After Effects of Postherpetic Neuralgia

Postherpetic neuralgia can occur after you have recovered from a case of shingles, causing pain and sensitivity in the areas of the body that were affected by the shingles rash. Approximately one in five people who have shingles develop postherpetic neuralgia, according to the Centers for Disease Control and Prevention (CDC). Several medications are available to treat the symptoms of the condition.

Identification

• Shingles is caused by the varicella zoster virus, the same virus that causes chicken pox. After you recover from a case of chicken pox, the virus retreats to the nerves near the spinal cord. If the virus is reactivated years later, it travels to the skin surface once again and shingles appear. Shingles is a painful skin rash usually found on the trunk, although it can appear on other parts of the body. Postherpetic neuralgia occurs when pain continues after the shingles rash has healed.

Effects

• Postherpetic neuralgia causes burning, stabbing pain. Pain may be sharp or can feel like an electrical shock. Pain may also be felt as a deep ache. Itching and numbness in the affected areas can cause increased discomfort and may extend a few inches beyond the location of the shingles rash. Some people who have postherpetic neuralgia develop very sensitive skin and cannot tolerate clothing touching their skin or slight changes in temperature. This condition, called allodynia, can occur on the trunk, chest or arms and legs. Headaches and difficulty sleeping may also accompany postherpetic neuralgia pain.

Significance

• The extreme nerve sensitivity caused by postherpetic neuralgia can make working or going about your daily routine very difficult. Focusing on anything other than your own discomfort can be challenging and you may need to rely on friends and family members for support and help while you recover from the condition. Some people suffer from depression or anxiety due to the effects of postherpetic neuralgia and may find it helpful to take antidepressant or anti-anxiety medication.

Treatment

• Antidepressants or anticonvulsants can be helpful in treating the pain of postherpetic neuralgia. Antidepressants affect brain chemicals involved with pain, while anticonvulsants help regulate abnormal electrical activity in the nerves. Prescription pain killers may be prescribed for severe pain. Corticosteroids injected near the spine can also help reduce pain, as can adhesive patches that contain the pain reliever lidocaine. If you are severely affected by pain, transcutaneous electrical nerve stimulation (TENS) treatments may be helpful. During treatment, electrodes are applied to the painful areas of your body. Painless electrical current passes through the electrodes to your nerve pathways, reducing or relieving pain.

Prevention

• Your risk of developing shingles and postherpetic neuralgia can be reduced by getting the chickenpox or shingles vaccine. The chickenpox vaccine is only recommended for people who have never had chickenpox. The vaccine reduces the chance that you will develop chicken pox and shingles. If you do develop either disease, the duration and symptoms of your illness may be shortened. The shingles vaccine is recommended for people 60 and older who have already had chickenpox. While there is no guarantee that you will not develop shingles after receiving the vaccine, immunization may result in less severe symptoms.