Postherpetic Neuralgia

What Is Postherpetic Neuralgia?

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Causes & Symptoms of Postherpetic Neuralgia

The cause of postherpetic neuralgia is the varicella zoster virus that remained after the initial chickenpox infection and revived again with the shingles infection. The damaged nerve fibers of the skin continue to send pain signals to the brain, long after the blisters have healed.

Postherpetic neuralgia has the following symptoms:

  • occurs at the site of the initial shingles outbreak — usually on the trunk, but sometimes on the face
  • the chronic pain can be described as unbearable, aching, stabbing, burning or sharp
  • pain can be triggered by a light touch — such as clothing brushing against the area
  • less commonly, itchiness or numbness may occur

Other complications that often arise from postherpetic neuralgia include:

  • depression that can come from a person isolating themselves to avoid pain triggers
  • fatigue from sleep difficulties associated with the neuralgia
  • concentration problems
  • loss of appetite

How Is Postherpetic Neuralgia Diagnosed?

A review of your symptoms and history of shingles is usually all your general practitioner needs to accurately diagnose postherpetic neuralgia.

Treatments for Postherpetic Neuralgia

NSPC Brain & Spine Surgery (NSPC) (NSPC) has an experienced multidisciplinary team of leading doctors who specialize in pain management and conditions relating to the nervous system.

The first line of treatments for postherpetic neuralgia are non-surgical:

  • Antidepressants can help your body reinterpret the nerve pain signals sent to your brain, by adjusting your body’s chemical balance.
  • Antiseizure medication, often prescribed for epilepsy, can help regulate the electrical nerve impulses and provide pain relief.
  • Topical agents may alleviate pain by delivering an analgesic directly through the skin. Capsaicin (compound in hot chili peppers) cream has brought relief to some.
  • Steroid injections near the spinal cord is sometimes recommended.
  • Opioid analgesics may bring alleviate pain, but can become habit-forming.

If the more conservative approaches do not relieve the symptoms, other more advanced treatment techniques may provide long-term pain curative results:

Rhizotomy—is a surgical procedure to damage the nerve or nerve root that is causing abnormal signals to be sent to the brain.

Transcutaneous Electrical Nerve Stimulation (TENS) involves electrodes placed on the skin (cutaneous) near the nerve pathways to disrupt the abnormal pain signals.

Peripheral Nerve Stimulation involves surgically implanting the electrodes near the nerves, similar to TENS. The electrical current sends messages that are non-pain-inducing to the brain, bringing pain relief.

Spinal Cord Stimulation also employs a small electrical current to modulate the nerve signals. The electrodes are implanted near the spinal column.

In our New York metro region locations, we have knowledgeable specialists in pain management as well as the specialties of neurophysiology and neuropsychology. Our premier medical teams can help you find the best treatment option for your postherpetic neuralgia.

Related NSPC Center

Long Island Brain and Spine Tumor Center

NSPC provides state-of-the-art treatment of benign and malignant brain and spine tumors, using minimally invasive procedures like Gamma Knife®, Novalis TX™, and CyberKnife® rather than major surgery whenever appropriate. Our physicians also perform experienced pediatric neurosurgery — they give personalized, individual attention combined with knowledge and experience to take on the most challenging of cases.


Brian Snyder

M.D., F.A.N.N.S.


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