Diagnosing Postherpetic Neuralgia

Postherpetic neuralgia is a painful condition that can develop as a medical complication of shingles (herpes zoster virus). It presents as a burning pain in the nerves and skin after the rash and blisters from the shingles virus have healed.

What is shingles?

The herpes zoster virus lies dormant in nerve cells in people who have had chickenpox. If the virus reactivates, it travels along nerve fibers to the skin and is referred to as shingles. Not everyone who had chickenpox will develop shingles.

Shingles is a painful condition that causes blisters and rashes on the skin. During a shingles outbreak, a burning or shooting pain occurs around the area of the blistered rash.

What is postherpetic neuralgia?

The pain associated with shingles normally ceases after the herpes zoster virus becomes dormant again; however, if pain lingers after the shingles rash disappears, postherpetic neuralgia has likely developed. When an individual has postherpetic neuralgia, nerves that were damaged during an outbreak of shingles send faulty pain signals to the brain.

Postherpetic neuralgia does not have a cure; however, certain treatments can ease symptoms. Postherpetic neuralgia can last for months or years; however, it normally improves over time. An estimated 20 percent of individuals who develop shingles will develop postherpetic neuralgia.

How is postherpetic neuralgia diagnosed?

Individuals experiencing severe pain in the same location where the shingles rash was located will most likely be diagnosed as having postherpetic neuralgia. A misdiagnosis of postherpetic neuralgia is rare. A health care professional bases the diagnosis of postherpetic neuralgia on an individual’s symptoms; further testing is not usually necessary. The diagnostic process typically includes the following:

• Examining the skin
• Determining the border of the affected area
• Obtaining a medical history
• Clarifying the time frame of the pain
• Identifying symptoms (burning, aching, shooting or stinging pain; touch sensitivity; itching or numbness)

After receiving a postherpetic neuralgia diagnosis, several treatment options are available; however, complete healing may take months or years.