September 2006, Volume 36 Number 9 , p 25 - 26
D'ARCY, YVONNE CRNP, CNS, MS
“IT FEELS AS IF a blowtorch is burning my chest.” That's how one patient described the extreme pain of postherpetic neuralgia (PHN), a lingering complication of shingles (herpes zoster). According to recent research, promptly treating shingles with antiviral medication cuts a patient's risk of developing PHN in half. In this article, I'll discuss how to intervene when a patient has shingles to lessen his risk of PHN. Then I'll outline what to do for a patient who has PHN.
Without antiviral treatment, 40% of patients with shingles will develop PHN; with antiviral treatment, this figure drops to 20%. Research also suggests that patients who have severe pain with a shingles outbreak are more likely to develop PHN and that aggressive pain management with topical agents, tricyclic antidepressants, opioid medications, or anticonvulsant drugs early in the course of shingles may lessen PHN pain ...