post herpetic neuralgia part 3

Anti depressants are widely used to treat post herpetic neuralgia. These drugs are quite effective in decreasing the pan sensation in at least 40% of individuals. The doses of the anti depressant selected are much lower than the actual dose used to treat depression. To date, all classes of antidepressant have been shown to have some benefit in relieving the pain of post herpetic neuralgia but the tricyclic anti depressants seem to work the best.

Anti convulsants. Some drugs used to treat seizures have also been found be useful in the treatment of post herpetic neuralgia. The classic anti convulsant is Gabapentin or neurontin today. Another related drug is called lyrica and it is also useful in the treatment of post herpetic neuralgia. These drugs do relieve pain in close to 30-40 percent of individuals but the duration of pain relief is not long lasting. In some cases, the drug does work initially but fails to work in the long run.

Some physicians have tried to inject corticosteroids around the spinal cord. The results of corticosteroid are not always reproducible but when it works the pain relief is long term. However, less than 5% of patients respond to these injections. Steroid injections are never first choice treatment for this disorder. Only individuals who fail the above drug therapies should receive steroidal injections.

Narcotics. Over the counter pain pills are useless for Post herpetic neuralgia. Narcotics like oxycontin, hydrocodone, and percocet do work but long-term use of these narcotics has been associated with physical dependence and addiction. With many cases of overdose, many physician s have become hesitant about writing prescriptions for such medications.

Transcutaneous electrical nerve stimulation involves insertion of tiny electrodes into the painful skin areas; the electrodes are then stimulated to deliver painless electrical impulses to the nerves. It is believed that these impulses can block the pain fibers or stimulate the nerves to release pain-relieving chemicals. While the treatment is effective, it does not work in everyone. Some individuals combine TENS with drug therapy to get the maximal benefit.

Spinal cord or peripheral nerve stimulation. Devices similar to TENS are now being placed underneath the skin for long-term use. These devices can be turned off or on as needed to control the pain. At the time of implantation, the doctor will test the device to see if it works. The electrodes are placed in the vicinity of the spinal cord and the small stimulator is placed in the upper buttock area but can be placed in the chest or abdomen. This method of pain control is quite expensive and does require a minor surgical procedure.

Lidocaine patches are small bandage like patches that do relieve only the mild pain. The patches are available with a prescription and can be applied on to the skin. They do not always work and are not recommended for moderate or severe pain.

As far as pain relief is concerned, no method provides complete relief. Some people do have little relief but many obtain no relief. The majority of patients live with the pain for many years. Luckily, in most cases, the pain of post herpetic neuralgia disappears within 3-6 months. In some unlucky individual, the pain may last a few years

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