Postherpetic Neuralgia - A Shingles Complication

It is a common occurence for shingles (zoster) complications, such as postherpetic neuralgia (PHN) to set in as an after effect of a shingles infection. It is a painful disease due to damage to the nerves caused by shingles.

when a person has experienced a chickenpox infection, they are at risk for a shingles event to present itself later in life, usually after the age of 60. Complications sometimes occur resulting in pain that can last for years.

Symptoms:

The pain of postherpetic neuralgia can be quite severe and occurs in the area where the shingles infection was located.

Symptoms include:

• Extreme pain


• Skin tenderness


• Itching and numbness


• Headaches


• Muscle weakness or paralysis

Postherpetic neuralgia complications occur mostly in the elderly, therefore as you age, PHN can prove to be more painful. Your health care professional should be notified within 48 hours of the onset of the shingles rash to help avoid PHN and the pain associated with it.

Should PHN occur, early and fast treatment can mean the difference between pain that is tolerable and pain that is chronic and intolerable. Most times, a combination of medications can help reduce pain's severity.

Treating the pain of postherpetic neuralgia:

Antidepressants: Your doctor may prescribe antidepressants, such as amitriptyline, desipramine (Norpramin), nortriptyline (Pamelor) and duloxetine (Cymbalta) can make the pain easier to handle.

Anticonvulsants: Can lessen postherpetic neuralgia, such as gabapentin (Neurontin), pregabalin (Lyrica) to manage the burning sensation.

Steroids: Corticosteroids are injected around the spinal cord afterthe blisters have healed.

Pain Meds: Such as tramadol (Ultram), oxycodone, Percocet or OxyContin. These medications must be used with caution due to the risk of addiction to these drugs.

Transcutaneous Electrical Nerve Stimulation (TENS): This treatment involves the placement of electrodes are placed over the affected area, delivering painless electrical impulses to the nerve pathways. However, this treatment is not prescribed for everyone.

Spinal Cord or Peripheral Nerve Stimulation: This option is implanted just under the skin, usually in the area of the buttocks.

Lidocaine Skin Patches: Bring temporary relief when applied directly over the painful skin area. These patches are not designed for the face and should not be placed there.

Even though most treatments bring total relief, some people may still have some pain. Still, others may not get any relief at all. Postherpetic neuralgia can last a few weeks to years, possibly resulting in depression.

Prevention:

There are vaccines available that can prevent shingles and PHN. Getting vaccinated against chickenpox (varicella), usually administered during childhood, produces antibodies in the blood against the varicella zoster virus, resulting in immunity to chickenpox.

Zostavax is a chickenpox booster vaccine designed to protect against shingles (Herpes zoster) from developing after the initial varicella infection. It is approved for persons who are 60 years old and up. Shingles can occur in anyone with a history of having chickenpox. Although zoster is usually seen in the elderly population, having had varicella means you can develop shingles. Even young children are susceptible.

by Barb Hicks, RN/LMT