Description

Postherpetic neuralgia (post-hur-PET-ik noo-RAL-khuh) is the most common complication of herpes zoster. This causes a burning pain in the nerves and the skin. The pain lasts long after the rash and blisters of shingles disappear.

The risk of postherpetic neuralgia increases with age. It mainly affects people over the age of 60 years. There is No cure, but treatments can relieve the symptoms. For most people, post-herpetic neuralgia gets better with time.

Symptoms

In general, the symptoms of postherpetic neuralgia are limited to the area of skin where the shingles outbreak happened for the first time. Commonly in a band around the trunk of the body, most often in one of the sides.

Symptoms may include:

  • Pain that lasts three months or more after the shingles rash has healed. The pain you may feel a burning, sharp, stabbing. Or you may feel a deep and persistent.
  • Not being able to stand touch of light. People with post-herpetic neuralgia often can't bear even the touch of clothing on the affected skin.
  • Itching or loss of sensation. Less frequently, post-herpetic neuralgia can cause an itching sensation or numbness.

When to see a doctor

See a health care provider at the first sign of shingles. The pain often starts before you notice a rash. The risk of postherpetic neuralgia is lower if you start to take virus-fighting medications called antivirals within 72 hours of receiving the shingles rash.

Causes

Varicella zoster virus causes shingles. Once you've had chickenpox, the virus stays in your body for the rest of your life. The virus can become active again and cause shingles. This risk increases with age. The risk also increases if something turns down the immune system of the body, such as chemotherapy drugs to treat cancer.

Postherpetic neuralgia happens if nerve fibers are damaged during an outbreak of herpes zoster. Damaged fibers can not send messages from the skin to the brain, as they usually do. Instead, the messages become confused and more. This causes pain that can last for months or even years.

Risk factors

With shingles, the things that can increase the risk of postherpetic neuralgia are:

  • Age. It has more than 60 years.
  • The bad cases of herpes zoster was. You had a severe rash and pain that prevented him from doing daily activities.
  • Another disease. You have a long-term disease, such as diabetes.
  • Where the shingles appeared. Had herpes on the face or trunk.
  • A delay in the treatment of shingles. Do not start taking the antiviral medication within 72 hours of the rash appearing.
  • There is No vaccine against shingles. That had not been vaccinated for shingles.

Complications

People with post-herpetic neuralgia may develop other problems that are common with long-term pain. Depends on how much time postherpetic neuralgia hard and painful it is. These other problems include:

  • Depression.
  • Sleep problems.
  • Fatigue
  • You do not feel hungry as usual.

Prevention

The shingles vaccine can help prevent herpes zoster and postherpetic neuralgia. Ask your health care provider when you should receive a vaccine.

In the united States, the Centers for Disease Control and Prevention (CDC) suggests that adults 50 years and older get the shingles vaccine called Shingrix. The agency also suggests Shingrix for adults 19 years of age who have weaker immune systems due to disease or treatment. Shingrix is suggested even if you have had herpes zoster, or the older vaccine, Zostavax. Shingrix is given in two doses, 2 to 6 months apart.

With two-dose Shingrix is more than 90% effective in the prevention of herpes zoster and postherpetic neuralgia. Other tiles of the vaccines offered outside of the united States. Talk with your vendor for more information on how to prevent herpes zoster and postherpetic neuralgia.

Diagnosis

Your doctor will check your skin. You can touch the skin in different places to find the edges of the affected area.

In most cases, no tests are needed.

Treatment

There is a treatment that relieves postherpetic neuralgia for all. It often takes a combination of treatments to relieve the pain.

Lidocaine skin patches

These are small, bandage-like patches. Contain the drug to relieve the pain of lidocaine. These patches can be cut to fit only the affected area. Put the patch in painful on the skin to obtain relief in the short term. Your health care provider may prescribe for you. Or you can buy the patches out of the platform, in a slightly lower dose. Store them in a place away from children.

Capsaicin skin patch

Capsaicin comes from the seeds of hot chili peppers. A large amount of capsaicin is available as a patch to the skin to relieve pain called Qutenza. You need to get your health care provider. A health professional trained to put the patch on the skin after using a drug to numb the affected area.

The process lasts for at least two hours. That is because health professionals need to monitor the side effects after the review continues. The patch is reduced to some people, the pain of up to three months. If it works, you can get a new patch about every three months.

Anticonvulsants

Some seizure medications may also alleviate the pain of postherpetic neuralgia. They include gabapentin (Neurontin, Gralise, others) and pregabalin (Lyrica). These drugs calm the nerves injured. Side effects include:

  • The feeling of drowsiness.
  • Difficulty thinking clearly.
  • Doesn't feel stable.
  • Swelling of the feet.

Antidepressants

Some medications for depression can do more than treat a mood disorder. Affect key chemicals in the brain that plays an important role in depression and the way in which the body interprets pain. They can help for the pain, even when you do not have depression. These medications include:

  • Nortriptyline (Pamelor).
  • Amitriptyline.
  • Duloxetine (Cymbalta).
  • Venlafaxine (Effexor XR).

Doctors often prescribe anti-depressants for post-herpetic neuralgia in smaller doses than depression alone.

The common side effects of these medications include:

  • The feeling of drowsiness.
  • Get a dry mouth.
  • Feeling faint.
  • The increase of weight.

Opiate pain relievers

Opioids are strong pain medications that a health care provider can prescribe for you. Some people with postherpetic neuralgia may need medications that contain tramadol (Conzip, Qdolo, others), oxycodone (Percocet, Oxycet, others) or morphine.

Opioids can cause side effects such as:

  • A mild sensation of dizziness.
  • The drowsiness.
  • Confusion.
  • Problems to make the movements of the intestine.

In the united States, the CDC urges health care providers for the use of opioids only for cancer-related problems and some other serious health problems. The agency wants providers to think twice before prescribing these powerful medicines for health problems such as post-herpetic neuralgia. This is because opioids increase the risk of addiction and death in some people.

An opioid can be prescribed for postherpetic neuralgia only if safer treatments have not worked. Before you start taking an opioid, your provider must:

  • Explain the medicine's benefits and risks.
  • Establish the goals of treatment for the relief of pain.
  • Make a plan to help you safely stop using the medicine if the risks become too great.

Take the lowest possible dose of an opioid. And get checkups as often as your health care provider suggests.

Driving while opioids can be dangerous. And it is not safe to take an opioid, along with alcohol or other drugs.

Steroid injections

Steroid injections in the spine can help some people with postherpetic neuralgia.

Lifestyle and home remedies

An over-the-counter medicines called capsaicin cream can relieve the pain of postherpetic neuralgia. It is made from the seeds of the hot chili peppers. Capsaicin (Capzasin-P, Zostrix, others) can cause a burning sensation and can irritate your skin. These side effects usually go away with time. But you must only use a small amount when the first attempt to ensure that you do not have the negative side effects.

Try not to get capsaicin cream on parts of your body that you do not have symptoms. Follow all of the instructions that come with the cream. Wear gloves when you put it on, and wash your hands afterwards.

Preparing for your appointment

You could start by seeing your family doctor. We may refer you to a nerve specialist called a neurologist. Or it could suggest that you consult with a doctor who specializes in the treatment of pain in the long term.

Here is the information to help you prepare for your appointment.

What you can do

When you make the appointment, ask if there is something that you need to do beforehand. For example, you may need to stop eating for a certain amount of time before taking a medical test. Make a list of:

  • Its symptoms, including those that do not seem to be related to the reason for your check-up. Be sure to keep in mind when the onset of symptoms.
  • Key personal information, including major stresses, recent life changes and family medical history.
  • All medications, vitamins or supplements that you take, including over-dose.
  • Questions to ask your health care provider.

Have a family member or friend if you can. A family member or a friend can help you remember the information they give you.

For postherpetic neuralgia, questions to ask your doctor include:

  • How long will my symptoms last?
  • What treatment do you suggest? And are there other options?
  • I have other health problems. How can I best manage them together?
  • Is there something that you should not do while I recover it?
  • You should see a specialist?
  • Are there brochures or other printed material I can have? What sites do you recommend?

Feel free to ask questions also.

What to expect from your doctor

Your doctor may ask you questions such as:

  • Do your symptoms occur some or all of the time?
  • How bad are the symptoms?
  • Have you had the chicken pox? When?
  • Has had a shingles vaccine?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Postherpetic neuralgia