Symptoms, Causes, and Treatment of Post Herpetic Neuralgia

Postherpetic neuralgia causes nerve and skin pain. Chicken pox and shingles are complications of post herpetic pain. Postherpetic neuralgia occurs when shingles pain persists. About 1 in 5 shingles patients develop PHN. Neuralgia is nerve-related pain. It usually occurs when nerve pain after shingles damage alters neurological structure or function. Burning or stabbing may feel like it's shooting along the nerve. Neuropathy is nervous system-generated pain. Injury does not cause it. Pinched nerves or trapped nerves are common names. The nerve sends pain signals because it is either damaged or upset.

What is Postherpetic Neuralgia (PHN)?

A complication of shingles infection, also known as herpes zoster, is postherpetic neuralgia pain (PHN). The reactivation of the varicella-zoster virus results in shingles. A painful, blistering rash and other symptoms characterize shingles pain. On one side of your body, usually your trunk, the rash forms a band. The rash develops into blisters. Pain may persist after rash/blisters. When pain persists, postherpetic neuralgia occurs.

Pain can either be constant or intermittent. It can hurt like burning, jabbing, or aching. Some say the area is numb or itchy. Chickenpox and shingles are caused by varicella-zoster.  Approximately 99% of Americans aged over 40 have experienced chickenpox. Shingles impact one in three Americans. Postherpetic neuralgia impacts 10–18% of individuals with shingles. Postherpetic neuralgia is the predominant complication of shingles.

Symptoms

Most postherpetic neuralgia symptoms are localized to the shingles outbreak site. It's usually in a band around the trunk on one side.

The symptoms may be:

• Post-shingles pain lasting three months or more. Burning, sharp, jabbing pain may occur. Deep and aching pain may be felt.

• Unable to tolerate light touch. Postherpetic neuralgia sufferers often can't tolerate clothing on their skin.

• Sense loss or itching. Occasionally, postherpetic neuralgia causes itching or numbness.

Causes

Shingles can cause PHN, a persistent nerve pain. The chickenpox-causing herpes varicella-zoster virus causes shingles. Chickenpox virus remains inactive in the nervous system after recovery. Reactivation of the herpes varicella-zoster virus can cause shingles later in life. Shingles are nerve and skin infections. Most often, chest and abdominal nerves on one side are affected.

Shingles damage nerves, disrupting nerve function. Misfiring nerves send chaotic pain signals to the brain. A throbbing, burning nerve pain can result. According to experts, shingles scar tissue next to nerves creates pressure. When nerves send inaccurate signals to the brain, many are pain signals. Why some patients develop PHN is unknown.

Management and  PHN Treatment

If shingles is spotted within the first three days of its outbreak, your healthcare provider may prescribe the antiviral medication acyclovir (Zovirax®), valacyclovir (Valtrex®), or famciclovir (Famvir®). These medications help rashes and blisters heal faster, prevent new sores from appearing, reduce pain and itching, and lessen the duration of pain after the sores have healed.

If you don't catch shingles early, your doctor has many postherpetic neuralgia (PHN) treatment options. If your pain is mild, your pain doctor in Dallas may suggest Tylenol® or NSAIDs like ibuprofen (Advil®, Motrin®). Lidocaine and capsaicin are creams and patches. Your healthcare provider may prescribe gabapentin (Neurontin®, Gralise®) and pregabalin (Lyrica®) for severe pain.

Escitalopram, quetiapine, and amitriptyline are antidepressants. Botox® injections in the painful area. Your pain management in Dallas may prescribe multiple medications or try them together. You and your doctor will discuss what's best for you. If your medication does not relieve your pain, see your doctor. Take your medications as directed.

Risk Factors

Postherpetic neuralgia risks with shingles include:

• Age: You're over 60.

• Shingles were bad: A severe rash and pain prevented you from engaging in daily activities.

• Other illnesses: Diabetes is a chronic disease.

• Shingles appearance: You had facial or torso shingles.

• A delay in shingles treatment: You didn't take antivirals within 72 hours of your rash.

• No shingles shot: Unvaccinated for shingles.

Complications

Postherpetic neuralgia can cause other long-term pain issues. It depends on postherpetic neuralgia duration and pain. Other issues may include:

• Depression

• Trouble sleeping

• Tiredness

• Feeling as hungry as usual

Is it Possible to Avoid Getting Shingles and Postherpetic Neuralgia?

Those who have never had chickenpox or have strong immunity to the varicella-zoster virus can avoid shingles. Most Brits have childhood chickenpox. Age reduces chickenpox immunity. Shingles are rarer in chickenpox-vaccinated people. The NHS childhood vaccination schedule does not include chickenpox. It is suggested that it be added to the routine schedule, but this is uncertain.

Varicella-zoster vaccines are routinely given to US residents aged 70–79. Since the vaccine loses efficacy with age, it is not recommended for people over 80. Vaccinating against shingles is the best way to prevent herpes zoster pain. This vaccine is safe and effective.

Conclusion