Postherpetic Neuralgia

Can medical cannabis help people with this condition? Find out more below. 

What is Postherpetic Neuralgia?

Postherpetic neuralgia (PHN) is a type of chronic pain that occurs after an individual has had an episode of shingles. Shingles, also known as herpes zoster, is a viral infection that causes a painful rash. PHN is characterized by pain that persists even after the rash has healed, typically lasting for at least three months. The pain can be severe and debilitating and can occur in the area where the rash was present and in other areas of the body.

What causes it?

The exact cause of postherpetic neuralgia is not fully understood, but it is thought to be related to nerve damage during the shingles infection. The varicella-zoster virus, which causes both chickenpox and shingles, can damage nerve fibers, leading to abnormal nerve activity and pain. Factors that increase the risk of developing PHN include age (people over 60 are more likely to develop it), the severity of the shingles infection, and having a weakened immune system.

How common is it?

PHN is a relatively common complication of shingles, affecting an estimated 10-18% of people who have had shingles. The risk of developing PHN increases with age, with up to 50% of people over the age of 60 experiencing it. Women are also more likely to develop PHN than men.

Are there types/stages?

PHN does not have specific types or stages, but it can vary in severity and duration. Some people may experience mild pain that resolves within a few months, while others may have severe pain that persists for years. The pain may also fluctuate in intensity, with some periods of relief and other times when it is more severe. Treatment options for PHN include medications to manage pain, such as antidepressants and anticonvulsants, as well as topical treatments and nerve blocks.

Signs & Symptoms

The primary symptom of postherpetic neuralgia (PHN) is chronic pain that persists in the affected area even after the shingles rash has healed. This pain may be described as burning, stabbing, or shooting, and it may be accompanied by other sensations such as tingling, itching, or numbness. The pain may be constant or intermittent and may worsen with physical activity or stress.

In addition to pain, PHN can also cause other symptoms. Some people may experience heightened sensitivity to touch, called allodynia, in the affected area. This means that even light touch or pressure can cause pain. Others may experience muscle weakness or difficulty with coordination, particularly if the nerves that control muscle function have been damaged.

PHN can also impact a person’s mental and emotional well-being. Chronic pain can lead to depression, anxiety, and difficulty sleeping. Some people may also experience a decreased quality of life due to limitations on their ability to participate in daily activities.

It is important to note that the signs and symptoms of PHN can vary from person to person, and some people may experience only mild pain while others may have more severe symptoms. If you have had shingles and are experiencing persistent pain, it is important to talk to your healthcare provider to determine if PHN is the cause and to develop an appropriate treatment plan.

Diagnosis & Treatment

To diagnose postherpetic neuralgia (PHN), your doctor will perform a physical exam and ask about your medical history and any symptoms you are experiencing. They may also perform additional tests, such as blood tests or imaging studies, to rule out other possible causes of your pain.

Once PHN has been diagnosed, your doctor will work with you to develop a treatment plan tailored to your specific needs. Treatment options for PHN include:

  1. Medications: Various medications may be used to manage PHN, including anticonvulsants, antidepressants, and opioids. These medications can help to reduce pain and improve mood.
  2. Topical treatments: Topical treatments such as lidocaine patches and capsaicin cream may relieve pain in specific areas.
  3. Nerve blocks involve injecting a local anesthetic into the affected nerves to block pain signals. This can provide temporary relief from PHN symptoms.
  4. Physical therapy: Physical therapy can help to improve muscle function and reduce pain.
  5. Counseling: Counseling and support groups can help manage the emotional impact of chronic pain.

In addition to these treatments, lifestyle changes such as stress management, exercise, and a healthy diet may also be recommended to help manage PHN symptoms.

Can medical cannabis help?

Medical marijuana may be a potential treatment option for people with postherpetic neuralgia (PHN). The compounds in cannabis, including delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), have been shown to have pain-relieving properties and may be effective in managing chronic pain.

There is limited research on the use of medical cannabis specifically for PHN, but some studies have suggested that cannabis may help manage pain associated with nerve damage. In a 2019 study published in the Journal of Pain, researchers found that medical cannabis was associated with reduced chronic pain and improved quality of life among people with neuropathic pain, including those with PHN.

One of the potential benefits of medical cannabis is that it may offer an alternative to opioid medications, which can be highly addictive and have serious side effects. Medical cannabis has a lower risk of addiction and overdose than opioids, making it a potentially safer option for managing chronic pain.

However, it is important to note that medical cannabis is not a first-line treatment for PHN, and it may not be appropriate for everyone. It is also important to use medical cannabis under the guidance of a healthcare provider knowledgeable about its use and potential risks.

If you are considering using medical cannabis for PHN, talk to your healthcare provider to determine if it may be a helpful treatment option. They can guide dosing, potential side effects, and interactions with other medications you may be taking.

Last Updated: July 25, 2023

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