Question: I am just getting over shingles and now I have postherpetic neuralgia, which is driving me crazy. Is there anything I can do?
Dr. Hibberd's Answer:
Shingles is the reactivation of dormant chickenpox virus. The virus migrates to the skin, where it causes an intense, painful, blistering rash. After the skin reaction is clear, the pain may persist as neuralgia. Vaccination may minimize or even prevent recurrence. The vaccine (Zostavax) has FDA approval for those older than 60.
Aggressive early treatment of shingles may minimize the neuralgia, which may be severe and can last from weeks to months. Typically, anti-inflammatory, selected anti-seizure, and some low-dose antidepressant medications are used to reduce nerve pain.
Pain management occasionally may involve supervised management with blocks and suitable narcotic medications under physician supervision and direction.
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