Postherpetic
Neuralgia - PHN
Post herpetic neuralgia
(or PHN) is the common complication of the shingles
condition. Every year some one million adults
in the US develop shingles and with increasing
age, approximately 20% of them go on to suffer
post herpetic neuralgia and intractable pain.
Shingles is a viral infection of the nerve roots
causing pain and a band of rash that usually spreads
on just one side of the body. PHN is the third
and chronic phase in the development of the shingles
condition which results in persistent pain lasting
30 days or more after the lesions have crusted.
Both shingles and PHN are caused by a variation
of the herpes
virus, the same virus that also causes genital
herpes (HSV 2)
Postherpetic neuralgia
is a condition that can be more painful than shingles
and in some cases, this pain is intolerable. This
is why it is so important to treat the shingles
condition itself in the early stages so as to
shorten the length of the illness and to reduce
both the severity of the shingles symptoms and
the risk of complications such as PHN.
The pain associated with
postherpetic neuralgia is caused by damage to
the nerves. Nerve fibers send messages from the
skin to the brain but if the nerve fibers are
damaged during an outbreak of shingles, they are
not able to send messages in the normal manner.
The body then perceives these mixed messages as
pain. In most case of PHN, the pain will gradually
resolve with time even though it may take months
or, in the very worst cases, years.
Postherpetic neuralgia
treatment
There is no cure for PHN
and it is difficult to treat. This is another
reason why the shingles condition should be treated
early on so it does not have a chance to develop
into PHN. Postherpetic neuralgia treatment tends
to focus on:
Relieving the pain by
prescribing strong pain relievers.
Ensuring the sufferer
has a good night’s sleep.
Ensuring the sufferer
is not feeling depressed.
Everybody responds in a
different manner to different drugs so any medications
taken by mouth are started in small dosages. Gradually,
the dose is increased until the patient begins
to feel pain relief. If the patient complains
of a side effect, then the dose has to be decreased
again. It is all a matter of the correct balance.
There is a topical pain
reliever which has been approved by the FDA called
Lidoderm. This is applied as a patch, reducing
the pain without numbing the skin. It also acts
as a barrier against pain triggers such as items
of clothing or bed linen. There are no serious
side effects and no interaction with any other
medication.
There is also a natural
healing product made from pure essential oils.
The formula is used to eliminate shingles and
PHN outbreaks while a companion preventative formula
is used in a maintenance program to prevent future
outbreaks and strengthen the immune system. A
weakened immune system is the main cause of shingles
and PHN and is therefore a very important factor.
This product has proved to be very successful
and can be ordered on line.
A further interesting Postherpetic
Neuralgia treatment is the anecdotal testimonies
from PHN sufferers who have suggested that smoking
marijuana relieves the pain in much the same way
as it has been found to relieve the pain of multiple
sclerosis. This has led to the study of cannabinoids
(which are the compounds in marijuana or cannabis)
for a number of nerve disorders, including chronic
nerve-related pain. The results of the first study
concluded that it was effective in reducing pain
and had no major side effects.
Home care also forms part
of postherpetic neuralgia treatment and if you
are helping to care for someone suffering from
PHN, you should do everything you can to help
your patient to be as comfortable as possible.
Such patients are frequently elderly and in considerable
pain.
Ensure that all the medication
is working properly, particularly anything for
pain. Liaise with the doctor if you have concerns;
report any side effects.
Keep clothing
loose and use cool compresses to relieve discomfort
as long as your patient is not sensitive to the
cold.
Think of ways
to relieve the stress such as warm, soaking baths;
medication; playing soothing and relaxing music.
He or she will sleep better if relaxed
Watch out for
sadness and depression.
Encourage your
patient to take regular nourishment even if they
only eat small portions.
Try not to be
upset if they are cross or moody – this
is caused by the pain.
Have regular breaks
from the care of your patient with PHN so that
you return refreshed.
It is important to remember
that in most people who develop postherpetic neuralgia,
the pain will gradually resolve with time.
See also Shingles,
Herpes,
Genital
Herpes
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