What is Postherpetic Neuralgia?
What is Post-Herpetic Neuralgia?

Postherpetic neuralgia (post-her-PET-ic noo-RAL-jah) is a painful condition affecting your nerve fibers and skin. The burning pain associated with postherpetic neuralgia can be severe enough to interfere with sleep and appetite.

Postherpetic neuralgia is a complication of shingles, which is caused by the chickenpox virus. Most cases of shingles clear up within a few weeks. But if the pain lasts long after the shingles rash and blisters have disappeared, it's called postherpetic neuralgia.

The risk of postherpetic neuralgia increases with age, primarily affecting people over the age of 60. Effective treatment of postherpetic neuralgia is difficult, and the pain can last for months or even years.

Symptoms

The signs and symptoms of postherpetic neuralgia are generally limited to the area of your skin where the shingles outbreak first occurred. This is most commonly in a band around your trunk, usually on just one side of your body.

They may include:

Pain. The pain associated with postherpetic neuralgia most commonly has been described as burning, sharp and jabbing, or deep and aching.

Sensitivity to light touch. People who have postherpetic neuralgia often cannot bear even the touch of clothing on the affected skin.

Itching and numbness. Less commonly, postherpetic neuralgia can produce an itchy feeling or numbness.

Weakness or paralysis. In rare cases, you might also experience muscle weakness or paralysis if the nerves involved also control muscle movement.

Causes

During an initial infection of chickenpox, some of the virus can remain dormant in some of your body's nerve cells. Years later, the virus may reactivate, causing shingles.

Postherpetic neuralgia occurs if your nerve fibers are damaged during an outbreak of shingles. Damaged fibers aren't able to send messages from your skin to your brain as they normally do. Instead, the messages become confused and exaggerated, causing chronic, often excruciating pain that may persist for months — or even years.

Western Medicine Treatment

There is no single treatment that relieves postherpetic neuralgia in all people. In many cases, it may take a combination of treatments to reduce the pain.

Lidocaine skin patches

These are small, bandage-like patches that contain the topical, pain-relieving medication lidocaine. These patches can be cut to fit only the affected area. You apply the patches, available by prescription, directly to painful skin to deliver temporary relief.

Tricyclic antidepressants

Antidepressants such as nortriptyline and amitriptyline affect key brain chemicals that play a role in both depression and how your body interprets pain. Doctors typically prescribe antidepressants for postherpetic neuralgia in smaller doses than they do for depression.

Certain anticonvulsants

Anti-seizure medications also can lessen the pain associated with postherpetic neuralgia. These medications stabilize abnormal electrical activity in your nervous system caused by injured nerves.
Doctors may prescribe gabapentin (Neurontin), pregabalin (Lyrica) or another anticonvulsant to help control burning and pain.

Opioid painkillers

Some people may need prescription-strength pain medications containing tramadol (Ultram, Ryzolt), oxycodone (Percocet) or morphine. However, these drugs can be addictive. Although this risk is generally low, discuss it with your doctor.

Adopted from mayoclinic.com