Controlling the pain of postherpetic neuralgia

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Controlling the pain of postherpetic neuralgia

Postherpetic neuralgia is ongoing pain that develops in some people who have shingles. Postherpetic neuralgia causes facial nerve problems, headaches, and persistent pain that last for at least 30 days and may continue for months to years. However, most cases of postherpetic neuralgia end within the first year.

Talk with your health professional about the following methods that may relieve your pain.

Over-the-counter medications

• Pain medications (analgesics), such as acetaminophen, aspirin, or ibuprofen, may be enough to help control pain.
• Anesthetics (such as benzocaine) are available in forms that you can apply directly to the skin for pain relief. Anesthetics cause partial or complete loss of feeling when applied to a particular area of skin around the area of pain.
• Capsaicin is a naturally occurring substance found in hot chili peppers. Medications containing capsaicin, such as Zostrix, may relieve the pain of postherpetic neuralgia. When applied to the skin, capsaicin blocks the skin's nerve impulses, stopping pain without interfering with other sensations. Do not apply capsaicin to the skin during the active rash stage; this could cause extreme aggravation of the rash. Capsaicin sometimes causes burning, stinging, or redness of the skin.

Prescription medications

• The Lidoderm patch contains lidocaine anesthetic. You apply it directly to the painful skin area. The lidocaine patch numbs the area, is simple to use, and causes no known serious side effects.
• Corticosteroid injections, sometimes used in combination with other medications, reduce the pain and area of skin affected by postherpetic neuralgia.
• Tricyclic antidepressants (such as amitriptyline) interfere with the chemical substances that send pain messages.
• Anticonvulsants (such as gabapentin) can relieve pain by calming the nerve pathways that send pain signals.
• Nerve block injections (anesthetic shots around the infected nerve) temporarily relieve pain.
• Opioids (such as codeine) suppress the feeling of pain.

Credits

Last updated:	March 21, 2007
Author:	Debby Golonka, MPH
Reviewed By:	Wajeeh E. Nasser, MD - Family Medicine, Randall D. Burr, MD - Dermatology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman