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Would Neuralgia And Nerve Pain Caused By Herpes Zoster Last A Long Time Around The Affected Area?

Posted on Fri, 23 Apr 2021

Question: I have had herpes zoster last month. the area affected was right side of my trunk above the waist. Could not take the recommended antiviral tabs on time . it has been one month since then. the blisters have dried out but there is severe skin sensitivity and nerve pain in the area affected. have been taking pregastar M and nuurobion since last onw week. The skin sensitivity does not allow mw to wear a shirt or to withstand movements due to walking or driving in a car . sometimes even the wind from fans triggers the pain. please advise a suitable cure / medicine . am worried as have been told that this neuralgia may last a very long time . I am a 57 year old male

Answered by Dr. Neeraj Kumar (3 hours later)

Brief Answer:
Increase dose of drugs

Detailed Answer:
Hello,
I have gone through your question and understand your concern.
Post herpetic neuralgia is problematic.
Drugs like amitriptyline, nortriptyline, carbamazepine, pregabalin, Gabapentin can be used in increasing doses for appropriate pain control.
Local application of Gabapentin ointment over involved area can be tried too.
You can discuss and follow up with your treating Neurologist for increase in dose and addition of amitriptyline or other drugs as mentioned above.
Hope you found the answer helpful.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Neeraj Kumar (1 hour later)

Ok Thanks
As i understand most of the medicines mentioned are pain relievers. is there a permanent cure for the damaged nerves that i have now and how much time it will take to return to normal with medication .

additionally i need to know the root cause for acquiring this herpes. i am told that it may be because of drop in my overall immunity when the dormant virus becomes active.
I am only 57 and concerned that if it is because of drop in immunity what can be done to increase my immunity for future? Any medication which i need to take life long?

Answered by Dr. Neeraj Kumar (51 minutes later)

Brief Answer:
Continue treatment as advised

Detailed Answer:
Hello,
The pain relief varies among patients.
The exact duration cannot be ascertained at this early stage.
There is no permanent cure as it is sequale of herpes zoster.
In non responsive cases, surgical options needs to be taken.
The cause of lowered immunity may be aging, diabetes, steroids, alcohol intake.
Sometimes the actual cause cannot be ascertained.
For improving immunity, regular exercise, nutritious diet, proper sleep and avoiding stress helps.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Neeraj Kumar (18 hours later)

that concerns me. no permanent solution means i may have to live with nerve pain for ever . is my understanding correct?

I would like to know if this post herpatic neurolgia in my case is so painful, because i did not take anti viral drugs for treatment?

wud the condition have been better if i had taken a full course of anti viral drugs in the beginning itself?

Answered by Dr. Neeraj Kumar (1 hour later)

Brief Answer:
Take treatment as discussed

Detailed Answer:
Hello,
Use of antiviral and steroids early in the course has been found to be preventing post herpetic neuralgia.

The pain in most cases responds well with treatment as mentioned earlier. No need of life long medications.

Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Neeraj Kumar (55 minutes later)

You have recommended gabapentin ointment as additional measure. could not get this in the market as the pharmacies need the brand name or company name. Kindly suggest the brand name to enable me buy the ointment .

also i am now taking Pregastar M 75 ( pregabalin and mecobalamin 750 ) twice daily instead of once daily. how long do you recommend i should take this medicine ? does this require tapering off before stopping and do i expect any side effects later on .

Answered by Dr. Neeraj Kumar (22 hours later)

Brief Answer:
Take treatment as advised

Detailed Answer:
Hello,
You need to check online the available brand of Gabapentin ointment in your country.
It is available by different names on different country.
You can continue twice daily pregabalin.
No tapering required.
No long term side effects. Weight gain and pedal swelling may occur.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Kampana