Postherpetic Neuralgia (Shingles)
Postherpetic neuralgia is a complication of the painful shingles rash, which is caused by the chickenpox virus. When the rash clears, inflammation in the nerve can result in continued pain.
While most cases of shingles occur in adults, approximately 5 percent of cases are in children. About one in four patients with shingles will develop postherpetic neuralgia. Children who've had chickenpox face a greater risk of developing shingles if their immune systems have been weakened by diseases such as AIDS or cancer, or by certain medicines.
Postherpetic neuralgia affects the nerve fibers and skin, and the burning pain associated with postherpetic neuralgia can be severe enough to interfere with sleep and appetite.
The Pediatric Pain Management Center at Children’s Health offers children and parents a specially trained team that evaluates and treats chronic pain, acute pain and headaches. Our interdisciplinary approach involves many other specialties to treat pain using multiple approaches at once. The Center can help lessen the pain associated with a variety of diseases and disorders including, but not limited to, chest and back conditions, nerve injuries, rheumatologic conditions, sports injuries and cancer. We also have a dedicated headache clinic for those children suffering from headaches.
Once the shingles rash clears, sometimes the pain lingers. This persistent nerve pain can be sharp, burning, throbbing or aching along with itching, numbness and sensitivity to touch.
Tests and Diagnosis
Because postherpetic neuralgia is a complication of shingles, your child’s provider will ask you about when your child had chicken pox and shingles. Your provider will also want to know about the type of pain and its location and when it is typically experienced.
Currently, there's no cure for postherpetic neuralgia, but there are treatment options to soothe and quiet the misfiring nerves that are creating the pain. A specific treatment plan will be created based on your child’s symptoms, level of pain and age. Multiple treatments may be combined and can include:
- Pain relievers – over-the-counter or prescription
- Anti-seizure or anti-depressant medications, which can ease neuropathic pain
- Topical creams or patches
- Physical therapy
- Occupational therapy
- Desensitization therapy
- Psychological counseling
- Electrode nerve stimulation
- Lifestyle changes, such as weight loss or activity modifications
- Massage therapy
- Nerve blocks
What causes postherpetic neuralgia?
Postherpetic neuralgia is a complication of the painful rash called shingles, which is caused by the chickenpox virus. Inflammation in the nerve can result in continued pain, even after the shingles rash is gone.
Will the pain go away on its own?
The persistent nerve pain from postherpetic neuralgia can ease on its own. But the pain can interfere with your child’s quality of life and affect movement and appetite. Pain treatment is available.