More than just a bad case of shingles

Could you be at risk of contracting the painful condition postherpetic neuralgia?

22 April 2015
by Ruth Rehbock

Its name is quite a mouthful, but postherpetic neuralgia (PHN) is an intensely debilitating pain brought on by a previous attack of shingles (medically known as herpes zoster), even if the last time you had it was as chickenpox when you were a child.

Normally, PHN sufferers have PHN for one to two months, while about a third have symptoms that last about three months. Only around one fifth of people with PHN have it for a year or longer.

“A most distressing form is the Trigeminal neuralgia (tic douloureaux) where there are brief paroxysms of searing pain. This is felt in the distribution of one or more branches of the trigeminal nerve in the face,” says Dr Vanessa Cockram, a GP based in Joburg.

To prevent getting postherpetic neuralgia means you never had chickenpox, or you have very good immunity against the chickenpox virus (medically known as the varicella-zoster virus). One of the ways of preventing chickenpox or only getting a mild dose is to have the vaccine against varicella-zoster virus.

In 2005, experts conducted a trial of the chickenpox vaccine for people aged 60. They proposed that the vaccine given later in life would boost their immunity against the virus. The scientists thought that the vaccine may help to reduce the risk of older individuals contracting shingles.

And they were right. The trial showed that there were fewer cases of shingles and PHN in older people who had the vaccine.

In 2011, experts conducted a larger study. They compared 75 000 older people who had been immunised against more than 200 000 who had not. It was found that in the immunised group that the rate of shingles was only six per 1000 per year compared with 13 per 1000 for the group that was not immunised.

Complications of PHN include a change in lifestyle as a sufferer may become reliant on or addicted to pain medications. They may be unable to get enough sleep or be unable to exercise because of constant pain. They may have to limit other activities too. They may not be able to touch or even allow anything to touch the affected area.

Constipation is another complication of PHN, caused by opioids – the pain medication they would be using. It has been noted that in very few cases of PHN, people also suffer from weak muscles.

While coping with PHN is not easy, it’s important to remember that most cases only last a few months. If possible, speak to your doctor about prescribing more local pain relievers such as topical creams in order to avoid the negative effects of taking too many heavy painkillers.