Postherpetic Neuralgia
Last updated: 1 Aug 2025
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Postherpetic Neuralgia
Postherpetic Neuralgia (Pain caused by shingles) is a common complication associated with herpes zoster. This pain is characterized by a burning sensation in the nerves and skin and may persist long after the rash and blisters from shingles have healed. The risk of experiencing this pain increases with age, particularly in individuals over 60 years old. While there is no definitive cure for the pain, treatments are available to alleviate symptoms.
Symptoms
Generally, pain caused by shingles is confined to the area of skin where the shingles rash occurred, often on one side of the trunk. The symptoms include:
- Pain lasting more than three months after the shingles rash has healed.
- Pain described as burning, sharp shooting pain.
- Pain may occur with even light touch or exposure to light wind.
- Some patients may experience itching or decreased sensation.
Causes
The virus that causes chickenpox (Chickenpox Virus) is responsible for shingles. Once a person has had chickenpox, the virus remains dormant in the body for life and may reactivate, causing shingles. The risk increases with age and is further increased by factors that weaken the immune system, such as chemotherapy or immunosuppressive medications.
Pain from shingles arises when nerves are damaged during the shingles infection. The damaged nerves can no longer transmit signals from the skin to the brain normally, leading to abnormal pain perception, resulting in pain along the nerve pathways that may take months or years to resolve.
Risk Factors
Factors that increase the risk of developing pain from shingles include:
- Age over 60 years.
- Severity of the shingles rash.
- Underlying health conditions such as diabetes.
- Delayed treatment of shingles, specifically if antiviral medication is not started within 72 hours of rash appearance.
- Not receiving the shingles vaccine.
Complications
Individuals with pain caused by shingles may experience other problems associated with chronic pain, depending on the duration and severity of the pain. Other issues may include:
- Depression.
- Sleep disturbances.
- Fatigue.
- Decreased appetite.
Prevention
Receiving the shingles vaccine can reduce the incidence of pain associated with shingles, particularly in individuals who:
- Are 50 years of age or older, especially those with a history of chickenpox.
- Have weakened immune systems, such as individuals who have undergone organ transplants, those with autoimmune diseases like SLE, individuals with HIV infection, or those taking immunosuppressive medications.
Treatment
One of the treatments for pain resulting from shingles is Pulsed Radiofrequency Ablation (PRF).
Mechanism of Action:
PRF involves using radiofrequency waves to stimulate the nerves that transmit pain signals without destroying the tissue or nerves. This procedure creates an electric field that modulates nerve function, which is believed to reduce pain signal transmission and may assist in nerve recovery.
Who is PRF Suitable For?
PRF is typically utilized in patients who have not responded to other treatments for shingles, such as medications (antidepressants, anticonvulsants, pain relievers) or other modality like laser therapy or injections.
Steps in PRF Treatment:
1. Identify the nerve location affecting pain using an ultrasound machine.
2. Insert the PRF probe near the target nerve.
3. Stimulate the nerve with the PRF device for 5 minutes at a temperature of about 42 degrees Celsius and a frequency of 2-5 Hz.
4. After treatment, patients may experience slight pain or swelling, which usually resolves within 2-3 days.
Effectiveness:
Clinical studies have shown that PRF can help reduce pain and improve the quality of life for patients suffering from shingles-related pain. Although it cannot offer a permanent solution, it can relieve pain for several months.
Advantages of PRF:
- Does not damage the nerve, preventing permanent nerve injury.
- Relatively low risk.
- Can provide long-lasting pain relief with fewer side effects compared to long-term medication use.
Limitations:
- Effectiveness may vary among individuals.
In summary, pain caused by shingles is a common complication, characterized by burning pain in the nerves and skin, with higher risks associated with increasing age. While no definitive cure exists, various treatments can alleviate pain, and PRF is a low-risk option suitable for patients who do not respond to traditional therapies.
Postherpetic Neuralgia (Pain caused by shingles) is a common complication associated with herpes zoster. This pain is characterized by a burning sensation in the nerves and skin and may persist long after the rash and blisters from shingles have healed. The risk of experiencing this pain increases with age, particularly in individuals over 60 years old. While there is no definitive cure for the pain, treatments are available to alleviate symptoms.
Symptoms
Generally, pain caused by shingles is confined to the area of skin where the shingles rash occurred, often on one side of the trunk. The symptoms include:
- Pain lasting more than three months after the shingles rash has healed.
- Pain described as burning, sharp shooting pain.
- Pain may occur with even light touch or exposure to light wind.
- Some patients may experience itching or decreased sensation.
Causes
The virus that causes chickenpox (Chickenpox Virus) is responsible for shingles. Once a person has had chickenpox, the virus remains dormant in the body for life and may reactivate, causing shingles. The risk increases with age and is further increased by factors that weaken the immune system, such as chemotherapy or immunosuppressive medications.
Pain from shingles arises when nerves are damaged during the shingles infection. The damaged nerves can no longer transmit signals from the skin to the brain normally, leading to abnormal pain perception, resulting in pain along the nerve pathways that may take months or years to resolve.
Risk Factors
Factors that increase the risk of developing pain from shingles include:
- Age over 60 years.
- Severity of the shingles rash.
- Underlying health conditions such as diabetes.
- Delayed treatment of shingles, specifically if antiviral medication is not started within 72 hours of rash appearance.
- Not receiving the shingles vaccine.
Complications
Individuals with pain caused by shingles may experience other problems associated with chronic pain, depending on the duration and severity of the pain. Other issues may include:
- Depression.
- Sleep disturbances.
- Fatigue.
- Decreased appetite.
Prevention
Receiving the shingles vaccine can reduce the incidence of pain associated with shingles, particularly in individuals who:
- Are 50 years of age or older, especially those with a history of chickenpox.
- Have weakened immune systems, such as individuals who have undergone organ transplants, those with autoimmune diseases like SLE, individuals with HIV infection, or those taking immunosuppressive medications.
Treatment
One of the treatments for pain resulting from shingles is Pulsed Radiofrequency Ablation (PRF).
Mechanism of Action:
PRF involves using radiofrequency waves to stimulate the nerves that transmit pain signals without destroying the tissue or nerves. This procedure creates an electric field that modulates nerve function, which is believed to reduce pain signal transmission and may assist in nerve recovery.
Who is PRF Suitable For?
PRF is typically utilized in patients who have not responded to other treatments for shingles, such as medications (antidepressants, anticonvulsants, pain relievers) or other modality like laser therapy or injections.
Steps in PRF Treatment:
1. Identify the nerve location affecting pain using an ultrasound machine.
2. Insert the PRF probe near the target nerve.
3. Stimulate the nerve with the PRF device for 5 minutes at a temperature of about 42 degrees Celsius and a frequency of 2-5 Hz.
4. After treatment, patients may experience slight pain or swelling, which usually resolves within 2-3 days.
Effectiveness:
Clinical studies have shown that PRF can help reduce pain and improve the quality of life for patients suffering from shingles-related pain. Although it cannot offer a permanent solution, it can relieve pain for several months.
Advantages of PRF:
- Does not damage the nerve, preventing permanent nerve injury.
- Relatively low risk.
- Can provide long-lasting pain relief with fewer side effects compared to long-term medication use.
Limitations:
- Effectiveness may vary among individuals.
In summary, pain caused by shingles is a common complication, characterized by burning pain in the nerves and skin, with higher risks associated with increasing age. While no definitive cure exists, various treatments can alleviate pain, and PRF is a low-risk option suitable for patients who do not respond to traditional therapies.
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