Neuralgia is a term that describes nerve pain. Postherpetic neuralgia is a nerve pain that occurs at the site of a previous attack of a condition called shingles (see below).
The pain of postherpetic neuralgia may be intense and can take the form of:
- burning
- stabbing
- aching
- itching
- an ‘electric shock’
- sensitivity of the skin in the affected area
Shingles
Shingles is a condition that is caused by re-activation of the varicella-zoster virus, which lies dormant (inactive) in the nerves following a chickenpox infection earlier in life. The virus becomes active in two or three nerve roots and causes a flu-like illness.
Shingles can occur at any age but is more common in older people or those whose immune system has been weakened by medications such as steroids, or people having chemotherapy.
Shingles most commonly affects the nerves of the chest and face but it can affect any nerve. Shingles usually causes pain and a rash on one side of the body only (unilateral). Sometimes, the pain develops before the rash.
In most cases, the rash and pain of shingles lasts two to four weeks. The rash is similar to the chickenpox rash, with small blisters that burst, heal and leave small scars on the skin. Postherpetic neuralgia occurs when the nerve pain that is caused by shingles continues for longer than three months after the rash has healed.
It is not possible to get shingles from someone with chickenpox. The varicella-zoster virus already exists inside the body and is re-activated. If you have grandchildren who have chickenpox, looking after them while they have the condition can actually boost your immunity. If you have shingles, it is possible for someone who has never had chickenpox to develop chickenpox, particularly if they come into direct contact with the rash.
See the Health A-Z topic about Shingles for more information about the condition.
How common is postherpetic neuralgia?
It is difficult to estimate how many people are affected by postherpetic neuralgia. This is because there are many varying definitions of the condition, depending on how long it takes to develop, and how long someone feels pain.
Approximately 10-15% of people with shingles will go on to develop postherpetic neuralgia. Around 75% of people who have had shingles and are 70 years old or more will develop postherpetic neuralgia.
The risk of developing postherpetic neuralgia increases with age. It is more common in people who are over 60.
Outlook
About 95% of people with postherpetic neuralgia make a full recovery within a year of developing the condition. But occasionally, the nerves do not heal completely and the symptoms last for several years or permanently.
Treatments are available that can ease the symptoms of postherpetic neuralgia, although they may not relieve the pain completely.
Most people will respond to medication, such as tricyclic antidepressants, which can be prescribed to reduce the pain. See Postherpetic neuralgia - treatment for more information about tricyclic antidepressants as a treatment.
About 40-50% of people with postherpetic neuralgia do not respond to any form of treatment. A vaccine is available for people who are over 50 to boost immunity and to prevent reactivation of the virus. This has been shown to reduce considerably the likelihood of getting shingles for at least five years. It may need to be repeated for lasting immunity.
Living with postherpetic neuralgia can be very difficult. Postherpetic neuralgia can interfere with your ability to carry out certain daily activities, such as dressing and bathing. You may also have problems sleeping and feel tired (mental or physical tiredness).
Living with pain, particularly if it affects your quality of life, can also lead to depression (feelings of extreme sadness or despair that last for a long time).
See the Health A-Z topic about Depression for more information.
