Postherpetic neuralgia is a form of neuropathic pain that occurs after an infection with the varicella–zoster virus VZV, the virus responsible for chickenpox and shingles.
The first infection with the virus usually occurs in childhood, presenting as chickenpox.
After the symptoms subside, the virus does not completely leave the body but remains in a latent state.
Later in life, it may reactivate and cause shingles.
Reactivation of the virus is more common in people over the age of 60.
However, it can also occur at younger ages, especially in individuals with a weakened immune system, such as:
Shingles manifests as a vesicular rash presented in a specific distribution, depending on the affected nerve.
It is accompanied by intense burning pain, which is a key symptom of the disease.
Even after the rash subsides, the pain may persist for a long period without other visible symptoms, which can make diagnosis more challenging.
Patients describe the pain as:
Postherpetic neuralgia can significantly affect daily life.
Even light contact of clothing with the skin can be unbearable, limiting activities and negatively impacting emotional well-being.
How is postherpetic neuralgia treated?
Effective treatment of postherpetic neuralgia – PHN may be conservative or interventional.
The most common medicinal treatment includes anticonvulsants, tricyclic antidepressants (TCA), with analgesics and mild opioids often administered as additions.
In recent years, special 8% capsaicin adhesive patches have also been applied to the affected area, with particularly encouraging results.
If, however, conservative medicinal treatment proves unsuccessful or needs to be discontinued due to adverse effects, minimally invasive techniques developed in recent years may prove particularly effective, such as epidural injections of corticosteroids and local anesthetics, neuromodulation techniques, and sympathetic nerve blocks.
Shingles is a viral infection caused by the varicella-zoster virus (VZV). It presents with a vesicular rash in a specific area of the body and intense burning pain.
Shingles presents with a vesicular rash and burning pain. Postherpetic neuralgia appears after the rash has resolved and is characterized by persistent neuropathic pain.
Yes, postherpetic neuralgia is a form of neuropathic pain caused by damage or dysfunction of the nerves due to the varicella-zoster virus.
The same virus (Varicella Zoster Virus – VZV) causes both chickenpox in childhood and shingles later in life, through reactivation of the virus that remains in a latent state.
Shingles itself is not contagious, but the fluid from the blisters can transmit the virus to people who have never had chickenpox or have not been vaccinated. In such cases, the person will develop chickenpox, not shingles.
Initially, pain, burning, or tingling appears in a specific area of the body. A few days later, a vesicular rash develops, clearly distributed along a nerve.
Yes, the vaccine significantly reduces the risk of developing shingles and postherpetic neuralgia.
Yes, even if you have had shingles, you can receive the vaccine to reduce the likelihood of reoccurrence.
In mild cases, topical ointments can be used to relieve pain or itching. However, antiviral and analgesic medications remain the main treatment.
The condition occurs more frequently in people over 60 years old, as well as in individuals with a weakened immune system, such as those with AIDS, those taking immunosuppressive medications, or those undergoing chemotherapy.
Patients describe the pain as burning, sharp, or pressing. It is often accompanied by hyperalgesia (intense pain even with light touch), itching, and malaise.
Duration varies from patient to patient. It can last from a few weeks to several years, depending on age, immune system, and the treatment.
Yes, acupuncture can be used as a complementary therapy, helping to reduce pain and improve quality of life.
The most important strategy is vaccination against shingles. Additionally, early administration of antiviral medications within the first 72 hours of rash onset reduces the likelihood of developing postherpetic neuralgia.
