Post-Herpetic Neuralgia

Overview

Post-herpetic neuralgia (PHN) is a painful nerve condition that can develop after a shingles infection. It occurs when the varicella-zoster virus, responsible for chickenpox and shingles, damages nerves, leading to persistent pain and sensitivity in the affected area. PHN can significantly impact quality of life, especially in older adults.

At Royal Buckinghamshire Hospital, we offer expert neurological care and pain management strategies to help patients manage PHN effectively.

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Causes of Post-Herpetic Neuralgia

PHN occurs as a complication of shingles (herpes zoster), typically after the visible rash and blisters have healed. The virus can damage peripheral nerves, leading to long-lasting or even permanent nerve pain.

Risk factors include:

• Age over 50
• Severe or widespread shingles rash
• Delayed treatment of shingles
• Pre-existing health conditions affecting the immune system

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Symptoms of Post-Herpetic Neuralgia

The hallmark symptom is persistent nerve pain in the area where the shingles rash occured, which may include:

• Burning, stabbing or shooting pain
• Heightened skin sensitivity (even light touch causes pain)
• Tingling, numbness or itching
• Ongoing pain lasting for months or even years
• Sleep disturbances or mood changes due to chronic pain

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Diagnosis

PHN is diagnosed based on:

• Medical history, especially recent shingles infection
• Physical examination to assess nerve pain and skin sensitivity
• Neurological assessment, if necessary, to rule out other causes of nerve pain

No specific tests are usually required unless other neurological concerns are present

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Treatment & Pain Management

While there is no cure for PHN, a combination of treatments can help relieve symptoms and improve quality of life:

• Neuropathic pain medications, such as gabapentin or pregabalin
• Topical treatments, including lidocaine patches or capsaicin cream
• Antidepressants (e.g., amitriptyline) to manage nerve pain
• Nerve block injections, in severe cases
• Physiotherapy and rehabilitation to maintain mobility and improve function
• Psychological support for managing chronic pain-related stress

Early treatment of shingles can reduce the risk of developing PHN, making prompt medical attention essential.

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Arranging To Visit A Private GP

If you are experiencing ongoing nerve pain following shingles, our team at Royal Buckinghamshire Hospital is here to help. Early intervention can make a significant difference. Make an appointment with one of our private GPs who can refer you to our specialists. Appointments are available to everyone and can often be booked for the same day. There is no need to be registered with our The Royal Buckinghamshire Hospital, or live locally.

If you have insurance which covers a GP visit, we can in most cases invoice the insurer directly. Where you are paying directly, the cost for a 30 minute consultation is £100.

Any additional costs will always be discussed.