Shingles is a viral infection of the nerve roots affecting over a million people per year. Residual pain after having shingles is also referred to as postherpetic neuralgia, or PHN.
The pain occurs when the virus that causes shingles travels to nerve fibers, causing nerve damage that produces widespread, painful and sometimes excruciating skin rashes.
In the majority of shingles cases, this pain resolves itself over time. For 12 to 15 percent of those who develop shingles, the resolution is not so simple. This unfortunate minority may have to shift their focus from curing PHN to understanding how to manage chronic pain associated with permanent nerve damage.
Warning Signs & Symptoms
Symptoms of the shingles virus include headaches, sensitivity to light, flu-like symptoms, and itchiness, tingling, or mild to severe pain in areas with a rash.
A PHN diagnosis is given after pain associated with shingles persists more than three months after other components of the virus have healed. However, if you or your physician suspects that the healing process is beginning to plateau or slow, then treatment should be sought immediately. The earlier that aggressive treatment begins, the less likely it will progress into a permanent condition.
Risk Factors & Possible Causes
Doctors have not determined why some shingles sufferers experience greater and longer-lasting pain and others do not. However, there are some commonly observed factors that may indicate that a patient is more likely to develop PHN:
- Patients over the age of 60
- Female patients tend to develop PHN more than male patients
- Patients who experience symptoms prior to a rash appearing
- Severe pain in the early stages of the virus
- A severe rash from the beginning of the virus
Tests to Diagnose Pain from Shingles
Diagnosis of the shingles virus can usually be made by observing the area(s) affected by a rash. Lab tests for herpes may also be ordered. Doctors can typically diagnose PHN by observing and monitoring pain after other symptoms associated with shingle have ceased.
At this time, there is no perfect solution for treating lasting pain from shingles. Treatment varies depending on how the individual responds, and in cases of permanent nerve damage, doctors focus on pain management.
Medications that have had some success are:
- Tricylic antidepressants
- Strong opioids (closely monitored by the physician to avoid addiction and inefficacy)
- Lidocaine patches
- Epidural Steroids
- Sympathetic Ganglion Nerve Blocks
The most effective way to avoid developing PHN is to get vaccinated for the shingles virus.This is not 100 percent effective, but it can help prevent shingles and many believe it can help decrease or eliminate the occurrence of PHN as well.