Postherpetic neuralgia is basically a complication of shingles. This condition is caused by chicken pox and the risk of getting it increases as you age, especially after you hit your sixties. The condition causes a rash on the skin which comes with burning and itching sensations. These sensations tend to remain even after the rash disappears, making this condition quite frustrating for those who are suffering from it. Unfortunately, there is no cure for this condition. The treatment methods mainly focus on making the condition more bearable for the patients.
Although there is no cure, there are a variety of treatment options available. While no single treatment can help with the condition, it is usually a combination of different treatment types that end up relieving the pain. Doctors most commonly prescribe lidocaine skin patches, capsaicin patches, anti-convulsions, anti-depressants, opiod painkillers, steroids, and occasionally some pain medications that are available over the counter to help with the symptoms. Since there isn’t one specific treatment type that helps, finding the perfect combination to get rid of the symptoms can take a while. This can be very disheartening for patients who are suffering from extreme burning and itching sensations and can even hamper their daily tasks. However, it is important to note that eventually one does come across the correct medication and it can go a long way in pain management.
Oncepostherpetic neuralgia is diagnosed, the treatment can begin. Lidocain skin patches are meant to be used topically on the areas where the infection shows itself. These patches eradicate pain. Capsaicin skin patches are patches that are made of chilli. Though that may sound counterintuitive (rubbing chillies on wounds never sounds like a good idea), these patches help a lot when it comes to relieving pain topically. Unlike the lidocaine patch, these patches cannot be applied at home and can only be applied by someone who is trained to use them. The infected area is numbed before the application, which is why the chillies don’t hurt you.
Anti-convulsion medications are also known to work. Since postherpetic neuralgia is a condition that affects the nerve endings, leading to the rash and itching and burning sensations, the medication can help stabilize abnormal activities in the nerves. Anti-depressants, on the other hand, are prescribed to alter the way your body perceives the pain it feels. It is not just used for people who are depressed. Anti-depressants are prescribed in dosages that are small and manageable so that they don’t play havoc on your mood and emotions.
For some people, the pain can be more intense than others and over the counter medications do not really help too much. If this is the case, your doctor will end up prescribing opiod painkillers to you. These painkillers are extremely strong and can help numb out almost any pain. They may help you manage your pain very well and can even help you lead a normal life.
If you have been diagnosed with postherpetic neuralgia, then you are eligible to try out any of these treatments, per your doctors recommendations.
Anyone who is not diagnosed with postherpetic neuralgia is not eligible to try out any of these treatments. If you just have chicken pox, you cannot use these treatments.
Many of the medications that can be prescribed to help manage postherpetic neuralgia can have certain side effects. If you have been prescribed anti-convulsion medication, then you can expect drowsiness, swelling in the feet, unclear thinking, and unsteadiness. Similarly, anti-depressants can also lead to drowsiness, changes in your mood, dry mouth, weight gain, or even light-headedness. As to be expected, it is the opiod painkillers that come with the most amount of side effects to be vary of. These painkillers can make you feel extremely drowsy. They can even cause some dizziness, constipation, and confusion. Opiod painkillers are also addictive in nature.
The treatment of this condition never truly ends as there is no cure for it. Thus all guidelines given to you by your doctor regarding pain management apply to the rest of your life. Since you will be on so many medications, you may have to watch your diet or bring about certain changes in your lifestyle like avoiding alcohol, operating heavy machinery, and even driving.
The condition lasts for a lifetime, which is why there is no recovery period. However, there are periods in which you will not feel any pain, depending on the pain medication that you are on. For instance, capsaicin patches can lead to pain relief for up to three months in total while opiod painkillers can lead to pain relief for as long as you take the medication.
Most painkillers in India cost anywhere between Rs. 50 and Rs. 200, depending on the make and dosage of the product.
Since there is no permanent cure of this condition, the pain relief that you may feel will also not be permanent. It will last as long as you take your medication.
There are no specific home remedies to dealing with this condition. However, you can try using anaesthetic creams topically as and when you require them. You can also try hot and cold compresses to relieve some of the pain. Soaking in a hot bath with an anti-inflammatory essential oil such as lavender essential oil can also help with some of the symptoms like itching, though not necessarily with the burning. Wearing sock gloves on your hands while you sleep to prevent scratching yourself can also help with pain as you may break the skin while scratching intensely. Finally, you can also try massages to soothe your skin and acupuncture as well, though they can only provide a little bit of relief. Sticking to the treatment plan outlined by your doctor can help you the most.
The condition of persistent pain in the body, where an outbreak of the Varicella Zoster virus has caused Shingles, is termed as post-herpetic neuralgia. It is a debilitating complication of the herpes zoster virus. The blisters that occur in shingles develop a crust formation and neuralgia begins after these crusts are formed. It may also occur in people who do not produce the crustaceous lesions. A burning pain that is long-lasting, even after the rash and the blisters disappear, is observed. There is a criteria of the pain to be persistent for around three months for the confirmation of post herpetic neuralgia.
The cause of this condition is damage of the sensory nerves that can occur due to the movement of the reactivated Herpes Zoster virus from the nerves to the skin. In an individual affected with chickenpox, the infection can involve dorsal root ganglia, where the virus lies dormant. Under conditions like stress due to infection or in an immuno-compromised individual, after a period of time, reactivation of the virus takes place. This reactivation causes production of Shingles on the body. The dormant virus reaches the skin and reactivates to produce lesions.
With an increase in age, the chances of developing post-herpetic neuralgia also increase. It primarily affects older individuals in the age group of 60 to 70 years. Treatment is aimed at pain management and providing symptomatic relief, with improvement of the neuralgia over a period of time. Symptoms of this condition are limited to the area of shingles’ outbreak. Trunk is commonly affected on a unilateral site. It can also occur on face. Common symptoms include pain lasting 3 months or longer after healing of the shingles rash, allodynia, numbness over the affected area and itching. Even a slight touch of cloth over the affected area can cause alleviated pain to the individual. Disturbed sleep and development of clinical depression is usually associated with post herpetic neuralgia. The medications given for post herpetic neuralgia are aimed at pain relief and resolving of symptoms. Management of chronic pain can be brought about by the use of a combination of pain relieving drug classes.
Some commonly used drugs for treatment of post-herpetic neuralgia are as follows:
In case you have a concern or query you can always consult an expert & get answers to your questions!
Typical Trigeminal Neuralgia and Atypical Trigeminal Neuralgia.
The typical form or this disorder results in certain episodes of severe, sudden, shock-like pain in one side of the face, which lasts for seconds to few minutes.
Trigeminal Neuralgia may have symptoms which include one or more of patterns like the following:
A person might come across spontaneous attacks of pain or even attacks which might get triggered by certain things like touching the face, chewing, speaking or even while brushing the teeth.
When trigeminal neuralgia occurs, the trigeminal nerve’s function gets disrupted. The problem occurs through a contact between an artery or a vein and the trigeminal nerve at the base of one’s brain. This contact puts pressure on the nerve, thus causing it to malfunction.
Trigeminal Neuralgia can occur due to people getting aged or due to any kind of disorder that causes damage to the myelin sheath that protects certain nerves. A number of triggers can lead to the pain of trigeminal neuralgia, which include:
What Is Radiofrequency Ablation for Trigeminal Neuralgia?
Radiofrequency Ablation or RFA is a technique by way of surgery, which helps to direct high-frequency heat on to the targeted areas of the body, such as tumors and tissues. When a person suffers chronic pain that means the high-frequency heat is getting targeted to the nerves.
A person suffering from trigeminal neuralgia, would have his or her doctor, who is a neurosurgeon, uses radiofrequency ablation to hit the trigeminal nerve, thereby destroying the nerve’s ability to get the pain signals transmitted to one’s brain.
Medication is the first line of treatment for trigeminal neuralgia by a neurosurgeon, to see how the patient reacts. If that person suffers from severe pain in the face and does not show any improvement through medication, then the doctor might recommend him/her to go for radiofrequency ablation surgery.
How Is The Procedure Conducted?
During the radiofrequency ablation for trigeminal neuralgia, people remain awake and asleep at different times. The process includes:
When the patient is asleep under the influence of general anaesthesia, a neurosurgeon would carefully place a needle through the corner of one’s mouth in order to reach the trigeminal nerve, which lies at the base of the skull. Then, once the X-rays confirm the needle is right in place, the neurosurgeon would wake the patient up, stimulate the nerve and ask the patient if he or she could feel the stimulation exactly at the place where the pain is experienced. This particular step confirms that the doctor has hit the right location. Once, the patient gets back to sleep, the doctor uses radiofrequency heat to minimally injure the nerve, sufficiently enough to induce a numb feeling on the face along with tingling, thus take the pain away.
Trigeminal neuralgia can be best described as an ongoing condition that affects a group of nerves called the fifth cranial nerve which is responsible for sensation in the face. Individuals suffering from this pain say that the pain feels like that of an electric shock and sometimes it becomes unbearably severe. According to medical experts, the trigeminal neuralgia is the acutest pain that an individual can suffer from where the pain mostly affects the lower portion of the face along with the jaw and may also affect the lips, nose, ears and eyes. Trigeminal neuralgia is thought to affect over 1 million people across the world and 1 person in every 15,000 people suffers from this disease.
Understanding the causes of trigeminal neuralgia
The human face comprises of two trigeminal nerves, one on each side of the face and each splits into 3 branches which aid in transmitting sensations of pain as well as a touch from the teeth, mouth, and face to the brain. Most cases of trigeminal neuralgia are said to be triggered by the blood vessels, which sometimes presses the root of the trigeminal nerve. This is known to make the nerve transmit signals which lead to the feeling of stabbing and throbbing pain in the facial regions.
The exertion of pressure on the nerves is mostly caused by multiple sclerosis and tumor and some other suspected causes of trigeminal neuralgia include, pressing of the blood vessel against the root of the trigeminal nerve, demyelization of the trigeminal nerves during the advanced stages of multiple sclerosis, physical damage to the nerve caused by an injury, a surgical procedure or a severe infection, although rare, pressing of a tumor against the trigeminal nerve may also cause it and family history and genetic conditions are also responsible for causing trigeminal neuralgia
Diagnosing trigeminal neuralgia:
If the primary health care provider feels that the symptoms of facial pain are indicative of trigeminal neuralgia, then the patient’s face is required to be examined and evaluated more carefully to detect the affected parts with precision. Other conditions which may have similar symptoms including tooth problems and sinusitis would be eliminated first. Then an MRI scan would be performed which would help understand whether the trigeminal neuralgia is triggered by some underlying medical issues. But the MRI would not be able to reveal the reasons behind the irritation of the nerve unless tumor or multiple sclerosis is the cause. This is because it is not possible to visualize the blood vessel that stands next to the nerve root.
Getting the right treatment for trigeminal neuralgia:
If you wish to discuss any specific problem, you can consult a pain management specialist.
Fried Methi (Fenugreek) 100gm
Haldi (Turmeric) 100gm
Ganthoda (Granthik) 10gm
Mix it properly
Dose: one tea Spoon Morning & Evening
Castrol oil – one tea spoon with warm water/ milk /tea at bed time once or twice in weak
Fried Lahsun- with ghee and take one two prices every day morning.
Fried Methi (Fenugreek) 100gm
Gud (Jagarry) 50gm
Mix it properly and take two tea spoons early morning.