Postherpetic neuralgia: Causes, treatment, and prevention

Anticonvulsants

The pain of PHN can be lessened with anticonvulsants, because they are effective at calming nerve impulses and stabilizing abnormal electrical activity in the nervous system caused by injured nerves.

Gabapentin, or Neurontin, and pregabalin, also known as Lyrica, are examples of commonly prescribed anticonvulsants for this type of pain.

Steroids

A corticosteroid medication can be injected into the area around the spinal cord.

Injected steroids are effective for patients with PHN and others who experience chronic, or persistent, long-term pain. The patient should not receive this medication until the shingles pustular skin rash has completely disappeared.

Transcutaneous electrical nerve stimulation (TENS)

This treatment involves placing electrodes over the areas where pain occurs. These emit small electrical impulses. The patient turns the TENS device on and off as required.

Some people find that TENS relieves pain, while others do not. Its effectiveness has not been confirmed by research.

Spinal Cord or Peripheral Nerve Stimulation

These devices offer a safe, efficient, and effective way to relieve many types of neuropathic pain conditions. Similar to TENS, they are implanted under the skin along the course of peripheral nerves. Before implantation, doctors do a trial run using a thin wire electrode to determine patient response.

The spinal cord stimulator is inserted through the skin into the epidural space over the spinal cord. The peripheral nerve stimulator is placed under the skin above a peripheral nerve. As soon as the electrodes are in place, they are switched on to administer a weak electrical current to the nerve.

Experts believe that by stimulating the non-painful sensory pathway, the electrical impulses trick the brain into “turning off” or “turning down” the painful signals, resulting in pain relief.
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