Post herpetic neuralgia

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I had shingles in march 06 . I have a stressful job and busy life. I got acyclovir within 24hours and took time off owrk. AT times my pain was controlled with paracetamol and codeine however aftr 3months thiings were not significantly better so i tried amitryptaline, unfortunately this made me very drowsy. i had 3 sessions of accupuncture which didn't help. Then my Gp tried me on gabapentin. this helped enormously although i owuld still have bad days, recently the gabapentin stopped working despite being at maximum dose . For the last 2 months I have been using lidocaine patches these together with a cognitive behavoiural therpay approach to pain really helps. I would urge anyone with PHN to go to their GP try different medication and alos look at CBT.

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  • Posted

    Acyclovir is for viral infection not for shingles or PHN. 

    Please update your post. 

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  • Posted

    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 (SC) 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 SC 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) or ultrasound peripheral nerve blocks. 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. 

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