PHN is a chronic neuropathic pain disorder that develops after herpes simplex virus infection (shingles). Typically, starts after the shingles resolves and the pain can persist indefinitely. The pain is described as sever burning pain associated with numbness and tingling sensation and hyperesthesia (hypersensitivity) over the affected nerve. Typically, the pain presents in the distribution of a dermatome over the affected (the nerve distribution) area.
The diagnosis of PHN is based on the history and clinical examination. Treatment can be difficult due to the severity of the pain. Initial approach is the use of anticonvulsants (Lyrica, Neurontin, Trileptal), antidepressants (Cymbalta, Nortriptyline, Amitriptyline, Effexor), tramadol and the opiates. Topical creams, gels and patches can be helpful. Interventional procedures can also help in treating pain associated with PHN is dependant on the location of the pain and may include nerve blocks, epidurals, sympathetic blocks, a spinal cord stimulator, and/or intrathecal pump.