Postherpetic neuralgia is a painful skin condition that occurs after a shingles eruption. The chickenpox virus (also called herpes zoster or varicella zoster) remains in the body and when reactivated causes a pain to travel the nerve fibers and produce a rash with painful blisters—shingles. After the blisters have cleared up (postherpetic), pain (neuralgia) can remain in the area that had been affected by the shingles.
Causes and Symptoms of Postherpetic Neuralgia
The cause of postherpetic neuralgia is the varicella zoster virus that remained after the initial chickenpox infection and revived again with the shingles infection. The damaged nerve fibers of the skin continue to send pain signals to the brain, long after the blisters have healed.
Postherpetic neuralgia has the following symptoms:
occurs at the site of the initial shingles outbreak — usually on the trunk, but sometimes on the face
the chronic pain can be described as unbearable, aching, stabbing, burning or sharp
pain can be triggered by a light touch — such as clothing brushing against the area
less commonly, itchiness or numbness may occur
Other complications that often arise from postherpetic neuralgia include:
depression that can come from a person isolating themselves to avoid pain triggers
fatigue from sleep difficulties associated with the neuralgia
loss of appetite
How Is Postherpetic Neuralgia Diagnosed?
A review of your symptoms and history of shingles is usually all your general practitioner needs to accurately diagnose postherpetic neuralgia.
Treatments for Postherpetic Neuralgia
Neurological Surgery, P.C. (NSPC) has an experienced multidisciplinary team of leading doctors who specialize in pain management and conditions relating to the nervous system.
The first line of treatments for postherpetic neuralgia are non-surgical:
Antidepressants can help your body reinterpret the nerve pain signals sent to your brain, by adjusting your body’s chemical balance.
Antiseizure medication, often prescribed for epilepsy, can help regulate the electrical nerve impulses and provide pain relief.
Topical agents may alleviate pain by delivering an analgesic directly through the skin. Capsaicin (compound in hot chili peppers) cream has brought relief to some.
Steroid injections near the spinal cord is sometimes recommended.
Opioid analgesics may bring alleviate pain, but can become habit-forming.
If the more conservative approaches do not relieve the symptoms, other more advanced treatment techniques may provide long-term pain curative results:
Rhizotomy — is a surgical procedure to damage the nerve or nerve root that is causing abnormal signals to be sent to the brain. Transcutaneous Electrical Nerve Stimulation (TENS) involves electrodes placed on the skin (cutaneous) near the nerve pathways to disrupt the abnormal pain signals. Peripheral Nerve Stimulation involves surgically implanting the electrodes near the nerves, similar to TENS. The electrical current sends messages that are non-pain-inducing to the brain, bringing pain relief. Spinal Cord Stimulation also employs a small electrical current to modulate the nerve signals. The electrodes are implanted near the spinal column.
In our New York metro region locations, we have knowledgeable specialists in pain management as well as the specialities of neurophysiology and neuropsychology. Our premier medical teams can help you find the best treatment option for your postherpetic neuralgia.