Postherpetic neuralgia is a term used for the lingering nerve pain after a bout of shingles. Shingles is caused by a virus called varicella-zoster, the same virus that causes chickenpox. Individuals who have had chickenpox may have this virus lying dormant in their bodies, which later re-erupts in a rash on one side of the face or body. One in five individuals will experience severe nerve pain as a result of this virus, generally in the same area where the rash was located. Individuals over sixty years old, women, patients who experienced pain initially with the rash, and individuals with other health problems are more likely to experience postherpetic neuralgia. Thankfully, there are treatments available for postherpetic neuralgia. Find out what these are now.
Corticosteroids are often used to reduce inflammation and lessen the effects of the immune system. These mimic the hormone cortisol produced naturally by the body. Corticosteroid medications are often used medically to soothe skin rashes, treat inflamed tendons and joints, and to decrease symptoms in certain inflammatory conditions, such as rheumatoid arthritis and gout. Steroid injections are administered into affected areas to reduce nerve pain from shingles. However, continuous use this type of medication is not advisable, due to negative side effects.
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Capsaicin Skin Patch
Capsaicin, which is what makes peppers hot, is a compound extracted from the pepper plant. The same chemicals that give peppers their heat can also be used to reduce painful symptoms, as it helps block pain signals to the brain. Capsaicin is usually made into a cream for topical use, but it is also available as a patch patients can apply to their skin for longer-lasting relief. These patches are only available from the doctor. The area where the capsaicin skin patch will be applied must be numbed first. Some individuals, unfortunately, may react to the capsaicin skin patch. The effectiveness of a single capsaicin patch can last up to three months.
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Research has found antidepressant medications can also be used to relieve chronic pain conditions like postherpetic neuralgia, even when depression isn't also present. Although the mechanism isn't well understood, scientists believe antidepressants increase the neurotransmitter chemicals that reduce the sensation of pain. Several different types of antidepressant medications appear to help with postherpetic neuralgia, including tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors (SNRIs), and selective serotonin reuptake inhibitors (SSRIs). However, these medications do not reduce pain immediately, and the effects must accumulate over weeks. Some of the medications have side effects individuals may not tolerate well. However, changing to a different medication in the same category can improve tolerance.
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The same medications used to control seizures have been found to have a beneficial effect in reducing certain types of pain, including postherpetic neuralgia. Science does not provide a complete explanation of why anticonvulsants work, but evidence suggests the medications interfere with the overactive pain signals from damaged nerves. Side effects include nausea, vomiting, double vision, drowsiness and trouble with coordination, and some individuals experience swelling in the feet and legs. New types of anticonvulsant medications cause fewer side effects than the older types and are better tolerated. Doctors will monitor patients carefully for side effects from these medications.
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Postherpetic neuralgia can also be reduced with the use of topical medications that provide an anesthetic effect. These medications, such as lidocaine, come in a variety of forms, including as a cream, gel, and patch. Compounds with a five to eight percent lidocaine concentration are generally available. Capsaicin creams can also be applied to affected areas, with good results. Generally, a .075 percent concentration is used for this purpose. Prescription topical anesthetics such as .5 or one percent ketamine cream can be helpful for some aspects of chronic pain conditions like postherpetic neuralgia. Amitriptyline creams in one or two percent concentrations are sometimes used to relieve nerve pain as well.