Postherpetic Neuralgia

________________________________________________________________________

KEY POINTS

• Postherpetic neuralgia is pain that you have after having shingles. Shingles is a painful skin rash caused by the same virus that causes chickenpox.
• Your provider may prescribe pain medicine, a nerve block, or nerve ablation to destroy the nerve.
• If you have never had chickenpox, you can get a shot to help prevent infection with the chickenpox virus.
• If you are 50 or older, you can get a different shot that helps prevent shingles.

________________________________________________________________________

What is postherpetic neuralgia?

Postherpetic neuralgia is pain that you have after having shingles. Shingles is a painful skin rash caused by the same virus that causes chickenpox. The pain from shingles usually goes away in a month or 2. If you still have pain more than 3 months after the blisters from shingles have healed, you have postherpetic neuralgia.

What is the cause?

The virus that causes chickenpox and shingles is called varicella zoster. Sometimes when you have shingles, the virus damages nerves. This can cause pain, numbness, or tingling for months or even years after the shingles rash has healed.

The older you are when you have shingles, the more likely it is that you will have postherpetic neuralgia.

What are the symptoms?

The main symptom is pain in the area where you had the shingles rash. The pain may be stabbing, aching, or burning. It may come and go or it may be constant for months or years.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history, especially your history of shingles. Your provider will examine you. There are no special tests for postherpetic neuralgia.

How is it treated?

To help relieve the pain, your provider may recommend or prescribe:

• A cream or skin patch with numbing medicine to put on the painful area
• Medicines you take by mouth, such as:
  • Acetaminophen
  • Prescription medicine to help with pain, including an antidepressant medicine

If the medicines aren’t helping the pain, you and your healthcare provider may consider 1 or more procedures, such as:

• Nerve block, which is a shot of long-lasting pain medicine into or next to the nerve causing the pain
• Nerve destruction, or ablation, which uses a microwave probe to destroy the nerve

A variety of treatments may be tried to ease the pain of postherpetic neuralgia. What helps one person may not help another. If a treatment does not work, tell your healthcare provider so that you might try another treatment.

How can I take care of myself?

Here are some things you can do to help relieve the pain and feel better:

• Take all medicines as directed by your healthcare provider.
• Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the painful area every 3 to 4 hours for up to 20 minutes at a time.

If you are feeling overwhelmed by the pain, let your provider know. You may want to look for a chronic pain support group.

How can I help prevent postherpetic neuralgia?

If you have never had chickenpox, you can get a shot to help prevent infection with the chickenpox virus. Most children now get shots to prevent chickenpox.

If you are 50 or older, you can get a different shot that helps prevent shingles. This shot is recommended for people 60 years of age and older. The shingles shot does not always prevent shingles. However, if you do get shingles after you have gotten the shot, you may have less pain while you have rash. The shot also makes it less likely that you will keep having pain after the rash goes away.

The shingles shot is not used to treat shingles once you have it. If you do get shingles, early treatment with medicine prescribed by your healthcare provider may help prevent some or all postherpetic pain.