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Shingles: Are you risking nerve pain?

Nerve pain, called postherpetic neuralgia, is a common symptom that continues for 3-6 months after a shingles rash has cleared up.

Up to one in five people with shingles develop this painful and uncomfortable complication.

However, treatments are available to help relieve postherpetic neuralgia.

Doctors don't know why the pain from shingles goes away in some people and not others, but the longer you have postherpetic neuralgia, especially after a year, the less likely it is to go away completely.

Shingles: The risk factors

Researchers have long known that older people are more likely to get postherpetic neuralgia, but recent studies have found other factors that increase risks.

In one study published in the US journal Neurology, researchers looked at data from 965 people with shingles. The researchers identified five risk factors for developing postherpetic neuralgia in people who had been recently diagnosed with shingles:

  • Older
  • Female
  • Presence of symptoms before the rash appeared such as numbness, tingling, itching or pain
  • Severe pain during the illness' initial stages
  • Severe rash

Importantly the researchers found the more risk factors you have, the greater the risk of developing postherpetic neuralgia.

For instance only 17% of women with shingles went on to get postherpetic neuralgia, as did 26% of people with severe pain. But 50% of women who were over 60 years old and had symptoms before the rash, severe rash and acute pain went on to get postherpetic neuralgia.

Psychological symptoms and shingles development

Researchers are not just looking at biological and neurological risk factors for PHN. Psychological stress may also be a risk factor for postherpetic neuralgia..=

One study showed that people with shingles who went on to develop postherpetic neuralgia were more likely to have had symptoms of personality disorders, hypochondria, intense worry about their disease and other bodily complaints.

Another study found that the risk of developing postherpetic neuralgia was higher in people who were living alone when they developed shingles than people living with others.

Preventive shingles treatment

If you're worried about postherpetic neuralgia, there are antiviral medicines that can reduce the risks of getting the condition. These normally need to be started within two to three days of onset of the shingles.

Have shingles? Get treatment, take action

  • If you have shingles, it's important to talk to your doctor about your risk of developing postherpetic neuralgia. Ask whether preventive treatment with antiviral drugs would help.
  • People with postherpetic neuralgia should also try to stay active and connected.
  • Many treatments can help, including creams, antidepressants and painkillers.
  • The most important thing is to get prompt medical attention if you think you might have shingles.
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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on April 25, 2016

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