Postherpetic Neuralgia Treatment

Depending on where shingles has advanced to will determine the

Postherpetic Neuralgia Treatment

for that particular pain. People with shingles optics (where the virus has invaded the ophthalmic nerve) may suffer painful eye inflammations that can leave them blind for a while or permanently harm them vision. People with this type of shingles should see an ophthalmologist immediately. If shingles appears on the face and affects the auditory nerve, this can also cause complications in hearing. Infections of facial nerves can lead to temporary paralysis of the face.

Postherpetic Neuralgia

Sometimes and especially in the elderly although younger people are starting to affected, symptoms of shingles can persist long after the outbreak has healed. These cases can result in facial paralysis, headache, and persistent pain. Possibly this happens because the nerve cells that transmit pain sensations have been the most intensely affected or have been sensitized by virus attack. Pain is a major complication of persistent shingles. This pain, called postherpetic neuralgia, is one of the most terrible known to man, the kind of pain that leads to insomnia, weight loss, depression and a preoccupation with unrelenting torment is an absolute characteristic of people with chronic pain.

Although it can be extraordinarily painful, postherpetic neuralgia is not life threatening. Careful clinical studies have shown that about a dozen in four different categories of drugs can provide pain relief. These include:

• Tricyclic antidepressants – Tricyclic antidepressants are often the first type of medication administered to patients with postherpetic neuralgia. Although commonly prescribed amitriptyline in the past with positive results, producing a high number of side effects. Desipramine and nortriptyline have fewer side effects and therefore are a better option for older adults, who are the group most likely to suffer the most from postherpetic neuralgia. The most common side effects caused by tricyclic antidepressants include dry mouth and eyes, constipation and numbness. People suffering from cardiac arrhythmia, or who have suffered a heart attack or have acute angle-closure glaucoma should use a different class of drugs.
• Anti-convulsants – Some medications that reduce seizures also treat postherpetic neuralgia because both seizures and pain exists in an abnormal increase in nerve cells. An anti-convulsant an old drug, carbamazepine, is effective against postherpetic neuralgia but potentially dangerous side effects, although rare. Therefore, a newer anti-convulsant, gabapentin is prescribed far more often. Side effects of this drug include drowsiness or confusion, dizziness and sometimes swelling of the ankles.
• Opiates – Opioids are powerful medications for pain are used for all types of pain. Include oxycodone, morphine, tramadol and methadone. Opioids have side effects – drowsiness, mental sluggishness and constipation – and can become addictive, so its use should be carefully monitored especially in those with a history of addiction.
• Topical local anesthetic – The local anesthetic applied directly to the skin in the painful area affected by postherpetic neuralgia are also effective. Lidocaine laque most commonly prescribed and is in a cream, gel or aerosol. Also as a patch, which has been approved by the Food and Drug Administration for use specifically in postherpetic neuralgia. In topical local anesthetics, the drug remains on the skin and therefore does not cause problems such as drowsiness or constipation. Capsaicin cream is available without prescription and has some effectiveness, but most people experience a strong burning sensation when applied.
• Postherpetic itch -The itching that occasionally occurs during or after the shingles outbreak can be very severe and painful.  Clinical experience indicates that postherpetic itch is even more difficult to treat than postherpetic neuralgia itself. Topical local anesthetics (to numb the skin) provide substantial relief in some patients. Since postherpetic itching usually occurs in skin that has suffered severe sensory loss, it is especially important to avoid scratching. Scratching the numb skin for a long time or very strong can cause injury.

There are many options in order to have relief from this illness.  Many people may also become immune to the current medication and will have to have it changed since the internal system or external treatment will feel as if it has stopped working, therefore lessening the pain relief.  If this does happen then there will have to be another option for your postherpetic neuralgia treatment that your doctor will be able to help with.

Shingles Symptoms

The first

Shingles Symptoms

are often burning pain or tingling and sometimes numbness on or under the skin. The person may also feel ill with fever, chills, headache or upset stomach. After a few days, appears on reddened skin, a rash of small fluid-filled blisters, similar to those of chickenpox. The pain associated with shingles can be intense and is often described as “relentless”.

People with injuries to the torso may feel spasms of pain with the soft touch. The blisters are usually limited to a band called dermatome, which extends to one side of the trunk, around the waist or are grouped on one side of the face.

The distribution of patches of shingles gives an indication of where the chickenpox virus has been hiding since the initial infection. Scientists now know that the shingles lesions correspond to the dermatome supplied by a specific sensory nerve when it leaves the brain or spinal cord.

For most healthy individuals, this second battle against varicella leads usually to a new triumph of the immune system. The attack of shingles can last longer than the chicken pox and the patient may need pain medication, but in most cases the body has sufficient resources to fight the disease. The lesions heal, the pain subsides within 3 to 5 weeks and in most patients the blisters leave no scars.

The severity and duration of an attack of shingles can be significantly reduced using prescription antiviral drugs like acyclovir, valacyclovir, and famciclovir. The ancyclovir is available in generic form, but the pills should be taken five times a day, whereas valacyclovir and famclovir taken only three times a day. It is very important not to miss a single dose or stop taking before the time indicated by your doctor. Antiviral drugs can halve the risk of being postherpetic neuralgia. Which is chronic pain that can persist for months or years after the disappearance of the rash of shingles. Doctors recommend starting antiviral drug supply at the first sign of an outbreak of shingles or even if the typical symptoms indicate that the eruption is about to erupt. While the patient is not examined by a doctor at the start of the disease may be helpful to begin taking antiviral medications if they still are producing new eruptions. They should also consider other treatments such as anti-inflammatories like prednisone corticosteroidales. These are used routinely when affected eye or other facial nerves.

If you have any of these signs it is crucial to is to act upon the shingles symptoms immediately to get a proper diagnosis in order to avoid further complications once the shingles has cleared.

Who is at Risk for Shingles

So

Who is at Risk for Shingles?

About 10 percent of normal adults will suffer from shingles at some point in their life, usually after age 50, but many more people are starting to be diagnosed with it prior to that.

The incidence increases with age, so the likelihood of developing shingles is 10 times higher in adults over age 60 than children under 10. Most people who get shingles develop an immunity to the virus and will no longer have the disease. However, the disease may relapse in some individuals, usually they are people with a weakened or compromised immune system, such as those undergoing chemotherapy or other autoimmune issues.

A person who is suffering from a disease that damages the immune system or who are taking drugs that suppress the immune system is very good candidate for an attack of shingles. Even in healthy individuals, temporary depression of the immune system caused by stress, an injury, cold and even a sunburn, can provoke an attack of shingles. It is important to know your medical history to help you in case you do have shingles symptoms. Early detection will help people in the long run if they do come down with shingles.

Other people at risk for shingles are pregnant women and their unborn children. For those children whose mothers had chickenpox late in pregnancy (5 to 21 days before giving birth) are also vulnerable to shingles. Sometimes these children are born with chickenpox or develop a typical case of chickenpox within a few days after birth.

It is important for people at risk for shingles such as pregnant women, should avoid being around anyone known to have chicken pox or shingles.  Even if you have had chicken pox as a child the virus and affect the unborn baby.  With others if you already have a compromised immune system it is important to boost your immune system to help with your overall health and help your body fight if you do get shingles. Besides shingles, there is nothing worse then having it advance into postherpetic neuralia then having an advanced illness lingering on for months if not years.