Post Herpetic Neuralgia

If you’re of a certain age, you know that shingles might be something that you will experience. 

But even if you experience shingles, which is a painful condition, the symptoms might not end there. Some people develop post-herpetic neuralgia, which is the most common complication of the shingles virus. Dealing with the shingles virus is hard enough, then dealing with the symptoms of post-herpetic neuralgia can be debilitating. The Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas are able to help treat herpetic neuralgia as quickly as possible so that pain is minimized and additional complications are avoided. 

What is herpetic Neuralgia?

Post-herpetic neuralgia is a complication of the shingles infection, which is also called herpes zoster. Shingles is caused by the reactivation of the varicella-zoster virus, which is the same virus that causes chickenpox. The adults who are diagnosed with shingles either never had the vaccine or had chickenpox as a child. There is no definitive reason why the dormant virus becomes active again, but it’s clearly evident when it does because there is a painful rash that turns into blisters. As the rash and blisters go away, pain could still remain. This is herpetic neuralgia. 

Post-herpetic pain is generally located in the same part of the body where the shingles rash and blisters occurred. This is most often on one side of the body and usually the core trunk of the body, including the back, chest or stomach. Symptoms include: 

• Burning, sharp and stabbing pain
• Itching or numbness
• Muscle weakness or paralysis
• Sensitivity to any touch

These symptoms can be life altering as they can greatly disrupt a person’s capability to eat, sleep and participate in many aspects of their daily life. 

What Causes Post-Herpetic Neuralgia?

Adults who did not receive a chickenpox vaccination as a child, or who has chickenpox as a child, have a greater chance of developing shingles than those who did. Those who are diagnosed with shingles have the possibility of developing herpetic neuralgia, which is the most common complication of the shingles virus. 

Post-herpetic neuralgia develops when nerves are damaged during the shingles infection. The nerve fibers at the skin of the affected area become confused and send exaggerated pain signals to the brain. This results in extreme pain from even the slightest touch or sensation. 

Symptoms of post-herpetic neuralgia can last for weeks, months, or even years in some cases after the shingles rash goes away. In addition to pain symptoms, patients can experience insomnia, decreased appetite, inability to concentrate, which can lead to depression over time. 

It’s important to note that early treatment is crucial for both alleviating symptoms from the shingles infection as well as reducing a person’s chance of developing herpetic neuralgia after the shingles symptoms have been resolved. 

Who is at Risk for Developing Post-Herpetic Neuralgia?

While not everyone who develops shingles will also develop post-herpetic neuralgia, there are certain risk factors that increase a person’s chance. These include: 

• Age: risk increases with age. Older people who are diagnosed with shingles have a greater chance of suffering from post-herpetic neuralgia and having more severe and long-lasting symptoms. 
• Weakened immune system: a weakened immune system, which usually happens with age, can allow for the herpes zoster virus to become active again. Additionally, people who have cancer, infectious diseases, or are taking medications that weaken the immune system are also at greater risk. 
• Severity of shingles: post-herpetic neuralgia is a greater possibility in patients who had a severe case of shingles
• Pre-shingles symptoms: those who experienced a painful, itchy or tingly feeling before the shingles rash became visibly present have a higher chance of developing post-herpetic neuralgia
• Not seeking medical care: patients who waited longer than three days after noticing the shingles rash before seeking medical attention and receiving medication are at a greater risk for developing post-herpetic neuralgia

How to Prevent Post-Herpetic Neuralgia

Receiving a vaccination can greatly reduce your chances of both developing shingles and post-herpetic neuralgia. Since 2006, Zostavax, the first singles virus, has proven to help reduce the risk of shingles and post-herpetic by more than half for adults who are 60 years or older. The protection has shown to last for five years. An added bonus is that Zostavax has also shown to help reduce a person’s chance for having a stroke. 

There is a newer shingles vaccination also available, Shingrix, which is providing effective in preventing shingles and post-herpetic neuralgia, but there is an increased risk of side effects at the injection site. 

It’s important to ask your pain management specialist which vaccination is best for you depending on your medical history, current health condition and age. 

How is Post-Herpetic Neuralgia Treated?

Unfortunately there is no best way to treat post-herpetic neuralgia. The best way to combat post-herpetic neuralgia pain symptoms is to partner with a pain management specialist who can accurately diagnose your symptoms and severity of pain and recommend the best medications. They will perform a physical exam, review your medical history, learn if you’ve had the vaccine or not, as well as ask how long you have been experiencing the symptoms. 

Most often, treatment options can include:

• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Pain-relieving skin patches
• Anti-seizure drugs
• Antidepressants
• Topical pain-relieving creams

The best way to prevent experiencing post-herpetic neuralgia is to make sure you have the herpes zoster vaccination in the first place. If you do feel you are experiencing some symptoms of shingles, it’s important to seek care from a pain management specialist as quickly as possible so that your chances of developing post-herpetic neuralgia are greatly diminished. Please schedule an appointment today with the Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas so that we can determine if you do have shingles and, if so, work together to quickly treat the infection so you avoid any long-lasting painful complications.