Postherpetic Neuralgia

By Akara Forsythe, MD

Innovative Pain Solution Centers

. https://www.innovativepainmd.com/

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Postherpetic Neuralgia

Postherpetic neuralgia is a pain that persists in some people who have had shingles. Postherpetic neuralgia affects the nerves and skin. It can be very painful. The pain can ache or burn. It can also feel like an electric shock. The pain often eases and goes away over time. Medication can often ease the pain.

Not everyone who gets shingles develops postherpetic neuralgia. The skin lesions of shingles heal in one to three months. But some people still have pain after the skin irritations heal. If the pain lasts longer than three months, you probably have postherpetic neuralgia.

The pain is often in the same area where the shingles blisters and rash occurred.

There's currently no cure. The duration of pain differs from person to person. For most people, the condition improves over time. Researchers found that over half of patients stop feeling pain within one year. Certain drugs, described below, may help with symptoms.

Antidepressants

Tricyclic antidepressants are effective and can be used for treatment of postherpetic neuralgia. The drugs affect brain chemicals that influence both depression and how your body recognizes pain. Side effects include drowsiness, dry mouth, and weight gain. Because these drugs are only given once a day, the drowsiness can be used to help get to sleep and stay asleep.

Antiepileptic Drugs

Two drugs used to treat epilepsy also minimize the pain from postherpetic neuralgia. They are gabapentin and pregabalin. Only gabapentin is currently available in the United States. Side effects of these drugs can include drowsiness and unclear thinking.

Opioids

Long-acting oral opioids are effective for treatment of postherpetic neuralgia. Opioids act on nerve cell receptors in the brain to relieve pain. People taking opioids may experience side effects such as dependency, nausea, mild dizziness, drowsiness, constipation, and unclear thinking. Care must be taken to strictly follow the directions on how to take opioid pain relievers.

Topical Lidocaine Patches

Lidocaine skin patches are also effective in reducing the pain of postherpetic neuralgia. The patches are put directly on the affected skin. They can provide relief for hours at a time.

Aspirin Cream and Capsaicin

Aspirin, an anti-inflammatory drug, and capsaicin, which causes degeneration of nerve fibers, in the skin may sometimes be used to relieve the pain and itching from postherpetic neuralgia.

It is important to talk with your doctor about your treatment options. Together you and your doctor can determine which treatment will provide a decrease in pain and improve quality of life.

Information obtained from the American Academy of Neurology