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Postherpetic shingle neuralgia is a condition that affects nerve fibers and skin, causing burning pain long after the rash and blisters of shingles are gone.

Symptoms of Postherpetic Shingle Neuralgia

Symptoms of this condition include:

  • Sensitivity to light touch, even the touch of clothing on the skin
  • Pain that lasts three months or longer, described as burning, sharp and jabbing, or deep and aching
  • Itching and numbness

Individuals with the condition can develop the following complications:

  • Depression
  • Fatigue
  • Difficulty sleeping
  • Lack of appetite
  • Difficulty concentrating

Causes of Postherpetic Shingle Neuralgia

Individuals who have recovered from chickenpox have the virus in their body for the rest of their lives. The virus can be reactivated as the individuals age and as a result of a suppressed immune system.

Postherpetic shingle neuralgia occurs if the nerve fibers were damaged by chickenpox. Damage to the nerve fibers affects the transmission of nerve impulses from the skin to the brain. As a result, the messages are confused and exaggerated, causing extreme pain that can last for months or even years.

Risk Factors

Individuals are at risk of developing postherpetic shingle neuralgia as a result of:

  • Severity of shingles
  • Age (being older than 50)
  • Other chronic illness (such as diabetes)
  • Shingles on the face or torso
  • Shingles antiviral treatment was delayed for more than 72 hours after the rash appeared

Treating the Pain with an Intercostal Nerve Block

An intercostal nerve block can help relieve pain in the chest caused by postherpetic shingle neuralgia by reducing inflammation and irritation in the intercostal nerves.

Patients who have not responded to other treatment may be good candidates for an intercostal nerve block. Patients should consult their physician to find out if the procedure can offer them effective pain relief.

Side Effects and Risks

The procedure is relatively safe, with few possible side effects such as bruising or soreness at the injection site.

Serious (and rare) complications may include nerve damage, bleeding, infection and collapsed lung.

What to Expect During the Procedure

Once the patient is lying face down on the table, the medical professional will clean the patient’s chest with an antiseptic. Next, the doctor will insert a needle under the rib and inject the anesthetic. Using x-ray guidance, the physician will then insert a second needle and inject the steroid pain medication. The injection site will become numb and the patient may notice improvement in their pain in as little as 15 minutes.

The steroid may relieve pain associated with a swollen nerve, with the full effects typically felt two to three days after the procedure. Results will vary, but the pain relief may last several months.

The procedure will take less than 30 minutes and patients will go home the same day.

After the Procedure

Patients should not engage in any rigorous activity for 24 hours after the intercostal nerve block. Patients can resume their diet and take medications immediately after the procedure.

If the treatment is effective, periodic injections may be necessary to help patients stay pain-free.