Postherpetic neuralgia (post-her-PET-ic noo-RAL-jah) is a painful condition affecting your nerve fibers and skin. The burning pain associated with postherpetic neuralgia can be severe enough to interfere with sleep and appetite.
Postherpetic neuralgia is a complication of shingles, which is caused by the chickenpox virus. Most cases of shingles clear up within a few weeks. But if the pain lasts long after the shingles rash and blisters have disappeared, it's called postherpetic neuralgia.
The risk of postherpetic neuralgia increases with age, primarily affecting people over the age of 60. Effective treatment of postherpetic neuralgia is difficult, and the pain can last for months or even years.
The signs and symptoms of postherpetic neuralgia are generally limited to the area of your skin where the shingles outbreak first occurred. This is most commonly in a band around your trunk, usually on just one side of your body.
They may include:
When to see a doctor
During an initial infection of chickenpox, some of the virus can remain dormant in some of your body's nerve cells. Years later, the virus may reactivate, causing shingles.
Postherpetic neuralgia occurs if your nerve fibers are damaged during an outbreak of shingles. Damaged fibers aren't able to send messages from your skin to your brain as they normally do. Instead, the messages become confused and exaggerated, causing chronic, often excruciating pain that may persist for months — or even years.
Preparing for your appointment
While you may initially talk to your family doctor about your signs and symptoms, he or she may refer you to a nerve specialist (neurologist) or a doctor who specializes in the treatment of chronic pain.
What you can do
What to expect from your doctor
He or she may ask you how the pain is affecting your enjoyment of life, your sleep and your interactions with others. Your doctor may also review in detail medications you may have tried for this pain, including the dosages and any side effects you experienced.
Tests and diagnosis
In most cases, postherpetic neuralgia can be diagnosed during the office exam. No tests are usually necessary.
Treatments and drugs
There is no single treatment that relieves postherpetic neuralgia in all people. In many cases, it may take a combination of treatments to reduce the pain.
Lidocaine skin patches
Lifestyle and home remedies
You may find that the following over-the-counter medications ease the pain of postherpetic neuralgia:
The varicella-zoster vaccine (Zostavax) can help prevent shingles and subsequent postherpetic neuralgia in adults age 60 and older.
Last Updated: 2010-05-28
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