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Postherpetic Neuralgia: Treating Nerve Pain After Shingles

More than half of all seniors beyond age 65 live with chronic pain. One cause: Shingles. Almost a third of Americans will develop shingles, a viral skin rash that has its origins in childhood illness and can lead to chronic pain.

What is Post-herpetic Neuralgia?

You probably contracted chickenpox as a child; that’s when most people are exposed to this highly infectious virus. Known clinically as varicella-zoster, the infection is characterized by mild fever and an itchy, red, inflamed rash that often leaves scars from incessant scratching.

Once chickenpox passes, people are usually immune to it. However, the varicella-zoster virus remains dormant in the body and can be reactivated many years later as shingles, formally known as herpes zoster (HZ), which affects the nerve clusters in specific areas and causes pain or itching.

After an outbreak, the nerve damage can cause pain that persists for months or even years. This post-shingles pain, called post-herpetic neuralgia (PHN), is the most common and debilitating complication of the herpes virus for people over 60.

Symptoms of post-herpetic neuralgia include:

  • Burning, shooting, or aching pain that lasts for three months or more;
  • Pain that may be constant or occur in response to a normally non-painful stimulus, such as a cold breeze;
  • Itching and numbness;
  • Extreme sensitivity to touch; even clothing can cause a reaction on an affected area.

PHN can also cause anxiety, depression, and insomnia.

How Do I Get Rid of Shingles Nerve Pain?

Shingles is a sneaky infection. People often have itching, tingling, or pain in the area of the body where the rash will develop, up to five days before the rash appears. Other symptoms may include:

  • Headache
  • Fever
  • Chills
  • Upset stomach

Because these latter symptoms are present in many illnesses, including the common flu virus, it’s essential to seek treatment early to ensure the fastest recovery from PHN. If you start to experience any shingles-like symptoms, it’s wise to contact your doctor right away, before the rash appears, so you can get started on antiviral medication ASAP.

In addition to antiviral medicine, treatment options for PHN include:

  • Anti-inflammatory injections (epidurals)
  • Tricyclic antidepressants
  • Capsaicin cream (capsaicin, the active ingredient in cayenne pepper, is also used to help ease arthritis pain)
  • Over-the-counter pain relievers such as aspirin (make sure your doctor knows what you’re taking)
  • Colloidal oatmeal baths
  • Lidocaine and other topical patches and gels
  • Calamine lotion
  • Cold compresses
  • Loose-fitting natural fiber clothing such as cotton and silk.

How Long Does It Take for Shingles Nerve Pain to Go Away?

While chronic pain can be debilitating, only about half those who develop shingles after age 60 will also develop PHN. Fortunately, the majority of these patients recover within four to eight weeks after the shingles virus has run its course.

About one-third of PHN patients have symptoms that last about three months, and about one-fifth have pain for up to a year or more.

Prognosis depends on how quickly a patient is treated for shingles, how long the disease lingers, and any complications that develop. People with suppressed immunity and those who are under chronic stress are at greater risk of shingles and post-herpetic neuralgia.

Consider the case of a 62-year-old woman who is caring for her much-older husband with dementia, serving as power of attorney (POA) for her brother-in-law in a nursing home, and monitoring her elderly father who lives in an out-of-state assisted living community and had a recent fall.

She caught the flu a few months ago, then developed shingles, and is now dealing with a mild case of post-herpetic neuralgia as well as a cold. While doing her best to take care of herself, the ongoing stress of caring for three elderly family members, both in person and by proxy, has clearly taken a serious toll on her health.

It’s essential for caregivers to ask for support and find ways to relieve stress in order to prevent or reduce PHN.

Can I Prevent Shingles?

The best way to reduce the risk of contracting shingles and the long-term pain associated with post-herpetic neuralgia is vaccination.

The Centers for Disease Control and Prevention (CDC) recommends healthy adults 50+ receive one of two licensed shingles vaccines. Your healthcare professional can advise you as to which is preferable for your age and health profile.

Managing Chronic Pain

We understand how pain affects the quality of life, and want to help you manage it so you can return to the activities that bring you joy as quickly as possible. The Area Agency on Aging 1-B offers no-cost classes throughout Metro Detroit to help you or your senior loved one learn to cope with chronic pain, such as that from post-herpetic neuralgia.

Our Chronic Pain Management classes are built on the Personal Action Toward Health (PATH) model, an evidence-based approach proven to help people learn to cope with chronic conditions. Workshops meet weekly for six weeks and are held in community settings such as senior centers, community centers, and religious centers, located throughout our six-county Southeast Michigan region. Classes are available for those 60 or older. They are free, but donations are always appreciated. They help us keep the classes going and offer them to more people.

Our instructors have often experienced chronic pain themselves, so they have a deep understanding of and empathy for what you’re going through. The small group settings will enable you to build rapport with a community of others who also understand, allowing you to benefit from one another’s experiences.

PATH Chronic Pain Management classes will help you to:

  • Make an action plan
  • Solve problems
  • Deal with difficult emotions
  • Relax
  • Manage pain and fatigue
  • Make informed treatment decisions
  • Work better with your healthcare professionals

For more information on our Chronic Pain Management classes, or to find a class near you, call 833-262-2200.