Post-Herpetic Neuralgia


Post-herpetic neuralgia is a complication of shingles, a disease caused by the varicella-zoster virus, which is also responsible for chickenpox.  The virus may lie dormant in the tissue near the central nervous system (the spinal cord and the brain) for years after a patient contracts the chickenpox before it manifests as shingles, which causes painful rashes and blisters.

Postherpetic neuralgia is characterized by nerve damage and persistent pain for at least a month after the initial shingles outbreak.  The pain can be burning, sharp, or aching, it can vary from mild to severe, and it can occur either sporadically or continuously, located in the same area affected by the shingles outbreak itself.  Other symptoms include allodynia (sensitivity to temperature or touch), muscle weakness, numbness, and even paralysis.

The risk of developing postherpetic neuralgia after shingles increases with age and is very high in people over the age of 60.  The herpes zoster vaccine is recommended for adults 60 or older as a prevention method for shingles.  Other factors which indicate an increased risk for developing postherpetic neuralgia are lowered immunity due to conditions like HIV infection, the severity of rashes and pain from shingles, and the specific body area affected.  The probability of developing postherpetic neuralgia, for example, is higher when shingles occurs on the face.  The pain formed by virus-affected nerve fibers and skin often disrupts the patient’s appetite and sleep patterns.

Medical treatment should be sought at the first sign of shingles.  Antiviral medications reduce the risk of progressing to post-herpetic neuralgia by half, when taken within the first 3 days of developing a rash.  Medications most often used to treat the pain of post-herpetic neuralgia are anti-convulsants, NSAIDs for mild cases, and opioids for more severe cases.  Numbing skin patches and topical creams are also available alternatives.  Mild doses of antidepressants may aid with minimizing the body’s perception of pain and improving sleep.  In very serious cases, electrical nerve stimulation may also be an option for pain relief.  Patients should be well aware of the side effects that exist for the above-mentioned pain medications, some of which include psychological disturbances, addiction, swelling, and drowsiness.  Lifestyle changes like a healthy diet, moderate exercise, regular sleep schedule, stress and depression-coping skills, and a positive attitude help deal with chronic pain of post-herpetic neuralgia.

Our clinic offers medication and nerve block injections to help those suffering from post-herpetic neuralgia.

postherpetic-neuralgia

Sources:

Eckman, A.S. “Postherpetic neuralgia.“  MedlinePlus.  Available from: http://www.nlm.nih.gov/medlineplus/ency/article/007423.htm.  Last accessed: August 2013.

“Postherpetic neuralgia.” MayoClinic.  Available from: http://www.mayoclinic.com/health/postherpetic-neuralgia/DS00277.  Last accessed:  August 2013.

Gentile, J.M.  “6 Lifestyle tips for postherpetic neuralgia.”  Practical Pain Management.  Available from: http://www.practicalpainmanagement.com/patient/conditions/postherpetic-neuralgia/6-lifestyle-tips-postherpetic-neuralgia.  Last accessed:  August 2013.

 

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