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Home > Post-Herpetic Neuropathy – Part I

Post-Herpetic Neuropathy – Part I

Jenny L.F. Andrus, MDJenny L. F. Andrus, MD 

In my practice as a busy Interventional Pain Management Specialist, I treat patients who suffer from a wide variety of painful issues, whether it be from injury, aging or from an illness, acquired condition or inherited disease.  Many of these problems become chronic because of the nature of the illness or disease state.  Post herpetic neuropathy (PHN) is a condition like that because it’s caused by damage to the nerves after shingles – caused by a form of the herpes virus. Its hallmark symptom is pain, often severe and debilitating, called post herpetic neuralgia (PHN).

What Causes Post-Herpetic Neuropathy?

According to the CDC, about a million people in the United States will get shingles (varicella zoster) this year and that statistic holds true each year.  That means one out of three Americans will develop shingles in their lifetime.  However, to develop shingles, you must have had chickenpox at some point in your life or have been exposed to the virus through direct contact with fluid from shingles blisters.  This virus remains dormant in your nerve cells and becomes reactivated many decades later, by some triggering event, illness or simply aging and a waning auto-immune response.

If you’ve ever had a cold sore develop on your lip, you’re familiar with the burning, tingling, weird feeling of the herpes virus in action.  That weird feeling usually develops one to two days before the tell-tale rash with the blisters of shingles. The patient may also develop a fever, chills, upset stomach or headache.  The blistering shingles rash occurs in clusters on the face, ears, neck, and torso, and typically in great abundance.  In addition to the rash, the burning, tingling areas will turn red and then develop into bumps, which then turn into fluid-filled blisters, which ooze and crust over. Imagine having painful blisters all over your neck, chest and torso and trying to work, sleep or do the simplest of tasks during the day.  Shingles pain has been described as some of the most uncomfortable misery possible for a human being to suffer. Luckily, it resolves within a few weeks, with proper medical attention.

What are the Symptoms of Post-Herpetic Neuropathy?

Eventually, the crusty lesions dry up and slowly go away. For some patients, the healed lesions can leave nerve damage in their wake, called post herpetic neuropathy.  The nerve damage results in a painful condition called post herpetic neuralgia, which can feel like burning, lightning bolts or electric shocks, shooting or stabbing pain, which can be intermittent or constant.  The nerve pain may leave temporarily and return, or it may never leave.

In the next article in this series, I’ll discuss who’s at risk for post-herpetic neuropathy and how it is diagnosed.


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