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Conditions

Postherpetic Neuralgia

What is postherpetic neuralgia?

Postherpetic neuralgia is the persistent, often quality-of-life altering pain associated with a shingles outbreak. This side effect of shingles is a painful nerve and skin condition caused by the virus herpes zoster. The same virus is responsible for chickenpox in youth and inexplicably causes shingles in some adults.

What causes postherpetic neuralgia?

The condition is caused when nerves are damaged during a shingles outbreak. The nerves become confused and no longer communicate properly between the skin and the brain. The result is sharp, annoying pain that may be so severe, the lightest touch can cause agony.

Typical diagnosis

During a visit with a pain physician, a postherpetic neuralgia patient should be prepared to answer a series of questions about the shingles outbreak, the symptoms suffered, and the forms of pain relief already exhausted.

Symptoms

The most common symptom is a burning pain that keeps the patient from sleep and diminishes appetite. Shingles patients who are able to see a pain physician within the first 72 hours of the signature rash appearing and can start a course of antivirals are half as likely to develop postherpetic neuralgia. Postherpetic neuralgia pain is typically located at the same site on the body where the shingles outbreak initially occurred — usually one side of the back, chest, or stomach.

Other common symptoms include:

  • Burning, sharp, and jabbing pain
  • Itching or numbness
  • Muscle weakness or paralysis
  • Sensitivity to any touch

Treatments (cont.)

Preventative measures

Shingles and related postherpetic neuralgia are entirely preventable by vaccine. Since 2006, a shingles vaccine has kept many older adults free from such outbreaks. Health officials at the Centers for Disease Control and Prevention (CDC) report that a clinical trial involving thousands of adults 60 years old or older showed Zostavax – the shingles vaccine – reduced the risk of shingles by about half (51%) and the risk of postherpetic neuralgia by 67%.

The vaccine was most effective in people age 60–69 but also provided some protection for older groups. Research continues on how long the vaccine lasts; current data show the vaccine protects adults from the illness, and the painful side effects, for at least six years. Those age 60 and older should request a Zostavax vaccine from their pain physician or general practitioner as a smart method of prevention.

Treatments

Various treatments are available for the treatment of postherpetic neuralgia.

Medications

While there is no specific cure for postherpetic neuralgia, there is a variety of pain medications and options available. These may include antidepressants, anticonvulsants, pain-relieving skin patches, opioids, and topical pain creams.

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