How should we treat postherpetic neuralgia?
DOI:
https://doi.org/10.12775/QS.2024.17.53070Keywords
Anticonvulsants, Antidepressants, Botulinum toxin, Capsaicin, Lidociane, Nerve block, Opioids, Postherpetic neuralgia, Quality of life, Spinal cord stimulation, Transcutaneous Electrical Nerve StimulationAbstract
Postherpetic neuralgia (PHN) is the most common long-term complication of varicella-zoster virus (VZV) reactivation. It is characterized primarily by persistent pain more than 90 days after the illness at the site where the rash was. This pain is sharp, burning, stabbing in nature. Postherpetic neuralgia can lead to a reduced quality of life and negatively affect sleep and daily functioning. The first line of treatment is currently conservative methods, which include anticonvulsants, antidepressants, topical lidocaine, as well as opioids and topical capsaicin. If these measures are ineffective, individually tailored interventional methods may be necessary. Among these, botulinum toxin A injection is the most common. Other methods focus on neuromodulation (which is the alteration of nerve activity through targeted delivery of a stimulus) or blocking individual elements of the nervous system.
References
Saguil A, Kane S, Mercado M, Lauters R. Herpes Zoster and Postherpetic Neuralgia: Prevention and Management. Am Fam Physician. 2017;96(10):656-663.
Mielniczek K. Botulinum toxin in the treatment of neuralgia and neuropathic pain. J Educ Health Sport [Internet]. 2021 Sep. 19 [cited 2024 Jun. 19];11(9):310-4. https://doi.org/10.12775/JEHS.2021.11.09.038
Borkowska A, Marosz S, Marosz K, Chilimoniuk Z, Sobstyl A, Dudziński D, Chałupnik A, Krupska K, Piecewicz-Szczęsna H. Raising awareness about the importance of chickenpox vaccination in children. J Educ Health Sport [Internet]. 2023 Sep. 19 [cited 2024 Jun. 20];19(1):119-28 https://doi.org/10.12775/JEHS.2023.19.01.012
Johnson RW, Rice AS. Clinical practice. Postherpetic neuralgia. N Engl J Med. 2014;371(16):1526-1533. doi:10.1056/NEJMcp1403062
Massengill JS, Kittredge JL. Practical considerations in the pharmacological treatment of postherpetic neuralgia for the primary care provider. J Pain Res. 2014;7:125-132. Published 2014 Mar 10. https://doi.org/10.2147/JPR.S57242
Iłżecka J. Hydrotherapy in nervous system diseases. Pedag Psychol Sport [Internet]. 2019 Jan. 9 [cited 2024 Jun. 20];5(1):55-60. https://doi.org/10.12775/PPS.2015.05.01.005
Budzeń K, Wesołowski P, Bąk S, Stachura T, Żelazny P. Lidocaine, old drug - new possibilities. Treatment of postoperative pain and reduction of postoperative complications with intravenous administration. J Educ Health Sport [Internet]. 2022 Sep. 14 [cited 2024 Jun. 20];12(9):763-72. https://doi.org/10.12775/JEHS.2022.12.09.090
Fornasari D, Magni A, Pais P, Palao T, Polati E, Sansone P. Changing the paradigm in postherpetic neuralgia treatment: lidocaine 700 mg medicated plaster. Eur Rev Med Pharmacol Sci. 2022;26(10):3664-3676. https://doi.org/10.26355/eurrev_202205_28862
Baron R, Mayoral V, Leijon G, Binder A, Steigerwald I, Serpell M. Efficacy and safety of 5% lidocaine (lignocaine) medicated plaster in comparison with pregabalin in patients with postherpetic neuralgia and diabetic polyneuropathy: interim analysis from an open-label, two-stage adaptive, randomized, controlled trial. Clin Drug Investig. 2009;29(4):231-241. https://doi.org/10.2165/00044011-200929040-00002
Binder A, Bruxelle J, Rogers P, Hans G, Bösl I, Baron R. Topical 5% lidocaine (lignocaine) medicated plaster treatment for post-herpetic neuralgia: results of a double-blind, placebo-controlled, multinational efficacy and safety trial. Clin Drug Investig. 2009;29(6):393-408. doi:10.2165/00044011-200929060-00003
Hans G, Sabatowski R, Binder A, Boesl I, Rogers P, Baron R. Efficacy and tolerability of a 5% lidocaine medicated plaster for the topical treatment of post-herpetic neuralgia: results of a long-term study. Curr Med Res Opin. 2009;25(5):1295-1305. https://doi.org/10.2165/00044011-200929060-00003
Yong YL, Tan LT, Ming LC, et al. The Effectiveness and Safety of Topical Capsaicin in Postherpetic Neuralgia: A Systematic Review and Meta-analysis. Front Pharmacol. 2017;7:538. Published 2017 Jan 10. https://doi.org/10.3389/fphar.2016.00538
Derry S, Rice AS, Cole P, Tan T, Moore RA. Topical capsaicin (high concentration) for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2017;1(1):CD007393. Published 2017 Jan 13. https://doi.org/10.1002/14651858.CD007393.pub4
Irving GA, Backonja MM, Dunteman E, et al. A multicenter, randomized, double-blind, controlled study of NGX-4010, a high-concentration capsaicin patch, for the treatment of postherpetic neuralgia. Pain Med. 2011;12(1):99-109. https://doi.org/10.1111/j.1526-4637.2010.01004.x
Saldaña MT, Pérez C, Navarro A, Masramón X, Rejas J. Pain alleviation and patient-reported health outcomes following switching to pregabalin in individuals with gabapentin-refractory neuropathic pain in routine medical practice. Clin Drug Investig. 2012;32(6):401-412. https://doi.org/10.2165/11599400-000000000-00000
Piotrowska K, Pabianek Łukasz. Physical activity – classification, characteristics and health benefits. Qual Sport [Internet]. 2019 Aug. 24 [cited 2024 Jun. 20];5(2):7-14. https://doi.org/10.12775/QS.2019.007
Hempenstall K, Nurmikko TJ, Johnson RW, A'Hern RP, Rice AS. Analgesic therapy in postherpetic neuralgia: a quantitative systematic review. PLoS Med. 2005;2(7):e164. https://doi.org/10.1371/journal.pmed.0020164
Duehmke RM, Derry S, Wiffen PJ, Bell RF, Aldington D, Moore RA. Tramadol for neuropathic pain in adults. Cochrane Database Syst Rev. 2017;6(6):CD003726. Published 2017 Jun 15. https://doi.org/10.1002/14651858.CD003726.pub4
Lin CS, Lin YC, Lao HC, Chen CC. Interventional Treatments for Postherpetic Neuralgia: A Systematic Review. Pain Physician. 2019;22(3):209-228.
Aggarwal A, Suresh V, Gupta B, Sonthalia S. Post-herpetic Neuralgia: A Systematic Review of Current Interventional Pain Management Strategies. J Cutan Aesthet Surg. 2020;13(4):265-274. https://doi.org/10.4103/JCAS.JCAS_45_20
Xiao L, Mackey S, Hui H, Xong D, Zhang Q, Zhang D. Subcutaneous injection of botulinum toxin a is beneficial in postherpetic neuralgia. Pain Med. 2010;11(12):1827-1833. doi:10.1111/j.1526-4637.2010.01003.x
Apalla Z, Sotiriou E, Lallas A, Lazaridou E, Ioannides D. Botulinum toxin A in postherpetic neuralgia: a parallel, randomized, double-blind, single-dose, placebo-controlled trial. Clin J Pain. 2013;29(10):857-864. https://doi.org/10.1097/AJP.0b013e31827a72d2
Park J, Park HJ. Botulinum Toxin for the Treatment of Neuropathic Pain. Toxins (Basel). 2017;9(9):260. Published 2017 Aug 24. https://doi.org/10.3390/toxins9090260
Peng F, Xia TB. Effects of Intradermal Botulinum Toxin Injections on Herpes Zoster Related Neuralgia. Infect Drug Resist. 2023;16:2159-2165. Published 2023 Apr 12. https://doi.org/10.2147/IDR.S401972
Cui Y, Zhou X, Li Q, et al. Efficacy of different acupuncture therapies on postherpetic neuralgia: A Bayesian network meta-analysis. Front Neurosci. 2023;16:1056102. Published 2023 Jan 10. https://doi.org/10.3389/fnins.2022.1056102
Watson CPN, Deck JH, Morshead C, Van der Kooy D, Evans RJ. Post-herpetic neuralgia: further post-mortem studies of cases with and without pain. Pain. 1991;44(2):105-117. https://doi.org/10.1016/0304-3959(91)90124-G
Rijsdijk M, Svensson CI, van Wijck AJ, Kalkman CJ, Yaksh TL. Analgesic properties of intrathecal glucocorticoids in three well established preclinical pain models. Scand J Pain. 2016;10:90-102. https://doi.org/10.1016/j.sjpain.2015.10.006
Ing MR, Hellreich PD, Johnson DW, Chen JJ. Transcutaneous electrical nerve stimulation for chronic post-herpetic neuralgia [published correction appears in Int J Dermatol. 2018 Mar;57(3):371]. Int J Dermatol. 2015;54(4):476-480. https://doi.org/10.1111/ijd.12385
Bates JA, Nathan PW. Transcutaneous electrical nerve stimulation for chronic pain. Anaesthesia. 1980;35(8):817-822. https://doi.org/10.1111/j.1365-2044.1980.tb03926.x
Barbarisi M, Pace MC, Passavanti MB, et al. Pregabalin and transcutaneous electrical nerve stimulation for postherpetic neuralgia treatment. Clin J Pain. 2010;26(7):567-572. https://doi.org/10.1097/AJP.0b013e3181dda1ac
Eid MM, Hamed NS, Abdelbasset WK, Elkholi SM, Eladl HM, Bahey El-Deen HA. A comparative study between transcutaneous electrical nerve stimulation and pulsed electromagnetic field therapy in the management of post-herpetic neuralgia of the sciatic nerve. Medicine (Baltimore).2022;101(44):e31433. https://doi.org/10.1097/MD.0000000000031433
Xu G, Xú G, Feng Y, Tang WZ, Lv ZW. Transcutaneous electrical nerve stimulation in combination with cobalamin injection for postherpetic neuralgia: a single-center randomized controlled trial. Am J Phys Med Rehabil. 2014;93(4):287-298. https://doi.org/10.1097/PHM.0000000000000002
Kalava A, Mihaylov SV, Austin HK, Acharya S. Peripheral Nerve Stimulation for a Refractory Case of Postherpetic Neuralgia in the Upper Limb: A Case Report. Cureus. 2024;16(2):e55168. Published 2024 Feb 28. https://doi.org/10.7759/cureus.55168
Zhao L, Song T. Case Report: Short-Term Spinal Cord Stimulation and Peripheral Nerve Stimulation for the Treatment of Trigeminal Postherpetic Neuralgia in Elderly Patients. Front Neurol. 2021;12:713366. Published 2021 Aug 3. https://doi.org/10.3389/fneur.2021.713366
Niv D, Maltsman-Tseikhin A. Postherpetic neuralgia: the never-ending challenge. Pain Pract. 2005;5(4):327-340. https://doi.org/10.1111/j.1533-2500.2005.00035.x
Dones I, Levi V. Spinal Cord Stimulation for Neuropathic Pain: Current Trends and Future Applications. Brain Sci. 2018;8(8):138. Published 2018 Jul 24. https://doi.org/10.3390/brainsci8080138
Huang M, Chen Q, Wu S, et al. Treatment Efficacy and Technical Advantages of Temporary Spinal Nerve Root Stimulation Compared to Traditional Spinal Cord Stimulation for Postherpetic Neuralgia. Pain Physician. 2022;25(6):E863-E873.
Isagulyan E, Tkachenko V, Semenov D, et al. The Effectiveness of Various Types of Electrical Stimulation of the Spinal Cord for Chronic Pain in Patients with Postherpetic Neuralgia: A Literature Review. Pain Res Manag. 2023;2023:6015680. Published 2023 Mar 24. https://doi.org/10.1155/2023/6015680
Saxena AK, Lakshman K, Sharma T, Gupta N, Banerjee BD, Singal A. Modulation of serum BDNF levels in postherpetic neuralgia following pulsed radiofrequency of intercostal nerve and pregabalin. Pain Manag. 2016;6(3):217-227. https://doi.org/10.2217/pmt.16.3
Chang MC. Efficacy of Pulsed Radiofrequency Stimulation in Patients with Peripheral Neuropathic Pain: A Narrative Review. Pain Physician. 2018;21(3):E225-E234.
Fan Z, Zheng X, Li D, Chen H, Li L. Comparison of lidocaine and ropivacaine stellate ganglion blockade in treating upper limb postherpetic neuralgia. Medicine (Baltimore). 2022;101(23):e29394. Published 2022 Jun 10. https://doi.org/10.1097/MD.0000000000029394
Luo Q, Wen S, Tan X, Yi X, Cao S. Stellate ganglion intervention for chronic pain: A review. Ibrain. 2022;8(2):210-218. Published 2022 May 28. https://doi.org/10.1002/ibra.12047
Chun-jing H, yi-ran L, hao-xiong N. Effects of dorsal root ganglion destruction by adriamycin in patients with postherpetic neuralgia. Acta Cir Bras. 2012;27(6):404-409. https://doi.org/10.1590/s0102-86502012000600008
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Julia Czerwik, Joanna Cieszkowska, Joanna Dmochowska, Marta Czubala, Wiktor Wróblewski
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 160
Number of citations: 0
