Shingles and nerve pain after shingles

Shingles and nerve pain after shingles

Zona, the term folk known as herpes zoster, is a skin disease with erythema and blisters grow in clusters, usually localized on one side of the body, with a lot of pain. This is a viral infection Herpes zoster (HZ) of acute central and peripheral nervous system, usually only happens on one side of the spinal nerve roots. Disease only occurs in people who have had chickenpox (varicella).


When shingles, patients with a burning sensation of floating in the skin erythema - vesicular beam together enlarged peripheral lymph nodes. Shingles can occur at any age but most often in people over 60 years old. The higher the risk the greater the age, the lesions usually appear only on one side of the body and can heal in 2-4 weeks. Early treatment of shingles within 2 - 3 days after erythema appeared to reduce the severity of the disease and may reduce the risk of post-shingles pain.

In 20% of patients with shingles, most of them over 60 years, the disease can cause symptoms of pain lasting for months or even years after the skin lesions have healed. This complication is known as nerve pain after shingles.

Nerve pain after shingles there is no specific treatment that mainly reduces pain. Common painkillers such as: paracetamol, nor-amidopyrine ... almost no effect. Medication is often indicated for the treatment of antidepressants, anti-seizure drugs or topical paste with lidocaine.

Drugs qutenza as you say the new Administration U.S. Food and Drug Administration (FDA) officially approved for use in the treatment of nerve pain following shingles. Qutenza is a patch containing 8% capsaicin (an ingredient found in peppers). Qutenza be affixed to the skin shingles pain and work as an effective analgesic for patients with neuropathic pain following shingles. Some side effects may experience itching, redness, swelling, or increase the burn sensation Telling the drug. Each patch qutenza contains 8% capsaicin (640 mcg/cm2), equivalent to 179mg capsaicin.
Many studies indicate that the quality of life in patients with shingles reduce the pain after shingles. Treatment of nerve pain following shingles is still difficult for conventional anti-inflammatory painkillers. So antidepressants 3 rounds and anti-epileptic drugs have been used in the treatment of nerve pain following shingles and good efficiency, improve the quality of life for patients.
Tricyclic antidepressants

Antidepressants 3 rounds (tricyclic Antidepressants) are groups to aromatic synthetic drugs 3 rounds. 3 types of drugs are: dibenzazepin (imipramine), dibenzocyclohepten (amitriptyline) or dibenzoxepin (doxepin). With anti-depressants, the anxiety and is indicated mainly in specialized mental, for those who suffer from depression. However, this class of drugs has nerve pain relief should be used in the treatment of nerve pain following shingles.

Amitriptyline mechanism of action to inhibit re-enter monoamine, serotonin and noradrenalin in monoaminergic neurons. In addition, amitriptyline anticholinergic effects in both the central and peripheral nervous.


Drug is contraindicated for people recovering from myocardial infarction, congestive heart failure, pregnant women and nursing mothers, children under 12 years of age. Should be avoided in combination with the following drugs: combined phenothiazine risk of seizures; hormones, birth control pills increase the effect of amitriptyline; combination of anticoagulants may enhance the effect of anticoagulants on 3 times; combined cimetidine can cause poisoning amitriptyline; combined with antihypertensive drugs such as clonidine, guanethidin, guanadrel reduce the antihypertensive effect; drug combination sympathomimetics can disrupt blood pressure, cardiac arrhythmias .

Amitriptyline is used with common side effects are fatigue, drowsiness, headache, tinnitus, cardiac arrhythmias, blood pressure, digestive disorders, nausea, vomiting, dry mouth, urinary retention. Due to the side effects of medications should use caution in the elderly, hyperthyroidism, urinary retention, glaucom angle closure, glaucoma, liver failure, kidney failure. It can cause sleepiness, drowsiness, avoid operating vehicles while taking the drug.

Antiepileptic drugs

In the treatment of nerve pain following shingles, anti-seizure drugs are also commonly used to treat pain. Anticonvulsant drug gabapentin is indicated primarily for the treatment of epilepsy and neuropathic pain, including postherpetic neuralgia shingles. However, caution should be used in the following cases: children under 12 years of age, pregnant women and nursing mothers. For people older than 65 years old, patients with renal impairment dose reduction.

Using gabapentin may have unwanted side effects such as drowsiness, dizziness, ataxia, headache, double vision, nausea and / or vomiting, rhinitis. Do not use the drug for the control and operation of vehicles.

In many cases, nerve pain after shingles, the above medications alone do not control the pain. These cases have a combination of nonsteroidal anti-inflammatory pain medications (NSAIDs), antidepressants and anticonvulsants. Besides, the use of additional sedative at night to help the patient to go to sleep. A number of measures to physiotherapy also good support in the treatment of nerve pain following shingles as electrical pulses, spectrum, ultrasound.