What is Post Herpetic Neuralgia?
Post-Herpetic Neuralgia(PHN) is a painful condition that can occur as a complication of shingles, a viral infection caused by the Varicella-Zoster virus, the same virus responsible for chickenpox. It is characterized by persistent, severe pain in the area where shingles blisters appeared. If pain persists beyond six months after treatment of Herpes Zoster, it is labelled as painful PHN.
What causes post herpetic neuralgia?
Post herpetic neuralgia develops when the Varicella-Zoster virus reactivates in nerve cells. After an initial chickenpox infection, the virus remains dormant in the body and can reactivate years later, causing shingles. The pain from shingles is the result of inflammation and damage to the nerves during the viral outbreak. In some individuals, this nerve damage persists after the shingles rash has healed, leading to post-herpetic neuralgia.
What are some of the factors that can increase the risk of post herpetic neuralgia?
- Age: The risk of PHN increases with age, with older individuals being more susceptible.
- Severity of Shingles: More severe cases of shingles are more likely to lead to PHN.
- Weakened Immune System: A compromised immune system due to conditions like HIV, certain medications, or other diseases can increase the likelihood of PHN.
What are the symptoms of post herpetic neuralgia?
The primary symptom of PHN is chronic pain in the area where the shingles rash occurred. This pain can be:
- Burning: A continuous burning sensation.
- Stabbing or Shooting: Intermittent sharp or shooting pains.
- Achy: Dull, persistent aching.
- Hypersensitivity: The affected area may become extremely sensitive to touch or temperature changes.
- Itching or Numbness: Some individuals may experience itching or numbness in addition to pain.
The pain associated with PHN can be severe and significantly impact a person’s quality of life. It may persist for weeks, months, or even years after the shingles rash has healed.
What are some of the treatment options for post herpetic neuralgia?
The most important factor to prevent Post herpetic Neuralgia is to get proper treatment for Herpes Zoster infection from a qualified doctor. Giving early anti viral treatment prevents the risk of developing Shingles later.
- Pain Medications: Prescription anti viral medicines and pain relievers can help manage the acute pain.
- Anticonvulsants: Medications like gabapentin and pregabalin are often prescribed to help control nerve-related pain.
- Antidepressants: Tricyclic antidepressants and selective serotonin-norepinephrine reuptake inhibitors (SNRIs) can be effective in reducing the pain associated with PHN.
- Topical Treatments: Creams or patches containing lidocaine or capsaicin can provide localized relief.
- Nerve Blocks: Injection of anesthetic agents near affected nerves can temporarily block pain signals. This includes nerve blocks and epidural injections to treat PHN. Giving nerve blocks during acute illness is helpful in controlling acute pain and prevention of PHN later.
- Vaccination: The shingles vaccine, which is recommended for individuals over 50, can reduce the risk of shingles and consequently lower the risk of PHN.
Early and proper treatment of Herpes Zoster is very important to prevent Painful PHN and if one experiences pain, it is imperative to contact a pain physician to manage it with minimally invasive interventions, so that one can lead a normal, pain-free life.
