Materiały źródłowe

• #1 Herpes Zoster and Postherpetic Neuralgia: Prevention and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1115/p656.html

  Postherpetic neuralgia, the most common complication of herpes zoster, is defined as pain in a dermatomal distribution that is sustained for at least 90 days after the rash. It occurs in approximately 20% of patients with herpes zoster, and 80% of cases occur in patients 50 years or older. Pain is described as burning or electric shocklike and may be associated with allodynia or hyperalgesia. Postherpetic neuralgia is caused by nerve damage secondary to an inflammatory response induced by viral replication within a nerve. Risk factors include older age, severe prodrome or rash, severe acute zoster pain, ophthalmic involvement, immunosuppression, and chronic conditions such as diabetes mellitus and lupus. Pain from postherpetic neuralgia is often debilitating and affects physical functioning, psychological well-being, and quality of life. Pain-management strategies should focus on symptom control. Although some patients have complete resolution of symptoms at several years, others continue medications indefinitely.

• #2 Postherpetic Neuralgia: Symptoms, Causes, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/12093-postherpetic-neuralgia

  Postherpetic neuralgia (PHN) is the most common complication of shingles. Pain-relieving medications can manage symptoms. For most people, PHN improves over time. […] Postherpetic neuralgia (PHN) results from damage to nerve fibers during shingles infection. The nerve fibers at the skin in the affected area send exaggerated pain signals to your brain. […] If shingles is caught within the first three days of its outbreak, your healthcare provider may prescribe the antiviral medication acyclovir (Zovirax), valacyclovir (Valtrex) or famciclovir (Famvir). These medications help the rash/blisters heal faster, keep new sores from forming, decrease pain and itching and reduce length of pain after sores have healed. […] Although there is no cure for PHN, it can be treated. For most people with PHN, pain improves with time and eventually goes away. For most people, the pain goes away in one to three months.

• #3 Postherpetic neuralgia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/postherpetic-neuralgia/symptoms-causes/syc-20376588

  Postherpetic neuralgia (post-hur-PET-ik noo-RAL-juh) is the most common complication of shingles. It causes a burning pain in nerves and skin. The pain lasts long after the rash and blisters of shingles go away. […] The risk of postherpetic neuralgia rises with age. It mainly affects people older than 60. There’s no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia gets better over time. […] People with postherpetic neuralgia can develop other problems that are common with long-term pain. It depends on how long the postherpetic neuralgia lasts and how painful it is. These other problems can include: Depression. Trouble sleeping. Tiredness. Not feeling as hungry as usual. […] Shingles vaccines can help prevent shingles and postherpetic neuralgia. Ask your health care provider when you should get a vaccine. […] With two doses, Shingrix is more than 90% effective in preventing shingles and postherpetic neuralgia. Other shingles vaccines are offered outside of the United States. Talk to your provider for more information on how well they prevent shingles and postherpetic neuralgia.

• #4 Postherpetic Neuralgia – Precision Spine Care – Neurological Pain in Texas

  https://precisionspinecare.com/conditions/postherpetic-neuralgia/

  Postherpetic neuralgia is the most common complication of shingles. The condition affects nerve fibers and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear. […] The risk of postherpetic neuralgia increases with age, primarily affecting people older than 60. Theres no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia improves over time. […] 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 one side of your body. […] Pain that lasts three months or longer after the shingles rash has healed. The associated pain has been described as burning, sharp and jabbing, or deep and aching. […] Sensitivity to light touch: People with the condition often cant bear even the touch of clothing on the affected skin (allodynia). […] Itching and numbness: Less commonly, postherpetic neuralgia can produce an itchy feeling or numbness.

• #5 Clinical Features of Shingles (Herpes Zoster) | Shingles (Herpes Zoster) | CDC

  https://www.cdc.gov/shingles/hcp/clinical-signs/index.html

  Postherpetic neuralgia (PHN) the most common complication of herpes zoster. […] PHN is the most common complication of herpes zoster. PHN is pain that persists in the area where the rash once was located; and continues more than 90 days after rash onset. PHN can last for months or even years. […] A person’s risk of having PHN after herpes zoster increases with age. Older adults are more likely to have longer lasting and more severe pain. Approximately 10% to 18% of people with herpes zoster will have PHN. […] PHN is rare in people younger than 40 years old. The likelihood of PHN is also higher in people who experience more pain with the rash or have a large rash.

• #6 Postherpetic Neuralgia: Seniors at Risk

  https://www.uspharmacist.com/article/postherpetic-neuralgia-seniors-at-risk

  Postherpetic neuralgia (PHN) is a common form of persistent neuropathic pain in the United States. Considered the most common complication of shingles, or herpes zoster (HZ), PHN occurs in approximately 10% to 15% of patients with HZ, and in 50% of those who develop shingles after age 60 years. Incidence of PHN increases dramatically with age and is uncommon in patients younger than 60 years. Prior to age 50 years, there exists virtually no risk of developing PHN; however, the risk increases to 50% to 75% after ages 60 and 75 years, respectively. […] Pain management of PHN can be particularly difficult. Treatments include lidocaine patch, topical capsaicin, gabapentin, pregabalin, and tricyclic antidepressants (TCAs); opioid analgesics may also be required. […] The impact of persistent pain on physical functioning should be assessed. Data have indicated that seniors with persistent pain may experience an increase in pain intensity with movement and, as a result, may limit the activities or movements that exacerbate the pain, such as walking or climbing stairs.

• #7 Clinical Features of Shingles (Herpes Zoster) | Shingles (Herpes Zoster) | CDC

  https://www.cdc.gov/shingles/hcp/clinical-signs/index.html

  Postherpetic neuralgia (PHN) the most common complication of herpes zoster. […] PHN is the most common complication of herpes zoster. PHN is pain that persists in the area where the rash once was located; and continues more than 90 days after rash onset. PHN can last for months or even years. […] A person’s risk of having PHN after herpes zoster increases with age. Older adults are more likely to have longer lasting and more severe pain. Approximately 10% to 18% of people with herpes zoster will have PHN. […] PHN is rare in people younger than 40 years old. The likelihood of PHN is also higher in people who experience more pain with the rash or have a large rash.

• #8 Postherpetic neuralgia – aftercare: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/patientinstructions/000555.htm

  Postherpetic neuralgia is pain that continues longer than a month after a bout of shingles. This pain may last from months to years. […] Postherpetic neuralgia can: […] Limit your everyday activities and make it hard to work. […] Affect how involved you are with friends and family. […] Cause feelings of frustration, resentment, and stress. These feelings may make your pain worse. […] Even though there is no cure for postherpetic neuralgia, there are ways to treat your pain and discomfort. […] You may also take acetaminophen (such as Tylenol) for pain relief. […] Your provider may prescribe a narcotic pain reliever. […] A narcotic pain reliever can: […] Make you feel sleepy and confused. […] Make your skin feel itchy. […] Make you constipated (unable to have a bowel movement easily).

• #9

  https://www.advocatehealth.com/health-services/brain-spine-institute/brain-care-center/conditions-treatments/neuromuscular-disorders/postherpetic-neuralgia

  Postherpetic neuralgia is a complication of shingles that causes pain in the areas that have been affected by shingles. […] Because of the potential for complications and the possibility of it becoming a chronic condition, postherpetic neuralgia can be debilitating for some people. Living with constant pain can make it hard to work or even take care of daily activities. […] Postherpetic neuralgia is resistant to treatment. Your doctor may use a variety of treatments to manage your symptoms. […] Some people find it helpful to use cold packs on the rash to help manage PHN pain. Wearing loose-fitting clothing made of cotton or silk may also be more comfortable. […] Let your doctor know if you use any of these postherpetic neuralgia treatments for comfort. Its important for them to be able to consider the whole picture of your care.

• #10 Varicella-zoster virus, shingles and postherpetic neuralgia | Nursing Times

  https://www.nursingtimes.net/tissue-viability-and-wound-care/varicella-zoster-virus-shingles-and-postherpetic-neuralgia-02-12-2003/

  The pain in PHN is severe and can have a devastating effect on patients quality of life, often leading to sleep disturbance, anorexia and loss of libido. It has been described as a constant burning, throbbing or aching, with intermittent shooting or stabbing sensations. Itching or numbness in the scars is often present. Patients often experience hypersensitivity of the skin (allodynia), in which minor stimuli such as movement of clothes or a draught can cause pain. […] People who suffer long-term pain such as PHN are four times more likely to suffer from anxiety and depressive disorders and twice as likely to have their ability to work severely compromised than those without pain. Psychological services such as those based in pain clinics may help patients to develop pain-coping strategies if pain relief is ineffective.

• #11 Postherpetic Neuralgia – Precision Spine Care – Neurological Pain in Texas

  https://precisionspinecare.com/conditions/postherpetic-neuralgia/

  Postherpetic neuralgia is the most common complication of shingles. The condition affects nerve fibers and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear. […] The risk of postherpetic neuralgia increases with age, primarily affecting people older than 60. Theres no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia improves over time. […] 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 one side of your body. […] Pain that lasts three months or longer after the shingles rash has healed. The associated pain has been described as burning, sharp and jabbing, or deep and aching. […] Sensitivity to light touch: People with the condition often cant bear even the touch of clothing on the affected skin (allodynia). […] Itching and numbness: Less commonly, postherpetic neuralgia can produce an itchy feeling or numbness.

• #12 POSTHERPETIC NEURALGIA – a patient’s guide – Family Doctor

  https://www.familydoctor.co.nz/categories/neurology/postherpetic-neuralgia-a-patients-guide/

  Postherpetic neuralgia is defined by the International Association for the Study of Pain as chronic pain with skin changes in a dermatomal distribution following HZ infection. […] Treatment for PHN should start early, preferably at the time of shingles infection, and should involve antiviral agents as well as oral analgesics and possibly neural blockade and steroids. Close daily symptom monitoring is required to manage this phase adequately. […] In the chronic, postherpetic neuralgia stage, treatment with topical creams, tricyclic antidepressants, active sensory and motor stimulation, or occasionally antiepileptic agents, may provide benefit when pain has been sustained over a longer time. […] In all instances such patients need to be monitored closely by their family doctor to ensure medication is being taken as required and to assess any untoward side effects. Social support and psychological interventions should also be considered. Although the measures described above will benefit many patients, the management of PHN remains, in some cases, an intractable problem.

• #13 Postherpetic Neuralgia – Precision Spine Care – Neurological Pain in Texas

  https://precisionspinecare.com/conditions/postherpetic-neuralgia/

  Postherpetic neuralgia is the most common complication of shingles. The condition affects nerve fibers and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear. […] The risk of postherpetic neuralgia increases with age, primarily affecting people older than 60. Theres no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia improves over time. […] 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 one side of your body. […] Pain that lasts three months or longer after the shingles rash has healed. The associated pain has been described as burning, sharp and jabbing, or deep and aching. […] Sensitivity to light touch: People with the condition often cant bear even the touch of clothing on the affected skin (allodynia). […] Itching and numbness: Less commonly, postherpetic neuralgia can produce an itchy feeling or numbness.

• #14 Post-herpetic neuralgia

  https://dermnetnz.org/topics/post-herpetic-neuralgia

  Post-herpetic neuralgia describes chronic skin pain in an area previously affected by herpes zoster (shingles). […] Post-herpetic neuralgia is usually a chronic neuropathic pain with a burning character, but some patients experience sharp stabbing pains. […] Chronic pain can lead to insomnia, anxiety and depression. […] The main risk factors for post-herpetic neuralgia are older age, immunosuppression, and severe infection. […] Acute herpes zoster pain is due to direct damage of peripheral nerves by the herpes zoster virus. Ongoing post-herpetic neuralgia is due to slow recovery and the involvement of the central nervous system. […] Herpes zoster pain and post-herpetic neuralgia are common and very debilitating conditions. But they can be prevented to a large extent by vaccination of at-risk individuals and by prompt antiviral treatment during the acute phase of herpes zoster infection. […] Multiple treatments are often required to control post-herpetic neuralgia. […] Support, psychotherapy and biofeedback techniques may help patients manage their pain. […] The duration of post-herpetic neuralgia is variable. In the majority of people, symptoms resolve within 6 months to 1 year.

• #15 Postherpetic Neuralgia – Precision Spine Care – Neurological Pain in Texas

  https://precisionspinecare.com/conditions/postherpetic-neuralgia/

  Postherpetic neuralgia is the most common complication of shingles. The condition affects nerve fibers and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear. […] The risk of postherpetic neuralgia increases with age, primarily affecting people older than 60. Theres no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia improves over time. […] 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 one side of your body. […] Pain that lasts three months or longer after the shingles rash has healed. The associated pain has been described as burning, sharp and jabbing, or deep and aching. […] Sensitivity to light touch: People with the condition often cant bear even the touch of clothing on the affected skin (allodynia). […] Itching and numbness: Less commonly, postherpetic neuralgia can produce an itchy feeling or numbness.

• #16 Varicella-zoster virus, shingles and postherpetic neuralgia | Nursing Times

  https://www.nursingtimes.net/tissue-viability-and-wound-care/varicella-zoster-virus-shingles-and-postherpetic-neuralgia-02-12-2003/

  The pain in PHN is severe and can have a devastating effect on patients quality of life, often leading to sleep disturbance, anorexia and loss of libido. It has been described as a constant burning, throbbing or aching, with intermittent shooting or stabbing sensations. Itching or numbness in the scars is often present. Patients often experience hypersensitivity of the skin (allodynia), in which minor stimuli such as movement of clothes or a draught can cause pain. […] People who suffer long-term pain such as PHN are four times more likely to suffer from anxiety and depressive disorders and twice as likely to have their ability to work severely compromised than those without pain. Psychological services such as those based in pain clinics may help patients to develop pain-coping strategies if pain relief is ineffective.

• #17 Postherpetic Neuralgia Treatment NYC | Pain Management NYC

  https://www.painmanagementnyc.com/nerve-pain/postherpetic-neuralgia/

  Postherpetic neuralgia is a painful condition that strikes people whove had shingles. […] For post herpetic neuralgia treatment or treatment of headaches, back pain and other forms of nerve pain, the best option in the Manhattan area is Pain Management NYC, where you find top-rated doctors and the new treatments for postherpetic neuralgia. […] The pain of postherpetic neuralgia may come and go or it may be constant. This pain can last for more than three months after the shingles rash has cleared up, and for some people, the pain lasts for a year or more. The discomfort can seriously disrupt your daily life, causing trouble sleeping, decreased appetite and difficulty concentrating. […] Theres no cure for PHN, but there are some options for treating the symptoms. […] A combination of medications may be needed to control the pain of PHN, which may include: Non-prescription pain medication. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen or ibuprofen reduce inflammation and discomfort.

• #18 Varicella-zoster virus, shingles and postherpetic neuralgia | Nursing Times

  https://www.nursingtimes.net/tissue-viability-and-wound-care/varicella-zoster-virus-shingles-and-postherpetic-neuralgia-02-12-2003/

  The pain in PHN is severe and can have a devastating effect on patients quality of life, often leading to sleep disturbance, anorexia and loss of libido. It has been described as a constant burning, throbbing or aching, with intermittent shooting or stabbing sensations. Itching or numbness in the scars is often present. Patients often experience hypersensitivity of the skin (allodynia), in which minor stimuli such as movement of clothes or a draught can cause pain. […] People who suffer long-term pain such as PHN are four times more likely to suffer from anxiety and depressive disorders and twice as likely to have their ability to work severely compromised than those without pain. Psychological services such as those based in pain clinics may help patients to develop pain-coping strategies if pain relief is ineffective.

• #19 Herpes Zoster and Postherpetic Neuralgia: Prevention and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1115/p656.html

  Postherpetic neuralgia, the most common complication of herpes zoster, is defined as pain in a dermatomal distribution that is sustained for at least 90 days after the rash. It occurs in approximately 20% of patients with herpes zoster, and 80% of cases occur in patients 50 years or older. Pain is described as burning or electric shocklike and may be associated with allodynia or hyperalgesia. Postherpetic neuralgia is caused by nerve damage secondary to an inflammatory response induced by viral replication within a nerve. Risk factors include older age, severe prodrome or rash, severe acute zoster pain, ophthalmic involvement, immunosuppression, and chronic conditions such as diabetes mellitus and lupus. Pain from postherpetic neuralgia is often debilitating and affects physical functioning, psychological well-being, and quality of life. Pain-management strategies should focus on symptom control. Although some patients have complete resolution of symptoms at several years, others continue medications indefinitely.

• #20 FF #272 Postherpetic Neuralgia | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/postherpetic-neuralgia/

  Postherpetic neuralgia (PHN) is a syndrome of zoster-associated pain persisting more than 3 months after resolution of an initial herpes zoster (HZ) rash (‘shingles’). […] Risk factors for PHN include severe acute shingles-related pain, rash severity (i.e., more than 50 lesions), increasing age, and immunocompromised status. […] This central sensitization is thought to be a key mechanism in the development and maintenance of the pain of PHN. […] For all patients with acute HZ and/or PHN, physical and emotional quality-of-life can be affected. […] In adults over 60 years old, live vaccination against the zoster virus reduces overall incidence of HZ by 50% and PHN by two-thirds. […] Initiating antiviral drugs within 72 hours of rash onset reduces acute and chronic pain associated with HZ.

• #21 Postherpetic neuralgia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/postherpetic-neuralgia/symptoms-causes/syc-20376588

  Postherpetic neuralgia (post-hur-PET-ik noo-RAL-juh) is the most common complication of shingles. It causes a burning pain in nerves and skin. The pain lasts long after the rash and blisters of shingles go away. […] The risk of postherpetic neuralgia rises with age. It mainly affects people older than 60. There’s no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia gets better over time. […] People with postherpetic neuralgia can develop other problems that are common with long-term pain. It depends on how long the postherpetic neuralgia lasts and how painful it is. These other problems can include: Depression. Trouble sleeping. Tiredness. Not feeling as hungry as usual. […] Shingles vaccines can help prevent shingles and postherpetic neuralgia. Ask your health care provider when you should get a vaccine. […] With two doses, Shingrix is more than 90% effective in preventing shingles and postherpetic neuralgia. Other shingles vaccines are offered outside of the United States. Talk to your provider for more information on how well they prevent shingles and postherpetic neuralgia.

• #22 Post-herpetic neuralgia

  https://dermnetnz.org/topics/post-herpetic-neuralgia

  Post-herpetic neuralgia describes chronic skin pain in an area previously affected by herpes zoster (shingles). […] Post-herpetic neuralgia is usually a chronic neuropathic pain with a burning character, but some patients experience sharp stabbing pains. […] Chronic pain can lead to insomnia, anxiety and depression. […] The main risk factors for post-herpetic neuralgia are older age, immunosuppression, and severe infection. […] Acute herpes zoster pain is due to direct damage of peripheral nerves by the herpes zoster virus. Ongoing post-herpetic neuralgia is due to slow recovery and the involvement of the central nervous system. […] Herpes zoster pain and post-herpetic neuralgia are common and very debilitating conditions. But they can be prevented to a large extent by vaccination of at-risk individuals and by prompt antiviral treatment during the acute phase of herpes zoster infection. […] Multiple treatments are often required to control post-herpetic neuralgia. […] Support, psychotherapy and biofeedback techniques may help patients manage their pain. […] The duration of post-herpetic neuralgia is variable. In the majority of people, symptoms resolve within 6 months to 1 year.

• #23 FF #272 Postherpetic Neuralgia | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/postherpetic-neuralgia/

  Postherpetic neuralgia (PHN) is a syndrome of zoster-associated pain persisting more than 3 months after resolution of an initial herpes zoster (HZ) rash (‘shingles’). […] Risk factors for PHN include severe acute shingles-related pain, rash severity (i.e., more than 50 lesions), increasing age, and immunocompromised status. […] This central sensitization is thought to be a key mechanism in the development and maintenance of the pain of PHN. […] For all patients with acute HZ and/or PHN, physical and emotional quality-of-life can be affected. […] In adults over 60 years old, live vaccination against the zoster virus reduces overall incidence of HZ by 50% and PHN by two-thirds. […] Initiating antiviral drugs within 72 hours of rash onset reduces acute and chronic pain associated with HZ.

• #24 FF #272 Postherpetic Neuralgia | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/postherpetic-neuralgia/

  Postherpetic neuralgia (PHN) is a syndrome of zoster-associated pain persisting more than 3 months after resolution of an initial herpes zoster (HZ) rash (‘shingles’). […] Risk factors for PHN include severe acute shingles-related pain, rash severity (i.e., more than 50 lesions), increasing age, and immunocompromised status. […] This central sensitization is thought to be a key mechanism in the development and maintenance of the pain of PHN. […] For all patients with acute HZ and/or PHN, physical and emotional quality-of-life can be affected. […] In adults over 60 years old, live vaccination against the zoster virus reduces overall incidence of HZ by 50% and PHN by two-thirds. […] Initiating antiviral drugs within 72 hours of rash onset reduces acute and chronic pain associated with HZ.

• #25 Postherpetic neuralgia – aftercare: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/patientinstructions/000555.htm

  Postherpetic neuralgia is pain that continues longer than a month after a bout of shingles. This pain may last from months to years. […] Postherpetic neuralgia can: […] Limit your everyday activities and make it hard to work. […] Affect how involved you are with friends and family. […] Cause feelings of frustration, resentment, and stress. These feelings may make your pain worse. […] Even though there is no cure for postherpetic neuralgia, there are ways to treat your pain and discomfort. […] You may also take acetaminophen (such as Tylenol) for pain relief. […] Your provider may prescribe a narcotic pain reliever. […] A narcotic pain reliever can: […] Make you feel sleepy and confused. […] Make your skin feel itchy. […] Make you constipated (unable to have a bowel movement easily).

• #26 Postherpetic neuralgia – aftercare Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/selfcare-instructions/postherpetic-neuralgia-aftercare

  Postherpetic neuralgia can: […] Limit your everyday activities and make it hard to work. […] Affect how involved you are with friends and family. […] Cause feelings of frustration, resentment, and stress. These feelings may make your pain worse. […] Even though there is no cure for postherpetic neuralgia, there are ways to treat your pain and discomfort. […] You can take a type of medicine called nonsteroidal anti-inflammatory drugs (NSAIDs). […] Your provider may prescribe a narcotic pain reliever. […] A narcotic pain reliever can: […] Your provider may recommend skin patches that contain lidocaine (a numbing medicine). […] Two other types of prescription medicines may help reduce your pain: […] You must take the medicines every day. […] Sometimes, a nerve block can be used to temporarily reduce pain.

• #27 Varicella-zoster virus, shingles and postherpetic neuralgia | Nursing Times

  https://www.nursingtimes.net/tissue-viability-and-wound-care/varicella-zoster-virus-shingles-and-postherpetic-neuralgia-02-12-2003/

  The pain in PHN is severe and can have a devastating effect on patients quality of life, often leading to sleep disturbance, anorexia and loss of libido. It has been described as a constant burning, throbbing or aching, with intermittent shooting or stabbing sensations. Itching or numbness in the scars is often present. Patients often experience hypersensitivity of the skin (allodynia), in which minor stimuli such as movement of clothes or a draught can cause pain. […] People who suffer long-term pain such as PHN are four times more likely to suffer from anxiety and depressive disorders and twice as likely to have their ability to work severely compromised than those without pain. Psychological services such as those based in pain clinics may help patients to develop pain-coping strategies if pain relief is ineffective.

• #28 Postherpetic neuralgia – aftercare: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/patientinstructions/000555.htm

  Postherpetic neuralgia is pain that continues longer than a month after a bout of shingles. This pain may last from months to years. […] Postherpetic neuralgia can: […] Limit your everyday activities and make it hard to work. […] Affect how involved you are with friends and family. […] Cause feelings of frustration, resentment, and stress. These feelings may make your pain worse. […] Even though there is no cure for postherpetic neuralgia, there are ways to treat your pain and discomfort. […] You may also take acetaminophen (such as Tylenol) for pain relief. […] Your provider may prescribe a narcotic pain reliever. […] A narcotic pain reliever can: […] Make you feel sleepy and confused. […] Make your skin feel itchy. […] Make you constipated (unable to have a bowel movement easily).

• #29 7 Herpes Zoster (Shingles) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/herpes-zoster-shingles-nursing-care-plans/

  Major nursing goals for a client with herpes zoster (shingles) may include increased understanding of the disease condition and treatment regimen, relief of discomfort from the lesions, emphasis on strict contact isolation, development of self-acceptance, and absence of complications. […] Managing acute pain in patients with herpes zoster (shingles) is a critical component of their care. The pain associated with shingles can be excruciating, debilitating, and long-lasting. Effective pain management is essential not only for the patients comfort but also for promoting healing and preventing the development of chronic pain conditions such as postherpetic neuralgia. […] Postherpetic neuralgia is a chronic pain syndrome that may continue after the skin lesions have healed. The client may have constant pain or intermittent episodes of pain.

• #30 Postherpetic neuralgia: epidemiology, pathophysiology, and pain manage | JMDH

  https://www.dovepress.com/postherpetic-neuralgia-epidemiology-pathophysiology-and-pain-managemen-peer-reviewed-fulltext-article-JMDH

  Nurse practitioners are especially crucial in establishing communication with patients and encouraging the initiation of appropriate pain-relieving treatments. […] The safety and tolerability of pharmacologic therapies are important issues to consider as postherpetic neuralgia affects primarily an older population. […] Approaches to PHN management include preventing HZ, and thus possibly PHN, through vaccination and/or antiviral treatment, and administering specific medications to treat PHN pain. […] Once PHN has been diagnosed, treatment should be directed at pain control and minimizing treatment-related adverse events. […] Prior to instituting an individual treatment plan, health-care professionals, including nurses, should carefully evaluate patients concomitant medications. […] To ensure the optimal effectiveness of the treatment, clear communication with the patient, frequent monitoring of adverse reactions, and patient satisfaction with the treatment are essential.

• #31 7 Herpes Zoster (Shingles) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/herpes-zoster-shingles-nursing-care-plans/

  Assess pain levels regularly using a validated pain scale (e.g., numerical rating scale) to monitor the severity and duration of postherpetic neuralgia (PHN). […] Offer emotional support and education to the patient regarding the potential complications of shingles, including their expected duration and ways to manage discomfort.

• #32 Postherpetic neuralgia: epidemiology, pathophysiology, and pain manage | JMDH

  https://www.dovepress.com/postherpetic-neuralgia-epidemiology-pathophysiology-and-pain-managemen-peer-reviewed-fulltext-article-JMDH

  At each patient visit, current pain levels, location of pain, and pain quality should be reassessed, and the patients ability to perform daily activities should be discussed. […] A treatment plan combining analgesics with different mechanisms of action may provide the best overall therapeutic effect, particularly the combination of an oral agent with topical lidocaine 5% patch, or a combination of gabapentin with opioids or a TCA. […] Nurses and nurse practitioners are especially crucial in establishing communication with patients and encouraging the initiation of appropriate pain-relieving treatments, leading to better outcomes in patients.

• #33 Postherpetic neuralgia: epidemiology, pathophysiology, and pain manage | JMDH

  https://www.dovepress.com/postherpetic-neuralgia-epidemiology-pathophysiology-and-pain-managemen-peer-reviewed-fulltext-article-JMDH

  At each patient visit, current pain levels, location of pain, and pain quality should be reassessed, and the patients ability to perform daily activities should be discussed. […] A treatment plan combining analgesics with different mechanisms of action may provide the best overall therapeutic effect, particularly the combination of an oral agent with topical lidocaine 5% patch, or a combination of gabapentin with opioids or a TCA. […] Nurses and nurse practitioners are especially crucial in establishing communication with patients and encouraging the initiation of appropriate pain-relieving treatments, leading to better outcomes in patients.

• #34 7 Herpes Zoster (Shingles) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/herpes-zoster-shingles-nursing-care-plans/

  Major nursing goals for a client with herpes zoster (shingles) may include increased understanding of the disease condition and treatment regimen, relief of discomfort from the lesions, emphasis on strict contact isolation, development of self-acceptance, and absence of complications. […] Managing acute pain in patients with herpes zoster (shingles) is a critical component of their care. The pain associated with shingles can be excruciating, debilitating, and long-lasting. Effective pain management is essential not only for the patients comfort but also for promoting healing and preventing the development of chronic pain conditions such as postherpetic neuralgia. […] Postherpetic neuralgia is a chronic pain syndrome that may continue after the skin lesions have healed. The client may have constant pain or intermittent episodes of pain.

• #35 7 Herpes Zoster (Shingles) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/herpes-zoster-shingles-nursing-care-plans/

  Educate the client about the following measures: Wear loose, nonrestrictive clothing made of cotton. […] Administer medications as indicated. Oral opioid analgesics (codeine, hydrocodone) are typically prescribed during the acute phase. Analgesics, antidepressants, and antiepileptics may be used in the management of postherpetic neuralgia. […] Encourage herpes zoster vaccination (Zostavax). This vaccination is recommended for individuals 60 years or older. […] Administering medications and providing pharmacologic support in patients with herpes zoster is crucial for symptom management, prevention of complications, and faster recovery. Antiviral agents, analgesics, and adjunctive medications are employed to alleviate pain, reduce viral replication, and minimize the risk of postherpetic neuralgia.

• #36 Post-herpetic neuralgia

  https://www.nhs.uk/conditions/post-herpetic-neuralgia/treatment/

  Post-herpetic neuralgia can be difficult to treat. It usually gets better eventually, but how long this takes can vary from a few months to over a year. […] A GP will usually prescribe medicines to help with pain, such as: paracetamol, or paracetamol with codeine, if you have mild or moderate pain this helps some people but it’s unlikely to completely relieve your pain […] If you have severe pain, if pain is affecting your daily activities, or if medicines from a GP have not worked, the GP may refer you for: cognitive behavioural therapy a type of talking therapy that can help you cope with pain […] If you have post-herpetic neuralgia there are things you can do to help ease the symptoms. […] wear loose cotton or silk clothes to avoid irritating your skin […] protect sensitive skin using a layer of bandage, cling film or plastic wound dressing under your clothes

• #37 Post-herpetic neuralgia

  https://www.nhs.uk/conditions/post-herpetic-neuralgia/treatment/

  try holding an ice pack (or bag of frozen vegetables) wrapped in a tea towel on the painful area for up to 20 minutes every 2 to 3 hours […] take cool baths or showers […] try keeping a daily pain diary to help you see how well any treatment is working and whether your symptoms are getting better.

• #38 Post-herpetic neuralgia

  https://www.nhs.uk/conditions/post-herpetic-neuralgia/treatment/

  try holding an ice pack (or bag of frozen vegetables) wrapped in a tea towel on the painful area for up to 20 minutes every 2 to 3 hours […] take cool baths or showers […] try keeping a daily pain diary to help you see how well any treatment is working and whether your symptoms are getting better.

• #39 Post-herpetic neuralgia

  https://www.nhs.uk/conditions/post-herpetic-neuralgia/treatment/

  Post-herpetic neuralgia can be difficult to treat. It usually gets better eventually, but how long this takes can vary from a few months to over a year. […] A GP will usually prescribe medicines to help with pain, such as: paracetamol, or paracetamol with codeine, if you have mild or moderate pain this helps some people but it’s unlikely to completely relieve your pain […] If you have severe pain, if pain is affecting your daily activities, or if medicines from a GP have not worked, the GP may refer you for: cognitive behavioural therapy a type of talking therapy that can help you cope with pain […] If you have post-herpetic neuralgia there are things you can do to help ease the symptoms. […] wear loose cotton or silk clothes to avoid irritating your skin […] protect sensitive skin using a layer of bandage, cling film or plastic wound dressing under your clothes

• #40 Post-herpetic neuralgia

  https://www.nhs.uk/conditions/post-herpetic-neuralgia/treatment/

  try holding an ice pack (or bag of frozen vegetables) wrapped in a tea towel on the painful area for up to 20 minutes every 2 to 3 hours […] take cool baths or showers […] try keeping a daily pain diary to help you see how well any treatment is working and whether your symptoms are getting better.

• #41

  https://www.aurorahealthcare.org/services/neuroscience/neurology/neurological-conditions/neuromuscular-disorders/postherpetic-neuralgia

  Postherpetic neuralgia is a complication of shingles that causes severe pain in the areas that were affected by shingles. […] Postherpetic neuralgia treatment options include medications like anticonvulsants, tricyclic antidepressants and prescription painkillers that are commonly used for PHN treatment. […] Using cold packs on the rash or opting for loose-fitting clothing made of cotton or silk can provide relief. […] Inform your doctor if you use these postherpetic neuralgia treatments for comfort to ensure comprehensive care.

• #42

  https://www.advocatehealth.com/health-services/brain-spine-institute/brain-care-center/conditions-treatments/neuromuscular-disorders/postherpetic-neuralgia

  Postherpetic neuralgia is a complication of shingles that causes pain in the areas that have been affected by shingles. […] Because of the potential for complications and the possibility of it becoming a chronic condition, postherpetic neuralgia can be debilitating for some people. Living with constant pain can make it hard to work or even take care of daily activities. […] Postherpetic neuralgia is resistant to treatment. Your doctor may use a variety of treatments to manage your symptoms. […] Some people find it helpful to use cold packs on the rash to help manage PHN pain. Wearing loose-fitting clothing made of cotton or silk may also be more comfortable. […] Let your doctor know if you use any of these postherpetic neuralgia treatments for comfort. Its important for them to be able to consider the whole picture of your care.

• #43

  https://www.aurorahealthcare.org/services/neuroscience/neurology/neurological-conditions/neuromuscular-disorders/postherpetic-neuralgia

  Postherpetic neuralgia is a complication of shingles that causes severe pain in the areas that were affected by shingles. […] Postherpetic neuralgia treatment options include medications like anticonvulsants, tricyclic antidepressants and prescription painkillers that are commonly used for PHN treatment. […] Using cold packs on the rash or opting for loose-fitting clothing made of cotton or silk can provide relief. […] Inform your doctor if you use these postherpetic neuralgia treatments for comfort to ensure comprehensive care.

• #44 Comprehensive nursing care improves symptoms and quality of life in elderly patients with postherpetic neuralgia | Scientific Reports

  https://www.nature.com/articles/s41598-024-69949-5

  Comprehensive nursing care interventions may effectively alleviate clinical symptoms, and diminish levels of depression and anxiety, while improving sleep quality in elderly patients with PHN. […] The aim of this study is to explore the clinical influence of comprehensive nursing care on elderly individuals with PHN. Comprehensive nursing care seeks to address the various physical, psychological, and social aspects of patients’ well-being. By providing holistic and individualized care, this approach is expected to alleviate symptoms, improve functional outcomes, and enhance the overall quality of life for patients suffering from PHN. […] Overall, comprehensive nursing care integrates physical, psychological, social, and educational interventions to address the diverse needs of patients and optimize health outcomes. Research supports the effectiveness of this approach in improving patient satisfaction, enhancing quality of life, and promoting recovery.

• #45 Effective pain management of post-herpetic neuralgia | Nursing Times

  https://www.nursingtimes.net/pain-management/effective-pain-management-of-post-herpetic-neuralgia-11-03-2003/

  Post-herpetic neuralgia is a neuropathic pain syndrome that is notoriously difficult to manage. […] Management is difficult with traditional analgesics because the shingles virus can cause so much nerve damage in the few days before a patient seeks medical help. Specific analgesic regimens for relieving nerve pain, therefore, are required. […] Health care practitioners have a duty to help people obtain both a swift diagnosis and offer early, appropriate treatment. […] The key to effective management is to start it early. Primary care practitioners are often best placed to do this. Effective management regimens are multimodal and involve medication, non-pharmacological therapies and psychosocial support. […] Patients must be reassured should they experience post-herpetic neuralgia that treatments and support are available.

• #46 Comprehensive nursing care improves symptoms and quality of life in elderly patients with postherpetic neuralgia | Scientific Reports

  https://www.nature.com/articles/s41598-024-69949-5

  Patients and their families were educated about the adverse consequences of negative psychological status, while actively involving them in the care process. Depression and anxiety levels were examined by the self-rating depression scale (SDS) and self-rating anxiety scale (SAS), allowing for personalized emotional care plans to be developed. […] Regular monitoring of patients’ progress and follow-up assessments were conducted to ensure the effectiveness of the interventions and to make any necessary adjustments to the care plan. Companionship, care, and spiritual support were offered to patients, and they were encouraged to participate in social activities suitable for their age group. Engaging in hobbies and interests was promoted to enhance their sense of social connectedness. […] Our study provides preliminary evidence that comprehensive care may improve clinical outcomes in elderly patients with PHN, including reduced depression, and anxiety, as well as improved sleep quality. However, further research involving larger-scale, multicenter trials is needed to confirm these findings and to identify the specific components of comprehensive care that contribute to improved outcomes.

• #47 Comprehensive nursing care improves symptoms and quality of life in elderly patients with postherpetic neuralgia | Scientific Reports

  https://www.nature.com/articles/s41598-024-69949-5

  Patients and their families were educated about the adverse consequences of negative psychological status, while actively involving them in the care process. Depression and anxiety levels were examined by the self-rating depression scale (SDS) and self-rating anxiety scale (SAS), allowing for personalized emotional care plans to be developed. […] Regular monitoring of patients’ progress and follow-up assessments were conducted to ensure the effectiveness of the interventions and to make any necessary adjustments to the care plan. Companionship, care, and spiritual support were offered to patients, and they were encouraged to participate in social activities suitable for their age group. Engaging in hobbies and interests was promoted to enhance their sense of social connectedness. […] Our study provides preliminary evidence that comprehensive care may improve clinical outcomes in elderly patients with PHN, including reduced depression, and anxiety, as well as improved sleep quality. However, further research involving larger-scale, multicenter trials is needed to confirm these findings and to identify the specific components of comprehensive care that contribute to improved outcomes.

• #48 Postherpetic neuralgia – aftercare Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/selfcare-instructions/postherpetic-neuralgia-aftercare

  Many non-medical techniques can help you relax and reduce the stress of chronic pain, such as: […] A common type of talk therapy for people with chronic pain is called cognitive behavioral therapy. […] Contact your provider if: […] Your pain is not well-managed […] You think you may be depressed or are having a hard time controlling your emotions.

• #49 Postherpetic neuralgia – aftercare – UF Health

  https://ufhealth.org/care-sheets/postherpetic-neuralgia-aftercare

  Many non-medical techniques can help you relax and reduce the stress of chronic pain, such as: Meditation, Deep-breathing exercises, Biofeedback, Self-hypnosis, Muscle-relaxing techniques, Acupuncture. […] A common type of talk therapy for people with chronic pain is called cognitive behavioral therapy. It may help you learn how to cope with and manage your responses to pain. […] Call your provider if: Your pain is not well-managed, You think you may be depressed or are having a hard time controlling your emotions.

• #50 Comprehensive nursing care improves symptoms and quality of life in elderly patients with postherpetic neuralgia | Scientific Reports

  https://www.nature.com/articles/s41598-024-69949-5

  Patients and their families were educated about the adverse consequences of negative psychological status, while actively involving them in the care process. Depression and anxiety levels were examined by the self-rating depression scale (SDS) and self-rating anxiety scale (SAS), allowing for personalized emotional care plans to be developed. […] Regular monitoring of patients’ progress and follow-up assessments were conducted to ensure the effectiveness of the interventions and to make any necessary adjustments to the care plan. Companionship, care, and spiritual support were offered to patients, and they were encouraged to participate in social activities suitable for their age group. Engaging in hobbies and interests was promoted to enhance their sense of social connectedness. […] Our study provides preliminary evidence that comprehensive care may improve clinical outcomes in elderly patients with PHN, including reduced depression, and anxiety, as well as improved sleep quality. However, further research involving larger-scale, multicenter trials is needed to confirm these findings and to identify the specific components of comprehensive care that contribute to improved outcomes.

• #51 Postherpetic neuralgia – aftercare: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/patientinstructions/000555.htm

  Postherpetic neuralgia is pain that continues longer than a month after a bout of shingles. This pain may last from months to years. […] Postherpetic neuralgia can: […] Limit your everyday activities and make it hard to work. […] Affect how involved you are with friends and family. […] Cause feelings of frustration, resentment, and stress. These feelings may make your pain worse. […] Even though there is no cure for postherpetic neuralgia, there are ways to treat your pain and discomfort. […] You may also take acetaminophen (such as Tylenol) for pain relief. […] Your provider may prescribe a narcotic pain reliever. […] A narcotic pain reliever can: […] Make you feel sleepy and confused. […] Make your skin feel itchy. […] Make you constipated (unable to have a bowel movement easily).

• #52 FloridaHealthFinder | Postherpetic neuralgia – aftercare | Health Encyclopedia | FloridaHealthFinder

  https://quality.healthfinder.fl.gov/health-encyclopedia/HIE/60/000555

  Postherpetic neuralgia is pain that continues longer than a month after a bout of shingles. This pain may last from months to years. […] Postherpetic neuralgia can: […] Limit your everyday activities and make it hard to work. […] Affect how involved you are with friends and family. […] Cause feelings of frustration, resentment, and stress. These feelings may make your pain worse. […] Even though there is no cure for postherpetic neuralgia, there are ways to treat your pain and discomfort. […] You may also take acetaminophen (such as Tylenol) for pain relief. […] Your provider may prescribe a narcotic pain reliever. […] A narcotic pain reliever can: […] Make you feel sleepy and confused. Do not drink alcohol or use heavy machinery while you are taking it. […] Make your skin feel itchy.

• #53 Patient education: Shingles (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/shingles-beyond-the-basics

  TCAs used to treat pain include amitriptyline, desipramine, and nortriptyline. It is common to feel tired when starting a TCA; this is not always an undesirable side effect, since it can help improve sleep when the medication is taken in the evening. TCAs are generally started in low doses, which are increased gradually. The pain-relief benefit may not be seen for three or more weeks. These medications may not be recommended for older adults with heart problems. […] Capsaicin — Capsaicin is a substance derived from chili peppers that can help to treat pain. Capsaicin cream (sample brand name: Zostrix) may be recommended to treat postherpetic neuralgia. However, the side effects of the cream (including burning, stinging, and skin redness) are intolerable for up to one-third of patients. […] Topical anesthetics — Lidocaine (sample brand name: Xylocaine) gel is a medicine that you can rub into your skin. Products that stick to your skin and release lidocaine are also available (eg, Lidoderm, which is a skin patch). You can wear these on your skin for up to 12 hours per day. They deliver a small amount of lidocaine, which helps to numb your skin, to the most painful or itchy areas. However, the benefit of lidocaine is likely to be moderate at best.

• #54 Patient education: Shingles (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/shingles-beyond-the-basics

  TCAs used to treat pain include amitriptyline, desipramine, and nortriptyline. It is common to feel tired when starting a TCA; this is not always an undesirable side effect, since it can help improve sleep when the medication is taken in the evening. TCAs are generally started in low doses, which are increased gradually. The pain-relief benefit may not be seen for three or more weeks. These medications may not be recommended for older adults with heart problems. […] Capsaicin — Capsaicin is a substance derived from chili peppers that can help to treat pain. Capsaicin cream (sample brand name: Zostrix) may be recommended to treat postherpetic neuralgia. However, the side effects of the cream (including burning, stinging, and skin redness) are intolerable for up to one-third of patients. […] Topical anesthetics — Lidocaine (sample brand name: Xylocaine) gel is a medicine that you can rub into your skin. Products that stick to your skin and release lidocaine are also available (eg, Lidoderm, which is a skin patch). You can wear these on your skin for up to 12 hours per day. They deliver a small amount of lidocaine, which helps to numb your skin, to the most painful or itchy areas. However, the benefit of lidocaine is likely to be moderate at best.

• #55 Herpes Zoster and Postherpetic Neuralgia: Prevention and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1115/p656.html

  Capsaicin 8% patches, applied for 30 to 90 minutes, provide effective pain relief for patients with postherpetic neuralgia. Gabapentin and pregabalin can be used for treatment of postherpetic neuralgia. Amitriptyline, nortriptyline, and desipramine can be used for pain relief in patients with postherpetic neuralgia. […] The potential harms of systemic therapies for postherpetic neuralgia should be considered before treating older patients or those with comorbidities. A thorough assessment, including a medication review and physical examination focusing on balance, gait, and orthostatic vital signs, will help minimize adverse effects of treatment and interactions between treatments and other medications. The American Geriatrics Society advocates initiating medications for persistent pain at low doses and titrating slowly.

• #56 Comprehensive nursing care improves symptoms and quality of life in elderly patients with postherpetic neuralgia | Scientific Reports

  https://www.nature.com/articles/s41598-024-69949-5

  Comprehensive nursing care interventions may effectively alleviate clinical symptoms, and diminish levels of depression and anxiety, while improving sleep quality in elderly patients with PHN. […] The aim of this study is to explore the clinical influence of comprehensive nursing care on elderly individuals with PHN. Comprehensive nursing care seeks to address the various physical, psychological, and social aspects of patients’ well-being. By providing holistic and individualized care, this approach is expected to alleviate symptoms, improve functional outcomes, and enhance the overall quality of life for patients suffering from PHN. […] Overall, comprehensive nursing care integrates physical, psychological, social, and educational interventions to address the diverse needs of patients and optimize health outcomes. Research supports the effectiveness of this approach in improving patient satisfaction, enhancing quality of life, and promoting recovery.

• #57 Comprehensive nursing care improves symptoms and quality of life in elderly patients with postherpetic neuralgia | Scientific Reports

  https://www.nature.com/articles/s41598-024-69949-5

  Comprehensive nursing care interventions may effectively alleviate clinical symptoms, and diminish levels of depression and anxiety, while improving sleep quality in elderly patients with PHN. […] The aim of this study is to explore the clinical influence of comprehensive nursing care on elderly individuals with PHN. Comprehensive nursing care seeks to address the various physical, psychological, and social aspects of patients’ well-being. By providing holistic and individualized care, this approach is expected to alleviate symptoms, improve functional outcomes, and enhance the overall quality of life for patients suffering from PHN. […] Overall, comprehensive nursing care integrates physical, psychological, social, and educational interventions to address the diverse needs of patients and optimize health outcomes. Research supports the effectiveness of this approach in improving patient satisfaction, enhancing quality of life, and promoting recovery.

• #58 Comprehensive nursing care improves symptoms and quality of life in elderly patients with postherpetic neuralgia | Scientific Reports

  https://www.nature.com/articles/s41598-024-69949-5

  Comprehensive nursing care interventions may effectively alleviate clinical symptoms, and diminish levels of depression and anxiety, while improving sleep quality in elderly patients with PHN. […] The aim of this study is to explore the clinical influence of comprehensive nursing care on elderly individuals with PHN. Comprehensive nursing care seeks to address the various physical, psychological, and social aspects of patients’ well-being. By providing holistic and individualized care, this approach is expected to alleviate symptoms, improve functional outcomes, and enhance the overall quality of life for patients suffering from PHN. […] Overall, comprehensive nursing care integrates physical, psychological, social, and educational interventions to address the diverse needs of patients and optimize health outcomes. Research supports the effectiveness of this approach in improving patient satisfaction, enhancing quality of life, and promoting recovery.

• #59 Comprehensive nursing care improves symptoms and quality of life in elderly patients with postherpetic neuralgia | Scientific Reports

  https://www.nature.com/articles/s41598-024-69949-5

  Patients and their families were educated about the adverse consequences of negative psychological status, while actively involving them in the care process. Depression and anxiety levels were examined by the self-rating depression scale (SDS) and self-rating anxiety scale (SAS), allowing for personalized emotional care plans to be developed. […] Regular monitoring of patients’ progress and follow-up assessments were conducted to ensure the effectiveness of the interventions and to make any necessary adjustments to the care plan. Companionship, care, and spiritual support were offered to patients, and they were encouraged to participate in social activities suitable for their age group. Engaging in hobbies and interests was promoted to enhance their sense of social connectedness. […] Our study provides preliminary evidence that comprehensive care may improve clinical outcomes in elderly patients with PHN, including reduced depression, and anxiety, as well as improved sleep quality. However, further research involving larger-scale, multicenter trials is needed to confirm these findings and to identify the specific components of comprehensive care that contribute to improved outcomes.

• #60 Postherpetic Neuralgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493198/

  Postherpetic neuralgia (PHN) is the most common long-term complication of varicella-zoster virus (VZV) reactivation. […] This activity will highlight the role of the interprofessional team in understanding vaccination and treatment of patients with this condition. […] Review the importance of improving care coordination among interprofessional team members to improve outcomes for patients with postherpetic neuralgia. […] The most successful treatments are multi-modal, with some researchers/clinicians focusing on prevention in high-risk populations rather than cure because of the debilitating and often refractory nature of PHN in already fragile patient populations. […] Therefore, side effect profiles of interventions take on greater importance. […] There is no one superior treatment regimen; however, expert consensus suggests that multimodal therapy is likely the best approach.

• #61 Postherpetic Neuralgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493198/

  Traditional non-invasive treatments include oral and topical medications. […] The American Academy of Neurology (AAN), Special Interest Group on Neuropathic Pain (NeuPSIG), and European Federation of Neurological Societies (EFNS) all recommend an oral tricyclic antidepressant (TCA), pregabalin, and the lidocaine 5% patch as first-line therapies. […] The leading cause of discontinuing capsaicin treatment is pain and irritation at the application site, suffered by almost all users in proportion to the capsaicin concentration. […] The degree of overall pain reduction is generally less than the lidocaine 5% patch. […] Therefore, multimodal therapeutic approaches recommended by expert consensus should be considered. […] Considering that postherpetic neuralgia is difficult to treat and outcomes are variable, prevention is of paramount importance. […] An interprofessional approach to managing patients with postherpetic neuralgia is the best way forward.

• #62 Review of current guidelines on the care of postherpetic neuralgia – PubMed

  https://pubmed.ncbi.nlm.nih.gov/21904096/

  An unfortunate minority of patients with acute herpes zoster (AHZ) experience pain beyond the typical 4-week duration, and roughly 10% develop the distressing complication of postherpetic neuralgia (PHN), often defined as pain persisting for 4 months after the onset of the rash. […] Current US and international guidelines on the care of patients with PHN are reviewed and interpreted here to facilitate their effective incorporation into the practice of primary care physicians, acknowledging the contrasts that often exist between the clinical trial populations analyzed to craft so-called evidence-based medicine and the individual patients seen in daily practice, many of whom may not have been candidates for those clinical trials. […] First-line treatments for PHN include tricyclic antidepressants, gabapentin and pregabalin, and the topical lidocaine 5% patch. Opioids, tramadol, capsaicin cream, and the capsaicin 8% patch are recommended as either second- or third-line therapies in different guidelines. […] Invasive procedures such as sympathetic blockade, intrathecal steroids, and implantable spinal cord stimulators have been studied for relief of PHN, mainly in patients refractory to noninvasive pharmacologic interventions.

• #63 Postherpetic Neuralgia Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1143066-treatment

  The goal of therapy for postherpetic neuralgia (PHN) is to reduce morbidity through the use of antidepressants, anticonvulsants, anesthetics, analgesics, corticosteroids, and antiviral agents. Vaccination is also effective for preventing herpes zoster (HZ) outbreaks and PHN. […] Use of a live attenuated varicella zoster virus (VZV) vaccine has been shown in a clinical trial to be effective in preventing HZ and PHN. […] In 2017, the FDA approved Lyrica CR (pregabalin extended-release tablets) for the management of PHN. […] Antidepressants used in the treatment of PHN include tricyclic antidepressants (TCAs; eg, amitriptyline and nortriptyline) and serotonin-norepinephrine reuptake inhibitors (SNRIs; eg, duloxetine and venlafaxine). […] Antivirals used in the management of PHN include acyclovir, famciclovir, and valacyclovir.

• #64 Postherpetic Neuralgia | Symptoms and Treatment

  https://patient.info/skin-conditions/shingles-herpes-zoster-leaflet/postherpetic-neuralgia

  Postherpetic neuralgia is a pain that persists in some people who have had shingles. It often eases and goes over time. Medication can often ease the pain. […] Postherpetic neuralgia is not like other pains, such as headaches or toothache. The pain is caused by the nerve endings which were affected by the shingles. These are inflamed or damaged by the infection. Because the pain is arising from the nerve endings, rather than the skin itself, normal painkillers are largely ineffective. Specific drugs may be required which act on the nerve endings themselves. […] Loose-fitting cotton clothes are best to reduce irritation of the affected area of skin. Pain may be eased by cooling the affected area with ice cubes (wrapped in a plastic bag or a tea towel), or by having a cool bath. […] An antidepressant medicine in the tricyclic group is a common treatment for PHN. It is not being used here to treat depression but to act on the nerve endings. The dose is much lower than that used for depression.

• #65 Patient education: Shingles (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/shingles-beyond-the-basics

  TCAs used to treat pain include amitriptyline, desipramine, and nortriptyline. It is common to feel tired when starting a TCA; this is not always an undesirable side effect, since it can help improve sleep when the medication is taken in the evening. TCAs are generally started in low doses, which are increased gradually. The pain-relief benefit may not be seen for three or more weeks. These medications may not be recommended for older adults with heart problems. […] Capsaicin — Capsaicin is a substance derived from chili peppers that can help to treat pain. Capsaicin cream (sample brand name: Zostrix) may be recommended to treat postherpetic neuralgia. However, the side effects of the cream (including burning, stinging, and skin redness) are intolerable for up to one-third of patients. […] Topical anesthetics — Lidocaine (sample brand name: Xylocaine) gel is a medicine that you can rub into your skin. Products that stick to your skin and release lidocaine are also available (eg, Lidoderm, which is a skin patch). You can wear these on your skin for up to 12 hours per day. They deliver a small amount of lidocaine, which helps to numb your skin, to the most painful or itchy areas. However, the benefit of lidocaine is likely to be moderate at best.

• #66 Postherpetic Neuralgia Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1143066-treatment

  The goal of therapy for postherpetic neuralgia (PHN) is to reduce morbidity through the use of antidepressants, anticonvulsants, anesthetics, analgesics, corticosteroids, and antiviral agents. Vaccination is also effective for preventing herpes zoster (HZ) outbreaks and PHN. […] Use of a live attenuated varicella zoster virus (VZV) vaccine has been shown in a clinical trial to be effective in preventing HZ and PHN. […] In 2017, the FDA approved Lyrica CR (pregabalin extended-release tablets) for the management of PHN. […] Antidepressants used in the treatment of PHN include tricyclic antidepressants (TCAs; eg, amitriptyline and nortriptyline) and serotonin-norepinephrine reuptake inhibitors (SNRIs; eg, duloxetine and venlafaxine). […] Antivirals used in the management of PHN include acyclovir, famciclovir, and valacyclovir.

• #67 Postherpetic Neuralgia – Novus Spine & Pain Center

  https://novusspinecenter.com/pain-conditions/postherpetic-neuralgia

  Possible pain management options include: Analgesics. Locally applied, a mix of aspirin with an appropriate solvent can help reduce pain. Lidocaine skin patches. A small, bandage-like patch containing the topical, pain-relieving medication lidocaine. Apply the patches, available by prescription, directly to the sensitive skin for temporary relief. Capsaicin skin patch. The application of a high concentration of an extract of chili peppers (capsaicin) available only in a doctors office. Trained personnel apply the patch after using a numbing medication on the affected area. The process takes at least two hours, but a single application is effective in decreasing pain for some patients for up to three months. Anticonvulsants. Certain anti-seizure medications can lessen the pain. These medications stabilize abnormal nervous system activity caused by injured nerves. Antidepressants. Certain antidepressants affect key brain chemicals that play a role in both depression and how your body interprets pain. Doctors will prescribe antidepressants for postherpetic neuralgia in smaller doses than for depression alone. Opioid painkillers. Certain prescription-strength medications can help relieve pain, but must be closely managed by a doctor. Opioids can cause nausea and drowsiness as well as become addictive. Steroid injections. A steroid injection into the spine (intrathecal) is helpful in some cases.

• #68 Postherpetic neuralgia – Wikipedia

  https://en.wikipedia.org/wiki/Postherpetic_neuralgia

  Opioid medications are not generally recommended for treatment except in specific circumstances. […] The pain from postherpetic neuralgia can be very severe and requires immediate treatment. There is no treatment which modifies the course of the disease and management primarily aims to control symptoms. […] Medications applied to the skin can be used alone if the pain from PHN is mild or in combination with oral medications if the pain is moderate to severe. […] Multiple oral medications have demonstrated efficacy in relieving postherpetic neuralgia pain. […] Pharmacological treatment of PHN is unsatisfactory for many patients and there is a clinical need for new treatments.

• #69 Postherpetic Neuralgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493198/

  Traditional non-invasive treatments include oral and topical medications. […] The American Academy of Neurology (AAN), Special Interest Group on Neuropathic Pain (NeuPSIG), and European Federation of Neurological Societies (EFNS) all recommend an oral tricyclic antidepressant (TCA), pregabalin, and the lidocaine 5% patch as first-line therapies. […] The leading cause of discontinuing capsaicin treatment is pain and irritation at the application site, suffered by almost all users in proportion to the capsaicin concentration. […] The degree of overall pain reduction is generally less than the lidocaine 5% patch. […] Therefore, multimodal therapeutic approaches recommended by expert consensus should be considered. […] Considering that postherpetic neuralgia is difficult to treat and outcomes are variable, prevention is of paramount importance. […] An interprofessional approach to managing patients with postherpetic neuralgia is the best way forward.

• #70 Postherpetic Neuralgia Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1143066-treatment

  Topical lidocaine patches have only minimal side effects and may be useful for relief of pain in this setting; they may be particularly helpful as adjuvant therapy in combination with agents such as gabapentin. […] Dorsal root entry zone (DREZ) lesioning has been employed as a means of treating PHN.

• #71 Postherpetic Neuralgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493198/

  Traditional non-invasive treatments include oral and topical medications. […] The American Academy of Neurology (AAN), Special Interest Group on Neuropathic Pain (NeuPSIG), and European Federation of Neurological Societies (EFNS) all recommend an oral tricyclic antidepressant (TCA), pregabalin, and the lidocaine 5% patch as first-line therapies. […] The leading cause of discontinuing capsaicin treatment is pain and irritation at the application site, suffered by almost all users in proportion to the capsaicin concentration. […] The degree of overall pain reduction is generally less than the lidocaine 5% patch. […] Therefore, multimodal therapeutic approaches recommended by expert consensus should be considered. […] Considering that postherpetic neuralgia is difficult to treat and outcomes are variable, prevention is of paramount importance. […] An interprofessional approach to managing patients with postherpetic neuralgia is the best way forward.

• #72 Postherpetic Neuralgia | Symptoms and Treatment

  https://patient.info/skin-conditions/shingles-herpes-zoster-leaflet/postherpetic-neuralgia

  Gabapentin is commonly tried to help manage postherpetic neuralgia. […] Lidocaine patches contain a special gel allowing the active ingredient, lidocaine, to seep into your skin. The aim is for the lidocaine to block the pain signals coming from the nerve. […] Some people have a severe itch with PHN. This is difficult to treat. An antihistamine taken at bedtime may improve sleep. […] The aim is to find the lowest dose required to ease the pain. This is because the lower the dose, the less likely that side-effects will be troublesome. […] Postherpetic neuralgia is extremely unusual in people aged under 50 and, if it does occur, it tends to be mild. […] Without treatment, PHN typically eases gradually and goes. Some people have a slow improvement over a long period of time. A very small number of people do not have any improvement over time without any treatment.

• #73 Patient education: Shingles (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/shingles-beyond-the-basics

  TCAs used to treat pain include amitriptyline, desipramine, and nortriptyline. It is common to feel tired when starting a TCA; this is not always an undesirable side effect, since it can help improve sleep when the medication is taken in the evening. TCAs are generally started in low doses, which are increased gradually. The pain-relief benefit may not be seen for three or more weeks. These medications may not be recommended for older adults with heart problems. […] Capsaicin — Capsaicin is a substance derived from chili peppers that can help to treat pain. Capsaicin cream (sample brand name: Zostrix) may be recommended to treat postherpetic neuralgia. However, the side effects of the cream (including burning, stinging, and skin redness) are intolerable for up to one-third of patients. […] Topical anesthetics — Lidocaine (sample brand name: Xylocaine) gel is a medicine that you can rub into your skin. Products that stick to your skin and release lidocaine are also available (eg, Lidoderm, which is a skin patch). You can wear these on your skin for up to 12 hours per day. They deliver a small amount of lidocaine, which helps to numb your skin, to the most painful or itchy areas. However, the benefit of lidocaine is likely to be moderate at best.

• #74 FF #272 Postherpetic Neuralgia | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/postherpetic-neuralgia/

  Best available evidence does not support the routine use of glucocorticoids in preventing PHN. […] PHN is a quintessential neuropathic pain syndrome, and the analgesic approach is like other neuropathic syndromes. […] A systematic review found general analgesics (e.g., short course of opioids) and magnesium sulfate (often given IV at a dose of 30 mg/kg) as the most preferred analgesic agents; antiepileptics (e.g., gabapentin, pregabalin) and tricyclic antidepressants (TCAs) were considered secondary treatments. […] Other guidelines cite strong evidence for TCAs, gabapentinoids (gabapentin, pregabalin), opioids, lidocaine 5% patch, and capsaicin 8% patch to manage PHN. […] Strong evidence also supports combined therapy of gabapentin plus opioids or TCAs. […] Topical salicylate and topical capsaicin 0.075% cream (available over the counter) are less likely to offer meaningful pain reduction. […] Epidural steroid injections and acupuncture are likely no better than placebo.

• #75 Herpes Zoster and Postherpetic Neuralgia: Prevention and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1115/p656.html

  Capsaicin 8% patches, applied for 30 to 90 minutes, provide effective pain relief for patients with postherpetic neuralgia. Gabapentin and pregabalin can be used for treatment of postherpetic neuralgia. Amitriptyline, nortriptyline, and desipramine can be used for pain relief in patients with postherpetic neuralgia. […] The potential harms of systemic therapies for postherpetic neuralgia should be considered before treating older patients or those with comorbidities. A thorough assessment, including a medication review and physical examination focusing on balance, gait, and orthostatic vital signs, will help minimize adverse effects of treatment and interactions between treatments and other medications. The American Geriatrics Society advocates initiating medications for persistent pain at low doses and titrating slowly.

• #76 Postherpetic Neuralgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493198/

  Traditional non-invasive treatments include oral and topical medications. […] The American Academy of Neurology (AAN), Special Interest Group on Neuropathic Pain (NeuPSIG), and European Federation of Neurological Societies (EFNS) all recommend an oral tricyclic antidepressant (TCA), pregabalin, and the lidocaine 5% patch as first-line therapies. […] The leading cause of discontinuing capsaicin treatment is pain and irritation at the application site, suffered by almost all users in proportion to the capsaicin concentration. […] The degree of overall pain reduction is generally less than the lidocaine 5% patch. […] Therefore, multimodal therapeutic approaches recommended by expert consensus should be considered. […] Considering that postherpetic neuralgia is difficult to treat and outcomes are variable, prevention is of paramount importance. […] An interprofessional approach to managing patients with postherpetic neuralgia is the best way forward.

• #77 Management of Herpes Zoster (Shingles) and Postherpetic Neuralgia | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0415/p2437.html

  Postherpetic neuralgia is generally a self-limited disease. Symptoms tend to abate over time. Less than one quarter of patients still experience pain at six months after the herpes zoster eruption, and fewer than one in 20 has pain at one year. […] Treatment is directed at pain control while waiting for the condition to resolve. Pain therapy may include multiple interventions, such as topical medications, over-the-counter analgesics, tricyclic antidepressants, anticonvulsants and a number of nonmedical modalities. Occasionally, narcotics may be required. […] Capsaicin, an extract from hot chili peppers, is currently the only drug labeled by the U.S. Food and Drug Administration for the treatment of postherpetic neuralgia. […] Tricyclic antidepressants can be effective adjuncts in reducing the neuropathic pain of postherpetic neuralgia. […] Effective treatment of postherpetic neuralgia often requires multiple treatment approaches. In addition to medications, modalities to consider include transcutaneous electric nerve stimulation (TENS), biofeedback and nerve blocks.

• #78 Patient education: Shingles (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/shingles-beyond-the-basics

  Oral pain medications — A short course of prescription pain medications (opioids) may be recommended if other treatments do not provide enough pain relief. […] Steroid injections — For people with postherpetic neuralgia who have severe pain despite using the above measures, an injection of steroids directly into the space around the spinal cord may be an option. Steroid injections are not used to treat facial pain.

• #79 Postherpetic Neuralgia Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1143066-treatment

  Topical lidocaine patches have only minimal side effects and may be useful for relief of pain in this setting; they may be particularly helpful as adjuvant therapy in combination with agents such as gabapentin. […] Dorsal root entry zone (DREZ) lesioning has been employed as a means of treating PHN.

• #80 Herpes Zoster Treatment & Management: Approach Considerations, Topical Treatments, Pharmacologic Therapy for Herpes Zoster

  https://emedicine.medscape.com/article/1132465-treatment

  The use of oral or epidural corticosteroids in conjunction with antiviral therapy has been found beneficial in treating moderate-to-severe acute zoster but has no effect on the development or duration of PHN. […] Combination therapies have shown promise for relieving PHN, but clinical evidence to support such approaches is limited. […] Pavan-Langston has proposed the following protocol for treatment of PHN: TCAs Nortriptyline, amitriptyline, or desipramine 25 mg; adjust up to 75 mg at bedtime; continue for several weeks if necessary […] Although anesthesia-based interventions such as local anesthetic blocking of sympathetic nerves or stellate ganglion blockade may produce transient relief, their effectiveness in reducing the protracted pain of PHN remains to be determined.

• #81 Postherpetic neuralgia (shingles) in children – Children’s Health Pain Management

  https://www.childrens.com/specialties-services/conditions/postherpetic-neuralgia

  Postherpetic neuralgia is a complication of the painful shingles (shingles) rash, which is caused by the chicken pox virus. When the rash clears, inflammation in the nerve can result in continued pain. […] Postherpetic neuralgia affects the nerve fibers and skin, and the burning pain associated with postherpetic neuralgia can be severe enough to interfere with sleep and appetite. […] Currently, there’s no cure for postherpetic neuralgia, but there are treatment options to soothe and quiet the misfiring nerves that are creating the pain. A specific treatment plan will be created based on your child’s symptoms, level of pain and age. […] Multiple treatments for postherpetic neuralgia (shingles) in children may be combined and can include: Pain relievers over-the-counter or prescription, Anti-seizure or anti-depressant medications, which can ease neuropathic pain, Topical creams or patches, Physical therapy (PT), Occupational therapy (OT), Desensitization therapy, Exercise, Psychological counseling, Electrode nerve stimulation, Lifestyle changes, such as weight loss or activity modifications, Massage therapy, Acupuncture, Nerve blocks. […] The persistent nerve pain from postherpetic neuralgia can ease on its own. But the pain can interfere with your child’s quality of life and affect movement and appetite. Pain treatment is available.

• #82 Can You Recover from Prolonged Postherpetic Neuralgia?

  https://www.fairviewrehab.com/rehab/can-you-recover-from-prolonged-postherpetic-neuralgia/

  One of the most common complications of the shingles virus is postherpetic neuralgia (PHN). The symptoms include varying degrees of burning, itching, aching, pain, or numbness. […] If untreated straight away, PHN could become a permanent debilitating problem causing physical and emotional distress, affecting activities, sleep, and mental health. […] Though there is almost no cure for this condition, treatments are available. One of the most effective options is physical therapy, which includes gentle exercises to improve functions and reduce pain. […] A safer method for PHN recovery is exercise, which well discuss more below. […] A trained physical therapist designs a customized treatment for individuals depending on the symptoms theyre dealing with. […] Your therapist may use manual therapy, which is massage therapy to reduce pain and muscle tension.

• #83 Can You Recover from Prolonged Postherpetic Neuralgia?

  https://www.fairviewrehab.com/rehab/can-you-recover-from-prolonged-postherpetic-neuralgia/

  One of the most common complications of the shingles virus is postherpetic neuralgia (PHN). The symptoms include varying degrees of burning, itching, aching, pain, or numbness. […] If untreated straight away, PHN could become a permanent debilitating problem causing physical and emotional distress, affecting activities, sleep, and mental health. […] Though there is almost no cure for this condition, treatments are available. One of the most effective options is physical therapy, which includes gentle exercises to improve functions and reduce pain. […] A safer method for PHN recovery is exercise, which well discuss more below. […] A trained physical therapist designs a customized treatment for individuals depending on the symptoms theyre dealing with. […] Your therapist may use manual therapy, which is massage therapy to reduce pain and muscle tension.

• #84 Can You Recover from Prolonged Postherpetic Neuralgia?

  https://www.fairviewrehab.com/rehab/can-you-recover-from-prolonged-postherpetic-neuralgia/

  Part of physical therapy for postherpetic neuralgia is aerobic exercises, including low-impact activities like walking, swimming, or biking. […] As you improve your movements, you also reduce the pain associated with this condition. […] There is no guarantee exercise can heal nerve damage caused by postherpetic neuralgia or any other injury. […] Despite the unclear results, pain reduction and improved symptoms are still worth the time spent exercising.

• #85 Can You Recover from Prolonged Postherpetic Neuralgia?

  https://www.fairviewrehab.com/rehab/can-you-recover-from-prolonged-postherpetic-neuralgia/

  Part of physical therapy for postherpetic neuralgia is aerobic exercises, including low-impact activities like walking, swimming, or biking. […] As you improve your movements, you also reduce the pain associated with this condition. […] There is no guarantee exercise can heal nerve damage caused by postherpetic neuralgia or any other injury. […] Despite the unclear results, pain reduction and improved symptoms are still worth the time spent exercising.

• #86 Postherpetic neuralgia: epidemiology, pathophysiology, and pain manage | JMDH

  https://www.dovepress.com/postherpetic-neuralgia-epidemiology-pathophysiology-and-pain-managemen-peer-reviewed-fulltext-article-JMDH

  At each patient visit, current pain levels, location of pain, and pain quality should be reassessed, and the patients ability to perform daily activities should be discussed. […] A treatment plan combining analgesics with different mechanisms of action may provide the best overall therapeutic effect, particularly the combination of an oral agent with topical lidocaine 5% patch, or a combination of gabapentin with opioids or a TCA. […] Nurses and nurse practitioners are especially crucial in establishing communication with patients and encouraging the initiation of appropriate pain-relieving treatments, leading to better outcomes in patients.

• #87 Postherpetic Neuralgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493198/

  Traditional non-invasive treatments include oral and topical medications. […] The American Academy of Neurology (AAN), Special Interest Group on Neuropathic Pain (NeuPSIG), and European Federation of Neurological Societies (EFNS) all recommend an oral tricyclic antidepressant (TCA), pregabalin, and the lidocaine 5% patch as first-line therapies. […] The leading cause of discontinuing capsaicin treatment is pain and irritation at the application site, suffered by almost all users in proportion to the capsaicin concentration. […] The degree of overall pain reduction is generally less than the lidocaine 5% patch. […] Therefore, multimodal therapeutic approaches recommended by expert consensus should be considered. […] Considering that postherpetic neuralgia is difficult to treat and outcomes are variable, prevention is of paramount importance. […] An interprofessional approach to managing patients with postherpetic neuralgia is the best way forward.

• #88 Postherpetic neuralgia: epidemiology, pathophysiology, and pain manage | JMDH

  https://www.dovepress.com/postherpetic-neuralgia-epidemiology-pathophysiology-and-pain-managemen-peer-reviewed-fulltext-article-JMDH

  At each patient visit, current pain levels, location of pain, and pain quality should be reassessed, and the patients ability to perform daily activities should be discussed. […] A treatment plan combining analgesics with different mechanisms of action may provide the best overall therapeutic effect, particularly the combination of an oral agent with topical lidocaine 5% patch, or a combination of gabapentin with opioids or a TCA. […] Nurses and nurse practitioners are especially crucial in establishing communication with patients and encouraging the initiation of appropriate pain-relieving treatments, leading to better outcomes in patients.

• #89 Pharmacotherapy for Neuropathic Pain in the Elderly: Focus on Postherpetic Neuralgia | Consultant360

  https://www.consultant360.com/articles/pharmacotherapy-neuropathic-pain-elderly-focus-postherpetic-neuralgia

  Pregabalin is recommended by the American Academy of Neurology as a level 1 treatment for PHN. […] Opioids are widely used to treat cancer-related pain. […] The efficacy of opioids in PHN has been documented in several studies. […] The 5% lidocaine patch is FDA approved to treat pain associated with PHN. […] The 8% capsaicin patch is approved in Europe for the treatment of peripheral neuropathic pain in nondiabetic adults and in the United States for the treatment of PHN. […] Combination therapy for neuropathic pain is gaining momentum because it produces better outcomes with a smaller dose of each drug, and it should be considered for older adults. […] Prevention is the most effective approach for PHN, and vaccination markedly decreases both the morbidity associated with HZ and the incidence of PHN.

• #90 Postherpetic Neuralgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493198/

  Traditional non-invasive treatments include oral and topical medications. […] The American Academy of Neurology (AAN), Special Interest Group on Neuropathic Pain (NeuPSIG), and European Federation of Neurological Societies (EFNS) all recommend an oral tricyclic antidepressant (TCA), pregabalin, and the lidocaine 5% patch as first-line therapies. […] The leading cause of discontinuing capsaicin treatment is pain and irritation at the application site, suffered by almost all users in proportion to the capsaicin concentration. […] The degree of overall pain reduction is generally less than the lidocaine 5% patch. […] Therefore, multimodal therapeutic approaches recommended by expert consensus should be considered. […] Considering that postherpetic neuralgia is difficult to treat and outcomes are variable, prevention is of paramount importance. […] An interprofessional approach to managing patients with postherpetic neuralgia is the best way forward.

• #91 Pharmacotherapy for Neuropathic Pain in the Elderly: Focus on Postherpetic Neuralgia | Consultant360

  https://www.consultant360.com/articles/pharmacotherapy-neuropathic-pain-elderly-focus-postherpetic-neuralgia

  Pregabalin is recommended by the American Academy of Neurology as a level 1 treatment for PHN. […] Opioids are widely used to treat cancer-related pain. […] The efficacy of opioids in PHN has been documented in several studies. […] The 5% lidocaine patch is FDA approved to treat pain associated with PHN. […] The 8% capsaicin patch is approved in Europe for the treatment of peripheral neuropathic pain in nondiabetic adults and in the United States for the treatment of PHN. […] Combination therapy for neuropathic pain is gaining momentum because it produces better outcomes with a smaller dose of each drug, and it should be considered for older adults. […] Prevention is the most effective approach for PHN, and vaccination markedly decreases both the morbidity associated with HZ and the incidence of PHN.

• #92 Postherpetic Neuralgia (Nerve Pain After Shingles) | Doctor

  https://patient.info/doctor/postherpetic-neuralgia-pro

  Amitriptyline is the most widely used, or nortriptyline as an alternative. […] Gabapentin and pregabalin have been shown to reduce pain and improve sleep patterns in patients with PHN. […] Topical lidocaine 5% patches can be considered if oral or other topical treatment is not suitable or is not tolerated. […] The 5% lidocaine medicated plaster has been shown to be as effective as systemic pregabalin in PHN but with an improved tolerability profile. […] There is an increasing body of evidence that botulinum toxin treatment is also effective in managing PHN. […] If the above treatment does not control pain after four to six weeks. […] Patients whose quality of life is being affected. […] The only well-documented means of preventing PHN is the prevention of herpes zoster. […] Vaccination is the most effective way to prevent the occurrence of herpes zoster complications in the elderly, in particular PHN.

• #93 Postherpetic Neuralgia: Symptoms, Causes, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/12093-postherpetic-neuralgia

  The Food and Drug Administration has approved a shingles vaccine, which can reduce your chance of getting shingles and PHN. The recombinant herpes-zoster vaccine (Shingrix) is recommended to prevent shingles in adults ages 50 and older. The vaccination is given in two doses, two to six months apart. The two-dose vaccine is 90% effective at preventing shingles and PHN. Protection lasts at least for four years after you get vaccinated. […] Once you develop chickenpox, the varicella-zoster virus remains in your body for life. If the virus reactivates and causes shingles, you have a few days around the rash outbreak to see your provider and get an antiviral medication, which can significantly lessen your symptoms. Still, if you develop PHN, your provider has many medications available to manage your symptoms.

• #94 Postherpetic Neuralgia Treatment & Management: Medical Care, Surgical Care

  https://emedicine.medscape.com/article/1143066-treatment

  The goal of therapy for postherpetic neuralgia (PHN) is to reduce morbidity through the use of antidepressants, anticonvulsants, anesthetics, analgesics, corticosteroids, and antiviral agents. Vaccination is also effective for preventing herpes zoster (HZ) outbreaks and PHN. […] Use of a live attenuated varicella zoster virus (VZV) vaccine has been shown in a clinical trial to be effective in preventing HZ and PHN. […] In 2017, the FDA approved Lyrica CR (pregabalin extended-release tablets) for the management of PHN. […] Antidepressants used in the treatment of PHN include tricyclic antidepressants (TCAs; eg, amitriptyline and nortriptyline) and serotonin-norepinephrine reuptake inhibitors (SNRIs; eg, duloxetine and venlafaxine). […] Antivirals used in the management of PHN include acyclovir, famciclovir, and valacyclovir.

• #95 FF #272 Postherpetic Neuralgia | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/postherpetic-neuralgia/

  Postherpetic neuralgia (PHN) is a syndrome of zoster-associated pain persisting more than 3 months after resolution of an initial herpes zoster (HZ) rash (‘shingles’). […] Risk factors for PHN include severe acute shingles-related pain, rash severity (i.e., more than 50 lesions), increasing age, and immunocompromised status. […] This central sensitization is thought to be a key mechanism in the development and maintenance of the pain of PHN. […] For all patients with acute HZ and/or PHN, physical and emotional quality-of-life can be affected. […] In adults over 60 years old, live vaccination against the zoster virus reduces overall incidence of HZ by 50% and PHN by two-thirds. […] Initiating antiviral drugs within 72 hours of rash onset reduces acute and chronic pain associated with HZ.

• #96 Postherpetic Neuralgia: Seniors at Risk

  https://www.uspharmacist.com/article/postherpetic-neuralgia-seniors-at-risk

  Pharmaceutical care planning should consider the premise that by successfully treating or reducing pain intensity, there may be improvement not only in physical functioning but also in psychosocial functioning. […] Consultation with a pain management specialist should be considered for some patients. […] Amitriptyline and imipramine should be avoided in the elderly since these agents may produce ataxia, impaired psychomotor function, syncope, and additional falls. […] Nortriptyline is the least likely TCA to cause orthostatic hypotension. […] The zoster vaccine live (Zostavax) was approved by the FDA in 2006; currently, it carries an indication for the prevention of shingles in individuals aged 50 and older. […] Data have shown that older patients who receive a zoster vaccine might also minimize their chances of developing PHN. […] Zoster vaccine live decreases the incidence of HZ and may also minimize the chance of developing PHN.

• #97 Post Herpetic Neuralgia/Shingles | DAVID KLOTH, MD | Connecticut Pain Care

  https://ctpaincare.com/pain-management/conditions/post-herpetic-neuralgiashingles/

  Post-herpetic neuralgia occurs following an acute episode of shingles when the pain does not improve as the rash resolves. […] The best treatment for post-herpetic neuralgia is prevention, meaning to treat those high-risk patients with acute shingles early and aggressively to prevent the development of post-herpetic neuralgia. […] There are many treatments available for acute herpes zoster to try to prevent it from progressing to a post-herpetic neuralgia. […] There are some treatments that are effective for treatment of post-herpetic neuralgia after it has been present for an extended period of time.

• #98 FF #272 Postherpetic Neuralgia | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/postherpetic-neuralgia/

  Postherpetic neuralgia (PHN) is a syndrome of zoster-associated pain persisting more than 3 months after resolution of an initial herpes zoster (HZ) rash (‘shingles’). […] Risk factors for PHN include severe acute shingles-related pain, rash severity (i.e., more than 50 lesions), increasing age, and immunocompromised status. […] This central sensitization is thought to be a key mechanism in the development and maintenance of the pain of PHN. […] For all patients with acute HZ and/or PHN, physical and emotional quality-of-life can be affected. […] In adults over 60 years old, live vaccination against the zoster virus reduces overall incidence of HZ by 50% and PHN by two-thirds. […] Initiating antiviral drugs within 72 hours of rash onset reduces acute and chronic pain associated with HZ.

• #99 Herpes Zoster Treatment & Management: Approach Considerations, Topical Treatments, Pharmacologic Therapy for Herpes Zoster

  https://emedicine.medscape.com/article/1132465-treatment

  The use of oral or epidural corticosteroids in conjunction with antiviral therapy has been found beneficial in treating moderate-to-severe acute zoster but has no effect on the development or duration of PHN. […] Combination therapies have shown promise for relieving PHN, but clinical evidence to support such approaches is limited. […] Pavan-Langston has proposed the following protocol for treatment of PHN: TCAs Nortriptyline, amitriptyline, or desipramine 25 mg; adjust up to 75 mg at bedtime; continue for several weeks if necessary […] Although anesthesia-based interventions such as local anesthetic blocking of sympathetic nerves or stellate ganglion blockade may produce transient relief, their effectiveness in reducing the protracted pain of PHN remains to be determined.

• #100 Herpes Zoster Treatment & Management: Approach Considerations, Topical Treatments, Pharmacologic Therapy for Herpes Zoster

  https://emedicine.medscape.com/article/1132465-treatment

  In the treatment of postherpetic neuralgia (PHN), a variety of medications have been identified as effective based on high-level evidence. Effective treatments include the following: Tricyclic antidepressants (TCAs) such as amitriptyline, nortriptyline, desipramine, and maprotiline […] The guidelines emphasize a structured approach to treating PHN, ensuring that patients receive the most effective and appropriate care based on current evidence. […] The only consistently successful method of treating PHN is to prevent it via prompt treatment of acute zoster and its associated pain. Early initiation of antiviral therapy, within 72 hours of onset, has been shown to alleviate acute pain and prevent PHN in most patients. […] Once PHN has developed, various treatments are available, including neuroactive agents (ie, TCAs), anticonvulsant agents (ie, gabapentin and pregabalin), and both systemic and topical analgesics (ie, opioids).

• #101 Postherpetic Neuralgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493198/

  Traditional non-invasive treatments include oral and topical medications. […] The American Academy of Neurology (AAN), Special Interest Group on Neuropathic Pain (NeuPSIG), and European Federation of Neurological Societies (EFNS) all recommend an oral tricyclic antidepressant (TCA), pregabalin, and the lidocaine 5% patch as first-line therapies. […] The leading cause of discontinuing capsaicin treatment is pain and irritation at the application site, suffered by almost all users in proportion to the capsaicin concentration. […] The degree of overall pain reduction is generally less than the lidocaine 5% patch. […] Therefore, multimodal therapeutic approaches recommended by expert consensus should be considered. […] Considering that postherpetic neuralgia is difficult to treat and outcomes are variable, prevention is of paramount importance. […] An interprofessional approach to managing patients with postherpetic neuralgia is the best way forward.

• #102 Postherpetic Neuralgia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/27517

  PHN is notoriously difficult to treat for many reasons. Complete resolution of symptoms is rare. […] Traditional non-invasive treatments include oral and topical medications. […] The American Academy of Neurology (AAN), Special Interest Group on Neuropathic Pain (NeuPSIG), and European Federation of Neurological Societies (EFNS) all recommend an oral tricyclic antidepressant (TCA), pregabalin, and the lidocaine 5% patch as first-line therapies. […] The other approach is to attempt to prevent the progression of HZ to PHN, with the understanding that the severity of an HZ episode is a risk factor for PHN. […] Considering that postherpetic neuralgia is difficult to treat and outcomes are variable, prevention is of paramount importance. Therefore, primary care physicians and geriatricians are tasked with administering vaccinations to at-risk populations. […] An interprofessional approach to managing patients with postherpetic neuralgia is the best way forward.

• #103 Postherpetic neuralgia: epidemiology, pathophysiology, and pain manage | JMDH

  https://www.dovepress.com/postherpetic-neuralgia-epidemiology-pathophysiology-and-pain-managemen-peer-reviewed-fulltext-article-JMDH

  Nurse practitioners are especially crucial in establishing communication with patients and encouraging the initiation of appropriate pain-relieving treatments. […] The safety and tolerability of pharmacologic therapies are important issues to consider as postherpetic neuralgia affects primarily an older population. […] Approaches to PHN management include preventing HZ, and thus possibly PHN, through vaccination and/or antiviral treatment, and administering specific medications to treat PHN pain. […] Once PHN has been diagnosed, treatment should be directed at pain control and minimizing treatment-related adverse events. […] Prior to instituting an individual treatment plan, health-care professionals, including nurses, should carefully evaluate patients concomitant medications. […] To ensure the optimal effectiveness of the treatment, clear communication with the patient, frequent monitoring of adverse reactions, and patient satisfaction with the treatment are essential.

• #104 Postherpetic Neuralgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493198/

  Postherpetic neuralgia (PHN) is the most common long-term complication of varicella-zoster virus (VZV) reactivation. […] This activity will highlight the role of the interprofessional team in understanding vaccination and treatment of patients with this condition. […] Review the importance of improving care coordination among interprofessional team members to improve outcomes for patients with postherpetic neuralgia. […] The most successful treatments are multi-modal, with some researchers/clinicians focusing on prevention in high-risk populations rather than cure because of the debilitating and often refractory nature of PHN in already fragile patient populations. […] Therefore, side effect profiles of interventions take on greater importance. […] There is no one superior treatment regimen; however, expert consensus suggests that multimodal therapy is likely the best approach.

• #105 Postherpetic neuralgia: epidemiology, pathophysiology, and pain manage | JMDH

  https://www.dovepress.com/postherpetic-neuralgia-epidemiology-pathophysiology-and-pain-managemen-peer-reviewed-fulltext-article-JMDH

  Postherpetic neuralgia is a neuropathic pain syndrome characterized by pain that persists for months to years after resolution of the herpes zoster rash. […] Patients with postherpetic neuralgia report decreased quality of life and interference with activities of daily living. […] Current guidelines recommend treatment of postherpetic neuralgia in a hierarchical manner, with calcium channel 2- ligands (gabapentin and pregabalin), tricyclic antidepressants (amitriptyline, nortriptyline, or desipramine), or topical lidocaine patches as first-line drugs. […] Patients should be educated on appropriate dosing, titration if applicable, the importance of adherence to treatment for optimal effectiveness, and possible side effects. […] Health-care professionals play a key role in helping to ameliorate the pain caused by postherpetic neuralgia through early recognition and diligent assessment of the problem; recommending evidence-based treatments; and monitoring treatment adherence, adverse events, responses, and expectations.

• #106 Effective pain management of post-herpetic neuralgia | Nursing Times

  https://www.nursingtimes.net/pain-management/effective-pain-management-of-post-herpetic-neuralgia-11-03-2003/

  Post-herpetic neuralgia is a neuropathic pain syndrome that is notoriously difficult to manage. […] Management is difficult with traditional analgesics because the shingles virus can cause so much nerve damage in the few days before a patient seeks medical help. Specific analgesic regimens for relieving nerve pain, therefore, are required. […] Health care practitioners have a duty to help people obtain both a swift diagnosis and offer early, appropriate treatment. […] The key to effective management is to start it early. Primary care practitioners are often best placed to do this. Effective management regimens are multimodal and involve medication, non-pharmacological therapies and psychosocial support. […] Patients must be reassured should they experience post-herpetic neuralgia that treatments and support are available.

• #107 Effective pain management of post-herpetic neuralgia | Nursing Times

  https://www.nursingtimes.net/pain-management/effective-pain-management-of-post-herpetic-neuralgia-11-03-2003/

  Post-herpetic neuralgia is a neuropathic pain syndrome that is notoriously difficult to manage. […] Management is difficult with traditional analgesics because the shingles virus can cause so much nerve damage in the few days before a patient seeks medical help. Specific analgesic regimens for relieving nerve pain, therefore, are required. […] Health care practitioners have a duty to help people obtain both a swift diagnosis and offer early, appropriate treatment. […] The key to effective management is to start it early. Primary care practitioners are often best placed to do this. Effective management regimens are multimodal and involve medication, non-pharmacological therapies and psychosocial support. […] Patients must be reassured should they experience post-herpetic neuralgia that treatments and support are available.

• #108 Postherpetic neuralgia: epidemiology, pathophysiology, and pain manage | JMDH

  https://www.dovepress.com/postherpetic-neuralgia-epidemiology-pathophysiology-and-pain-managemen-peer-reviewed-fulltext-article-JMDH

  Nurse practitioners are especially crucial in establishing communication with patients and encouraging the initiation of appropriate pain-relieving treatments. […] The safety and tolerability of pharmacologic therapies are important issues to consider as postherpetic neuralgia affects primarily an older population. […] Approaches to PHN management include preventing HZ, and thus possibly PHN, through vaccination and/or antiviral treatment, and administering specific medications to treat PHN pain. […] Once PHN has been diagnosed, treatment should be directed at pain control and minimizing treatment-related adverse events. […] Prior to instituting an individual treatment plan, health-care professionals, including nurses, should carefully evaluate patients concomitant medications. […] To ensure the optimal effectiveness of the treatment, clear communication with the patient, frequent monitoring of adverse reactions, and patient satisfaction with the treatment are essential.

• #109 Postherpetic neuralgia: epidemiology, pathophysiology, and pain manage | JMDH

  https://www.dovepress.com/postherpetic-neuralgia-epidemiology-pathophysiology-and-pain-managemen-peer-reviewed-fulltext-article-JMDH

  At each patient visit, current pain levels, location of pain, and pain quality should be reassessed, and the patients ability to perform daily activities should be discussed. […] A treatment plan combining analgesics with different mechanisms of action may provide the best overall therapeutic effect, particularly the combination of an oral agent with topical lidocaine 5% patch, or a combination of gabapentin with opioids or a TCA. […] Nurses and nurse practitioners are especially crucial in establishing communication with patients and encouraging the initiation of appropriate pain-relieving treatments, leading to better outcomes in patients.

• #110 Postherpetic neuralgia: epidemiology, pathophysiology, and pain manage | JMDH

  https://www.dovepress.com/postherpetic-neuralgia-epidemiology-pathophysiology-and-pain-managemen-peer-reviewed-fulltext-article-JMDH

  Nurse practitioners are especially crucial in establishing communication with patients and encouraging the initiation of appropriate pain-relieving treatments. […] The safety and tolerability of pharmacologic therapies are important issues to consider as postherpetic neuralgia affects primarily an older population. […] Approaches to PHN management include preventing HZ, and thus possibly PHN, through vaccination and/or antiviral treatment, and administering specific medications to treat PHN pain. […] Once PHN has been diagnosed, treatment should be directed at pain control and minimizing treatment-related adverse events. […] Prior to instituting an individual treatment plan, health-care professionals, including nurses, should carefully evaluate patients concomitant medications. […] To ensure the optimal effectiveness of the treatment, clear communication with the patient, frequent monitoring of adverse reactions, and patient satisfaction with the treatment are essential.

• #111 Postherpetic Neuralgia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/27517

  PHN is notoriously difficult to treat for many reasons. Complete resolution of symptoms is rare. […] Traditional non-invasive treatments include oral and topical medications. […] The American Academy of Neurology (AAN), Special Interest Group on Neuropathic Pain (NeuPSIG), and European Federation of Neurological Societies (EFNS) all recommend an oral tricyclic antidepressant (TCA), pregabalin, and the lidocaine 5% patch as first-line therapies. […] The other approach is to attempt to prevent the progression of HZ to PHN, with the understanding that the severity of an HZ episode is a risk factor for PHN. […] Considering that postherpetic neuralgia is difficult to treat and outcomes are variable, prevention is of paramount importance. Therefore, primary care physicians and geriatricians are tasked with administering vaccinations to at-risk populations. […] An interprofessional approach to managing patients with postherpetic neuralgia is the best way forward.

• #112 Postherpetic neuralgia: epidemiology, pathophysiology, and pain manage | JMDH

  https://www.dovepress.com/postherpetic-neuralgia-epidemiology-pathophysiology-and-pain-managemen-peer-reviewed-fulltext-article-JMDH

  Nurse practitioners are especially crucial in establishing communication with patients and encouraging the initiation of appropriate pain-relieving treatments. […] The safety and tolerability of pharmacologic therapies are important issues to consider as postherpetic neuralgia affects primarily an older population. […] Approaches to PHN management include preventing HZ, and thus possibly PHN, through vaccination and/or antiviral treatment, and administering specific medications to treat PHN pain. […] Once PHN has been diagnosed, treatment should be directed at pain control and minimizing treatment-related adverse events. […] Prior to instituting an individual treatment plan, health-care professionals, including nurses, should carefully evaluate patients concomitant medications. […] To ensure the optimal effectiveness of the treatment, clear communication with the patient, frequent monitoring of adverse reactions, and patient satisfaction with the treatment are essential.

• #113 For the Elderly, Compliance is Key for Postherpetic Neuralgia Management – MPR

  https://www.empr.com/home/features/for-the-elderly-compliance-is-key-for-postherpetic-neuralgia-management/

  Postherpetic neuralgia (PHN) is a condition associated with debilitating neuropathic pain that arises as a complication of herpes zoster infection (shingles). […] The pain from PHN may be more severe and debilitating among elderly patients. In addition, treating this neuropathic pain condition can be complicated in elderly patients because of polypharmacy, drug dosing schedules, adverse events, drug-drug interactions, and patient comorbidities. […] Compliance is also an issue with elderly patients due to forgetfulness and issues associated with drug sensitivity. Patients often have difficulty taking the medication as directed, which is usually three times a day. […] Finding options that improve compliance and reduce adverse events would likely improve pain control and outcomes in elderly patients.

• #114 Herpes Zoster and Postherpetic Neuralgia: Prevention and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1115/p656.html

  Capsaicin 8% patches, applied for 30 to 90 minutes, provide effective pain relief for patients with postherpetic neuralgia. Gabapentin and pregabalin can be used for treatment of postherpetic neuralgia. Amitriptyline, nortriptyline, and desipramine can be used for pain relief in patients with postherpetic neuralgia. […] The potential harms of systemic therapies for postherpetic neuralgia should be considered before treating older patients or those with comorbidities. A thorough assessment, including a medication review and physical examination focusing on balance, gait, and orthostatic vital signs, will help minimize adverse effects of treatment and interactions between treatments and other medications. The American Geriatrics Society advocates initiating medications for persistent pain at low doses and titrating slowly.

• #115 Herpes Zoster and Postherpetic Neuralgia: Prevention and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1115/p656.html

  Capsaicin 8% patches, applied for 30 to 90 minutes, provide effective pain relief for patients with postherpetic neuralgia. Gabapentin and pregabalin can be used for treatment of postherpetic neuralgia. Amitriptyline, nortriptyline, and desipramine can be used for pain relief in patients with postherpetic neuralgia. […] The potential harms of systemic therapies for postherpetic neuralgia should be considered before treating older patients or those with comorbidities. A thorough assessment, including a medication review and physical examination focusing on balance, gait, and orthostatic vital signs, will help minimize adverse effects of treatment and interactions between treatments and other medications. The American Geriatrics Society advocates initiating medications for persistent pain at low doses and titrating slowly.

• #116 For the Elderly, Compliance is Key for Postherpetic Neuralgia Management – MPR

  https://www.empr.com/home/features/for-the-elderly-compliance-is-key-for-postherpetic-neuralgia-management/

  Our study found that elderly patients did much better with the once-daily dosing simply because it was easier to take regularly. […] Our study participants were compliant with taking the once-daily dose of gastroretentive gabapentin, which also resulted in minimizing side effects, better pain control, improved patient satisfaction, and better sleep, Gupta said. […] The researchers found that once-daily gabapentin was effective and well tolerated in the elderly. We found that both the elderly and those 70 and younger had similar improvement in the worse, least, and average pain they experienced from PHN.

• #117 Postherpetic Neuralgia: Seniors at Risk

  https://www.uspharmacist.com/article/postherpetic-neuralgia-seniors-at-risk

  Pharmaceutical care planning should consider the premise that by successfully treating or reducing pain intensity, there may be improvement not only in physical functioning but also in psychosocial functioning. […] Consultation with a pain management specialist should be considered for some patients. […] Amitriptyline and imipramine should be avoided in the elderly since these agents may produce ataxia, impaired psychomotor function, syncope, and additional falls. […] Nortriptyline is the least likely TCA to cause orthostatic hypotension. […] The zoster vaccine live (Zostavax) was approved by the FDA in 2006; currently, it carries an indication for the prevention of shingles in individuals aged 50 and older. […] Data have shown that older patients who receive a zoster vaccine might also minimize their chances of developing PHN. […] Zoster vaccine live decreases the incidence of HZ and may also minimize the chance of developing PHN.

• #118 Postherpetic Neuralgia: Seniors at Risk

  https://www.uspharmacist.com/article/postherpetic-neuralgia-seniors-at-risk

  Pharmaceutical care planning should consider the premise that by successfully treating or reducing pain intensity, there may be improvement not only in physical functioning but also in psychosocial functioning. […] Consultation with a pain management specialist should be considered for some patients. […] Amitriptyline and imipramine should be avoided in the elderly since these agents may produce ataxia, impaired psychomotor function, syncope, and additional falls. […] Nortriptyline is the least likely TCA to cause orthostatic hypotension. […] The zoster vaccine live (Zostavax) was approved by the FDA in 2006; currently, it carries an indication for the prevention of shingles in individuals aged 50 and older. […] Data have shown that older patients who receive a zoster vaccine might also minimize their chances of developing PHN. […] Zoster vaccine live decreases the incidence of HZ and may also minimize the chance of developing PHN.

• #119 Herpes Zoster and Postherpetic Neuralgia: Prevention and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1115/p656.html

  Postherpetic neuralgia, the most common complication of herpes zoster, is defined as pain in a dermatomal distribution that is sustained for at least 90 days after the rash. It occurs in approximately 20% of patients with herpes zoster, and 80% of cases occur in patients 50 years or older. Pain is described as burning or electric shocklike and may be associated with allodynia or hyperalgesia. Postherpetic neuralgia is caused by nerve damage secondary to an inflammatory response induced by viral replication within a nerve. Risk factors include older age, severe prodrome or rash, severe acute zoster pain, ophthalmic involvement, immunosuppression, and chronic conditions such as diabetes mellitus and lupus. Pain from postherpetic neuralgia is often debilitating and affects physical functioning, psychological well-being, and quality of life. Pain-management strategies should focus on symptom control. Although some patients have complete resolution of symptoms at several years, others continue medications indefinitely.

• #120 FF #272 Postherpetic Neuralgia | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/postherpetic-neuralgia/

  Postherpetic neuralgia (PHN) is a syndrome of zoster-associated pain persisting more than 3 months after resolution of an initial herpes zoster (HZ) rash (‘shingles’). […] Risk factors for PHN include severe acute shingles-related pain, rash severity (i.e., more than 50 lesions), increasing age, and immunocompromised status. […] This central sensitization is thought to be a key mechanism in the development and maintenance of the pain of PHN. […] For all patients with acute HZ and/or PHN, physical and emotional quality-of-life can be affected. […] In adults over 60 years old, live vaccination against the zoster virus reduces overall incidence of HZ by 50% and PHN by two-thirds. […] Initiating antiviral drugs within 72 hours of rash onset reduces acute and chronic pain associated with HZ.

• #121 FF #272 Postherpetic Neuralgia | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/postherpetic-neuralgia/

  Postherpetic neuralgia (PHN) is a syndrome of zoster-associated pain persisting more than 3 months after resolution of an initial herpes zoster (HZ) rash (‘shingles’). […] Risk factors for PHN include severe acute shingles-related pain, rash severity (i.e., more than 50 lesions), increasing age, and immunocompromised status. […] This central sensitization is thought to be a key mechanism in the development and maintenance of the pain of PHN. […] For all patients with acute HZ and/or PHN, physical and emotional quality-of-life can be affected. […] In adults over 60 years old, live vaccination against the zoster virus reduces overall incidence of HZ by 50% and PHN by two-thirds. […] Initiating antiviral drugs within 72 hours of rash onset reduces acute and chronic pain associated with HZ.

• #122 Herpes Zoster and Postherpetic Neuralgia: Prevention and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1115/p656.html

  Postherpetic neuralgia, the most common complication of herpes zoster, is defined as pain in a dermatomal distribution that is sustained for at least 90 days after the rash. It occurs in approximately 20% of patients with herpes zoster, and 80% of cases occur in patients 50 years or older. Pain is described as burning or electric shocklike and may be associated with allodynia or hyperalgesia. Postherpetic neuralgia is caused by nerve damage secondary to an inflammatory response induced by viral replication within a nerve. Risk factors include older age, severe prodrome or rash, severe acute zoster pain, ophthalmic involvement, immunosuppression, and chronic conditions such as diabetes mellitus and lupus. Pain from postherpetic neuralgia is often debilitating and affects physical functioning, psychological well-being, and quality of life. Pain-management strategies should focus on symptom control. Although some patients have complete resolution of symptoms at several years, others continue medications indefinitely.

• #123 Postherpetic neuralgia: epidemiology, pathophysiology, and pain manage | JMDH

  https://www.dovepress.com/postherpetic-neuralgia-epidemiology-pathophysiology-and-pain-managemen-peer-reviewed-fulltext-article-JMDH

  Nurse practitioners are especially crucial in establishing communication with patients and encouraging the initiation of appropriate pain-relieving treatments. […] The safety and tolerability of pharmacologic therapies are important issues to consider as postherpetic neuralgia affects primarily an older population. […] Approaches to PHN management include preventing HZ, and thus possibly PHN, through vaccination and/or antiviral treatment, and administering specific medications to treat PHN pain. […] Once PHN has been diagnosed, treatment should be directed at pain control and minimizing treatment-related adverse events. […] Prior to instituting an individual treatment plan, health-care professionals, including nurses, should carefully evaluate patients concomitant medications. […] To ensure the optimal effectiveness of the treatment, clear communication with the patient, frequent monitoring of adverse reactions, and patient satisfaction with the treatment are essential.

• #124 Management of Herpes Zoster (Shingles) and Postherpetic Neuralgia | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0415/p2437.html

  Postherpetic neuralgia is generally a self-limited disease. Symptoms tend to abate over time. Less than one quarter of patients still experience pain at six months after the herpes zoster eruption, and fewer than one in 20 has pain at one year. […] Treatment is directed at pain control while waiting for the condition to resolve. Pain therapy may include multiple interventions, such as topical medications, over-the-counter analgesics, tricyclic antidepressants, anticonvulsants and a number of nonmedical modalities. Occasionally, narcotics may be required. […] Capsaicin, an extract from hot chili peppers, is currently the only drug labeled by the U.S. Food and Drug Administration for the treatment of postherpetic neuralgia. […] Tricyclic antidepressants can be effective adjuncts in reducing the neuropathic pain of postherpetic neuralgia. […] Effective treatment of postherpetic neuralgia often requires multiple treatment approaches. In addition to medications, modalities to consider include transcutaneous electric nerve stimulation (TENS), biofeedback and nerve blocks.

• #125 Post-herpetic neuralgia

  https://dermnetnz.org/topics/post-herpetic-neuralgia

  Post-herpetic neuralgia describes chronic skin pain in an area previously affected by herpes zoster (shingles). […] Post-herpetic neuralgia is usually a chronic neuropathic pain with a burning character, but some patients experience sharp stabbing pains. […] Chronic pain can lead to insomnia, anxiety and depression. […] The main risk factors for post-herpetic neuralgia are older age, immunosuppression, and severe infection. […] Acute herpes zoster pain is due to direct damage of peripheral nerves by the herpes zoster virus. Ongoing post-herpetic neuralgia is due to slow recovery and the involvement of the central nervous system. […] Herpes zoster pain and post-herpetic neuralgia are common and very debilitating conditions. But they can be prevented to a large extent by vaccination of at-risk individuals and by prompt antiviral treatment during the acute phase of herpes zoster infection. […] Multiple treatments are often required to control post-herpetic neuralgia. […] Support, psychotherapy and biofeedback techniques may help patients manage their pain. […] The duration of post-herpetic neuralgia is variable. In the majority of people, symptoms resolve within 6 months to 1 year.

• #126 Management of Herpes Zoster (Shingles) and Postherpetic Neuralgia | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0415/p2437.html

  Postherpetic neuralgia is generally a self-limited disease. Symptoms tend to abate over time. Less than one quarter of patients still experience pain at six months after the herpes zoster eruption, and fewer than one in 20 has pain at one year. […] Treatment is directed at pain control while waiting for the condition to resolve. Pain therapy may include multiple interventions, such as topical medications, over-the-counter analgesics, tricyclic antidepressants, anticonvulsants and a number of nonmedical modalities. Occasionally, narcotics may be required. […] Capsaicin, an extract from hot chili peppers, is currently the only drug labeled by the U.S. Food and Drug Administration for the treatment of postherpetic neuralgia. […] Tricyclic antidepressants can be effective adjuncts in reducing the neuropathic pain of postherpetic neuralgia. […] Effective treatment of postherpetic neuralgia often requires multiple treatment approaches. In addition to medications, modalities to consider include transcutaneous electric nerve stimulation (TENS), biofeedback and nerve blocks.

• #127 Postherpetic Neuralgia | Symptoms and Treatment

  https://patient.info/skin-conditions/shingles-herpes-zoster-leaflet/postherpetic-neuralgia

  Gabapentin is commonly tried to help manage postherpetic neuralgia. […] Lidocaine patches contain a special gel allowing the active ingredient, lidocaine, to seep into your skin. The aim is for the lidocaine to block the pain signals coming from the nerve. […] Some people have a severe itch with PHN. This is difficult to treat. An antihistamine taken at bedtime may improve sleep. […] The aim is to find the lowest dose required to ease the pain. This is because the lower the dose, the less likely that side-effects will be troublesome. […] Postherpetic neuralgia is extremely unusual in people aged under 50 and, if it does occur, it tends to be mild. […] Without treatment, PHN typically eases gradually and goes. Some people have a slow improvement over a long period of time. A very small number of people do not have any improvement over time without any treatment.

• #128 Postherpetic Neuralgia: Symptoms, Causes, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/12093-postherpetic-neuralgia

  Postherpetic neuralgia (PHN) is the most common complication of shingles. Pain-relieving medications can manage symptoms. For most people, PHN improves over time. […] Postherpetic neuralgia (PHN) results from damage to nerve fibers during shingles infection. The nerve fibers at the skin in the affected area send exaggerated pain signals to your brain. […] If shingles is caught within the first three days of its outbreak, your healthcare provider may prescribe the antiviral medication acyclovir (Zovirax), valacyclovir (Valtrex) or famciclovir (Famvir). These medications help the rash/blisters heal faster, keep new sores from forming, decrease pain and itching and reduce length of pain after sores have healed. […] Although there is no cure for PHN, it can be treated. For most people with PHN, pain improves with time and eventually goes away. For most people, the pain goes away in one to three months.

• #129 Postherpetic Neuralgia: Symptoms, Causes, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/12093-postherpetic-neuralgia

  Postherpetic neuralgia (PHN) is the most common complication of shingles. Pain-relieving medications can manage symptoms. For most people, PHN improves over time. […] Postherpetic neuralgia (PHN) results from damage to nerve fibers during shingles infection. The nerve fibers at the skin in the affected area send exaggerated pain signals to your brain. […] If shingles is caught within the first three days of its outbreak, your healthcare provider may prescribe the antiviral medication acyclovir (Zovirax), valacyclovir (Valtrex) or famciclovir (Famvir). These medications help the rash/blisters heal faster, keep new sores from forming, decrease pain and itching and reduce length of pain after sores have healed. […] Although there is no cure for PHN, it can be treated. For most people with PHN, pain improves with time and eventually goes away. For most people, the pain goes away in one to three months.

• #130 Post-herpetic neuralgia

  https://dermnetnz.org/topics/post-herpetic-neuralgia

  Post-herpetic neuralgia describes chronic skin pain in an area previously affected by herpes zoster (shingles). […] Post-herpetic neuralgia is usually a chronic neuropathic pain with a burning character, but some patients experience sharp stabbing pains. […] Chronic pain can lead to insomnia, anxiety and depression. […] The main risk factors for post-herpetic neuralgia are older age, immunosuppression, and severe infection. […] Acute herpes zoster pain is due to direct damage of peripheral nerves by the herpes zoster virus. Ongoing post-herpetic neuralgia is due to slow recovery and the involvement of the central nervous system. […] Herpes zoster pain and post-herpetic neuralgia are common and very debilitating conditions. But they can be prevented to a large extent by vaccination of at-risk individuals and by prompt antiviral treatment during the acute phase of herpes zoster infection. […] Multiple treatments are often required to control post-herpetic neuralgia. […] Support, psychotherapy and biofeedback techniques may help patients manage their pain. […] The duration of post-herpetic neuralgia is variable. In the majority of people, symptoms resolve within 6 months to 1 year.

• #131 Varicella-zoster virus, shingles and postherpetic neuralgia | Nursing Times

  https://www.nursingtimes.net/tissue-viability-and-wound-care/varicella-zoster-virus-shingles-and-postherpetic-neuralgia-02-12-2003/

  Postherpetic neuralgia (PHN) is pain that continues beyond the normal healing time of the shingles rash. It is usually self-limiting, but in some people it can be prolonged or persist indefinitely. The incidence depends on the definition used, but data suggest there are 25 000 new UK cases each year, and an annual prevalence approaching 50 000. Around 10-25% of patients with pain one month post-shingles have pain a year later. […] While there is no way of determining which patients with shingles will develop PHN, its incidence increases dramatically with age. Other risk factors include pain preceding the rash, greater acute pain severity, greater rash severity, sensory dysfunction in the affected dermatome during shingles, an extended rash period, a rash on the face or lower back, and being female.

• #132 Management of Herpes Zoster (Shingles) and Postherpetic Neuralgia | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0415/p2437.html

  Postherpetic neuralgia is generally a self-limited disease. Symptoms tend to abate over time. Less than one quarter of patients still experience pain at six months after the herpes zoster eruption, and fewer than one in 20 has pain at one year. […] Treatment is directed at pain control while waiting for the condition to resolve. Pain therapy may include multiple interventions, such as topical medications, over-the-counter analgesics, tricyclic antidepressants, anticonvulsants and a number of nonmedical modalities. Occasionally, narcotics may be required. […] Capsaicin, an extract from hot chili peppers, is currently the only drug labeled by the U.S. Food and Drug Administration for the treatment of postherpetic neuralgia. […] Tricyclic antidepressants can be effective adjuncts in reducing the neuropathic pain of postherpetic neuralgia. […] Effective treatment of postherpetic neuralgia often requires multiple treatment approaches. In addition to medications, modalities to consider include transcutaneous electric nerve stimulation (TENS), biofeedback and nerve blocks.

• #133 Postherpetic Neuralgia – Novus Spine & Pain Center

  https://novusspinecenter.com/pain-conditions/postherpetic-neuralgia

  In some cases, pain treatment for postherpetic neuralgia brings complete relief. However, most sufferers still experience some pain, while some may not obtain any relief. Although some people must live with postherpetic neuralgia the rest of their lives, the condition often disappears on its own within five years. […] Novus Spine Pain Center is in Lakeland, Florida, and specializes in treating postherpetic neuralgia. By using a comprehensive approach and cutting edge therapies, we work together with patients to restore function and regain an active lifestyle, while minimizing the need for opiates.

• #134 Comprehensive nursing care improves symptoms and quality of life in elderly patients with postherpetic neuralgia | Scientific Reports

  https://www.nature.com/articles/s41598-024-69949-5

  Comprehensive nursing care interventions may effectively alleviate clinical symptoms, and diminish levels of depression and anxiety, while improving sleep quality in elderly patients with PHN. […] The aim of this study is to explore the clinical influence of comprehensive nursing care on elderly individuals with PHN. Comprehensive nursing care seeks to address the various physical, psychological, and social aspects of patients’ well-being. By providing holistic and individualized care, this approach is expected to alleviate symptoms, improve functional outcomes, and enhance the overall quality of life for patients suffering from PHN. […] Overall, comprehensive nursing care integrates physical, psychological, social, and educational interventions to address the diverse needs of patients and optimize health outcomes. Research supports the effectiveness of this approach in improving patient satisfaction, enhancing quality of life, and promoting recovery.

• #135 Postherpetic neuralgia: epidemiology, pathophysiology, and pain manage | JMDH

  https://www.dovepress.com/postherpetic-neuralgia-epidemiology-pathophysiology-and-pain-managemen-peer-reviewed-fulltext-article-JMDH

  Postherpetic neuralgia is a neuropathic pain syndrome characterized by pain that persists for months to years after resolution of the herpes zoster rash. […] Patients with postherpetic neuralgia report decreased quality of life and interference with activities of daily living. […] Current guidelines recommend treatment of postherpetic neuralgia in a hierarchical manner, with calcium channel 2- ligands (gabapentin and pregabalin), tricyclic antidepressants (amitriptyline, nortriptyline, or desipramine), or topical lidocaine patches as first-line drugs. […] Patients should be educated on appropriate dosing, titration if applicable, the importance of adherence to treatment for optimal effectiveness, and possible side effects. […] Health-care professionals play a key role in helping to ameliorate the pain caused by postherpetic neuralgia through early recognition and diligent assessment of the problem; recommending evidence-based treatments; and monitoring treatment adherence, adverse events, responses, and expectations.

• #136 Postherpetic neuralgia: epidemiology, pathophysiology, and pain manage | JMDH

  https://www.dovepress.com/postherpetic-neuralgia-epidemiology-pathophysiology-and-pain-managemen-peer-reviewed-fulltext-article-JMDH

  At each patient visit, current pain levels, location of pain, and pain quality should be reassessed, and the patients ability to perform daily activities should be discussed. […] A treatment plan combining analgesics with different mechanisms of action may provide the best overall therapeutic effect, particularly the combination of an oral agent with topical lidocaine 5% patch, or a combination of gabapentin with opioids or a TCA. […] Nurses and nurse practitioners are especially crucial in establishing communication with patients and encouraging the initiation of appropriate pain-relieving treatments, leading to better outcomes in patients.

• #137 Postherpetic Neuralgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493198/

  Traditional non-invasive treatments include oral and topical medications. […] The American Academy of Neurology (AAN), Special Interest Group on Neuropathic Pain (NeuPSIG), and European Federation of Neurological Societies (EFNS) all recommend an oral tricyclic antidepressant (TCA), pregabalin, and the lidocaine 5% patch as first-line therapies. […] The leading cause of discontinuing capsaicin treatment is pain and irritation at the application site, suffered by almost all users in proportion to the capsaicin concentration. […] The degree of overall pain reduction is generally less than the lidocaine 5% patch. […] Therefore, multimodal therapeutic approaches recommended by expert consensus should be considered. […] Considering that postherpetic neuralgia is difficult to treat and outcomes are variable, prevention is of paramount importance. […] An interprofessional approach to managing patients with postherpetic neuralgia is the best way forward.

• #138 Postherpetic Neuralgia (Nerve Pain After Shingles) | Doctor

  https://patient.info/doctor/postherpetic-neuralgia-pro

  Amitriptyline is the most widely used, or nortriptyline as an alternative. […] Gabapentin and pregabalin have been shown to reduce pain and improve sleep patterns in patients with PHN. […] Topical lidocaine 5% patches can be considered if oral or other topical treatment is not suitable or is not tolerated. […] The 5% lidocaine medicated plaster has been shown to be as effective as systemic pregabalin in PHN but with an improved tolerability profile. […] There is an increasing body of evidence that botulinum toxin treatment is also effective in managing PHN. […] If the above treatment does not control pain after four to six weeks. […] Patients whose quality of life is being affected. […] The only well-documented means of preventing PHN is the prevention of herpes zoster. […] Vaccination is the most effective way to prevent the occurrence of herpes zoster complications in the elderly, in particular PHN.

• #139 Postherpetic Neuralgia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493198/

  Postherpetic neuralgia (PHN) is the most common long-term complication of varicella-zoster virus (VZV) reactivation. […] This activity will highlight the role of the interprofessional team in understanding vaccination and treatment of patients with this condition. […] Review the importance of improving care coordination among interprofessional team members to improve outcomes for patients with postherpetic neuralgia. […] The most successful treatments are multi-modal, with some researchers/clinicians focusing on prevention in high-risk populations rather than cure because of the debilitating and often refractory nature of PHN in already fragile patient populations. […] Therefore, side effect profiles of interventions take on greater importance. […] There is no one superior treatment regimen; however, expert consensus suggests that multimodal therapy is likely the best approach.

• #140 Postherpetic neuralgia: epidemiology, pathophysiology, and pain manage | JMDH

  https://www.dovepress.com/postherpetic-neuralgia-epidemiology-pathophysiology-and-pain-managemen-peer-reviewed-fulltext-article-JMDH

  At each patient visit, current pain levels, location of pain, and pain quality should be reassessed, and the patients ability to perform daily activities should be discussed. […] A treatment plan combining analgesics with different mechanisms of action may provide the best overall therapeutic effect, particularly the combination of an oral agent with topical lidocaine 5% patch, or a combination of gabapentin with opioids or a TCA. […] Nurses and nurse practitioners are especially crucial in establishing communication with patients and encouraging the initiation of appropriate pain-relieving treatments, leading to better outcomes in patients.

• #141 Comprehensive nursing care improves symptoms and quality of life in elderly patients with postherpetic neuralgia | Scientific Reports

  https://www.nature.com/articles/s41598-024-69949-5

  Comprehensive nursing care interventions may effectively alleviate clinical symptoms, and diminish levels of depression and anxiety, while improving sleep quality in elderly patients with PHN. […] The aim of this study is to explore the clinical influence of comprehensive nursing care on elderly individuals with PHN. Comprehensive nursing care seeks to address the various physical, psychological, and social aspects of patients’ well-being. By providing holistic and individualized care, this approach is expected to alleviate symptoms, improve functional outcomes, and enhance the overall quality of life for patients suffering from PHN. […] Overall, comprehensive nursing care integrates physical, psychological, social, and educational interventions to address the diverse needs of patients and optimize health outcomes. Research supports the effectiveness of this approach in improving patient satisfaction, enhancing quality of life, and promoting recovery.

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