Post-herpetic neuropathy/shingles

Shingles is characterised by a painful, stripe-shaped rash with many small blisters on one side of the body; the blisters appear in the area supplied by the spinal nerve that is affected, the so-called dermatome.
The condition is triggered by the Varicella zoster virus (VZV) and is more common among older and immunodeficient people. Children usually catch it at nursery school, and get chicken pox. Stress, difficult living conditions or illness cause the reactivation of an earlier VZV infection. The virus multiplies so much in the nerves that it comes out of the nerve endings and collects in the blisters. When this happens, some nerves are destroyed. This causes a burning pain and sometimes severe pain in the nerve itself and in the area of the skin that is served by the bundle of nerve fibres affected.

The pain is accompanied by fatigue, tiredness and feeling ill. The pain starts before the changes in the skin are noticeable. Small red patches on the skin turn into small blisters that burst before drying out and scarring. The shingles usually appears in the chest area, but the face – in particular the eyes – the arms, legs and genitals can be affected.

The condition is treated with Aciclovir, Brivudin, Famciclovir or Valaciclovir tablets. In cases with complications involving the eyes, ears or spinal cord, intravenous therapy is needed. Painkillers are also administered. Four to five weeks after the blisters become scabs, around 30 % of patients develop widespread or localised severe pain, which is called post-herpetic neuralgia. Treating this pain requires a combination of different painkillers (analgesics, anti-depressants and neuroleptics). Pain relief plasters can also be used. If they do not help, electric devices are used to block the pain at the level of the spinal cord – neurostimulation (SCS).

We are very experienced in giving this therapy, in addition to nerve root blocks, and would be more than happy to advise you about existing alternatives.