Pain in herpes treatment. Postherpetic neuralgia: symptoms and treatment

Herpes zoster is an infectious disease, accompanied by the appearance of a blistering rash and pain of high intensity. Despite the fact that the period of virus activity is short - the rash disappears in 10-14 days, it can be difficult for patients to survive: the pain is so pronounced that it does not allow them to work or rest, while patients do not know what to do, because painkillers may not help.

Causes of pain

Unlike a rash that goes away quickly, shingles pain persists for a long period of time: from 2-3 months to 1 year.

You can not postpone treatment or hope that the disease will pass by itself: there is a possibility of a transition to a chronic form, which will manifest itself frequently.

The nature of pain in herpes is different: the sensations may resemble tingling, cutting, burning. As for localization, it occurs in the same place as the rashes - therefore, sensations can affect the back, chest area,. Pain can be combined with numbness and itching. The intensity of pain increases at the slightest touch to the affected area and when moisture gets on it.

In addition to the listed symptoms, the general state of health worsens: weakness, apathy, sudden temperature fluctuations occur.

And the pain lasts the longest, in middle-aged patients the period accompanied by pain is usually limited to 6 months. This is due, among other things, to the general condition of the body, the functioning of the immune system.

Phases

The first, the acute phase, is characterized by a combination of neuropathic and inflammatory processes. This stage lasts about 30 days. It is followed by a subacute phase. Its duration is about 120 days. The last phase is postherpetic neuralgia.

Types of postherpetic syndrome

Depending on the nature of pain sensations, several types of syndrome can be conditionally distinguished:

1. Constant. Characterized by pressing pain, accompanied by a burning sensation.
2. Periodic. Manifested by lumbago, sharp tingling.
3. Allodynic. The pains are strong, burning. Appear under the influence of an external factor.

At the same time, different types of the syndrome can be observed in one patient.

The development of pain after herpes zoster significantly impairs the patient's quality of life. This manifests itself in:

• a general decrease in human activity;
• chronic fatigue;
• sleep disturbances, the inability to fully restore strength;
• increased anxiety, depression;
• decrease in social activity.

All this affects the character of a person, patients become withdrawn, nervous, anxious.

Treatment

Pain in shingles requires an integrated approach to treatment. They cannot be tolerated - they can lead to increased sensitivity of the damaged nerve and chronic pain. However, how to relieve pain in the treatment of herpes zoster is a topical issue for both patients and specialists.

Minor pain can be eliminated with the help of NSAIDs - non-steroidal anti-inflammatory drugs. These include Ibuprofen, Nimesulide. Preparations for oral administration are combined with local effects. Mataren ointment, Lidocaine gel can be applied to the affected areas of the skin. A patch with lidocaine can be used, but it should not be used during active rashes - the skin should be dry and clean.

Drugs belonging to the group of narcotic analgesics (Oxycodone) are characterized by high efficiency. Opioid analgesics have shown efficacy similar to tricyclic antidepressants. It is advisable to take anticonvulsants, for example, Pregabalin. Since viral damage is directly related to disruption of the nervous system, tricyclic antidepressants may be required. This category of drugs includes: Amitriptyline, Nortriptyline. Taking antidepressants can block the perception of pain.

Physical therapy methods can also be used. For example, electrical stimulation is used to restore normal sensitivity to an injured nerve. This method should be carried out in courses. Acupuncture also works well.

Non-steroidal anti-inflammatory drugs

• Ketoprofen;
• Aspirin;
• Nimesulide;
• Ketorolac;
• Naproxen;
• Desketoprofen;
• Ibuprofen.

Drugs related to NSAIDs are available in different forms: in, mixtures, powders for suspension. , recommended for use during this period, contain capsaicin - an extract of hot red pepper.

The patient must take anticonvulsants, antidepressants and painkillers on an ongoing basis so that the pain does not disturb the usual rhythm of life.

However, it is not always possible to cope with pain by these methods. Then anesthesia for herpes zoster is carried out with the help of novocaine blockades, which allow you to completely eliminate pain for a certain period of time. Blockades with novocaine are methods that can be used in exceptional cases - with very severe pain.

Activation of the herpes virus is always associated with a weakening of the protective functions of the body. The recovery period for all patients proceeds differently and depends on many factors, both external and internal. Therefore, strengthening the immune system can significantly weaken the virus, improve well-being and bring the moment of recovery closer.

Immunomodulators that can be prescribed in the treatment of herpes zoster include:

• Viferon - suppositories for rectal administration;
• Arbidol, Cycloferon for oral administration;
• Drug Neovir.

Folk recipes

To eliminate pain in shingles, in addition to drug treatment, traditional medicine can be used:

1. St. John's wort tincture can be used for oral administration. 40-60 drops of a pharmaceutical preparation are diluted in a glass of water. The same remedy can be applied externally: a napkin soaked in infusion is applied to the focus of pain.
2. For oral administration, you can buy yarrow and tansy tinctures. They should be diluted by adding 1 tablespoon of the mixture to 400 grams of water.
3. To relieve symptoms, it is recommended to take therapeutic baths. For a disinfecting effect on the skin, salt is added to the water, to relieve itching, colloidal flour is used as an additive. You can anesthetize the lesions by adding starch to the water.
4. As a local remedy for the treatment of affected areas, a mixture of soda and salt diluted with water to the consistency of thick sour cream is used. The mixture is applied to the skin 3 times a day. You can also lubricate the foci and tar. Cold soaks will help to eliminate itching and reduce the intensity of pain.

How to take care of your skin during this period?

You can protect the skin with an elastic bandage by placing a gauze napkin under it. Bandaging should be tight - a slipping bandage will only create additional friction.

Reducing the risk of developing postherpetic neuralgia

Unfortunately, it is difficult to predict how long the patient's condition will improve. Even with complex therapy and the use of various categories of drugs, it is not always possible to completely eliminate the pain syndrome.

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Yuri asks:

How to relieve pain in shingles, and how long does it take?

Shingles is characterized by skin rashes that disappear fairly quickly - within 10 to 14 days. But these rashes are combined with a strong pain syndrome, which is felt as tingling, pinching, cutting and shooting through the body area, which is innervated by the inflamed nerve. This pain syndrome is the main problem with herpes zoster, as it can persist for a whole year after the disappearance of the rash.

Pain after shingles can disturb a person for a long period of time - from 2 - 3 months to one year. The longest period of pain bother the elderly and children. In middle-aged people, pain usually lasts on average for six months. The duration of the pain syndrome depends on the state of the general organism. Unfortunately, at present there are no effective methods that can reduce the duration of the residual pain syndrome that torments a person after recovery from herpes zoster.

With shingles, it is necessary to resort to taking painkillers. Doctors do not recommend enduring the pain of shingles, as this can lead to increased sensitivity and the development of chronic pain in the future. The use of painkillers must be continued throughout the entire period of pain.

Currently, several types of drugs are used to relieve pain in shingles:

• Non-steroidal anti-inflammatory drugs (Aspirin, Ketorolac, Naproxen, Nimesulide, Ibuprofen, etc.);


• Tricyclic antidepressants (Amitriptyline, Doxipin, Ixel, Melipramine, Clomipramine, Imizin, etc.);


• Anticonvulsants (Gabapentin, Pregabalin);


• Novocaine blockade;


• Transcutaneous electrical stimulation of the affected nerves;


• Narcotic analgesics (Oxycodone, Tramadol);


• Preparations based on capsaicin (ointment Mataren plus, etc.).

• Aspirin;


• Nimesulide;


• Desketoprofen;


• ibuprofen;


• Naproxen;


• Ketorolac;

If during the active course of the disease a person has severe pain that is not stopped by non-steroidal anti-inflammatory drugs in combination with capsaicin ointments, then they resort to the use of tricyclic antidepressants, anticonvulsants or narcotic analgesics. Amitriptyline (an antidepressant), Gabapentin (an anticonvulsant), and Oxycodone (an narcotic analgesic) are most commonly used to relieve severe pain in shingles.

In the treatment of pain remaining after recovery from herpes zoster, tricyclic antidepressants, anticonvulsants, novocaine blockades, transcutaneous stimulation of the affected nerve, capsaicin ointments and non-steroidal anti-inflammatory drugs are used.

The most effective drugs in the treatment of neuralgia remaining after herpes zoster are the following:

• Amitriptyline, Doxepin (antidepressants);


• Gabapentin and Pregabalin (anticonvulsants).

• Novocaine blockades, which allow you to completely eliminate pain for a certain period of time;


• Transcutaneous electrical stimulation of damaged nerves allows you to normalize metabolism and restore their normal functioning.

In the treatment of pain left after shingles, narcotic analgesics are not used. Non-steroidal anti-inflammatory drugs are used as the main means, if the pain is not too severe.

Learn more on this topic:

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• Lichen planus (red dermatitis) - causes, symptoms and manifestations on the skin, on the mucous membranes of the oral cavity and genital organs (photo), diagnosis. Effective treatment in an adult, in children

Shingles is an infectious disease caused by the varicella zoster varicella zoster virus. Pain in shingles appears in the back, lower back, face. The disease is accompanied by a rash. There have been cases when the disease became the cause of cancer. There have also been cases of deaths. Reduced immunity, the main cause of the appearance of herpes.

Symptoms of the disease

The disease is transmitted by airborne droplets. After chickenpox, in a dormant state, the infection is in the posterior roots of the spinal cord and intervertebral nodes, where it persists for a long time. It manifests itself after a decrease in immunity in the body. There were cases when the disease proceeded without a rash, but was accompanied by severe pain in the lower back, on the face. Young children may develop blisters on their gums. After they burst, sores appear in the same place. Basically, the rash is formed where the intercostal nerves are located. On the face, herpetic vesicles protrude along the trigeminal nerve and along the nerve endings in the limbs. The disease affects the internal organs, nerve nodes, membranes and substances of the brain.

Do not self-medicate, especially if the disease has affected the body of a child or a pregnant woman.

Periods of illness

Symptoms	Periods
	Elementary	rashes	crusting
	Headache	Vesicles look like foci of pink spots 2-5 mm in size.	After 14-20 days, where there were rashes, a crust forms, and the places where the vesicles were dry up, and the crusts fall off.
	Temperature rise	With a transparent gray matter, then small bubbles begin to form
	Itching, burning, tingling, swollen lymph nodes	With an admixture of blood, black, the content of the vesicles may be with severe gangrenous form
	urinary retention	Fresh rash elsewhere similar to herpetic rash of a neurological nature

Why pain occurs and their nature with shingles

The symptom may occur in the region of the ribs.

The pain syndrome almost always corresponds to the place where the skin rash will be. At first, it can hurt a lot in the whole body. After there is pain in the abdomen and in the location of the ribs. As a rule, the pains are very strong, their character:

• superficial, burning;
• dynamic, hyperalgesia;
• allodynia (pain from factors that do not usually cause discomfort).

Herpes hurts due to inflammation or damage to the ganglion roots of the spinal cord, as well as peripheral nerves. Herpes zoster on the legs or arms is a rare case. After the symptoms of the disease have passed, pain in the legs may remain and occur in the joints and lower back. Pain relief for herpes zoster is a must. With this disease, the pain is intense and lasts for a long time.

Pain in the leg with herpes can be a sign of neuralgia, which requires immediate medical attention.

Treatment and drugs

When the rash heals, a crust forms in their place.

Herpes needs to be treated with several types of medicines. This includes anti-herpes and pain medications that are applied by mouth and topically when the affected skin is treated. It is advisable to start treatment within the first two days. After herpes zoster, a crust forms on the skin. In order to protect the affected skin from infection, it must be covered with a gauze bandage.

Types of drugs

• Antiherpetic. Stop the reproduction of the virus;
  • "Acyclovir";
  • "Zovirax";
  • "Valtrex";
  • Virolex;
  • "Viferon";
  • "Famvir".
• Nerve blockers - painkillers for herpes zoster:
  • Most often recommended:
    • "Indomethacin";
    • "Paracetamol";
    • "Butadion";
    • "Analgin".
  • Anticonvulsants:
    • "diazepam";
    • "Gabapentin".
  • Narcotic analgesics or antidepressants:
    • "Promedol";
    • "Tramal";
    • Fortral.
• Immunomodulatory - used as auxiliary substances to suppress the virus:
  • "Lavomax";
  • "Proteflazid".
• Medicines that relieve itching:
  • "Zovirax";
  • Virolex;
  • "Gerpevir";
  • "Herperax".
• Antibiotic therapy - antibiotics are prescribed in cases where purulent intoxication develops, infection of wounds:
  • "Metacycline";
  • "Rondomycin";
  • "Tetracycline".
• Antiseptics - from joining the infection to the wound:
  • "Miramistin";
  • "Chlorhexidine";
  • zinc ointment;
  • "Streptocide".
• Local warming medicines - to speed up the metabolism in damaged tissues:
  • "Golden Star";
  • "Doctor MOM".
• Vitamin-mineral complexes, which include vitamins A, E, C, injections of vitamins B1 and B6.

Content

The pharmacy chain today offers a large selection of various remedies for bodily herpes. Often it is not possible for an ordinary patient to understand all this abundance. As a result, the patient, when choosing an antiviral drug, should be guided by medical recommendations for suppressing the infection.

How to treat herpes on the body

A huge number of people suffer from a viral disease of this type. It is believed that it is impossible to completely cure herpes. Experts say that medicines can only really achieve the transition of the virus to a "sleeping" state. However, any fluctuations in the immunity of the infected will provoke a second exacerbation of the disease. For this reason, while taking medications for herpes on the body, exceptional attention should be paid to immunomodulatory drugs. The characteristic features of various virus attacks are:

• The appearance on the lips of grouped small bubbles.
• Increase in body temperature.
• Unpleasant sensations in the form of itching and burning.
• Perhaps the appearance of neuralgic headaches.
• The presence of signs of general malaise.
• Exacerbation of other chronic diseases.

It is important to say that the transition of any infection into a chronic form requires the body to activate cellular immunity. At this level, all the most "fierce" battles with pathogenic agents take place. T-lymphocytes involved in this process are the body's immune defenders, whose field of activity is atypical cells. It is possible to increase the functionality of T-killers by training the thymus-thymus gland, the dysfunction of which leads to infection with the following types of herpes:

1. Simple type 1 is a common cause of painful blisters on the lips.
2. A simple second type is the causative agent of a genital infection.
3. The varicella-zoster virus manifests itself as the well-known chickenpox.
4. Epstein-Barr virus is infectious mononucleosis.
5. Cytomegalovirus has the ability to cause abnormalities in intrauterine development of the fetus.
6. In addition to these, there are 3 more unexplored types of viral damage.

Painkillers for herpes

Analgesic drugs are widely used in the treatment of infection. By blocking nerve conduction, they temporarily alleviate the patient's condition. However, it should be understood that by eliminating the external symptoms of a viral lesion, it is unrealistic to get a full recovery. Medicines for herpes on the body of an analgesic nature are not recommended to be taken for a long time. Painkillers that can relieve the symptoms of herpes are:

• Lidocaine;
• Naproxen;
• Analgin;
• Aspirin;
• Paracetamol;
• NSAIDs (Ibuprofen).

Antiherpetic drugs

Patients who are affected by shingles (herpes) are naturally interested in the question of how to treat herpes on the body. A doctor will help you decide on the choice of drugs, who will make a detailed examination of the rashes that appear on the skin and prescribe effective antiherpetic drugs. Usually, preference is given to oral administration of drugs or their injection. At the same time, treatment with drugs for herpes on the body is necessarily accompanied by active vitamin therapy of the patient.

Tablets

The specified dosage form of drugs helps to cope with viral skin lesions of different localization. Herpes tablets are considered a general therapy. If the rash and fluid vesicles have not yet appeared, then the pills will help prevent the further development of the disease. Frequent relapses require the use of tablet drugs for 2-3 months. The lips are the most common site of infection. In this regard, it is considered appropriate to use the following antiseptic drugs that also fight against genital herpes:

1. Penciclovir;
2. Idoxuridin;
3. Valtrex;
4. Zovirax (a good remedy for prevention);
5. Famvir;
6. Tromantadin.

Ointments

Medicines for herpes on the body in the form of a remedy for external use have many advantages. The ointment for herpes on the body acts precisely, with the help of the excipients included in its composition, it helps to reduce itching and burning in the affected area. At the same time, the patient does not have to drink anything, loading his body with broad-spectrum antibiotics. To alleviate the symptoms of the disease in a child, ointments and creams are the best fit. Specific medicinal formulas of this group are drugs:

1. Vivorax;
2. Zovirax;
3. Oxolinic ointment;
4. Fenistil Pencivir.

injections

Antiviral injections are prescribed for frequent relapses of the disease. Injections from herpes have the most active effect on pathogenic microorganisms. Often, Foscarnet is administered intravenously to patients, which inhibits the further development of the infection. In addition to this medicine, experts recommend injections of Larifan, Imunofan, Viferon, which have an immunomodulatory effect on the body.

Antibiotics

Taking these drugs during the period of infection with a viral agent is not considered reasonable. Antibiotics may be prescribed by the attending physician if a secondary infection of the bacterial type is detected. If a fungal pathogen is attached, antimycotic drugs are prescribed. Medical practice shows that the following pathogenic agents associated with herpes can be other chronic diseases:

• staphylococcus;
• streptococcus;
• fungal elements such as Candida;
• trichomonas (oral or vaginal);
• chlamydial infection;
• gardnerellosis;
• haemophilus influenzae.

Means to increase immunity

With herpetic and any other infection, immune therapy is very important, aimed at improving the quality of the functioning of the human protective barrier against pathogens. Polyoxidonium and Cycloferon are often used as immunomodulators. However, do not forget about the vitamins necessary for each person.

Any viral attack leaves behind destroyed or damaged cells. In order to restore them, the body needs antioxidants that specialize in the construction of new tissue structures after the active activity of pathogens. Vitamins C and E do an excellent job with this task. In addition, selenium and zinc are often prescribed as the main components of cellular immunity.

Video

Shingles is a serious infectious disease caused by the herpes virus. With this disease, not only the skin is affected, but also the nervous system. Exacerbation of shingles occurs against the background of hypothermia, hypovitaminosis or chronic infection of any localization. The risk group includes the elderly, pregnant women and patients who have undergone a long course of antibiotic treatment.

With herpes zoster, a person suffers from severe pain that appears even from a light touch on the skin. This is due to the fact that the virus disrupts the functioning of nerve cells, while increasing the sensitivity of nerve endings. These pains can be compared with the pain that a person experiences with burns.

Attempts to endure pain without taking medications can lead to an increase in the threshold of pain sensitivity. In some cases, chronic pain haunts a person for months and years.

After confirming the diagnosis, the doctor may prescribe antiviral drugs or painkillers for shingles.

Ibuprofen

If the pain is not severe, the doctor will suggest the pain medication Ibuprofen.

Ibuprofen has anti-inflammatory and analgesic effects. The drug reduces pain in shingles.

Indications for its use are the following conditions:

• inflammatory diseases of the joints;
• pain of medium and low intensity of various origins;
• fever.

Children and adults take one tablet of Ibuprofen at a dosage of two hundred milligrams three times a day. Doctors recommend taking the first daily dose in the morning before meals. The following doses should be taken within 24 hours after meals. The duration of treatment depends on the condition of the patient and the course of the disease.

Ibuprofen has the following contraindications for use:

• hypersensitivity to Ibuprofen;
• diseases of the stomach;
• children's age up to twelve years;
• pathology of the liver and kidneys;
• third trimester of pregnancy.

The drug should not be taken simultaneously with other non-steroidal anti-inflammatory drugs.

Ketorolac

Ketorolac has an analgesic and anti-inflammatory effect. The drug is prescribed to eliminate pain in such conditions:

• hepatic and renal colic;
• pain after childbirth;
• sciatica;
• osteoarthritis;
• arthrosis;
• radiculitis;
• osteochondrosis.

Ketorolac is taken one tablet every six hours. Treatment lasts no more than seven days. Patients weighing up to fifty kilograms, as well as patients over sixty-five years of age, Ketorolac is prescribed in reduced doses.

The drug should not be used to treat herpes zoster in such cases:

• hypersensitivity to Ketorolac;
• severe or moderate renal failure;
• bronchial asthma;
• stomach diseases;
• period of pregnancy and lactation;
• nasal polyposis;
• under the age of sixteen;
• blood clotting disorders.

During the period of treatment with this drug, you can not engage in activities that require increased attention.

Paracetamol

Paracetamol has an analgesic and anti-inflammatory effect. This drug is prescribed for such conditions:

• neuralgia;
• migraine;
• myalgia;
• pain from injuries and burns;
• toothache.

Adults and adolescents weighing more than sixty kilograms take one tablet of Paracetamol at a dosage of five hundred milligrams up to four times a day. Treatment lasts five to seven days.

Children from three months to a year are prescribed Paracetamol in the form of a suspension of one teaspoon. Children from one to six years old take two teaspoons of the suspension. The multiplicity of reception is four times a day. The treatment lasts five days.

Paracetamol should not be used for herpes zoster in the following cases:

• blood diseases;
• hypersensitivity to one of the components of the drug;
• pathology of the liver and kidneys.

During treatment with this drug, the use of alcoholic beverages is prohibited. During pregnancy and lactation Paracetamol is prescribed with caution after evaluating the benefits to the mother and the risk to the unborn child.

Baralgin M

Analgesic Baralgin M belongs to the group of non-narcotic non-steroid drugs. The active substance of the drug metamizol has an analgesic, anti-inflammatory and antipyretic effect.

Indications for the use of Baralgin M are the following conditions:

• renal and hepatic colic;
• pain with neuralgia, sciatica, arthritis, myalgia;
• spasms of the bladder;
• toothache and headache.

With shingles, adults take one tablet of Baralgin M twice a day. Tablets are washed down with plenty of water. Treatment lasts no more than five days.

Baralgin M is contraindicated in such pathologies:

• individual intolerance to metamizole;
• bronchial asthma;
• diseases of the liver and kidneys;
• age up to fifteen years;
• first and third trimester of pregnancy.

Baralgin M is prescribed with caution for hypotension and circulatory disorders.

Naproxen

The non-steroidal anti-inflammatory drug Naproxen has analgesic, analgesic and antipyretic effects. The main active ingredient of this drug is naproxen sodium.

According to the instructions for use, Naproxen is prescribed for such diseases:

• osteoarthritis;
• arthritis;
• radiculitis;
• bursitis;
• neuralgia;
• myalgia;
• migraine.

Adults take one Naproxen tablet twice a day. For children, the drug is prescribed in the form of a suspension. The dosage is determined individually, depending on the weight of the child. From the cure

Naproxen should be discontinued in such cases:

• "aspirin" asthma;
• hypersensitivity to naproxen sodium;
• diseases of the stomach;
• age up to one year.

The drug is prescribed with caution during pregnancy.

Pentalgin

Pentalgin is an anti-inflammatory, analgesic and antispasmodic drug. This drug is used for pain syndromes.

The composition of Pentalgin includes such active substances:

• naproxen;
• drotaverine;
• paracetamol;
• caffeine;
• pheniramine.

Pentalgin is prescribed for such conditions:

• pain in the joints;
• toothache;
• renal colic;
• migraine;
• postoperative syndrome.

For shingles pain, dermatologists recommend taking one to three tablets a day. The daily dose of Pentalgin should not exceed four tablets. To achieve an analgesic effect, tablets are taken no more than five days.