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Pain Treatments for Postherpetic Neuralgia

Pain Treatments for Postherpetic Neuralgia

About one-third of all Americans get shingles — a viral infection that develops into painful stripes of a blistering rash that follows the path of a nerve. Anyone who’s ever had chickenpox in their life is susceptible to shingles, and up to 18% of people who get shingles end up with ongoing pain for months and years, long after the rash is gone, and this nerve pain can be debilitating.

This pain, called postherpetic neuralgia (PHN), can be severe and debilitating, disrupting your ability to sleep, eat, and perform normal daily activities. For many sufferers, relief is elusive no matter what they try.

Dr. Jay M. Shah at the SamWell Institute for Pain Management in Colonia and Livingston, New Jersey understands the intricate biomechanical factors that cause PHN and knows how to stop them. Here’s a closer look at PHN and the treatments that will finally bring you relief.

Understanding postherpetic neuralgia

If you’ve had shingles, you already know it came from the same virus that caused the chickenpox. The bright red, blistery rash that came with it was extremely painful, and you couldn’t wait for the virus to run its course so you could be free from the agony. But if you’re like many folks who’ve suffered through the shingles experience, that pain never went away, and you now have postherpetic neuralgia.

Postherpetic neuralgia typically affects older adults and presents as stabbing or burning pain, or hypersensitivity in the places where the shingles rash once was. The pain stems from nerve fiber damage that occurred during the height of your shingles infection. 

How to stop the pain of postherpetic neuralgia

You may have tried to ease the pain of PHN with nonsteroidal anti-inflammatory drugs, such as ibuprofen or acetaminophen, with little to no luck. You may even have used some topical creams or ointments that promise to calm the burning pain, but ended up with the same results. 

The reason these, and even prescription medications, don’t work well is that none of them address the fact that your nerves have been damaged. The best these treatments can offer is temporary dulling of the pain.

We have a better solution — three, actually.

1. Nerve blocks

With every touch and sensation, your nerves communicate messages to your brain conveying changes in temperature, pressure, and of course, pain. 

When you have PHN, your nerves misfire and send pain messages indiscriminately. While medication may bring a measure of relief for a short while, the source is still a damaged nerve that can’t be quelled by oral drugs.

Instead, Dr. Shah may suggest an image guided nerve block, an injection of medication that numbs the affected nerves. Once the medication bathes the damaged nerves, your pain stops immediately.

However, nerve blocks provide more than just pain relief; they enable Dr. Shah to pinpoint your nerve pain so he can target them under live xray or ultrasound with longer-lasting and more advanced interventional treatments. 

2. Spinal cord stimulation

Using a nerve block as a diagnostic tool to locate the exact source of your postherpetic pain, Dr. Shah may suggest a more permanent solution — spinal cord stimulation (SCS)

SCS works by disrupting the pain signals between your nerves and your brain using low-voltage electrical energy. To accomplish this, Dr. Shah implants very small leads in your back that carry the electrical energy directly to the targeted nerves, thus providing long term, medication free pain relief. 

He always starts this treatment with a  7-day trial period that includes an external device you wear on your clothing. After about a week, if you’ve experienced at least 50% pain relief or better, Dr. Shah implants the small device in your low back/flank area and connects the leads from the generator to help modulate and heal the nerves that typically cause intense pain. 

For many PHN sufferers, this makes a huge difference in their pain level and allows them to resume their active lifestyle again.

3. Dorsal root ganglion stimulation

Like SCS, dorsal root ganglion (DRG) stimulation involves an implanted device with electrical leads that send low-voltage currents to your nerves — but it targets a very different area.

Each of your nerve roots funnels its sensory messages to a bundle of nerve cell bodies called the dorsal ganglion root in your epidural space. So, by targeting your DRG instead of your peripheral nerves, Dr. Shah can focus the treatment and provide pain relief in precise locations on your body, including those affected by postherpetic neuralgia.

The procedure is similar to SCS, including a week-long trial period. 

If you battle with PHN and nothing seems to work, schedule a consultation with Dr. Shah to find out if you’re a good candidate for a nerve block, SCS, or DRG stimulation. Book your appointment online, or call our friendly staff today, and you could be out of pain soon. 

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