Jonathan Aarons M.D.

Tired of Chronic Pain?

Postherpetic Neuralgia

Postherpetic Neuralgia

Postherpetic neuralgia is a painful condition that occurs after an attack of Herpes Zoster or Shingles.  Shingles are the skin lesions that occur from the reactivation of the Herpes Zoster virus.  The virus is acquired, usually as a child, from chickenpox.  After an attack of chickenpox, the virus lays dormant in the body until it is reactivated.  Statistically, approximately 10% of patients who have Shingles will develop Postherpetic Neuralgia.  The pain is described as constant and burning in nature and is felt wherever the lesions of Shingles have occurred.  The area is often painful to touch and there may also be some numbness in that area as well.    Postherpetic neuralgis occurs more often in the elderly and those with a family history of this problem.  The condition is diagnosed clinically, when the pain occurs after the lesions of Shingles have healed.  Rarely, this problem can occur without the rash of Shingles ever being noticed.   Early treatment of the outbreak of Shingles may serve not only to limit the severity of the disease but to decrease the incidence of Postherpetic Neuralgia.  The treatment of Postherpetic Neuralgia should include aggressive pain management.  There are numerous modalities that are useful.  Lidoderm patches are a bandaid like medication that can help to decrease the pain.  Adjuvant analgesics such as Gabapentin, Carbamazepine, Cymbalta and Amitriptyline are useful.  Narcotics and opioids have only a limted usefulness in this condition.  Nerve blocks can also be used to limit the pain in the area controlled by specific nerves.  Adjunctive treatment such as heat, ice and Tens can also be used.

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