Shingles causes a painful skin and nerve condition. The same virus that is responsible for shingles, herpes zoster, is responsible for chicken pox in children and causes shingles in some adults. Post herpetic neuralgia is a persistently painful condition associated with shingles outbreaks. Post herpetic neuralgia results from nerve damage during a shingles outbreak, confusing the nerves and causing a light touch to potentially be experienced as agonizing pain. Post herpetic neuralgia usually appears at the same location as the shingles outbreak and is characterized by burning, sharp and jabbing pain, itching or numbness, muscle weakness or paralysis and sensitivity to touch. A burning pain is the most common symptom of post herpetic neuralgia and often disrupts sleep and reduces a patient’s appetite. If a patient is able to see a pain specialist within 3 days of the appearance of the signature rash, a course of antiviral medications can be started that reduce the chances of post herpetic neuralgia by about fifty percent.
There is no specific test or specific cure for post herpetic neuralgia, but there are several medications that can be helpful in the reduction of pain. These may include a combination of topical pain creams, opioids, antidepressants, pain relieving skin patches and anticonvulsants.
A shingles vaccine ( Zostavax) is most effective in patients between 60-69, but provides relief for older groups as well. The vaccine reduce shingles outbreaks and in turn reducing post herpetic neuralgia in many older patients.