While everyone’s experience with shingles is different, it’s generally associated with a painful rash. Within days of shingles, a blistery rash appears on one side of the body, most often around the torso. The rash eventually disappears, and most people won’t develop neuropathy or neuralgia after shingles (PHN). However, certain factors may increase the risk of PHN.
Symptoms
Postherpetic neuralgia is a condition caused by the damage done to nerves during the herpes zoster infection. The nerves that are located in the skin of the infected area send exaggerated pain signals to the brain. Postherpetic neuralgia may persist for up to 3 months after the rash has healed. It can also lead to sensitivity to light and pain from clothing.
Postherpetic neuralgia is a form of pain resulting from nerve damage caused by shingles. The pain may last for several months and interfere with the patient’s daily life. Some patients may experience muscle weakness, tremor, paralysis, and hypersensitivity to light. In some cases, postherpetic neuralgia may be chronic, requiring multiple treatments to relieve symptoms.
Treatment
During the first few days after shingles, doctors usually administer a nonsteroidal analgesic to the affected area. This medication is not likely to produce noticeable results, but it will ease the pain and temporarily stabilize abnormal electrical activity in the nervous system. The pain in this area is often vague, and treatment must be individualized to the type of pain. Another treatment is an injection of a local anesthetic into the affected area, called a Trigeminal Nerve Block.
Postherpetic neuralgia is a common side effect of shingles. The nerve fibers that surround the affected area cannot send normal messages to the brain, and so the pain continues for months, even years after the disease has gone away. Neuralgia can occur on both sides of the body and is most common in older adults. Among the younger population, only 10 percent will develop it, but forty percent of individuals over sixty years of age will experience the complication.
Prevention
Treatment for postherpetic neuralgia includes the use of anticonvulsants, which can help ease pain. These medications calm nerve impulses and stabilize abnormal electrical activity in the nervous system. Many people find that pregabalin and lidocaine patches can help minimize pain. Antiviral medicine may also reduce the risk of neuralgia after shingles. A physician will recommend treatment if you feel PHN symptoms.
Getting the varicella vaccine can help prevent shingles and postherpetic neuralgia. Although its long-term effects are not known, the vaccine helps prevent the virus from lying dormant in your body. Although it is not 100 percent effective, it does reduce the risk of shingles by up to 51% among older people. Getting vaccinated is important because the rash is highly contagious and can spread to other people.
NSAIDs
NSAIDs can be helpful in treating postherpetic neuralgia. NSAIDs help reduce the pain, stop itching, and decrease the duration of postherpetic neuralgia. NSAIDs are also helpful in the shortening of the length of time people experience pain after shingles. But they are not a cure for postherpetic neuralgia.
NSAIDs like oxycodone and gabapentin may help ease the acute pain. But if the pain is persistent or chronic, patients may need prescription glucocorticoids. NSAIDs for neuralgia after shingles are used to relieve the pain of people with shingles who experience postherpetic neuralgia, which is caused by the virus attacking nerves during the infection. Postherpetic neuralgia can be characterized by burning and shooting pain, as well as skin sensitivity to light.
Opioids
While there are no specific medical guidelines that recommend the use of opioids for neuralgia after shingles, studies show that they can provide pain relief and lessen the risk of dependence and mental disorders. The study compared opioids to an antidepressant and placebo. Although both have potential side effects, the use of opioids was preferred by 54 percent of patients. Among the 44 who completed the study, 38% reported opioid-induced pain relief. Another 11 patients took antidepressants and placebo.
Researchers looked at the long-term analgesic effects of oxycodone in patients with shingles and chronic neuropathic pain. The study included two-week double-blind trials that compared different dosages and formulations of oxycodone with a placebo or an active treatment. Although the study’s sample size was small, VAS scores and SF-36 pain severity improved in both groups. The researchers concluded that there was no difference in analgesic effects between TF and IL epidural steroids.