Postherpetic Neuralgia

Postherpetic Neuralgia(PHN) is a chronic nerve pain condition that occurs after an attack of shingles (herpes zoster). Nerve damage occurs during the shingles outbreak, leading to persistent pain even after the rash and blisters heal. It significantly impacts quality of life and is more common in older adults and immunocompromised people.

Neuropathic Symptoms:

It can vary and may include the following:

Pain: stabbing or throbbing in the affected area.
Increased sensitivity: pain upon touch (allodynia) or heightened pain from stimuli that would not typically cause discomfort (hyperalgesia).
Numbness or tingling.
Itching or burning sensations.

Assessment and Diagnosis:

The diagnosis primarily relies on the symptoms, which include the following:

Persistent pain lasting more than three months after the rash resolves.

Exclusion of other potential causes of nerve damage pain

Multimodal Treatment:

The treatments aim to manage neuropathic symptoms and enhance quality of life:

Oral analgesics, including anti-neuropathic medications to calm overactive nerves.

Topical treatments: Lignocaine patch for numbing the area

Capsaicin patch for nerve desensitisation

Psychological support: stress management and cognitive behavioural therapy (CBT).

Nerve blocks to interrupt nerve pain signals.

Prevention by early treatment of shingles and vaccination.