Chronic Pain Management for Postherpetic Neuralgia

The past few months I have spoken with several people who had recent Shingles episodes. Shingles is a form of postherpetic neuralgia. Postherpetic neuralgia (PHN) is a painful condition affecting the nerve fibers and skin. Postherpetic neuralgia is a complication of shingles, a second outbreak of the varicella-zoster virus, which initially causes chickenpox.

During an initial infection of chickenpox, some of the virus remains in the body, lying dormant inside nerve cells. Years later, the virus may reactivate, causing shingles. Once reactivated, the virus travels along nerve fibers, causing pain. When the virus reaches the skin, it produces a rash and blisters. A case of shingles (herpes zoster) usually heals within a month. But some people continue to feel pain long after the rash and blisters heal — a pain called PHN.

Current treatment of the disease is not completely satisfactory, and many patients suffering from PHN must deal with pain for months or even years after the initial lesions have disappeared. Antiviral agents such as acyclovir (the prescription medication Zovirax) are associated with absence or reduced duration of PHN if they are started within 72 hours of appearance of the lesions.

However, many patients are not diagnosed within this period. In addition, some acyclovir studies show no improvement in PHN even if started within the 72 hour period. Other treatments such as narcotics, antidepressants, and antiepileptics offer symptomatic control in some patients, but the pain control is frequently inadequate and side effects, such as dizziness, drowsiness, and constipation, limit their use. The limited efficacy of current treatments prompted a search for alternative approaches.

Postherpetic neuralgia (PHN) is difficult to treat. Once PHN develops, a patient may need a multidisciplinary approach that involves a pain specialist, psychiatrist, primary care physician, and other health care providers.

To learn more about the importance of using a team approach in chronic pain management please check out my article The Need for Multidisciplinary Chronic Pain Management that you can download for free on our Ariticles page.

If you would like to see my upcoming trainings and especially to learn about my 20 hour (three days) Addiction-Free Pain Management® Certification Training on December 7-9, 2009 in Sacramento California designed to teach treatment strategies for people living with chronic pain and coexisting disorders including disorders including addiction please Click Here and scroll down to the December 7-9, 2009 for the description and how to sign up.

You can learn more about the Addiction-Free Pain Management® System at our website www.addiction-free.com. If you or a loved one is undergoing chronic pain management, especially if you're in recovery or believe you may have a medication or other mental health problem and you want to learn more effective chronic pain management tools, please go to our Publications page and check out my books; especially the Addiction-Free Pain Management® Recovery Guide: Managing Pain and Medication in Recovery. To purchase this book please Click Here.

To read the latest issue of Chronic Pain Solutions Newsletter please Click here. If you want to sign up for the newsletter, please Click here and input your name and email address. You will then recieve an autoresponse email that you need to reply to in order to finalize enrollment.