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Post Herpetic Neuralgia

What is Post Herpetic Neuralgia?

Post Herpetic Neuralgia (PHN) is the term given to pain that sometimes lingers on after a Shingles outbreak has gone away.
This pain is associated with nerve tissue damage that is caused by the Herpes varicella-zoster virus and can be extremely painful and continuous for some people.
Shingles is a re-activation of the Chickenpox virus, which tends to be more prevalent in elderly people or those with a compromised immune system. Younger people may also experience Shingles (although it is less common) and anyone with a history of chickenpox can be affected.
Post Herpetic Neuralgia does not affect everyone who has Shingles, only a small minority. It is the nerve pain caused by scarring of nervous system tissue in the spinal cord.

Facts about PHN

  • PHN is not contagious, it cannot be passed onto another person
  • Elderly people or those with a weakened immune system are more likely to experience PHN after having Shingles
  • Taking medications that weaken the immune system also increase this risk
  • People over 70 years of age are much more like to experience PHN than those in the 50 to 70 year age group
  • If pain begins before there is any sign of a Shingles rash, PHN is more likely to develop later on
  • The more painful the Shingles episode is, the more likely that PHN will eventuate
  • Approximately 20% of people who have Shingles will experience PHN afterwards
  • 65% of people with PHN will have no more pain after three months and 80% will have no more pain after one year[1]

Does the neuralgia go away?

Yes, for most people PHN will go away completely without any treatment. More than half of all cases of PHN are completely healed after three months. For a small percentage of people however, the pain may last for several months or longer. This is a good reason to take prevention seriously, particularly if you are elderly or have a compromised immune system and experience Shingles.

Prevention

Antiviral medications

As soon as a Shingles outbreak develops, taking a herpes antiviral drug such as Valtrex, Famvir or Acyclovir could greatly reduce the chance of Post Herpetic Neuralgia developing later on. This is recommended within the first 2 to 3 days, or as soon as symptoms develop.

Vitamin E

Many studies suggest that Vitamin E supplementation can be neuroprotective. This means that Vitamin E may be beneficial for the treatment and prevention of Post Herpetic Neuralgia, the nerve pain that sometimes remains after a Shingles (Herpes varicella-zoster) rash.[2]

Symptoms

The symptoms of Post Herpetic Neuralgia sometimes occur after a Shingles episode.

Symptoms may include:

  • Pain that lingers on after a shingles break-out has passed
  • Burning, stabbing or throbbing pains along the spinal cord, trunk of the body or in and around areas that have been affected by Shingles. The pain may also affect other areas where the rash did not appear.
  • Pain that is often triggered by touch or stimulation
  • Even very gentle touch, such as the brush of clothing on the skin, could result in great discomfort
  • This can cause pain when doing everyday movements and may make some tasks extremely painful

Pain Relief

The following therapies may help to reduce the pain associated with Post Herpetic Neuralgia:

Strong painkillers

Prescriptions medications, such as codeine or oxycodone, are the standard treatment given by Medical Doctors for the management of PHN.

Essential Oils

One approach that can be helpful is to rub a blend of specific oils or extracts onto the affected area, such as:

  • Vitamin E
  • Rosemary
  • Lavender
  • Evening Primrose
  • Turmeric (extract or cream)

Rubbing these onto the affected area on a regular basis may help to settle down and rejuvenate the nerve tissue affected by the herpes virus.

Supplements

  • Vitamins A, C and E
  • Chromium
  • B complex
  • One 400 mg of chondroitin sulfate daily and 500 glucosamine sulfate 2-3 times daily (or as prescribed)
  • Alpha-lipoic acid (ALA) reverses nerve damage in diabetics, so may also assist with PHN from herpes

Diet and Nutrition

Natural sources of gamma-linolenic acid, such as from borage or black current seed oil, help reduce inflammation in diabetic nerve damage, and therefore may help to reverse neuropathy associated with herpes.

diet high in a nutrient called inositol (found in cantaloupe, peanuts, grapefruit, and whole grains) can also help with neuropathy.

Capsaicin cream

Capsaicin is a substance contained in cayenne peppers. Although it may not provide complete pain relief, it may help relieve minor pain in some people. Capsaicin cream is applied directly to the skin over the painful area.

Acupuncture

Acupuncture is used to relieve pain and treat certain health conditions. It may be used alone or as part of a treatment program which could bring some relief to the nerve pain associated with Post Herpetic Neuralgia.

References

  • ^ Miller, Dr Chris. “Post Herpetic Neuralgia: Essential Facts” Australian Herpes Management Forum June 2006
  • ^ Pace, A., Savarese, A., et al. “Neuroprotective effect of vitamin E supplementation in patients treated with cisplatin chemotherapy.” J Clin Oncol. 2003 Mar 1;21(5):927-31.

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