P.H.N. – Post-Herpetic Neuralgia

What is P.H.N.?

PHN is chronic pain following a Shingles infection. PHN, shingles and chickenpox are all caused by the same virus infection.  After getting chickenpox as a child, the virus stays in the body, living quietly in nerves attached to the spinal cord.  Shingles happens when the chickenpox virus, called the varicella-zoster virus, wakes up again – usually causing burning pain and a rash on the abdomen, chest, arms or face.  The pain can feel unbearable!

In some people, the rash subsides, but the pain does not go away. Damage to the sensory nerves caused by the virus and the body’s inflammation reaction are thought to be the cause for the more chronic or permanent effects.

Who can get P.H.N.?

Patients affected by shingles and PHN are usually over 50 years of age, but anyone who has had chickenpox can get it. The shingles vaccine is available and is recommended for everyone over the age of 50, in order to prevent the infection.

How is P.H.N. diagnosed?

PHN is usually diagnosed very easily.  It almost always follows on immediately from a shingles infection, which is typically a bright red, itchy, painful rash in one area on one side of the body.  After the acute infection is over, and the rash has gone away, the pain persists in the same area.

Can P.H.N. be treated surgically?

Doctors may prescribe medications, both oral and creams, to help with symptoms of the acute shingles infection.  Some of these medications can be helpful with the chronic pain of PHN, but rarely are they complete or long-lasting.  Surgery can be performed to disconnect the damaged portions of the nerves, so that the chronic pain signals cannot travel to the brain.

There are only a handful of surgeons performing these techniques.  In the right hands, this straightforward outpatient operation is highly successful and provides a permanent solution!

Surgeons at Neuropax clinic successfully treat PHN – in many cases permanently – with resection of the small damaged nerves.  With a straightforward examination and some local anesthetic injections in the clinic, the nerves injured during the acute infection can be found.  This gives the surgeon a target on which to perform a neurectomy – a procedure that removes small portions of the nerves that are the cause of the pain – thereby disconnecting the pain signal from the brain.  This leaves a numb patch on the skin where the pain used to be.  The straightforward procedure is done as an outpatient – you go home the same day!  In most cases, the nerve pain is gone or nearly gone the next day.   In some patients the pain resolution can take a few months, as the cut nerve ends take time to heal.  

Call Neuropax today for a consultation to see if you might be a candidate for this procedure.