Postherpetic Neuralgia

Overview
Postherpetic neuralgia is pain in the area where a shingles infection once occurred. The pain may last for months or years.

Causes
Postherpetic neuralgia occurs when the nerves have been damaged after an outbreak of shingles. Shingles is caused by the varicella zoster virus, the same virus that causes chickenpox.
Postherpetic neuralgia is more likely to occur in people over age 60.

Symptoms
The main symptom is pain in the area where shingles once occurred. The pain can range from mild to very severe. It lasts for months, sometimes years, after the original shingles infection.

Treatment
Anticonvulsant drugs, usually used for seizures, may help with the pain of damaged nerves. Gabapentin and pregabalin are the ones most commonly used to treat postherpetic neuralgia.

Skin patches with lidocaine (a numbing medicine) may also be prescribed to relieve some of the pain for a period of time.

Pain medications are often needed. Sometimes acetaminophen or NSAIDs such as ibuprofen are enough. Many patients will need stronger, prescription drugs such as codeine, hydrocodone, oxycodone.

Drugs used to treat depression (antidepressants) may also help reduce pain, as well as help with sleep.

Electrical nerve stimulators may be used for severe, long-term cases of postherpetic neuralgia.
Consultation with a pain specialist may be necessary in some cases.