Postherpetic neuralgia is a complication of shingles. Long after shingles have disappeared and the rash and blisters have gone, the condition will cause burning pain. The risk of this condition increases with age and is more common in people age 60 or older. Anyone that has had shingles should also know the signs and symptoms and treatment for postherpetic neuralgia.
Postherpetic Neuralgia Causes
Chickenpox remains in the body for the rest of your life. Doctors still don’t know what causes the virus to re-emerge after years of being dormant. If the virus comes back, it returns as shingles. The virus reactivates, often when the immune system is suppressed, causing rashes, blisters, and significant pain for some sufferers.
Postherpetic neuralgia is the result of nerves becoming damaged when shingles present. The nerve fibers become damaged and are unable to send the nerve signal to the brain. Nerve fibers will continue to send these messages, which become “confused,” leading to severe pain that can last months or years in the most severe cases.
While shingles are the main cause of the condition, there are certain risk factors that may increase the risk of postherpetic neuralgia:
- 50+ years of age
- Severe bouts of shingles
- Shingles on the torso or face
- Shingles treatment didn’t occur within the first 72 hours
- Diabetes or other chronic diseases
Prolonged postherpetic neuralgia can lead to difficulty sleeping, depression, and severe fatigue. Noticing the symptoms early on will allow you to seek treatment options faster and better manage the pain you’re experiencing.
Postherpetic Neuralgia Symptoms
Postherpetic Neuralgia Symptoms are often in the same area where the shingles appeared. For most people, shingles of the torso are what lead to this complication. The person’s torso is where most of the symptoms will be present in this case, but they may be present in any area of the body where shingles were present.
The following symptoms are most common with postherpetic neuralgia:
- Itching or numbness of the area (least common)
- Extreme sensitivity to a light touch on the impacted area of the skin
- Burning or sharp pain that is often described as “deep” and lasts for three or more months
Ideally, you’ll seek treatment the moment that you notice a rash from shingles. A doctor can administer an antiviral in the first 72 hours of shingles presenting that can reduce the risk of complications and postherpetic neuralgia forming. Waiting to seek treatment greatly increases your risk of complications following a shingles outbreak.
How Long Does Postherpetic Neuralgia Last?
If you’re suffering from postherpetic neuralgia, you may be wondering how long you’ll have to deal with these uncomfortable symptoms.
For many people, the pain and discomfort associated with shingles last about three months. If symptoms persist after this point, it’s usually considered postherpetic neuralgia.
Once it progresses to this condition, the pain can last for years. In some cases, it can last the person’s entire lifetime.
Diagnosis and Conventional Treatment for Postherpetic Neuralgia
Diagnosing postherpetic neuralgia is a straightforward process that starts with a physical examination. Your doctor will take a closer look at your skin and may check different areas for pain. A medical history will also be taken.
Because this condition is a complication of shingles, your doctor will want to make sure that you’ve had shingles.
Treatment for postherpetic neuralgia usually involves a combination of different things. There is no single treatment for this condition.
Conventional treatments can include:
- Capsaicin patches: Capsaicin, which is an extract of chili peppers, can help alleviate pain. Capsaicin patches must be applied by a trained medical professional, and you must be monitored during treatment. Although this is technically a natural treatment, the high dose of capsaicin can cause side effects. Monitoring is necessary, but a single application can provide up to three months of pain relief for some people.
- Lidocaine patches: Lidocaine is a pain-relieving drug that can be applied to the affected area. These patches are available over the counter or as a prescription. They provide temporary relief.
- Antidepressants: Some antidepressants affect the way the body interprets pain. Doses are generally lower than what is prescribed for depression alone.
- Anticonvulsants: Some anti-seizure medications are used to reduce the pain of postherpetic neuralgia. These medications work to stabilize nervous system activity.
Natural Therapies for Postherpetic Neuralgia
Along with conventional treatments, there are natural therapies that may help with the pain and other symptoms associated with postherpetic neuralgia, such as:
The goal of acupuncture is to help free blockages that may be hindering the body’s natural energy flow. It’s an ancient Chinese practice, and it may also be effective for postherpetic neuralgia.
One systemic review found that acupuncture may help reduce pain and discomfort in patients with postherpetic neuralgia.
The pain-relieving effects of acupuncture are often long-lasting.
Other research suggests that cannabinoids may help with inflammation and nerve pain by targeting glycine receptors.
Along with tinctures and oils, CBD is also found in creams. Topical CBD can be helpful when treating postherpetic neuralgia because it can be applied directly to the affected area for quick pain relief.
Over the counter capsaicin creams may help with the pain caused by postherpetic neuralgia. These creams aren’t as potent as the patches administered in doctor’s offices, but they can provide temporary relief.
While natural and effective, these creams can cause mild side effects. They can cause skin irritation or a burning sensation. Fortunately, these effects usually disappear after a few uses.
Vitamin C was the focus of a 2012 study on attenuating postherpetic neuralgia pain. The vitamin was also the focus of a 2012 study on shingles. The vitamin was administered intravenously to a group of 67 patients between April 2009 and December 2010.
The treatment lasted for two weeks for patients and led to a drop in assessment of pain.
Baseline pain during and after shingles outbreaks was significantly lower than patients that did not have vitamin C treatment. Only 6% of the patients in the study went on to have complications of postherpetic neuralgia. The study fails to mention if this is statistically lower or higher than the average number of people that suffer from postherpetic neuralgia following a shingles outbreak.
Preventing Postherpetic Neuralgia
While there is no surefire way to prevent postherpetic neuralgia, you can take steps to reduce the risk of developing this condition. The most important thing you can do is seek medical help as soon as symptoms of shingles appear.
Seeking treatment early on (within two days, ideally) can help greatly reduce the chance of developing postherpetic neuralgia. Aggressive treatment not only reduces the risk, but it can also lower the severity and length of postherpetic neuralgia if it does develop.
Vaccination is another effective way to prevent postherpetic neuralgia. The varicella-zoster vaccine helps protect against shingles in people over the age of 60 who have already had chickenpox. It’s important to remember that vaccines don’t provide 100% immunity against the virus. However, it significantly reduces the risk of shingles and the complications that come along with it. If you already have shingles and postherpetic neuralgia, the vaccine will do nothing for you. It’s used for preventative purposes and cannot treat the condition.