Postherpetic neuralgia - treatment, symptoms, causes, diagnosis

Postherpetic neuralgia is a condition that is accompanied by pain and usually follows an episode of herpes zoster. The term itself refers to the condition (pain after herpes).

Shingles (herpes zoster) - the cause is the reactivation of the varicella zoster virus, which is latent in the human body and for unknown reasons is activated and causes an episode of herpes zoster. The exact reasons for the activation of the virus are not yet known.

The reactivated virus spreads along the nerves, causing pain and rashes or small blisters on the skin. Typically, shingles rash and pain usually occur on one side of the torso or head. Most often, rashes occur in the chest area. The disease usually lasts for several weeks and goes away without leaving a trace. But sometimes the virus damages nerve fibers, which results in pain and other symptoms after the rash disappears. This is postherpetic neuralgia

Symptoms of postherpetic neuralgia vary (depending on the individual characteristics of the individual) and may include severe pain, numbness, tingling, and paresthesia in the area affected by the viral infection. Postherpetic neuralgia can have a negative impact on both daily life and ability to work. But, at present, there are quite effective ways to treat this condition (physiotherapy, drug treatment).

Risk factors

Only those who have had chickenpox can get shingles. But there are certain groups that are more susceptible to postherpetic neuralgia:

Age – the chance of postherpetic neuralgia is higher in the older age group. (30% of people over 60 years of age who have had herpes zoster subsequently develop postherpetic neuralgia) and only 10% of the younger group develop postherpetic neuralgia.
Localization of rashes - symptoms of neuralgia are more pronounced if the rashes were in the forehead or eyes.
Concomitant pathology – The presence of a suppressed immune system (after chemotherapy or taking immunosuppressants) or diseases such as AIDS.

Early treatment of herpes zoster is important. Treatment started within 2-3 days after the rash appears can help reduce symptoms and avoid the risk of postherpetic neuralgia.

Causes

Postherpetic neuralgia has a specific pathogenesis. Nerves in their structure are similar to electrical wires that run throughout the body and conduct impulses from the central nervous system and back, with information about the state of organs and tissues. Sensory nerves transmit pain, temperature, and tactile sensations.

Postherpetic neuralgia occurs when the shingles virus damages sensory nerves. Damaged nerves begin to function poorly and send pain impulses to the central nervous system. This leads to chronic pain or sensory disturbances in certain areas of the body.

Diet for herpes zoster in adults

You can: fish and lean meat, milk, fermented milk products, a large amount of vegetables, fruits containing vitamins A, B, C, E. Not allowed: canned foods, smoked foods, pickles, sweets, carbonated drinks, alcohol. The menu should contain only food prepared from fresh ingredients. The diet for herpes zoster will not be strict. But to speed up recovery and increase defenses, it is recommended to eat foods high in vitamins (especially vitamin E and C as antioxidants) and microelements: prunes, dried apricots, cranberries, rose hips and others. It is not recommended for a diet for herpes zoster in adults during the period of exacerbation of fatty meats and fish, smoked and pickled foods, offal and canned food, as well as excess sweets. ', 'DETAIL_TEXT_TYPE' => 'html', '~DETAIL_TEXT_TYPE' => 'html', 'PREVIEW_TEXT' => ' Diet for shingles will help speed up recovery. Nutrition should be nutritious.', '~PREVIEW_TEXT' => ' Diet with shingles will help speed up recovery. 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Information about the disease

Shingles on the face is quite common. The trigeminal, facial and optic nerves are most often affected. The rash itself is often preceded by general malaise, headache, fever, as well as the appearance of pain, itching and burning at the site of the future rash.

The rashes are initially presented as small nodules, transforming into vesicles with transparent contents and forming a “plaque” along the dermatome (an area of skin innervated by a certain nerve) on one side of the face. The rash usually does not extend beyond the midline of the head.

This is accompanied by a disturbance in general well-being, burning and itching of the blisters themselves. Subsequently, a crust forms and the elements dry out.

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Symptoms

Symptoms of postherpetic neuralgia typically occur only in the area of the body affected by shingles and include:

Pain (can be sharp, cutting, throbbing, burning),
Numbness, tingling, itching
Headaches if shingles is localized to the head or face
Rarely, muscle weakness or paralysis if the nerve supplying a particular muscle is damaged.

Sometimes patients experience allodynia. Allodynia is a reaction that is not proportionate to the stimulus (that is, the patient reacts to minor stimuli such as a slight change in temperature or the touch of clothing with severe pain).

Residual effects

After the rash has completely cleared, propolis lozenges should be applied. They will help eliminate residual pain.
In spring, you can lubricate your skin with the milky juice of dandelions.
Dandelions are used to prepare food for the winter. To do this, fill a jar with inflorescences and fill it with high-quality vodka. Dandelions should be infused in a dark place for 40 days, shaking daily. This tincture is stored in a cool, cool place in an tinted glass bottle. Should be taken in small portions 3 times a day after meals. Prevention is carried out for 3-4 months.

And remember that timely suppression of the herpes virus will help quickly get rid of the disease. If the treatment process is delayed, complications can be significant. Good health to you!

Diagnosis

If pain occurs after an episode of rashes or sensory disturbances, you should consult a doctor. Diagnosis is based on medical history, examination and laboratory tests (necessary to exclude other diseases). Instrumental diagnostic methods (CT, MRI, EMG, ultrasound) are prescribed only if there is a need for differential diagnosis.

Forecast

Exercise therapy, physiotherapy and drug treatment in most cases help reduce symptoms and restore quality of life. Especially if treatment is carried out in a timely manner.

Painkillers and healing folk remedies

As soon as the burst bubbles dry, you should apply compresses from plants:

sagebrush;
immortelle;
burdock;
elm bark;
calendula and meadowsweet;
mint and others.

Sagebrush

Treatment is carried out with alcohol tincture of wormwood. To do this, soak a cotton pad in the tincture and apply it for 15-20 minutes. Next, the skin should be lubricated with castor oil. This treatment is carried out repeatedly.

Immortelle

A tablespoon of immortelle is brewed with a glass of boiling water and wrapped. Keep the infusion for an hour. Then moisten the sore spots on the skin with this infusion, applying a napkin for 10 minutes.

Burdock

Crushed burdock leaves (2 tablespoons) are brewed with boiling water. Keep the infusion for 30 minutes, then moisten the gauze and apply a compress overnight.

Elm bark

In May, two-year-old elm shoots are cut off and freed from the upper bark. The green thin film is peeled off, dried in the sun and brewed as tea. Napar is drunk 3 times a day in a regular glass. This is to boost immunity and treat herpes.

Infusion of calendula and meadowsweet

Take 2 pinches of dried meadowsweet and calendula flowers, add vodka (0.5 liters) and leave for 2 weeks. This alcohol infusion is used internally and made into lotions. Take a tablespoon per 100 g orally. boiled or spring water three times a day. The lotions are applied for 15 minutes.

Mint

Peppermint is poured with boiling water and steamed in a water bath for 15-20 minutes. Then lotions are made from napar repeatedly.

Salt and soda lotion

To speed up the healing of skin wounds, you can make lotions from a mixture of salt, soda and water. You need a composition that resembles the consistency of liquid gruel or sour cream. Apply this mixture to the affected areas three times a day, then wash off.

Garlic infusion

Garlic infused with castor oil has proven itself well. 100 gr. grated garlic, pour a glass of castor oil and steam in the oven at 50-60 degrees for three hours. The cooled mass is filtered and then lubricated on the affected areas 3-4 times a day.

Treatment

Drug treatment:

Analgesics such as acetaminophen (Tylenol, Panadol, Tempra), and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, naproxen, and Celebrex.
Opioids – Your doctor may prescribe opioid analgesics for severe pain that is not controlled by regular analgesics, but these medications should be used with caution due to the risk of serious side effects. For example: This group includes tramadol or oxycodone. Some studies suggest that oxycodone may also help reduce allodynia.
Antidepressants – These medications are effective in treating depression. In addition, they improve sleep (for example, amitriptyline, Cymbalta, etc.).
Anticonvulsants – Drugs in this group are intended mainly for the prevention of convulsive conditions. But sometimes they are quite effective for postherpetic neuralgia (Neurontin, Lyrica, Topamax, carbamazepine).
Blocks - Injections of corticosteroid into paravertebral points sometimes lead to a significant reduction in pain.
Local painkillers - ointments, gels containing analgesics or anesthetics (lidocaine). Helps temporarily reduce symptoms.

Prevention

Certain antiviral medications may help prevent or reduce the effects of shingles, thereby reducing the risk of postherpetic neuralgia:

Chickenpox vaccine – The varicella zoster virus vaccine (Varivax) is now a routine childhood vaccine, but may also be recommended for older children and adults who have never had chickenpox. This vaccine does not guarantee that a person will not get chickenpox or shingles, but it may reduce the duration and severity of symptoms and the risk of complications such as postherpetic neuralgia.
Shingles vaccine - (Zostavax) can be given to people over 60 years of age (who have had chickenpox but not shingles). Zostavax is not recommended for use in certain groups of people (for example, those undergoing cancer treatment or those who are immunocompromised).
Antiviral medications – Antiviral medications such as acyclovir, valocyclovir, famciclovir, when taken within the first 72 hours after the shingles rash appears, can help shorten the duration of shingles and reduce the chance of developing postherpetic neuralgia.

Physiotherapy helps reduce pain and relieve inflammation. Various techniques are used (including transcutaneous electrical stimulation).

Exercise therapy helps restore the elasticity of ligaments and muscles. Exercises can be carried out both on simulators and in the form of gymnastics.

Acupuncture. This method is quite effective in restoring conductivity and reducing pain.

How is shingles transmitted?

Herpes zoster (syn. - herpes zoster) is a secondary infection that develops only in people who have previously had chickenpox. Activation of the virus usually occurs against the background of a weakening of the cellular component of immunity and exposure to unfavorable factors, such as:

Hypovitaminosis
Taking hormonal medications
Radiation or chemotherapy
Blood diseases, diabetes, oncology

Women are more susceptible to relapses of herpes zoster, as well as carriers of the interleukin gene mutation and older people - for example, among adults aged 85 years, 50% of people have suffered at least one episode of the disease. And in patients with immunodeficiencies, in particular with HIV, the risk of reactivation of herpes type 3 increases 20 times compared to people with normal immune status.