Ever heard of a condition called post-herpetic neuralgia (PHN)? In fact, postherpetic neuralgia is a very disturbing condition due to the pain it causes, and sometimes it appears after your body has been exposed to the shingles virus. The pain that accompanies postherpetic neuralgia generally appears in the area of the body affected by the rash, and is usually felt along the nerve pathways on one side of the body. While a painful, itchy, blistering rash is the main characteristic of a shingles infection, sometimes nerve pain can also be a symptom. In many cases, the initial symptom of herpes zoster is the appearance of a tingling or burning sensation on the skin and according to experts, there are three ways you can do to treat the nerve pain that accompanies a herpes zoster infection, namely: treating the infection, controlling the pain that appears, and reduce the risk of complications.
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Part 1 of 5: Relieves Pain and Itching From Herpes Zoster
Step 1. Don't scratch the blister
As difficult as it is, don't touch the blister, let alone scratch it. After all, over time, the blisters will dry up and peel off on their own. If you scratch, the blisters will actually open again and become more susceptible to infection!
Scratching the blisters will also spread bacteria all over the surface of your hands. If you have already done so, don't forget to wash your hands afterwards to keep the environment around you clean
Step 2. Apply a baking soda paste to relieve irritation
Baking soda has a pH greater than 7 and, therefore, is alkaline. As a result, baking soda has the ability to neutralize acidic chemicals, precisely with a pH below 7, and relieve itching caused by it.
- Apply a paste made from the mixture of 3 tsp. baking soda with 1 tsp. water. After that, the itching should subside and the blisters will dry up faster.
- Baking soda paste can be applied as often as possible to relieve itching that appears.
Step 3. Compress the blister with a cold pad
Apply a cool, damp compress to relieve discomfort for 20 minutes, several times a day.
To make a cold compress, you can wrap a plastic bag filled with ice cubes in a clean towel, then apply it to your skin. If you want, the role of ice cubes can also be replaced with frozen vegetable packaging. Most importantly, make sure the skin is not compressed for more than 20 minutes to avoid tissue damage
Step 4. Apply benzocaine cream to the blister area after the skin compress
One type of topical cream that can be applied immediately after the skin is compressed is a benzocaine cream that can be purchased without a doctor's prescription. In particular, benzocaine works as a local anesthetic capable of numbing the nerves under the skin.
Alternatively, you can also ask your doctor to prescribe a 5% lidocaine patch. Apply the bandage over the painful area, as far as the tape is attached to the skin, not to the wound. If necessary, you can apply up to 3 tapes at a time, and wear them for up to 12 hours a day
Part 2 of 5: Dealing with Infectious Wounds
Step 1. Recognize the symptoms of an infected wound
Infection indicates that the wound has deteriorated. That is why, you should immediately consult a doctor if you feel you are experiencing it. Some of the symptoms to watch out for are:
- Fever
- Increased intensity of inflammation that triggers additional pain
- The wound feels warm to the touch
- The wound surface looks smooth and shiny
- The occurrence of worsening of symptoms
Step 2. Soak the infected wound in Burow's solution
To reduce abnormal fluid production from the wound, clean the irritated layer, and soothe the skin, you can soak the infected area in Burow's solution.
- Burow's solution contains antibacterial and astringent properties and can be purchased without a prescription at most pharmacies.
- Instead of soaking the wound, you can also compress the wound with Burow's solution using a cold pad for 20 minutes, several times a day.
Step 3. Apply capsaicin cream after the blister has dried
Once the blister appears to be covered with a dry layer, try applying a capsaicin cream such as Zostrix to the area. Do this up to 5 times a day to speed up the wound healing process.
Part 3 of 5: Taking Medication After Blisters Are Gone
Step 1. Apply lidocaine tape
Once the blister is gone, you can apply a 5% lidocaine patch to the affected skin area to relieve any remaining nerve pain. The medicinal plaster is able to relieve pain effectively without pocketing the risk of negative side effects.
Lidocaine plasters can be purchased at most pharmacies and online health stores. If you need a higher dose, try asking your doctor for a prescription
Step 2. Try taking a non-steroidal anti-inflammatory drug to relieve any remaining pain
In addition to narcotic drugs, non-steroidal anti-inflammatory drugs are often prescribed to make the pain subside faster. The price of these drugs is usually not expensive. In fact, chances are you already have one at home!
Some examples of nonsteroidal anti-inflammatory drugs are acetaminophen, ibuprofen, or indomethacin. All three can be taken up to three times a day, although of course you have to follow the dosage instructions provided on the back of the package label to find out how to use it most accurately
Step 3. Try taking corticosteroids to relieve nerve pain
Corticosteroids are prescribed quite often for elderly people who are still healthy and experience moderate to high-intensity pain. In addition, the doctor will most likely prescribe it at the same time as antiviral drugs.
Consult this possibility with your doctor, especially because corticosteroids are effective because higher doses can only be purchased with a doctor's prescription
Step 4. Talk to your doctor about the possibility of taking narcotic analgesics
Sometimes, narcotic analgesics are prescribed to treat nerve pain caused by a herpes zoster infection. However, understand that narcotics can only relieve symptoms, not treat the root cause.
In addition, narcotics are substances that are susceptible to addiction in patients. That is why, its use should be strictly monitored by a doctor
Step 5. Get a prescription for a tricyclic antidepressant from your doctor
Sometimes, doctors will prescribe tricylic antidepressants to treat specific nerve pain caused by a shingles infection. Although the exact mechanism is unknown, some theories suggest that tricyclic antidepressants work by blocking pain receptors in the body.
Step 6. Take antiepileptic drugs to treat nerve pain that occurs
In fact, antiepileptic drugs have been commonly used in various clinical trials to treat neuropathic pain and today, there are quite a number of antiepileptic drugs that can be prescribed by doctors to control the condition of shingles patients, such as phenytoin, carbamazepine, lamotrigine, and gabapentin.
Remember, the last two tips should only be used for more serious nerve pain problems. Therefore, do not forget to consult both to the doctor first
Part 4 of 5: Treating Nerve Pain Using Surgical Procedures
Step 1. Consult the doctor about the possibility of injecting alcohol or phenol
One of the simplest surgical techniques that can be done to relieve pain in the nerves is to inject alcohol or phenol into a peripheral nerve branch. The procedure will actually damage the nerve permanently and make it no longer painful.
Remember, this procedure should only be performed by expert medical personnel. In addition, your medical condition and history will also influence the doctor's decision to perform or not perform the procedure
Step 2. Try a transcutaneous electrical nerve stimulation (TENS) procedure
In this procedure, the doctor will insert electrodes through the painful nerve. The electrodes then deliver very minimal and painless electrical impulses to the surrounding nerve pathways.
- So far, no one knows how electrical impulses work to relieve pain in nerves. One theory is that these electrical impulses stimulate the production of endorphins, the body's natural pain suppressants.
- Unfortunately, this procedure is not suitable for everyone. However, its effectiveness tends to increase if it is taken at the same time as the consumption of a drug called pregabalin.
Step 3. Consider a peripheral nerve stimulation or spinal cord stimulation procedure
The device used is similar to TENS, but is implanted deep under the skin. Like TENS, it can also be switched on and off as needed to control pain.
- Before the implant surgery is performed, the doctor will test using electrodes or thin welding wire to make sure the stimulator can relieve pain effectively.
- During the test, electrodes are inserted through the membrane that lines the spine so that they reach the epidural cavity to stimulate the spinal cord, or are inserted under the skin over the peripheral nerves to stimulate these nerves.
Step 4. Consult the possibility of performing a pulsed radiofrequency lesioning (PRF) procedure
In fact, it is a very safe and effective method of relieving pain with the help of radio frequencies. In particular, the therapy is able to control pain at the molecular level. After one procedure, the pain should be gone for a maximum of 12 weeks.
Part 5 of 5: Overcoming Herpes Zoster Early on
Step 1. Recognize the symptoms of a herpes zoster infection
The earliest symptoms that generally appear are pain, itching, and tingling in the skin. Sometimes, these symptoms are followed by confusion, fatigue, fever, headache, memory loss, and nausea or abdominal pain.
Up to five days after the initial symptoms appear, a painful rash may appear on one side of the face or body
Step 2. See a doctor within 24-48 hours of infection
If you think you have a herpes zoster infection, immediately consult a doctor within 24-48 hours afterward. Antiviral drugs such as famciclovir, valtrex, and acyclovir can be used to treat the symptoms of herpes zoster effectively, but only if treatment is started within 48 hours of infection.
If new antiviral drugs are taken 48 hours after infection, they are likely to be less effective. In addition, always remember that antiviral drugs are not able to prevent the occurrence of postherpetic neuralgia
Step 3. Use topical medications to treat shingles before the condition gets worse
In addition to asking you to take an antiviral medication, your doctor may prescribe a topical medication, such as Caladryl, which can help relieve pain and itching in an open wound.
- Caladryl works by sending signals to the brain to disguise the pain that appears. If you want to use it, you can buy it in the form of sticks, gels, lotions, and liquid sprays at pharmacies.
- Caladryl can be applied every 6 hours, up to 4 times a day. Do not forget to clean and dry the skin before applying Caladryl.
- Alternatively, ask your doctor to prescribe a 5% lidocaine (Lipoderm) adhesion patch. Apply the plaster to the problem area of the skin to help relieve the pain that appears.
- One of the over-the-counter drug options that you can buy without a prescription at the pharmacy is capsaicin cream (Zostrix, Zostrix HP). To use it, the cream only needs to be applied to the problem areas of the skin 3-4 times a day. There may be a burning or tingling sensation after the cream is applied, but don't worry as the effect won't last long. If the sensation does not subside, stop using the cream! Also, make sure you always wash your hands and dry them properly after applying the cream.
Step 4. Talk to your doctor about the possibility of taking oral medications to treat postherpetic neuralgia
Your doctor may prescribe gabapentin (Neurontin) or pregabalin (Lyrica) to help control the symptoms of postherpetic neuralgia. You can take these drugs for a maximum of 6 months, although your doctor will reduce the dose gradually before the sixth month arrives. Remember, never stop taking medication suddenly! Instead, reduce the dose gradually with the help of a doctor.
Every drug has side effects. For the types of drugs described above, some side effects that may occur are impaired memory ability, drowsiness, changes in electrolyte balance, and liver problems. If you experience negative side effects, immediately consult a doctor
Step 5. Consult the doctor about the possibility of corticosteroid therapy
If you experience moderate to high-intensity pain due to a herpes zoster virus infection, your doctor will likely prescribe the oral corticosteroid prednisone and acyclovir for you to take. Corticosteroid therapy may be able to relieve your nerve pain, but understand that it doesn't work the same for everyone.
- Your doctor may only prescribe corticosteroids if you are not taking drugs that may interact negatively with them. To avoid the risk of negative side effects, don't forget to tell your doctor about the medicines you are taking.
- For example, your doctor may prescribe a maximum dose of 60 mg of prednisone to take for 10-14 days, and will gradually reduce the dose before you stop taking the drug completely.
