Q. I am a 49-year-old man who had a bout of shingles on the upper left part of my face about a year ago.

When I recovered 10 days later, I suffered from post-herpetic neuralgia (PHN). I still feel pain around my left forehead and eyebrow, and my left scalp constantly feels itchy.

I went to see a neurologist and have been taking the anti-convulsant drugs, Gabapentin and Carmabezapine. Unfortunately, I still feel the pain. After about eight months on the drugs and with not much improvement, but with side effects like drowsiness and lethargy, I decided to stop.

Though I have heard about PHN patients having suffered for as long as three years, I would not want to be one of them.

How can I alleviate or even eradicate my pain, so that I can return to my normal life?

A. Post-herpetic neuralgia (PHN) is a nerve pain that continues for three months or more due to damage caused by shingles.

Shingles is caused by the varicella zoster virus - which also causes chicken pox.

The pain may be described as burning, stabbing or gnawing. It ranges from mild to very severe and is confined to the same outbreak area of the skin.

In traditional Chinese medicine (TCM), PHN is likely caused by deficiencies in the stomach, spleen and liver, or it could be due to a lack of qi (vital energy) and blood.

In TCM, the liver is responsible for the flow of qi in the body. When the liver is weak - due to ageing, stress, excessive alcohol consumption, depression and anxiety - qi will stagnate and create blood stasis during a bout of shingles.

This then triggers post-herpetic neuralgia with stabbing pain as well as itchiness in the affected areas of the face, eyes, chest, ribs and sides of the waist. The patient may also pass out dry stools, be depressed and irritable, and suffer from insomnia. And when he does fall asleep, he will have many dreams.

The stomach receives and digests food, while the spleen transforms nutrients from food into blood and qi. When the stomach and spleen are weak - due to ageing, a poor diet, weak constitution, over-exertion or chronic illnesses - the nutrients are converted into phlegm and dampness instead.

Over time, this creates heat and fire in the body.

All four of these disease-causing factors will trigger PHN, with pain and a burning sensation at the affected areas.

The person may have a white tongue, poor appetite and yellowish urine. He may also lack strength in the limbs and be unable to clear the bowels smoothly.

People who lack qi and blood - due to old age, a weak constitution and chronic illnesses - may have difficulty recovering fully from shingles. When the rash from their shingles begins to dry and scab, it creates blood stasis and triggers persistent pain with numbness and sensory abnormalities in the affected areas.

The patient may then lack the strength to talk, have a poor appetite and pale or yellowish complexion. He may also experience dizziness and heart palpitations with insomnia and dry skin.

WAYS TO RELIEVE PAIN

Chinese herbal medicine, acupuncture, moxibustion and cupping therapy can help you to improve your condition by strengthening the affected organs and dispelling pathogenic factors

Herbs like Chinese gentian, Chinese thorowax root and kudzuvine root are used to strengthen the liver and, in turn, enhance qi and blood circulation to reduce pain and itchiness.

As for strengthening the stomach and spleen to dispel heat and dampness, try largehead atractylodes rhizome, Indian bread, honeysuckle flower and weeping forsythia capsule.

To increase qi and enhance blood circulation to reduce one's pain, go for milkvetch root, Sichuan lovage rhizome and Chinese angelica.

You should take easily digestible food, such as porridge with coix seeds and lily bulb or common yam rhizome and gordon euryale seeds.

Drink sufficient water and eat more fruit and vegetables.

Abstain from cold, spicy and oily food, seafood (such as prawns and crabs), alcohol and smoking to reduce the heat and pain.

Listen to some music to calm yourself and avoid intense emotions such as anger, anxiety and sadness to prevent stagnation of liver qi.

Keep yourself warm, sleep early and do light exercises regularly - such as taiji and brisk walking - to enhance qi and blood circulation.

Keep the skin outbreak area clean and avoid friction and collision with objects to prevent pain.

Lim Lay Beng

Traditional Chinese medicine practitioner at YS Healthcare TCM Clinic

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