Shingles is an incredibly uncomfortable disease thanks to the painful rash it is known for. For most patients, recovery brings welcome relief. Unfortunately, relief is not always possible. There are some shingles patients who continue to experience nerve pain long after the skin heals. The pain can last for months or even years.
When it does, the patient has a new condition to deal with: postherpetic neuralgia (PHN). It is one of the many chronic pain conditions that the specialists at Lone Star Pain Medicine treat. As a pain management clinic in Weatherford, TX, Lone Star prefers interventional treatments rather than broad-based medication therapies.
A Nasty Shingles Complication
Postherpetic neuralgia is the most common complication of shingles. It can be chronic as well, making it especially difficult to treat older patients who are also experiencing pain from other sources.
As for shingles, it is caused by the varicella-zoster virus, the same virus that causes chickenpox. A person who has had chickenpox may have long since recovered, but the virus remains dormant in nerve tissue. It can be activated decades later as a result of age, stress, or even a weakened immune system. A reactivated virus travels along nerve fibers until it eventually reaches the skin and triggers shingles.
The painful rash associated with shingles is problematic enough, but nerve fibers can become damaged and inflamed as the virus does its work. Damaged nerves no longer send normal signals to the brain. Instead, they become hyperactive. They begin firing chaotic and often exaggerated pain signals long after the shingles rash has completely cleared up.
If the pain lasts more than a couple of months, it is considered chronic. And as anyone with chronic pain can testify, it is tough to live with day after day, week after week.
The Symptoms Tell the Tale
Pain medicine doctors like to say that PHN symptoms tell the tale. What they mean by this is that the condition is easily diagnosed because the symptoms are hyper-local to the same general area where the shingles rash was located. A shingles rash will typically wrap around one side of the torso or chest. It might also impact the face.
Key PHN symptoms include:
- A deep, persistent pain that is often described as a burning, electric, or sharp sensation.
- Skin sensitive enough to be triggered by the light weight of a shirt or a gentle breeze.
- Numbness and tingling in the same area, as paradoxical as that sounds.
- Mild muscle weakness and itching that feels impossible to scratch.
As long as the affected nerves remain hyperactive, symptoms will persist. Some people live with postherpetic neuralgia for the rest of their lives. Others are fortunate enough to experience a gradual reduction over weeks, months, or years.
Treating PHN With Interventional Strategies
Doctors tend to treat PHN with over-the-counter pain meds or oral nerve medications. When traditional treatments don’t provide sufficient relief, a pain medicine doctor is likely to recommend interventional strategies. Interventional therapies are more targeted. They are also designed mainly to stop the source of pain from communicating with the brain.
Examples include:
- Intercostal nerve blocks.
- Epidural steroid injections.
- Sympathetic nerve blocks.
- Peripheral nerve stimulation.
- Spinal cord stimulation.
Lone Star is quick to point out that interventional therapies are not intended exclusively to offer pain relief. They are also designed to help patients take their lives back. If you have had shingles and are now dealing with PHN, don’t assume you’ll have to live with the condition permanently just because over the counter or prescription medications didn’t help. There are a variety of interventional treatments that might do the trick for you.