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 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.

• #3 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. Risk factors for PHN, including older age, can be found in Table 1. […] 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. In some cases, intrathecal methylprednisolone may be of benefit. Treatment should be individualized based on patient characteristics and the agents adverse effect and drug interaction profile. Consultation with a pain management specialist should be considered for some patients.

• #4 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.

• #5 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. […] There’s no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia gets better over time. […] The symptoms of postherpetic neuralgia are limited to the area of skin where the shingles outbreak first happened. […] The shingles rash is associated with an inflammation of nerves beneath the skin. […] Postherpetic neuralgia happens if nerve fibers get damaged during an outbreak of shingles. Damaged fibers can’t send messages from the skin to the brain as they usually do. Instead, the messages become confused and heightened. This causes pain that can last months or even years. […] Shingles vaccines can help prevent shingles and postherpetic neuralgia. […] With two doses, Shingrix is more than 90% effective in preventing shingles and postherpetic neuralgia.

• #6 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.

• #7 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. […] There’s no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia gets better over time. […] The symptoms of postherpetic neuralgia are limited to the area of skin where the shingles outbreak first happened. […] The shingles rash is associated with an inflammation of nerves beneath the skin. […] Postherpetic neuralgia happens if nerve fibers get damaged during an outbreak of shingles. Damaged fibers can’t send messages from the skin to the brain as they usually do. Instead, the messages become confused and heightened. This causes pain that can last months or even years. […] Shingles vaccines can help prevent shingles and postherpetic neuralgia. […] With two doses, Shingrix is more than 90% effective in preventing shingles and postherpetic neuralgia.

• #8 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.

• #9 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 you constipated (unable to have a bowel movement easily). […] Your provider may recommend skin patches that contain lidocaine (a numbing medicine).

• #10 Shingles Pain Management | Effective Therapy | ProActive Pain Care

  https://proactivepaincare.com/conditions/post-herpetic-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. […] There’s no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia improves over time. […] Postherpetic neuralgia occurs if your nerve fibers are damaged during an outbreak of shingles. Damaged fibers can’t send messages from your skin to your brain as they normally do. Instead, the messages become confused and exaggerated, causing chronic, often excruciating pain that can last months or even years. […] Depending on how long postherpetic neuralgia lasts and how painful it is, people with the condition can develop other symptoms that are common with chronic pain such as: Depression, Fatigue, Difficulty sleeping, Lack of appetite, Difficulty concentrating.

• #11 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. […] 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. […] 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.

• #12 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.

• #13 Post-herpetic neuralgia (PHN; pain after shingles) | Healthengine Blog

  https://healthinfo.healthengine.com.au/pain-after-shingles-postherpetic-neuralgia-phn

  Postherpetic neuralgia (PHN) is a condition where enduring pain continues after a case of shingles (herpes zoster (HZ)) has cleared up. PHN occurs once the HZ rash has healed and there is no inflammation remaining at the site of infection. […] PHN can be a highly distressing and debilitating condition that can negatively affect a persons physical, emotional and social wellbeing. […] People at risk need to be closely monitored so that if HZ occurs, their doctor can immediately intervene. […] The best treatment for PHN is prevention. In order to have the best chance of preventing PHN patients and their doctors must act early once the HZ has presented itself. […] A lifestyle change can make a big difference to treatment success and managing pain in PHN. Lifestyle changes that may help people with PHN include: Avoiding activities, situations and clothing that exacerbate the pain; Learning how to manage the condition and how to cope with the pain and side effects of the treatment; Improving positive outlook by adopting a healthier lifestyle, which also benefits physical and psychological profile; and Modifying thinking patterns in order to reduce stress and anxiety through help with psychotherapy programs such as cognitive behavioural therapy.

• #14 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.

• #15 Postherpetic neuralgia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/postherpetic-neuralgia/diagnosis-treatment/drc-20376593

  Your health care provider will check your skin. They might touch the skin in different places to find the borders of the affected area. […] No single treatment relieves postherpetic neuralgia for everyone. It often takes a mix of treatments to ease the pain. […] Health care providers often prescribe antidepressants for postherpetic neuralgia in smaller doses than they do for depression alone. […] An opioid may be prescribed for postherpetic neuralgia only if safer treatments haven’t worked. […] Shots of steroids into the spine may help some people with postherpetic neuralgia. […] An over-the-counter medicine called capsaicin cream may ease the pain of postherpetic neuralgia. […] For postherpetic neuralgia, questions to ask your doctor include: What treatment do you suggest? And are there other choices? […] Your doctor is likely to ask you questions such as: How bad are your symptoms?

• #16 Postherpetic Neuralgia (Shingles) Specialists in Minnesota

  https://www.nuraclinics.com/conditions/general-body-pain/shingles-postherpetic-neuralgia/

  Postherpetic neuralgia is the most common complication of shingles. It occurs when the nerve fibers damaged during a shingles outbreak continue to send pain signals to the brain even after the rash and other symptoms have cleared. This pain can persist for weeks, months or even years after the rash. […] If you suspect postherpetic neuralgia as a complication of your shingles, seek specialist treatment as soon as possible to avoid living with debilitating pain for longer than you have to. […] If you notice any of these symptoms — especially if you’ve had chickenpox in the past — it’s essential to consult a healthcare professional for proper diagnosis and treatment. […] A definitive diagnosis of PHN is made when the pain in the affected area persists for at least three months following the resolution of the shingles rash.

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

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

  Herpes zoster (commonly referred to as shingles) and postherpetic neuralgia result from reactivation of the varicella-zoster virus acquired during the primary varicella infection, or chickenpox. […] With postherpetic neuralgia, a complication of herpes zoster, pain may persist well after resolution of the rash and can be highly debilitating. […] Patients with postherpetic neuralgia may require narcotics for adequate pain control. Tricyclic antidepressants or anticonvulsants, often given in low dosages, may help to control neuropathic pain. […] About 20 percent of patients with herpes zoster develop postherpetic neuralgia. The most established risk factor is age; this complication occurs nearly 15 times more often in patients more than 50 years of age. Other possible risk factors for the development of post-herpetic neuralgia are ophthalmic zoster, a history of prodromal pain before the appearance of skin lesions and an immunocompromised state.

• #18 Postherpetic Neuralgia (Shingles) Specialists in Minnesota

  https://www.nuraclinics.com/conditions/general-body-pain/shingles-postherpetic-neuralgia/

  Postherpetic neuralgia is the most common complication of shingles. It occurs when the nerve fibers damaged during a shingles outbreak continue to send pain signals to the brain even after the rash and other symptoms have cleared. This pain can persist for weeks, months or even years after the rash. […] If you suspect postherpetic neuralgia as a complication of your shingles, seek specialist treatment as soon as possible to avoid living with debilitating pain for longer than you have to. […] If you notice any of these symptoms — especially if you’ve had chickenpox in the past — it’s essential to consult a healthcare professional for proper diagnosis and treatment. […] A definitive diagnosis of PHN is made when the pain in the affected area persists for at least three months following the resolution of the shingles rash.

• #19 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.

• #20 Postherpetic neuralgia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/postherpetic-neuralgia/diagnosis-treatment/drc-20376593

  Your health care provider will check your skin. They might touch the skin in different places to find the borders of the affected area. […] No single treatment relieves postherpetic neuralgia for everyone. It often takes a mix of treatments to ease the pain. […] Health care providers often prescribe antidepressants for postherpetic neuralgia in smaller doses than they do for depression alone. […] An opioid may be prescribed for postherpetic neuralgia only if safer treatments haven’t worked. […] Shots of steroids into the spine may help some people with postherpetic neuralgia. […] An over-the-counter medicine called capsaicin cream may ease the pain of postherpetic neuralgia. […] For postherpetic neuralgia, questions to ask your doctor include: What treatment do you suggest? And are there other choices? […] Your doctor is likely to ask you questions such as: How bad are your symptoms?

• #21 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 above three medical societies recommend opioids as either first or second-line treatments, which underscores the pain-reducing capability of this medication class. […] The mainstay of prevention is the vaccination against HZV. […] Preventative vaccination of at-risk populations may ultimately prove to be the safest and most efficacious approach to addressing the significant morbidity associated with PHN. […] 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.

• #22 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 (Neurontin) and pregabalin (Lyrica) can be used for treatment of postherpetic neuralgia. Amitriptyline, nortriptyline (Pamelor), and desipramine can be used for pain relief in patients with postherpetic neuralgia (number needed to treat = 3; 95% confidence interval, 2 to 4). […] 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.

• #23 Postherpetic neuralgia – aftercare: MedlinePlus Medical EncyclopediaLock

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

  Zostrix, a cream that contains capsaicin (an extract of pepper), may also reduce your pain. […] Two other types of prescription medicines may help reduce your pain: […] Anti-seizure medicines, such as gabapentin and pregabalin, are used most often. […] Medicines to treat pain and depression, most often ones called tricyclics, such as amitriptyline or nortriptyline. […] You must take the medicines every day. […] Sometimes, a nerve block can be used to temporarily reduce pain. […] 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.

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

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

  Treatment of acute shingles with antiviral agents (ie, acyclovir, valacyclovir, famciclovir, brivudin) within 72 hours of rash appearance has some effect at preventing the subsequent development of PHN. […] Vaccination has been shown to markedly decrease the morbidity associated with HZ and the incidence of PHN for a mean duration of at least 3 years. […] The HZ vaccine has been approved by the US Food and Drug Administration (FDA) and by the European Medicines Agency (EMA) for individuals aged 50 years and older. […] Several of the same classes of drugs used for painful DPN can be used to treat PHN. […] Tricyclic antidepressants (TCAs) are recommended as first-line therapy for PHN. […] Gabapentin is another recommended first-line therapy for PHN. […] Pregabalin is recommended by the American Academy of Neurology as a level 1 treatment for PHN.

• #25 Postherpetic neuralgia – aftercare: MedlinePlus Medical EncyclopediaLock

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

  Zostrix, a cream that contains capsaicin (an extract of pepper), may also reduce your pain. […] Two other types of prescription medicines may help reduce your pain: […] Anti-seizure medicines, such as gabapentin and pregabalin, are used most often. […] Medicines to treat pain and depression, most often ones called tricyclics, such as amitriptyline or nortriptyline. […] You must take the medicines every day. […] Sometimes, a nerve block can be used to temporarily reduce pain. […] 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.

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

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

  Treatment of postherpetic neuralgia — Treatment is available to reduce pain and maintain quality of life in people with postherpetic neuralgia (see 'Postherpetic neuralgia’ above). Treatment generally begins with a medication used to prevent seizures. If that doesn’t work, a low-dose tricyclic antidepressant and/or topical treatment may be used. On occasion, prescription opioid medications may be prescribed temporarily. […] Anti-seizure medications — Medications that are traditionally used to prevent seizures, called anticonvulsants, can sometimes reduce the pain of postherpetic neuralgia. Anticonvulsants commonly used for postherpetic neuralgia include gabapentin (sample brand name: Neurontin) and pregabalin (sample brand name: Lyrica). […] Tricyclic antidepressants — Tricyclic antidepressants (TCAs) are commonly used to treat the pain of postherpetic neuralgia. The dose of TCAs is typically much lower than that used for treating depression. It is believed that these drugs reduce pain when used in low doses, but it is not clear how the drug works.

• #27 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 you constipated (unable to have a bowel movement easily). […] Your provider may recommend skin patches that contain lidocaine (a numbing medicine).

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

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

  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. […] 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.

• #29 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.

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

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

  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.

• #31 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 you constipated (unable to have a bowel movement easily). […] Your provider may recommend skin patches that contain lidocaine (a numbing medicine).

• #32 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.

• #33 Postherpetic neuralgia – aftercare: MedlinePlus Medical EncyclopediaLock

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

  Zostrix, a cream that contains capsaicin (an extract of pepper), may also reduce your pain. […] Two other types of prescription medicines may help reduce your pain: […] Anti-seizure medicines, such as gabapentin and pregabalin, are used most often. […] Medicines to treat pain and depression, most often ones called tricyclics, such as amitriptyline or nortriptyline. […] You must take the medicines every day. […] Sometimes, a nerve block can be used to temporarily reduce pain. […] 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.

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

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

  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. […] 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.

• #35 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 (Neurontin) and pregabalin (Lyrica) can be used for treatment of postherpetic neuralgia. Amitriptyline, nortriptyline (Pamelor), and desipramine can be used for pain relief in patients with postherpetic neuralgia (number needed to treat = 3; 95% confidence interval, 2 to 4). […] 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.

• #36 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. […] 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. […] Patients should be educated on appropriate dosing, titration if applicable, the importance of adherence to treatment, and possible side effects. […] 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. […] 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.

• #37 Relieve Shingles and Postherpetic Neuraligia – Premier Med Group

  https://premiermedgroup.com/pain-conditions/shingles-pain/

  Postherpetic Neuralgia (PHN) is a severe, persistent pain condition that can occur following an outbreak of shingles, a reactivation of the varicella-zoster virus. […] The risk of developing PHN increases with age as the immune system naturally weakens, leading to the potential reactivation of the virus. […] Regarding treatment, patients may consider nerve blocks for managing shingles pain. […] Nerve blocks applied during the acute phase of herpes zoster infection (Shingles) can help shorten the duration of zoster-related pain. […] Somatic blocks, including paravertebral and repeated or continuous epidural blocks, are also recommended to prevent PHN. […] Nerve block injections interrupt pain signals sent to the brain, providing relief for shingles and PHN patients. […] Administering nerve blocks during the acute phase of herpes zoster can shorten the duration of zoster-related pain.

• #38 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.

• #39 Relieve Shingles and Postherpetic Neuraligia – Premier Med Group

  https://premiermedgroup.com/pain-conditions/shingles-pain/

  Somatic blocks, including paravertebral and repeated or continuous epidural blocks, are often used in PHN prevention. […] Nerve block injections are crucial in alleviating Shingles Pain and Postherpetic Neuralgia (PHN). […] Pain management specialists evaluate eligibility for nerve block injections as a treatment option for individuals with Shingles Pain and Postherpetic Neuralgia (PHN). […] Nerve block injections are primarily a treatment option for managing existing Shingles Pain and Postherpetic Neuralgia (PHN) rather than for prevention. […] Multiple studies have shown positive outcomes, with pain reduction and improved quality of life reported by patients. […] The specific type of nerve block injection chosen depends on the location and severity of the pain experienced by the individual.

• #40 Shingles & Postherpetic Neuralgia – Ainsworth Institute

  https://ainsworthinstitute.com/conditions/shingles-and-postherpetic-neuralgia/

  The main goals for shingles is to relieve acute pain and prevent postherpetic neuralgia. To this aim, there are a number of medication options: […] Treating PHN can be extremely difficult, so every effort should be made early on to prevent it. Even with the treatments currently available, it is rare for one to make a complete recovery from PHN and become totally pain free. The most effective treatment algorithms are those which employ a comprehensive and multidisciplinary approach. The application of select medications combined with interventional pain management treatments offers the best chances for those afflicted with PHN to regain their lives and most effectively treat their pain. […] Choosing the right pain management doctor is crucial to have the best chance of success in beating shingles and PHN. The board certified physicians at the Ainsworth Institute are recognized leaders in the field schedule a consultation today with one of our experts and take the first step toward taking your life back.

• #41 Postherpetic neuralgia – aftercare: MedlinePlus Medical EncyclopediaLock

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

  Zostrix, a cream that contains capsaicin (an extract of pepper), may also reduce your pain. […] Two other types of prescription medicines may help reduce your pain: […] Anti-seizure medicines, such as gabapentin and pregabalin, are used most often. […] Medicines to treat pain and depression, most often ones called tricyclics, such as amitriptyline or nortriptyline. […] You must take the medicines every day. […] Sometimes, a nerve block can be used to temporarily reduce pain. […] 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.

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

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

  Sometimes, a nerve block can be used to temporarily reduce pain. […] 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.

• #43 Post-herpetic neuralgia (PHN; pain after shingles) | Healthengine Blog

  https://healthinfo.healthengine.com.au/pain-after-shingles-postherpetic-neuralgia-phn

  Postherpetic neuralgia (PHN) is a condition where enduring pain continues after a case of shingles (herpes zoster (HZ)) has cleared up. PHN occurs once the HZ rash has healed and there is no inflammation remaining at the site of infection. […] PHN can be a highly distressing and debilitating condition that can negatively affect a persons physical, emotional and social wellbeing. […] People at risk need to be closely monitored so that if HZ occurs, their doctor can immediately intervene. […] The best treatment for PHN is prevention. In order to have the best chance of preventing PHN patients and their doctors must act early once the HZ has presented itself. […] A lifestyle change can make a big difference to treatment success and managing pain in PHN. Lifestyle changes that may help people with PHN include: Avoiding activities, situations and clothing that exacerbate the pain; Learning how to manage the condition and how to cope with the pain and side effects of the treatment; Improving positive outlook by adopting a healthier lifestyle, which also benefits physical and psychological profile; and Modifying thinking patterns in order to reduce stress and anxiety through help with psychotherapy programs such as cognitive behavioural therapy.

• #44 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/

  In established post-herpetic neuralgia, the aim is to focus on curtailing the neuropathic element of the pain. […] The impact of post-herpetic neuralgia is likely to be lower if tricyclic antidepressants are commenced early in combination with antivirals. […] Patients should be made aware that these drugs are also used for people with depression and that it will take a few weeks of treatment before they will feel the benefits (hence the advantage of starting early). […] Non-pharmaceutical methods of treating post-herpetic neuralgia include protecting the skin from external stimulation by covering the affected area with a clear adhesive dressing. […] Because stress and anxiety exacerbate pain, it makes sense to offer the patient support with relaxation and reassurance as part of the analgesic regimen.

• #45 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 above three medical societies recommend opioids as either first or second-line treatments, which underscores the pain-reducing capability of this medication class. […] The mainstay of prevention is the vaccination against HZV. […] Preventative vaccination of at-risk populations may ultimately prove to be the safest and most efficacious approach to addressing the significant morbidity associated with PHN. […] 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.

• #46 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.

• #47 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) can last for weeks, months, or in some people, years after the shingles rash goes away. […] 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). […] If your shingles outbreak is not caught early, your healthcare providers has many options to manage your postherpetic neuralgia (PHN) symptoms. […] Although there is no cure for PHN, it can be treated. For most people with PHN, pain improves with time and eventually goes away. […] The Food and Drug Administration has approved a shingles vaccine, which can reduce your chance of getting shingles and PHN.

• #48 Shingles Pain Management | Effective Therapy | ProActive Pain Care

  https://proactivepaincare.com/conditions/post-herpetic-neuralgia/

  The Centers for Disease Control and Prevention (CDC) recommends that adults 50 and older get a Shingrix vaccine to prevent shingles, even if they’ve had shingles or the older vaccine Zostavax. Shingrix is given in two doses, two to six months apart. […] The CDC says two doses of Shingrix is more than 90 percent effective in preventing shingles and postherpetic neuralgia.

• #49 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) can last for weeks, months, or in some people, years after the shingles rash goes away. […] 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). […] If your shingles outbreak is not caught early, your healthcare providers has many options to manage your postherpetic neuralgia (PHN) symptoms. […] Although there is no cure for PHN, it can be treated. For most people with PHN, pain improves with time and eventually goes away. […] The Food and Drug Administration has approved a shingles vaccine, which can reduce your chance of getting shingles and PHN.

• #50 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).

• #51 Post-herpetic Neuralgia:

  https://www.patientcareonline.com/view/post-herpetic-neuralgia

  The approach we describe here is guided by the patient’s susceptibility to adverse drug effects, the presence of comorbid illness, and the severity of the disease. Such an approach ameliorates symptoms and increases functional capacity while minimizing risk. […] Post-herpetic neuralgia causes neuropathic pain that is described as burning and paroxysmal and is accompanied by itching and allodynia. […] The pain and dysfunction associated with the condition are generally mild and self-limited but can be severe, long-lasting, and debilitating enough to cause insomnia and impair daily functioning. […] Treatment of shingles with an NSAID or opioid may reduce the risk of post-herpetic neuralgia because of decreased pain intensity. […] Treatment of shingles with amitriptyline helps ameliorate post-herpetic neuralgia (NNT, 5.1), and a low dose is usually well tolerated.

• #52 Post-herpetic neuralgia (PHN; pain after shingles) | Healthengine Blog

  https://healthinfo.healthengine.com.au/pain-after-shingles-postherpetic-neuralgia-phn

  Postherpetic neuralgia (PHN) is a condition where enduring pain continues after a case of shingles (herpes zoster (HZ)) has cleared up. PHN occurs once the HZ rash has healed and there is no inflammation remaining at the site of infection. […] PHN can be a highly distressing and debilitating condition that can negatively affect a persons physical, emotional and social wellbeing. […] People at risk need to be closely monitored so that if HZ occurs, their doctor can immediately intervene. […] The best treatment for PHN is prevention. In order to have the best chance of preventing PHN patients and their doctors must act early once the HZ has presented itself. […] A lifestyle change can make a big difference to treatment success and managing pain in PHN. Lifestyle changes that may help people with PHN include: Avoiding activities, situations and clothing that exacerbate the pain; Learning how to manage the condition and how to cope with the pain and side effects of the treatment; Improving positive outlook by adopting a healthier lifestyle, which also benefits physical and psychological profile; and Modifying thinking patterns in order to reduce stress and anxiety through help with psychotherapy programs such as cognitive behavioural therapy.

• #53 Postherpetic neuralgia – WikEM

  https://www.wikem.org/wiki/Postherpetic_neuralgia

  Postherpetic neuralgia (PHN) is a complication of acute herpes zoster (AHZ), also known as „Shingles” […] PHN can be challenging to treat, and may require trials and titration of various therapies, usually in a primary care or neurology outpatient setting. […] Prevention of PHN by early antiviral therapy for AHZ is a cornerstone of ED management […] Treating shingles with antiviral therapy within 72 hours of rash appearance plays an important role in preventing the development of PHN. […] Given that the pain is often difficult to control, much of the management will occur in a primary care setting, and will often involve trials and titration of multiple agents. […] Usually discharge home with pain management as described above.

• #54 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 improves symptoms and quality of life in elderly patients with postherpetic neuralgia. This study evaluates the clinical impact of comprehensive nursing care on senior patients suffering from postherpetic neuralgia (PHN), a chronic neuropathic pain condition resulting from the reactivation of the varicella-zoster virus. […] 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 management of PHN involves a multidimensional approach that aims to alleviate pain, improve physical and psychological functioning, and enhance the overall quality of life for affected individuals. […] 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.

• #55 Nursing Care Plan For Herpes Zoster – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-herpes-zoster/

  Nursing care for patients with herpes zoster plays a pivotal role in alleviating symptoms, preventing complications, and promoting the overall well-being of the affected individuals. […] A comprehensive nursing assessment for herpes zoster is essential for tailoring care to the patients unique needs and minimizing the risk of complications. […] Nursing diagnoses guide the development of individualized care plans for patients with herpes zoster. […] Nursing interventions for herpes zoster aim to alleviate pain, prevent complications, offer emotional support, and educate patients on managing their condition. […] By providing comprehensive care that addresses physical, psychological, and educational needs, nurses can help patients navigate the challenges associated with herpes zoster and facilitate their recovery.

• #56 7 Herpes Zoster (Shingles) Nursing Care Plans – Nurseslabs

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

  Use this nursing care plan and management guide to help care for patients with shingles. Enhance your understanding of nursing assessment, interventions, goals, and nursing diagnosis, all specifically tailored to address the unique needs of individuals facing herpes zoster. This guide equips you with the necessary information to provide effective and specialized care to patients dealing with shingles. […] 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. […] The following are the nursing priorities for patients with herpes zoster (shingles): Manage acute pain and discomfort.

• #57 7 Herpes Zoster (Shingles) Nursing Care Plans – Nurseslabs

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

  Assessing and monitoring for potential complications is an essential aspect of managing patients with herpes zoster (shingles). […] Pain is a common complication of shingles, and prompt assessment helps in evaluating the effectiveness of pain management interventions, such as medications and non-pharmacological approaches. […] Offer emotional support and education to the patient regarding the potential complications of shingles, including their expected duration and ways to manage discomfort.

• #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

  Overall, comprehensive nursing care integrates physical, psychological, social, and educational interventions to address the diverse needs of patients and optimize health outcomes. […] 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. […] 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.

• #59 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. […] 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. […] Patients should be educated on appropriate dosing, titration if applicable, the importance of adherence to treatment, and possible side effects. […] 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. […] 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.

• #60 7 Herpes Zoster (Shingles) Nursing Care Plans – Nurseslabs

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

  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. […] 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.

• #61 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.

• #62 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 improves symptoms and quality of life in elderly patients with postherpetic neuralgia. This study evaluates the clinical impact of comprehensive nursing care on senior patients suffering from postherpetic neuralgia (PHN), a chronic neuropathic pain condition resulting from the reactivation of the varicella-zoster virus. […] 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 management of PHN involves a multidimensional approach that aims to alleviate pain, improve physical and psychological functioning, and enhance the overall quality of life for affected individuals. […] 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.

• #63 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.

• #64 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.

• #65 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. […] 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. […] Patients should be educated on appropriate dosing, titration if applicable, the importance of adherence to treatment, and possible side effects. […] 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. […] 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.

• #66 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/

  It is imperative that health-care professionals recognise shingles and post-herpetic neuralgia, because early diagnosis and treatment will yield the best results. […] Successful management of post-herpetic requires the use of therapies that specifically relieve nerve pain. Tricyclic antidepressants, gabapentin, topical and non-pharmacological treatments, and psychological support, all have a role to play.

• #67

• #68 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.

• #69 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.

• #70 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. […] 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. […] Patients should be educated on appropriate dosing, titration if applicable, the importance of adherence to treatment, and possible side effects. […] 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. […] 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.

• #71 Post-herpetic Neuralgia:

  https://www.patientcareonline.com/view/post-herpetic-neuralgia

  Gabapentin effectively treats pain and sleep disturbance caused by post-herpetic neuralgia. […] The FDA has approved gabapentin for the treatment of post-herpetic neuralgia, and in 2003 the members of the Fourth Annual Conference on the Mechanism and Treatment of Neuropathic Pain designated gabapentin as a first-line medication for the treatment of post-herpetic neuralgia. […] Three RCTs of the TCAs nortriptyline and amitriptyline demonstrate that they ameliorate post-herpetic neuralgia with a NNT of 2 to 3. […] Prescribing a TCA for post-herpetic neuralgia and comorbid depression effectively treats both conditions. […] Effective treatment of post-herpetic neuralgia often requires multiple medications. […] Combination therapy is a powerful and commonly used approach to post-herpetic neuralgia. In many cases, it is preferable to monotherapy because of the low individual success rates of agents when used alone. […] In addition to medications, some patients use nondrug modalities to treat post-herpetic neuralgia. […] Effective treatment of post-herpetic neuralgia often requires the use of several modalities. A multimodal, multidisciplinary approach might include psychological or behavioral interventions.

• #72 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 you constipated (unable to have a bowel movement easily). […] Your provider may recommend skin patches that contain lidocaine (a numbing medicine).

• #73 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 may also take acetaminophen (such as Tylenol) for pain relief. […] 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). […] Zostrix, a cream that contains capsaicin (an extract of pepper), may also reduce your pain. […] Two other types of prescription medicines may help reduce your pain: […] You must take the medicines every day.

• #74 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. […] 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. […] 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.

• #75 Post-herpetic neuralgia (PHN; pain after shingles) | Healthengine Blog

  https://healthinfo.healthengine.com.au/pain-after-shingles-postherpetic-neuralgia-phn

  Postherpetic neuralgia (PHN) is a condition where enduring pain continues after a case of shingles (herpes zoster (HZ)) has cleared up. PHN occurs once the HZ rash has healed and there is no inflammation remaining at the site of infection. […] PHN can be a highly distressing and debilitating condition that can negatively affect a persons physical, emotional and social wellbeing. […] People at risk need to be closely monitored so that if HZ occurs, their doctor can immediately intervene. […] The best treatment for PHN is prevention. In order to have the best chance of preventing PHN patients and their doctors must act early once the HZ has presented itself. […] A lifestyle change can make a big difference to treatment success and managing pain in PHN. Lifestyle changes that may help people with PHN include: Avoiding activities, situations and clothing that exacerbate the pain; Learning how to manage the condition and how to cope with the pain and side effects of the treatment; Improving positive outlook by adopting a healthier lifestyle, which also benefits physical and psychological profile; and Modifying thinking patterns in order to reduce stress and anxiety through help with psychotherapy programs such as cognitive behavioural therapy.

• #76 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

  Overall, comprehensive nursing care integrates physical, psychological, social, and educational interventions to address the diverse needs of patients and optimize health outcomes. […] 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. […] 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.

• #77 Postherpetic neuralgia – aftercare – UF Health

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

  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. […] Your provider may recommend skin patches that contain lidocaine (a numbing medicine). Some are prescribed and some you can buy on your own at the pharmacy. These may relieve some of your pain for a short time. […] Sometimes, a nerve block can be used to temporarily reduce pain. Your provider will tell you if this is right for you. […] 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.

• #78 Postherpetic neuralgia – aftercare – UF Health

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

  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. […] Your provider may recommend skin patches that contain lidocaine (a numbing medicine). Some are prescribed and some you can buy on your own at the pharmacy. These may relieve some of your pain for a short time. […] Sometimes, a nerve block can be used to temporarily reduce pain. Your provider will tell you if this is right for you. […] 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.

• #79 Postherpetic neuralgia – aftercare: MedlinePlus Medical EncyclopediaLock

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

  Zostrix, a cream that contains capsaicin (an extract of pepper), may also reduce your pain. […] Two other types of prescription medicines may help reduce your pain: […] Anti-seizure medicines, such as gabapentin and pregabalin, are used most often. […] Medicines to treat pain and depression, most often ones called tricyclics, such as amitriptyline or nortriptyline. […] You must take the medicines every day. […] Sometimes, a nerve block can be used to temporarily reduce pain. […] 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.

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

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

  The most common chronic complication of herpes zoster is postherpetic neuralgia. Pain that persists for longer than one to three months after resolution of the rash is generally accepted as the sign of postherpetic neuralgia. […] 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.

• #81 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.

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

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

  If you currently have shingles, you need to wait until the shingles rash has gone away. Talk with your provider about the proper time to begin vaccination with Shingrix. […] PHN tends to happen in older individuals who may have other health conditions, which can complicate treatment and results. Pain can last weeks, months and even longer than a year. In some people, the pain can be debilitating. In most people, PHN lessens with time.

• #83 Shingles and Postherpetic Neuralgia – Facial Pain AssociationIcon / Teal / print@1xicon-heart@1xicon-plane

  https://www.facepain.org/understanding-facial-pain/diagnosis/postherpetic-neuralgia/

  PHN typically starts during the shingles outbreak, but lasts after the rash and blisters have healed. Chicken pox causes shingles later in life. People over the age of 60 have an increased risk of shingles. Treatment for PHN does not cure it, but aims to minimize its symptoms. […] Medication can help to alleviate the pain of PHN, including anti-seizure medications, antiviral agents, antidepressants, and opioid pain relievers. The pain of PHN can be lessened with anticonvulsants, because they are effective at calming nerve impulses and stabilizing abnormal electrical activity in the nervous system caused by injured nerves. Gabapentin, or Neurontin, and pregabalin, also known as Lyrica, are commonly prescribed to treat this type of pain. Topical patches containing lidocaine, or other pain relievers, are also very effective. […] In most cases, the pain will gradually go away. There is a small risk the pain will return intermittently, or be with you for the rest of your life. However, the majority of patients experience no postherpetic neuralgia pain within one year.

• #84 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.

• #85 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/

  It is imperative that health-care professionals recognise shingles and post-herpetic neuralgia, because early diagnosis and treatment will yield the best results. […] Successful management of post-herpetic requires the use of therapies that specifically relieve nerve pain. Tricyclic antidepressants, gabapentin, topical and non-pharmacological treatments, and psychological support, all have a role to play.

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