals
S4 and S5: the buttocks
The coccygeal nerves and their dermatome
The dermatome corresponding with the coccygeal nerves is located on the buttocks, in the area directly around the tailbone, or coccyx.

Associated health conditions
Symptoms that occur within a dermatome sometimes indicate damage or disruption to the dermatome’s corresponding nerve. The location of these symptoms can, therefore, help doctors diagnose certain underlying medical conditions.
Some conditions that can affect the nerves and their corresponding dermatomes are:
Shingles
Shingles, or herpes zoster, is a viral infection caused by the reactivation of the varicella-zoster virus. This is the same virus that causes chickenpox.
After the body recovers from chickenpox, the virus can lie dormant and eventually reactivate as shingles.
In adults, shingles typically causes a rash to form on the trunk, along one of the thoracic dermatomes. The rash may be preceded by pain, itching, or tingling in the area.
Some other symptoms of shingles can include:
a headache
sensitivity to bright light
a general feeling of being unwell
A person with a weakened immune system may develop a more widespread shingles rash that covers three or more dermatomes. Doctors refer to this as disseminated zoster.
Pinched nerves
A pinched nerve occurs when a nerve root has become compressed by a bone, disc, tendon, or ligament. This compression can occur anywhere along the spine, but it usually occurs in the lower, or lumbar, region.
A pinched nerve can cause pain, tingling, or numbness in its corresponding dermatome. As such, the location of the symptoms can help a doctor identify the affected nerve.

The doctor then diagnoses and treats the underlying cause of the pinched nerve and recommends ways to relieve the symptoms.
Traumatic injury
A traumatic injury to the nerves may result from an accident or surgery.
The severity of symptoms can help doctors determine the extent of the nerve injury.

Summary
Dermatomes are areas of skin, each of which is connected to a single spinal nerve. Together, these areas create a surface map of the body.
Dysfunction or damage to a spinal nerve can trigger symptoms in the corresponding dermatome. Nerves damage or dysfunction may result from infection, compression, or traumatic injury.
Doctors can sometimes use the severity of symptoms in a dermatome to determine the extent and location of nerve damage. They then work to diagnose and treat the underlying cause of the damage.

Article Provided By: medicalnewstoday

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Everything You Should Know About Allodynia

Everything You Should Know About Allodynia

What is allodynia?
Allodynia is an unusual symptom that can result from several nerve-related conditions. When you’re experiencing it, you feel pain from stimuli that don’t normally cause pain. For example, lightly touching your skin or brushing your hair might feel painful.
To ease allodynia, your doctor will try to treat the underlying cause.
What are the symptoms of allodynia?
The main symptom of allodynia is pain from stimuli that don’t usually cause pain. In some cases, you might find hot or cold temperatures painful. You might find gentle pressure on your skin painful. You might feel pain in response to a brushing sensation or other movement along your skin or hair.
Depending on the underlying cause of your allodynia, you might experience other symptoms too.
For example, if it’s caused by fibromyalgia, you might also experience:
anxiety
depression
trouble concentrating
trouble sleeping
fatigue
If it’s linked to migraines, you might also experience:
painful headaches
increased sensitivity to light or sounds
changes in your vision
nausea
What causes allodynia?
Some underlying conditions can cause allodynia. It’s most commonly linked to fibromyalgia and migraine headaches. Postherpetic neuralgia or peripheral neuropathy can also cause it.
Fibromyalgia
Fibromyalgia is a disorder in which you feel muscle and joint pain throughout your body. But it’s not related to an injury or a condition such as arthritis. Instead, it seems to be linked to the way your brain processes pain signals from your body. It’s still something of a medical mystery. Scientists don’t quite understand its roots, but it tends to run in families. Certain viruses, stress, or trauma might also trigger fibromyalgia.
Migraine headaches
Migraine is a type of headache that causes intense pain. Changes in nerve signals and chemical activity in your brain trigger this type of headache. In some cases, these changes can cause allodynia.
Peripheral neuropathy
Peripheral neuropathy happens when the nerves that connect your body to your spinal cord and brain become damaged or destroyed. It can result from several serious medical conditions. For example, it’s a potential complication of diabetes.
Postherpetic neuralgia
Postherpetic neuralgia is the most common complication of shingles. This is a disease caused by the varicella zoster virus, which also causes chicken pox. It can damage your nerves and lead to postherpetic neuralgia. Heightened sensitivity to touch is a potential symptom of postherpetic neuralgia.

 

What are the risk factors for allodynia?
If you have a parent who has fibromyalgia, you’re at higher risk of developing it and allodynia. Experiencing migraines, developing peripheral neuropathy, or getting shingles or chickenpox also raises your risk of developing allodynia.

How is allodynia diagnosed?
If you notice your skin has become more sensitive to touch than normal, you can start to diagnose yourself. You can do this by testing your nerve sensitivity. For example, try brushing a dry cotton pad on your skin. Next, apply a hot or cold compress on your skin. If you experience a painful tingling feeling in response to any of these stimuli, you might have allodynia. Make an appointment with your doctor to get a formal diagnosis.
Your doctor may conduct a variety of tests to assess your nerve sensitivity. They will also ask about your medical history and other symptoms that you might have. This can help them start to identify the cause of your allodynia. Be sure to answer their questions as honestly and completely as possible. Tell them about any pain in your extremities, headaches, poor wound healing, or other changes that you’ve noticed.
If they suspect you might have diabetes, your doctor will likely order blood tests to measure the level of glucose in your bloodstream. They might also order blood tests to check for other possible causes of your symptoms, such as thyroid disease or infection.

How is allodynia treated?
Depending on the underlying cause of your allodynia, your doctor might recommend medications, lifestyle changes, or other treatments.
For example, your doctor might prescribe medications such as lidocaine (Xylocaine) or pregabalin (Lyrica) to help ease your pain. They might also recommend taking a nonsteroidal anti-inflammatory drug, such as naproxen (Alleve). In some cases, your doctor might recommend treatment with electrical stimulation, hypnotherapy, or other complementary approaches.
It’s also important for your doctor to address the underlying condition that’s causing your allodynia. For instance, successful diabetes treatment can help improve diabetic neuropathy. This can help lower your risk of allodynia.
Lifestyle changes
Identifying triggers that make your allodynia worse can help you manage your condition.
If you experience migraine headaches, certain foods, beverages, or environments might trigger your symptoms. Consider using a journal to track your lifestyle habits and symptoms. Once you’ve identified your triggers, take steps to limit your exposure to them.
Managing stress is also important if you’re living with migraine headaches or fibromyalgia. Stress can bring on symptoms in both of these conditions. Practicing meditation or other relaxation techniques might help you reduce your stress levels.
Wearing clothes made of light fabrics and going sleeveless may also help, if your allodynia is triggered by the touch of clothing.
Social and emotional support
If treatment doesn’t relieve your pain, ask your doctor about mental health counseling. These services might help you learn to adjust to your changing physical health. For example, cognitive behavior therapy can help you change how you think about and react to difficult situations.
It might also help to seek the advice of other people with allodynia. For example, look for support groups in your community or online. In addition to sharing strategies to manage your symptoms, it might help to connect with others who understand your pain.

Article Provided By: healthline
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Neuropathic Pain

Neuropathic Pain

What is neuropathic pain?
Neuropathic pain can result after damage or dysfunction of the nervous system. Pain can rise from any level of the nervous system. These levels are the peripheral nerves, spinal cord, and brain. Pain centers receive the wrong signals from the damaged nerve fibers. Nerve function may change at the site of the nerve damage, as well as areas in the central nervous system (central sensitization).
Neuropathy is a disturbance of function or a change in one or several nerves. About 30% of neuropathy cases is caused by diabetes. It is not always easy to tell the source of the neuropathic pain. There are hundreds of diseases that are linked to this kind of pain.
What are some of the sources of neuropathic pain?
Alcoholism
Amputation (results in phantom pain)
Chemotherapy drugs (Cisplatin®, Paclitaxel®, Vincristine®, etc.)
Radiation therapy
Complex regional pain syndrome
Diabetes
Facial nerve problems
HIV infection or AIDS
Shingles
Spinal nerve compression or inflammation
Trauma or surgeries with resulting nerve damage
Nerve compression or infiltration by tumors
Central nervous system disorders (stroke, Parkinson’s disease, multiple sclerosis, etc.)
What are the symptoms of neuropathic pain?
Many symptoms may be present in the case of neuropathic pain. These symptoms include:
Spontaneous pain (pain that comes without stimulation): Shooting, burning, stabbing, or electric shock-like pain; tingling, numbness, or a “pins and needles” feeling
Evoked pain: Pain brought on by normally non-painful stimuli such as cold, gentle brushing against the skin, pressure, etc. This is called allodynia. Evoked pain also may mean the increase of pain by normally painful stimuli such as pinpricks and heat. This type of pain is called hyperalgesia.
An unpleasant, abnormal sensation whether spontaneous or evoked (dysesthesia)
Trouble sleeping
Emotional problems due to disturbed sleep and pain
Pain that may be lessened in response to a normally painful stimulus (hypoalgesia)
Diagnosis and Tests
How is neuropathic pain diagnosed?
Your doctor will take a medical history and do a physical exam. Neuropathic pain is suggested by its typical symptoms when nerve injury is known or suspected. Your doctor will then try to find the underlying cause of the neuropathy and then trace the symptoms.
Management and Treatment
How is neuropathic pain treated?
The goals of treatment are to:
Treat the underlying disease (for example, radiation or surgery to shrink a tumor that is pressing on a nerve)
Provide pain relief
Maintain functionality
Improve quality of life
Multimodal therapy (including medicines, physical therapy, psychological treatment, and sometimes surgery) is usually required to treat neuropathic pain.
Medicines commonly prescribed for neuropathic pain include anti-seizure drugs such as Neurontin®, Lyrica®, Topamax®, Tegretol®, and Lamictal®. Doctors also prescribe antidepressants such as Elavil®, Pamelor®, Effexor®, and Cymbalta®. A doctor’s prescription for anti-seizure drugs or antidepressants does not mean you have seizures or are depressed.
A topical patch (Lidocaine® or Capsaicin®) or a cream or ointment can be used on the painful area. Opioid analgesics can provide some relief. However, they generally are less effective in treating neuropathic pain. Negative effects may prevent their long-term use.
The pain can also be treated with nerve blocks given by pain specialists, including injections of steroids, local anesthetics, or other medicines into the affected nerves.
Neuropathic pain that has not responded to the therapies mentioned above can be treated with spinal cord stimulation, peripheral nerve stimulation, and brain stimulation.
Outlook / Prognosis
What is the outlook for people with neuropathic pain?
Neuropathic pain is difficult to get rid of, but is not life-threatening. Without rehabilitation and sometimes psychosocial support, treatment has a limited chance of success. With help from a pain specialist using the multimodal approaches listed above, your neuropathic pain can be managed to a level that improves your quality of life.
© Copyright 1995-2020 The Cleveland Clinic Foundation. All rights reserved.

Article Provided By: clevelandclinic
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Postherpetic Neuralgia

Postherpetic neuralgia (post-hur-PET-ik noo-RAL-juh) is the most common complication of shingles. The condition affects nerve fibers and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear.
The chickenpox (herpes zoster) virus causes shingles. The risk of postherpetic neuralgia increases with age, primarily affecting people older than 60. There’s no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia improves over time.

 

Symptoms
The signs and symptoms of postherpetic neuralgia are generally limited to the area of your skin where the shingles outbreak first occurred — most commonly in a band around your trunk, usually on one side of your body.
Signs and symptoms might include:
Pain that lasts three months or longer after the shingles rash has healed. The associated pain has been described as burning, sharp and jabbing, or deep and aching.
Sensitivity to light touch. People with the condition often can’t bear even the touch of clothing on the affected skin (allodynia).
Itching and numbness. Less commonly, postherpetic neuralgia can produce an itchy feeling or numbness.
When to see a doctor
See a doctor at the first sign of shingles. Often the pain starts before you notice a rash. Your risk of developing postherpetic neuralgia is lessened if you begin taking antiviral medications within 72 hours of developing the shingles rash.

Causes

Shingles affects the nerves

Once you’ve had chickenpox, the virus remains in your body for the rest of your life. As you age or if your immune system is suppressed, such as from medications or chemotherapy, the virus can reactivate, causing shingles.
Postherpetic neuralgia occurs if your nerve fibers are damaged during an outbreak of shingles. Damaged fibers can’t send messages from your skin to your brain as they normally do. Instead, the messages become confused and exaggerated, causing chronic, often excruciating pain that can last months — or even years.
Risk factors
When you have shingles, you might be at greater risk of developing postherpetic neuralgia as a result of:
Age. You’re older than 50.
Severity of shingles. You had a severe rash and severe pain.
Other illness. You have a chronic disease, such as diabetes.
Shingles location. You had shingles on your face or torso.
Your shingles antiviral treatment was delayed for more than 72 hours after your rash appeared.
Complications
Depending on how long postherpetic neuralgia lasts and how painful it is, people with the condition can develop other symptoms that are common with chronic pain such as:
Depression
Fatigue
Difficulty sleeping
Lack of appetite
Difficulty concentrating
Prevention
The Centers for Disease Control and Prevention (CDC) recommends that adults 50 and older get a Shingrix vaccine to prevent shingles, even if they’ve had shingles or the older vaccine Zostavax. Shingrix is given in two doses, two to six months apart.
The CDC says two doses of Shingrix is more than 90 percent effective in preventing shingles and postherpetic neuralgia. Shingrix is preferred over Zostavax. The effectiveness may be sustained for a longer period of time than Zostavax. Zostavax may still be used sometimes for healthy adults age 60 and older who aren’t allergic to Zostavax and who don’t take immune-suppressing medications.

By Mayo Clinic Staff

 

Article Provided By: Mayoclinic
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