The most common complication of shingles is nerve pain. This condition is also called postherpetic neuropathy (PHN). The doctor can prescribe a variety of medications to help manage the pain.
The varicella-zoster virus causes shingles, the same virus responsible for Chickenpox. Sensory nerves and the skin supplied by the nerves are affected. It can cause symptoms like tingling, painful skin, and a rash. These symptoms usually disappear within 2 to 4 weeks.
Long-term nerve pain (PHN) develops in 10-18% of people where the rash first appeared. The pain may last for many months or even years. The pain can be debilitating for some people and interfere with their daily lives.
The doctor has several options for helping a patient with PHN to reduce pain. If one option does not work, the patient can discuss other options with their doctor.
This article will discuss the various medications available for shingles pain. These include narcotics, antidepressants, and anticonvulsants.
Narcotic Analgesics
threeTrustedSource medical organizations that recommend opioids for PHN include the American Academy of Neurology, the Special Interest Group on Neuropathic Pain, and the European Federation of Neurological Societies.
Opioids are a type of narcotic pain reliever that works by binding to opioid receptors present in the Central Nervous System (CNS). This blocks the pain signals that the body sends to the brain through the spinal cord.
Experts, however, point outthrusted sources that opioid use is becoming more controversial due to disagreements about appropriate usage. These drugs are more likely to be misused, lead to addiction and cause death.
Opioids can manage pain in the PHN but also have side effects beyond addiction and misuse. Includes.
- Constipation
- Slow breathing
- Confusing words and phrases
- nausea
- Euphoria
- Drowsiness
Antidepressants
Certain antidepressants, known as Tricyclic Antidepressants (TCAs), may relieve shingles nerve pain. AAN, Neuse, and EFNS recommend oral TCAs for PHN pain.
They work slightly differently, but these antidepressants inhibit the reuptake at the synapse of serotonin or norepinephrine. These antidepressants are available in various oral forms, including capsules, tablets, and oral solutions.
Other antidepressants, such as serotonin-norepinephrine reuptake inhibitors (SNRIs) and selective serotonin reuptake inhibitors (SSRIs), have not shownTrusted Source any better results than TCAs. Both have similar side effects.
TCAs are known to cause side effects, including shingles pain. Some common side effects include trusted Sources:
- Constipation
- Weight gain
- dizziness
- Dry mouth
- Increased appetite
Doctors may be cautious when prescribing these drugs to populations more susceptible to adverse effects.
Anticonvulsants
Anticonvulsants can be used to treat shingles nerve pain. These medications are used to treat seizure disorders such as Epilepsy. However, the Food and Drug Administration (FDA) approves gabapentinTrustedSource and pregabalinTrustedSource as a treatment for PHN.
Both gabapentin and pregabalin block calcium channels in slightly different ways. This can result in a decrease in nerve transmissions into the brain.
Different formulas and dosages are available depending on the individual’s needs. Both medications have similar side effects. The most common is dizziness, followed by a strong desire for sleep.
Other Treatment Options
There are several other treatment options for nerve pain caused by shingles.
AAN, Neuse, and EFNS recommend using lidocaine 5% patches as first-line therapy. The patch can be applied directly to the area of the skin causing the pain. There are a few side effects that can be associated with the use of this patch.
You may also consider the following:
- Capsaicin in a cream or patch: This treatment can irritate the application area.
- Botox Injections: Further studies are needed to confirm the effectiveness of Botox for nerve pain.
- Epidural Steroid Injections and Neuromodulation: While additional research is needed, evidence suggests it can work for some people.
- Acupuncture_ This traditional form of medicine can help reduce the painful symptoms of Shingles.
- Home remedies Wearing loose clothing, applying Calamine lotion, taking oatmeal baths, and applying cool compresses can also relieve pain and reduce shingles rash.
- Pain relief medications available over-the-counter: Acetaminophen or nonsteroidal anti-inflammatory (NSAID) drugs may be helpful.
- Transcutaneous electrical nerve stimulation or pulsed electromagnetic field therapy: Techniques Trusted sources that utilize small electric currents or magnet energy may help block and promote healing.
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