Excruciating Pain After Shingles

I fully understand your situation. I have had the PHN since getting shingles in 2008. My affected area is from my navel all around to my spine. The pain should ease off, but nothing I have taken makes it go away. The best I have is temporary relief using Aspercreme with 4% Lidocaine cream.I find heat makes me itch, so I limit my tine in summer. Also take warm instead of hot baths. Have you tried any type of topical cream? I had lidocaine patches at the beginning which did help. I took Lyrica then Gabapen. They worked at first but not enough. Wish I had better news. I found getting plenty of rest helps. I found coloring helped...its a good distraction.

Hi appletea

I appreciate your suffering as I went through this painful experience, aft my shingles rash healed.

Initially, I was taking ibuprofen tablets in conjunction with a topical cream to cope with the intense pain. After a couple of months the topical cream was sufficient to relieve much of the pain, so I could manage without analgesics.

My topical mixture is as follows :

250 grams of Invite Vitamin E cream(does not form a skin with continued use).

Two 5 gram tubes of Aciclovir Cream( a cold sore cream for a related virus).

65 grams of Dencorub Heat Gel (26 percent methyl salicylate & 7 percent menthol).

Mix thoroughly, apply sparingly to the affected area, as required for pain relief. Rub in well to obtain maximum affect.

Try this treatment, to overcome the pain. If necessary exchange the heat gel for Dencorub Arthritis Cream, for a different pain relieving agent.

There is unfortunately no cure for PHN, so any long term relief is important for pain control.

Kind regards Ray

I too had shingles in the genital area and rectal area along with my right buttock.  So far, I am on Lyrica 300 mg/day.  It doesn't take away the pain and it makes me loopy.  I find ice works somewhat ( I sit on an ice pack). I also take acetaminophen but am afraid to keep taking it for long periods due to possible liver damage.  I find aromatherapy helps a little with trying to sleep using lavender essential oil.  Sometimes I don't get any sleep at all during the night.  I usually take a short nap in the daytime and I take my ice pack with me. Me neurologist wants me to increase the Lyrica to 500mg but my insurance won't cover more than 300 mg.  I'm still waiting for a phone call from the pharmacy or the doctor to let me know the status. What have you tried so far?

Hi Roberta

Yes the treatment is suitable for all but the most sensitive areas such as close to the eyes. However there is an alternative that should work reasonably well, although I have never tried it.

The alternative is Dencorub Arthritis Cream, which has 10 percent Triethanolamine Salicylate. As it is a lower strength painkiller I would use the full 100gram tube in the mixture. If you find this does not reduce the pain adequately you could perhaps double  

it and test the results. There is no problem with overdosing as this is a topical treatment.

Let me know how you find this treatment if you decide on the alternative treatment.

Kind Regards Ray.

Hi Roberta.

As I have mentioned, I believe it is appropriate for pain relief in all areas, except close to the eyes. 

However, if you are very sensitive, I would recommended the alternative Arthritis Cream, as it is very gentle. It does however have less painkilling properties, so it is necessary to put more into the mixture. 

I would try useing half of the mixture with 100grams of Dencorub Arthritis Cream, and testing it carefully. If, as I believe it will not cause a problem, but relieve the pain, then use it sparingly. If it is too strong then mix it with the other half of the cream. It is a matter of trial and error, as we are all different.

Let me know how effective it is in pain relief, as I have only used the Dencorub Heat Gel.

Kind Regards, Ray.

This is exactly what I am experiencing. I've been diagnosed with shingles however the rash has never showed up. The way you described the pain is exactly what I've been having and I thank you so much as youre the only other person ive heard describe it like this. Its behind my ears and on my neck and jawline. If I even have a hair brush the skin on top of my ear or my shirt rub against my neck/jaw it starts the attack. I am getting around 6 of these a day and am exhausted by the end of it.I feel your pain and would appreciate any info into any follow up you may have had. :-)

I am an Anesthesiology trained Interventional Pain Physician who trained at the Mayo Clinic. 

There is an article in ASIPP Pain Physician magazine that reported early intervention with subcutaneous injection of Lidocaine 1% with Kenalog has significantly reduced pain from PHN shingles and also reduced the percentage of chronic pain from PHN (shingles). This procedure is very easy to perform and can be done by your primary care provider. 

The success of long term relief is based upon how early this modality of SQ injection of local anesthetic and steroid is performed in relation to the diagnosis/discovery of the onset of shingles.

Dealing with chronic PHN pain can be very difficult. As health care providers, we usually utilize oral medication such as Gabapentin, Lyrica, Cymbalta, or older TCA medications such as amitriptyline or Nortriptyline.  We sometimes prescribe Lidoderm or other topical agents such as capsaicin type of creams. These pharmacological agents seems to help some patients with various levels of success.

Sometimes, we perform fluoroscopic guided epidural steroid injections (ESI). If the pain is severe and intractable to less invasive treatment options, we sometime resort to dorsal root ganglion (DRG) or spinal cord stimulation (SCS). 

Information in this article is not to be construed as providing medical care. Please be aware that you should always seek guidance from your health provider for your medical treatment.  

Hope this helps.