Postherpetic Neuralgia - Treatment

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How is PHN treated?

Treatment is individualized for each patient; there is no treatment that is effective for all PHN patients, so clinicians often use two or more of the drug categories with examples listed below:

  • Lidocaine skin patches ([Lidoderm] small, bandage-like patches applied to painful areas)
  • Capsaicin skin patches ([Capsagel, Salonpas] applied in a doctor's office by trained staff)
  • Opioids (tramadol [Ultram], oxycodone [OxyContin], morphine)
  • Anticonvulsants (pregabalin [Lyrica], gabapentin [Neurontin]) have been shown to lessen the pain of PHN probably by stabilizing abnormal electrical activity in your nervous system.
  • Antidepressants (venlafaxine [Effexor], duloxetine [Cymbalta]) are often prescribed in lower doses than for depression.

Because some drugs (opioids) can be addictive and because some patients may need long-term treatments (over one year), consultation with a pain-management specialist may be advised. Some individuals claim tamanu oil rubbed into the affected may reduce the symptoms of PHN. One small study and a few case reports indicate that acupuncture can be helpful in relieving the pain of PHN. Infrequently, other methods are used. TENS (transcutaneous electrical nerve stimulation) devices are designed to interrupt the body's pain sensations while nerve blocks (short-term chemical nerve sensation blockade) and nerve ablation (surgically cutting a nerve) are also used. Results vary but the methods often do not give lasting pain relief.

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Comment from: Gary53, 55-64 Male (Patient) Published: November 12

I came down with a case of shingles in early 2008 at the age of 54. The pain and agony of postherpetic neuralgia (PHN) has been constant now for almost seven years. I tried all the standard treatments shy of surgery, and the very, very minimal relief was not worth the unpleasant side effects. I even tried ten sessions of acupuncture early in 2014 and was pain-free for a few hours after the first session, but after a couple months of treatment the pain had returned to original levels, so I ended the treatments. I have accepted that this 24/7 curse will be with me for the rest of my life.

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Comment from: Mary, 75 or over Female (Patient) Published: May 14

I had a shingles shot and about 2 years later got shingles. I have now had postherpetic neuralgia (PHN) for about 5 years. It is mostly on my left rib area. I have bad pain most all the time. I take gabapentin and Lyrica which kind of keeps the worst pain away, but still almost constant pain. I have had a spinal stimulator but had it taken out because it seemed to stimulate the nerves more than gave any relief. I've had several shots in my spine, all to no avail, and I had the Qutenza patch which was very painful and did nothing; topical gels, patches, all nothing. I sure wish someone would fix this!

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