Diagnosis and Treatments of Postherpetic Neuralgia
Postherpetic neuralgia is a complication of shingles, caused by the chickenpox virus. It affects nerve fibers and skin, causing burning sensations that last long after the rash and blisters of shingles disappear. The danger of postherpetic neuralgia rises with age, primarily concerning people older than 60. There is no permanent cure, but treatment can help to ease the pain. The signs and symptoms are limited to the first occurrence of shingles outbreak on your skin. The shingles mostly break around the trunk or usually on one side of your body. These three signs and symptoms can be of concern:
- You have been experiencing pain from the last three months or longer post the shingles rash has healed.
Diagnosis
Most cases do not require any tests to be done. Doctors touch the border of the affected area on your skin to determine the severeness.
Treatment
No particular postherpetic neuralgia treatment can help relieve all people. For many affected patients, it takes a combination of treatments to reduce the pain.
- Lidocaine skin patches
Small patches like bandages that contain the topical, pain-relieving medication lidocaine.
High concentration from an extract of chili peppers (capsaicin) is another available skin patch option that is known to relieve the pain from postherpetic neuralgia. The patch is available only at a doctor’s clinic and has to be applied by trained professionals post using a numbing medication on the affected area. The process can take up to two hours, but a single application is known to be effective in reducing the pain for some people. People who have had effective treatment with capsaicin skin patch have said, they have been relieved of the pain for at least three months.
Certain anti-seizure medications, including gabapentin (Neurontin, Gralise) and pregabalin (Lyrica), are known to reduce the pain caused by postherpetic neuralgia. Stabilizing unusual electrical motion in your nervous system that is created due to injured nerves is the reason these medications are prescribed. There are specific side effects of these medicines like drowsiness, unclear thinking, unsteadiness, and swollen feet.
Certain antidepressants like nortriptyline (Pamelor), duloxetine (Cymbalta) and venlafaxine (Effexor XR) affect brain chemicals that play a crucial role in depression and how your body responds or reacts to pain. Doctors prescribe smaller doses of antidepressants for postherpetic neuralgia, where the dosages are lower than the prescribed medicines for depression. Drowsiness, dry mouth, light-headedness, and weight gain are the common side effects of these medicines.
People with severe pain and effects require prescription-strength pain medications that contain tramadol (Ultram, Conzip), oxycodone (Percocet, Roxicet, Xartemis XR) or morphine. These painkillers are known to cause mild dizziness, drowsiness, confusion, and constipation. Although the risk of getting addicted is low, there are chances people might get addicted and hence, it is better to consult a doctor before consuming these medications. Tramadol is known to provoke psychological reactions, such as emotional disturbances and suicidal thoughts. One has to be careful not to mix alcohol or other drugs with opioid medications.
A specific steroid is known to be injected into the spine as a postherpetic neuralgia treatment. However, evidence of effectiveness is inconsistent. There is a low risk of any reaction from these injections including meningitis which has been associated with the use of steroids.
Lifestyle and home remedies for postherpetic neuralgia treatment
Following over-the-counter medications can help you ease the pain of postherpetic neuralgia:
- Capsaicin
Made from the seeds of hot chili peppers capsaicin cream might help relieve pain from postherpetic neuralgia. One might experience a burning sensation or irritated skin, but these side effects disappear post some time. As capsaicin cream can irritate the skin so avoid contact with skin that is not affected. Wear gloves and wash hands thoroughly post applying the cream. - Topical analgesics and anesthetics
Aspirin mixed into an absorbing cream or non-prescription-strength lidocaine cream might help reduce skin hypersensitivity.
Living with postherpetic neuralgia can be difficult as it affects the ability to carry out simple daily chores like dressing and bathing. The disease comes with other added problems like extreme tiredness, sleeping difficulties, and depression. It is suggested to consult a doctor post 72 hours of developing the shingles rash to start medication immediately and reduce your chances of prolonged suffering as the pain starts before you notice a rash. Consult a doctor before applying or consuming any postherpetic neuralgia treatment medication to avoid side effects, and you will be able to live a happy and illness-free life.
