Postherpetic neuralgia

Postherpetic neuralgia (post-her-PET-ic noo-RAL-jah) is a complication of shingles, which is caused by the chickenpox (herpes zoster) virus. Most cases of shingles clear up within a few weeks. But if the pain lasts long after the shingles rash and blisters have disappeared, it's called postherpetic neuralgia.

Postherpetic neuralgia affects your nerve fibers and skin, and the burning pain associated with postherpetic neuralgia can be severe enough to interfere with sleep and appetite. The risk of postherpetic neuralgia increases with age, primarily affecting people older than 60. The area affected also makes a difference. When shingles occurs on the face, for example, the likelihood of postherpetic neuralgia is significantly higher than for other parts of the body.

Currently, there's no cure for postherpetic neuralgia, but there are treatment options to ease symptoms. For most people, postherpetic neuralgia improves over time.

Symptoms Causes Prevention

The signs and symptoms of postherpetic neuralgia are generally limited to the area of your skin where the shingles outbreak first occurred — most commonly in a band around your trunk, usually on just one side of your body.

Signs and symptoms may include:

  • Pain. The pain associated with postherpetic neuralgia most commonly has been described as burning, sharp and jabbing, or deep and aching.
  • Sensitivity to light touch. People who have postherpetic neuralgia often cannot bear even the touch of clothing on the affected skin, a condition called allodynia.
  • Itching and numbness. Less commonly, postherpetic neuralgia can produce an itchy feeling or numbness.
  • Weakness or paralysis. In rare cases, you might also experience muscle weakness or paralysis if the nerves involved also control muscle movement.

When to see a doctor

See a doctor at the first sign of shingles. Often the pain starts before you notice a rash. Your risk of developing postherpetic neuralgia is cut in half if you begin taking antiviral medications within 72 hours of developing the shingles rash. While steroids are sometimes prescribed for a more rapid resolution of the shingles rash and to provide short-term pain relief, their role in preventing postherpetic neuralgia has not been proved.

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