Postherpetic Neuralgia (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Jerry R. Balentine, DO, FACEP
Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
In this Article
- Postherpetic neuralgia (PHN) facts
- What is postherpetic neuralgia (PHN)?
- What causes postherpetic neuralgia?
- What are the risk factors for postherpetic neuralgia?
- What are postherpetic neuralgia symptoms and signs?
- How is postherpetic neuralgia diagnosed?
- How is postherpetic neuralgia treated?
- How long does postherpetic neuralgia last?
- What are the complications of postherpetic neuralgia?
- What is the prognosis for postherpetic neuralgia?
- Can postherpetic neuralgia be prevented?
- Find a local Doctor in your town
How is postherpetic neuralgia diagnosed?
The majority of patients who are diagnosed with PHN are done by follow-up of a shingles infection or by the patient's history of a recent shingles infection. The pain is located in the same nerve distribution (dermatome) area, usually on only one side of the person's body where the shingles lesions occurred.
How is postherpetic neuralgia treated?
Treatment is individualized for each patient; there is no treatment that is effective for all PHN patients, so clinicians often use two or more of the drug categories with examples listed below:
- Lidocaine skin patches ([Lidoderm] small, bandage-like patches applied to painful areas)
- Capsaicin skin patches ([Capsagel, Salonpas] applied in a doctor's office by trained staff)
- Opioids (tramadol [Ultram], oxycodone [OxyContin], morphine)
- Anticonvulsants (pregabalin [Lyrica], gabapentin [Neurontin]) have been shown to lessen the pain of PHN probably by stabilizing abnormal electrical activity in your nervous system.
- Antidepressants (venlafaxine [Effexor], duloxetine [Cymbalta]) are often prescribed in lower doses than for depression.
Because some drugs (opioids) can be addictive and because some patients may need long-term treatments (over one year), consultation with a pain-management specialist may be advised. Some individuals claim tamanu oil rubbed into the affected may reduce the symptoms of PHN. One small study and a few case reports indicate that acupuncture can be helpful in relieving the pain of PHN. Infrequently, other methods are used. TENS (transcutaneous electrical nerve stimulation) devices are designed to interrupt the body's pain sensations while nerve blocks (short-term chemical nerve sensation blockade) and nerve ablation (surgically cutting a nerve) are also used. Results vary but the methods often do not give lasting pain relief.
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