Shingles - Pain

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What is postherpetic neuralgia?

The most common complication of shingles is postherpetic neuralgia. This occurs when the nerve pain associated with shingles persists beyond one month, even after the rash is gone. It is a result of irritation of the nerves of sensation by the virus. The pain can be severe and debilitating. Postherpetic neuralgia occurs primarily in people over the age of 50 and affects 10%-15% of people with shingles. There is evidence that treating shingles with antiviral agents can reduce the duration and occurrence of postherpetic neuralgia.

The pain of postherpetic neuralgia can be reduced by a number of medications. Tricyclic antidepressant medications (amitriptyline [Elavil] and others), as well as antiseizure medications (gabapentin [Neurontin], carbamazepine [Tegretol], pregabalin [Lyrica]), have been used to relieve the pain associated with postherpetic neuralgia. In 2012, the FDA approved the use of gabapentin enacarbil (Horizant), previously used for the management of restless legs syndrome, for the treatment of postherpetic neuralgia. Capsaicin cream (Zostrix), a derivative of hot chili peppers, can be used topically on the area after all the blisters have healed, to reduce the pain. Lidocaine pain patches (Lidoderm) applied directly to the skin can also be helpful in relieving nerve pains by numbing the nerves with local lidocaine anesthetic. These options should be discussed with your health care professional.

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See what others are saying

Comment from: Lizzy, 65-74 Female (Patient) Published: January 02

I was hospitalized for a week four years ago with shingles on my face, scalp and around my eye. On narcotics for 3 months, I could not drive for 3 months due to light sensitivity. Four times a day for 2 weeks I felt 'someone poured gasoline on my head and set fire' melting skin sensation. It was horrible. Now, 4 years later I have daily eye pain and very severe itching. I have tried every drug; now I'm taking Lyrica which helps a tiny bit. Shingles changed my life!

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Comment from: ramlan, 55-64 Male (Patient) Published: April 11

I had shingles on my right leg 2 months ago and was hospitalized for a week. There were no rashes or any sign of it, I can only feel throbbing nerve pain inside my leg. After visiting 4 doctors for diagnosis, I was sent home and prescribed a painkiller. I requested to be hospitalized at the 4th visit and after an acupuncture treatment, rashes formed and shrouded on my right leg. It looks like cluster of boils but not itchy. To my astonishment, in my medical record I was diagnosed as having a viral infection.

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