Pain

Understanding Postherpetic Neuralgia

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Postherpetic neuralgia is a painful condition that can develop as a medical complication of shingles (herpes zoster virus). It presents as a burning pain in the nerves and skin after the rash and blisters from the shingles virus have healed.

What is shingles?

The herpes zoster virus lies dormant in nerve cells in people who have had chickenpox. If the virus reactivates, it travels along nerve fibers to the skin and is referred to as shingles. Not everyone who had chickenpox will develop shingles.

Shingles is a painful condition that causes blisters and rashes on the skin. During a shingles outbreak, a burning or shooting pain occurs around the area of the blistered rash.

What is postherpetic neuralgia?

The pain associated with shingles normally ceases after the herpes zoster virus becomes dormant again; however, if pain lingers after the shingles rash disappears, postherpetic neuralgia has likely developed. When an individual has postherpetic neuralgia, nerves that were damaged during an outbreak of shingles send faulty pain signals to the brain.

Postherpetic neuralgia does not have a cure; however, certain treatments can ease symptoms. Postherpetic neuralgia can last for months or years; however, it normally improves over time. An estimated 20 percent of individuals who develop shingles will develop postherpetic neuralgia.

What are the symptoms?

Postherpetic neuralgia symptoms normally occur where the shingles rash developed, usually on one side of the body. Symptoms include, but are not limited to, the following:

  • Severe pain lasting longer than three months (after shingles)
  • Burning, sharp, jabbing, deep or aching pain in or around the location of the shingles outbreak
  • Sensitivity to touch (allodynia) [insert allodynia link], such as clothes touching the skin, resulting in extreme pain
  • Itching or numbness at the location of the shingles outbreak
  • Burning sensations from slight pressure
  • Temperature sensitivity to slight temperature changes

Who is at risk?

Although anyone who experiences shingles is at risk for developing postherpetic neuralgia, certain factors and conditions increase the likelihood:

  • 50 years of age or older
  • A severe case of shingles
  • Severe pain during shingles outbreak
  • Diabetes
  • Location of the shingles rash on the face or torso
  • Delayed antiviral treatment of over 72 hours after the shingles rash first appeared
  • A weakened immune system
  • HIV
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