Post-herpetic neuralgia
Overview
Post-herpetic neuralgia is long lasting pain that can happen after having shingles. It usually gets better gradually, and there are treatments that can help.
Symptoms
Post-herpetic neuralgia is common after you've hadshingles. It affects the areas of your body where you had the shingles rash. The symptoms usually start while you have the shingles rash or soon after it gets better. In rare cases symptoms start a few weeks or months after the shingles rash has gone. Symptoms of post-herpetic neuralgia may include: aching, burning or sharp pain in your skin that may be constant or come and goskin that's very sensitive to pain – you may have pain from slight touch or pressure, or from changes in temperatureitchy skinloss of feeling in your skin The pain is often mild, but some people have severe pain.
Causes
Post-herpetic neuralgia is caused by damage to your nerves fromshingles. It's not known why some people continue to have pain for a long time after shingles has gone. It's more likely to happen if your shingles symptoms were severe and if the shingles rash affected a large area of your body. Post-herpetic neuralgia is more common in older people and people with other health conditions such as diabetes or a weakened immune system.
Treatment
Post-herpetic neuralgia can be difficult to treat. It usually gets better eventually, but how long this takes can vary from a few months to over a year. A GP will usually prescribe medicines to help with pain, such as: paracetamol, or paracetamol withcodeine, if you have mild or moderate pain – this helps some people but it's unlikely to completely relieve your painmedicine to treat nerve pain, such asamitriptyline,duloxetine,gabapentinorpregabalin, if paracetamol and codeine have not workedplasters containing lidocaine (a local anaesthetic), if you have mild pain or other medicines are not suitable for youtramadol, if you have severe pain – you can usually only take this for a short time Medicines for nerve pain may not work straight away. You'll usually start on a low dose that will be increased gradually over a few weeks. You'll have check-ups to see how well it's working and if you're getting any side effects. If you have severe pain, if pain is affecting your daily activities, or if medicines from a GP have not worked, the GP may refer you for: cognitive behavioural therapy– a type of talking therapy that can help you cope with paintreatment from a specialist in nerve conditions (neurologist) or a specialist pain clinic – this may include treatments such as stronger skin patches, injections, ortalking therapiesto help you cope