What Is Postherpetic Neuralgia?

Anyone who has had a case of shingles is relieved when the rash it causes finally starts to go away. But if you still feel pain even after your skin has cleared up, you might have a condition called postherpetic neuralgia.

About 1 out of 5 people who had shingles will get this lingering effect and doctors don’t know exactly why. The pain can get better after a few months, though some cases last even longer. Medications can help control it.

You should call your doctor if you’ve had shingles and you still hurt after your other symptoms are gone.

People with this condition say it can feel like an electric shock. You may feel tingling along with burning or stabbing sensations. Your skin can be highly sensitive to touch, and you find it hard to wear clothes because of the way they rub on you.

Why Does It Happen?

It is something of a journey from infection to postherpetic neuralgia, and you can think of it in 3 steps.

Step 1: It all starts with a virus called varicella-zoster. You probably know about the first kind of itchy outbreak it causes if you get infected -- chickenpox. After that runs its course, the virus then “hides out” in your nervous system. It can stay that way for many decades.



Step 2: Sometimes this virus reawakens years later and travels along pathways to your skin. Lesions can erupt, often on one side of your torso or face. That’s shingles. Doctors aren’t sure exactly why the virus reactivates.

Step 3: In some cases, shingles can cause inflammation of your nerve fibers and roots and damage them. They can’t send messages from your skin to your brain as they usually do. That scramble of signals can trigger the ongoing pain of neuralgia, and sometimes it can be severe.

You feel the pain in the same areas where the rash broke out. If the pain lasts more than a year, it can become permanent.

Who Gets Postherpetic Neuralgia?

Not everyone who has shingles will have these sharp, ongoing pains afterward. But doctors have found a number of things that can increase your chances of getting it. They include:

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Age: People who are older than 60. Some people from 50 to 59 with certain medical problems that could weaken their immune systems or who have ongoing pain or skin conditions may want to consider the vaccine. Talk to your doctor to find out more if you fall into this group.

Gender: Women seem to get it more than men.

Early symptoms: People who have numbness, tingling, or itching before a shingles rash even appears tend to get the lingering pain later.

Pain at the start: If you had severe pain or rash during the beginning of your outbreak, you have a greater chance of the neuralgia later.

Other health problems: People with ongoing conditions that can weaken the immune system, such as HIV and cancer, seem more likely to get it.

Talk to your doctor if you have ongoing pain long after your shingles rash has gone away. She can come up with a mix of treatments to help you ease the symptoms.

WebMD Medical Reference Reviewed by Carol DerSarkissian on September 13, 2016

Sources

SOURCES:

Mayo Clinic, “Postherpetic neuralgia: Definition,” “Shingles: Causes,” “Postherpetic neuralgia: risk factors.”

National Health Service UK, “Post-herpetic neuralgia.”

University of Maryland Medical Center, “Postherpetic neuralgia: symptoms.”

UCLA Health: “Postherpetic Neuralgia: Symptoms.”

American Academy of Family Physicians: “Shingles.”



Center for Shingles and Postherpetic Neuralgia: "Surgical options for treating postherpetic neuralgia, "Treating shingles with tricyclic antidepressants to lessen the risk of PHN."



Johnson R., BMJ, April 5, 2003.



Neurology: “Risk factors for postherpetic neuralgia in patients with herpes zoster.”



Lyrica: "PNH: How Lyrica Works."



American Family Physician: ”Herpes Zoster and Postherpetic Neuralgia: Prevention and Management.”



NINDS: “Shingles: Hope through Research.”



New England Journal of Medicine: “A Vaccine to Prevent Herpes Zoster and Postherpetic Neuralgia in Older Adults.”



 

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