How to Treat Nerve Pain After Shingles

For most people, the symptoms of shingles usually fade away along with the rash that may have appeared along one side of their body or face. But for some people, pain persists long after their skin has cleared.

It’s called postherpetic neuralgia, and it’s a complication of shingles. You might feel intense sensations of tingling, burning, and shooting that don’t let up. This could last for 3 months or longer, and you could be sensitive to touch and have trouble wearing clothes.

If you’ve had shingles and you’re hurting weeks or months later, talk to your doctor.

She’ll want to know more about your symptoms and come up with a treatment plan. That can include a mix of medications and other things to give you relief.

What Can I Take to Feel Better?

Your doctor has a host of ways to treat your pain after shingles, including a variety of medications. They include:

Anticonvulsants: These medications were developed to control seizures, but they can also help reduce the pain of postherpetic neuralgia. Examples are:

Carbamazepine (Carbatrol, Equetro, Epitol, Tegretol)

Gabapentin (Fanatrex, Neurontin)

Pregabalin (Lyrica)

Tricyclic antidepressants: These have been shown to help ease the pain of postherpetic neuralgia. They include:

Amitriptyline (Elavil)

Desipramine (Norpramin)

Nortriptyline (Pamelor)

Prescription painkillers: Over-the-counter medicine may be enough for mild cases, but others might need more powerful opioid (narcotic) painkillers, such as:

Hydrocodone with acetaminophen (Lorcet, Lortab, Norco, Vicodin)

• Long-acting hydrocodone (Zohydro ER, Hysingla ER)

Hydromorphone (Dilaudid, Exalgo)

Meperidine (Demerol)

Methadone (Dolophine, Methadose)

• Morphine (Astramorph, Avinza, Kadian, MS-Contin, Oramorph SR)

Oxycodone (OxyContin, OxyFast, Roxicodone)

• Oxycodone and naloxone (Targiniq ER)

• Oxycodone and acetaminophen (Percocet)

Talk to your doctor or pharmacist about side effects of any new prescription or over-the-counter medication.

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Topical Treatments

You might find relief with treatments you put on your skin. You can talk to your doctor about:

Creams: Some of these contain capsaicin, the ingredient in cayenne pepper that gives it a kick. Examples are Capsin and Zostrix. You can buy this over the counter but make sure your doctor knows if you plan on using these.

Patches: Capsaicin is also in Qutenza, which is applied via a patch for one hour every 3 months. You need to visit the doctor’s office for this.

Lidoderm is a patch that has a numbing agent called lidocaine. It’s applied directly to the painful area of skin. You need a prescription.

Other Ways to Ease the Pain

Most people with postherpetic neuralgia use medication to control their symptoms. But there are other ways to control the pain, too. They include:

TENS (transcutaneous electrical nerve stimulation): You use a device that shoots tiny electrical currents into the area of pain on the skin. This helps block the pain.

Cold packs: Try a gel-filled one to numb the area unless cooler objects make your neuralgia worse.

Comfortable clothes: Go for looser fits and fabrics such as cotton and silk.

Can I Prevent It?

The FDA has approved a shingles vaccine. It’s called Zostavax. The vaccine is now recommended for everyone 60 and older. For this age group, it reduces the chance of getting shingles by about one half. People from 50 to 59 may want to talk to their doctor about it if they are having ongoing pain or skin issues or have a weakened immune system.

Even in those who get the vaccination and still develop shingles, the painful period is reduced.

Certain medicines can also reduce the severity of shingles and how long it lasts. The main treatment is with antiviral drugs during the early stages of shingles, within 2 to 3 days of symptoms coming on. Medications used include:

Acyclovir (Zovirax)

Famciclovir (Famvir)

Valacyclovir (Valtrex)

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

Sources

SOURCES:

NIH. National Institute on Aging, “Shingles: How Long Does Shingles Last?”

UCLA Health, “About Postherpetic Neuralgia.”

Mayo Clinic, “Postherpetic Neuralgia: Symptoms.”

National Health Services UK: “Post-herpetic neuralgia – Treatment.”

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.



Jung, B., Neurology, May 2004



Lyrica: "PNH: How Lyrica Works."



Mounsey A., American Family Physician, Sept. 15, 2005.



NINDS:“Shingles: Hope through Research.”



Oxman, M. New England Journal of Medicine, June 2, 2005.



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Food and Drug Administration:“FDA Licenses New Vaccine to Reduce Older Americans’ Risk of Shingles.”



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