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The Causes & Treatment Options For Postherpetic Neuralgia

Postherpetic neuralgia is a type of chronic nerve pain that persists in the region where the shingles rash was previously present but has now subsided. As a result of shingles, postherpetic neuralgia is the most frequent consequence. It's still unclear how to prevent it or what the best course of action is. The varicella-zoster virus is what produces the shingles rash and agony (the same virus that causes chickenpox). Herpes zoster is another name for shingles.

The shingles rash typically disappears along with the pain it causes. This typically occurs after two to four weeks, but typically only lasts for two to three days. After the shingles outbreak has healed for two to three months, postherpetic neuralgia is identified. It is likely that the person has postherpetic neuralgia if similar but resistant pain continues at this point. Post-herpetic neuralgia is the term for pain that lasts for a longer period of time. In rare circumstances, post-herpetic neuralgia pain can be difficult to cure and extremely intense. If this does occur, your postherpetic neuralgia specialist will need to be able to provide you another alternative for treatment

Symptoms of Postherpetic neuralgia 

A shingles attack may include pain that:

  • Between mild and severe
  • After shingles, the discomfort frequently persisted, however in rare instances, it can still
  • Be present months or years afterward.
  • Has a typical cutting, stabbing, or burning quality
  • Either continuously or irregularly
  • May happen even with a light touch (allodynia
  • Is frequently worse in older persons compared to younger people.
  • There might even be numb spots.
Causes of Postherpetic neuralgia

An infection of herpes zoster is the cause of PHN. The varicella-zoster virus reactivation is what leads to an outbreak of herpes zoster. It should be noted that while this virus is not the same as those that cause genital or oral herpes, it is in the same family. When the virus infects a person for the first time, chickenpox results (varicella). The varicella-zoster virus "sleeps" in the dorsal root ganglion, which are bundles of sensory nerve cell bodies found in the roots of nerves exiting the back of the spinal cord, after chickenpox has subsided. The virus could be dormant for decades. Between 20–30% of the time, the virus will reactivate and cause an episode of shingles.

You can also check our post on: Everything You Need to Know About GERD

Risk Factors

With age, there is a marked increase in the risk of PHN. Those over the age of 50 experience more than 70% of herpes zoster episodes. In general, 20% of people with herpes zoster develop PHN. Patients above the age of 80 are at an increased risk of up to 30%.

The following are other PHN risk factors:

  • Early signs of herpes zoster, such as discomfort and/or strange feelings, that develop before the rash.
  • Acute and severe pain.
  • Significant rashes, such as a rise in papules, vesicles, pustules, and crusts.
  • Persistent rash.
  • Affected eyes or the vicinity that is close to the ophthalmic nerve
  • A compromised immune system, such as that caused by HIV infection, excessive doses of corticosteroids, or cancer treatment.

Treatment for Postherpetic neuralgia

Postherpetic neuralgia is not a life-threatening condition, despite the fact that it can be quite painful. A dozen medications in four different categories have been found to be effective at relieving pain in careful clinical investigations. They consist of:


Tricyclic antidepressants: Patients with postherpetic neuralgia frequently receive tricyclic antidepressants as their first course of treatment.


Anticonvulsants: Due to the connection between postherpetic neuralgia and an aberrant rise in nerve cells, several drugs that lower seizures also treat postherpetic neuralgia.


Opiates: Opioids are potent painkillers used to treat all sorts of pain. Including methadone, tramadol, morphine, and oxycodone.


Topical local anesthetics are also beneficial for treating postherpetic neuralgia pain when applied directly to the skin in the painful location. Most frequently prescribed lidocaine is available as a cream, gel, or spray.


There are numerous ways to recover from this condition. As a result of the internal system or external treatment feeling as though it has stopped working, many patients may also develop an immunity to the existing drug and may need to have it changed, which will reduce the pain relief. If this does occur, If this does happen then there will have to be another option for your postherpetic neuralgia treatment that your doctor will be able to help with.

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