Postherpetic neuralgia is a type of pain associated with shingles symptoms. Varicella zoster is the herpes virus responsible for a shingles outbreak. This is the same virus that causes chickenpox.
After contracting chickenpox, the virus remains dormant in the body, only to resurface as a painful rash many years later. The reactivated virus usually affects persons over 50 years of age. In persons who have had chickenpox, it is estimated that at least half will contract shingles at some point in their lives. Postherpetic neuralgia will affect about 20 percent of those individuals.
Early Onset Pain
Individuals may experience general muscle aches and the sensation of sharp or burning pain in the affected area prior to the outbreak. For most individuals, the pain at this stage will be mild or tolerable, or nonexistent.
Early onset pain may or may not be associated with the development of postherpetic neuralgia in the nerve endings. Some patients have reported severe localized pain in the affected nerve area prior to the eruption of the rash.
Postherpetic Neuralgia Causes
Postherpetic neuralgia is linked to nerve damage that occurs during a shingles outbreak. After recovery from chickenpox, the virus enters the nerve system located close to the spine. After reactivation, the virus travels through the nerve fibers to the nerve endings.
Pain occurs when the damaged nerves send confusing messages to the brain. These damaged nerve fibers continue to send pain signals to the brain long after recovery from the shingles outbreak. This pain is often severe and chronic. It may continue for several months or several years.
Postherpetic neuralgia tends to persist longer in patients who experienced sever pain prior to the skin eruption and in those who experienced intense pain during the shingles outbreak. It is also more common in patients who had skin eruptions close to the eyes or nose. It is also more prevalent in persons with weakened immune systems and those undergoing treatment for cancer.
Types of Pain Associated with Postherpetic Neuralgia
Pain may be constant or intermittent. Not all patients will experience the same sensations, intensity or level of pain. Commonly reported sensations include a gnawing, aching, deep or throbbing pain. Patients also report stabbing, burning and electrical sensations.
Some individuals develop a sensitivity to touch. The touch of another person, bathing or the wearing of clothing causes great pain and discomfort for many patients. Less common are the sensations of itching and burning. In rare instances, some patients experience numbness and paralysis.
Managing Postherpetic Neuralgia
Most over the counter analgesics will not help much in managing the pain. Because the pain signals to the brain are confused, it is more difficult to treat. Most people tend to use a combination of treatments.
Some individuals report success in using lidocaine or capsaicin creams in conjunction with oral prescription pain medication. Prescription strength lidocaine creams or patches are also available. In severe case, oxycodone may be prescribed. Antidepressants and anticonvulsants are also used in the treatment of pain management.
Pain management is crucial for individuals suffering from severe postherpetic neuralgia. Excruciating pain may lead to depression and withdrawal from social activities.