Doctor Says

Various therapies can be considered

Post-herpetic neuralgia (PHN) is notoriously difficult to treat.

Anti-convulsants, anti-depressants or even opioids may be used to help manage your pain.

Local anaesthetic gels or plasters can also be used. These topical preparations will not give rise to side effects such as drowsiness or lethargy.

Your doctor may also recommend using a combination of drugs for better efficacy. When conservative management with medications fails, interventional pain therapies can be considered.

These include sympathetic nerve blocks, radiofrequency treatment of the trigeminal nerve as well as nerve stimulation.

How each person responds to such treatment is unpredictable.

In general, it is more achievable to get partial reduction in pain rather than complete resolution of it.

This is because the trigeminal nerve is permanently damaged by the shingles virus.

Currently, a shingles vaccine is available which can reduce the risk of developing shingles by 50 per cent and the risk of PHN by about two-thirds.

Those who have had shingles can also go for this vaccine, though their immune system would also have been boosted from that episode of shingles.

In general, they should wait at least six months after the infection has resolved.

Dr Ho Kok Yuen

Specialist in anaesthesiology and clinical director of the Raffles Pain Management Centre at Raffles Hospital

A version of this article appeared in the print edition of The Straits Times on May 03, 2016, with the headline 'Various therapies can be considered '. Print Edition | Subscribe