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Not everyone who has shingles develops postherpetic neuralgia, but statistics report that 20-30% of those with the virus end up with this type of neuropathic pain. In people 60-70 years of age, the risk of developing PHN after shingles is 60%, and for those over 70 years of age, the rate goes up to 75%.

Doctors have identified several risk factors that increase the likelihood of developing PHN after shingles. These risk factors include:

. Being a woman
. Older age
. Severity of the rash
. Severity of pain during the initial stages of the disease
. Presence of symptoms before the rash appeared (includes itching, pain, numbness, and tingling)
. Psychological stress

Neuralgia occurs in one area of the body, usually on one side (unilateral). PHN follows the area originally affected by the shingles, with pain traveling along the distribution of the nerve. The pain can be:

. Intermittent or continuous
. Sharp, shooting, stabbing, or burning
. Accompanied by itching, tingling, numbness, and/or hypersensitivity to touch

There are several treatment options for postherpetic neuralgia. Treatment options include:

Medications - Anticonvulsants (gabapentin and pregabalin) have been shown to block the pain associated with neuralgia. Tricyclic antidepressants (amitriptyline) is also prescribed. Topical agents directly applied to the skin are beneficial, such as anesthetic lidocaine and Capsaicin cream.

TENS - Transcutaneous electrical nerve stimulation is a device that stimulates the skin around the affected area by delivering mild electrical currents. These impulses interfere with pain signal transmission to relieve pain.

Selective nerve root block - With this technique, the doctor inserts a small needle through the back and near the spinal cord. After using x-ray guidance to assure needle placement, a long-acting anesthetic agent is injected near the nerves. According to a recent study, the success rate of selective nerve root block was around 70%.

Acupuncture - With this ancient Chinese treatment, the practitioner inserts tiny thin needles into various points on the body. This stimulates the release of endorphins and restores body energy, called qi.

Intrathecal injections - According to a randomized double-blind trial, intrathecal injections of steroid and anesthetic agents are 90% effective for PHN. This involves injecting the medications near the spinal cord.

Spinal cord stimulation (SCS) - When other treatment measures fail, the doctor may recommend an implanted spinal cord stimulator. The tiny device is surgically implanted in the buttocks or abdomen, and tiny electrodes attached to wires are positioned near the nerves. In a study of patients with intractable PHN pain of 2 years duration or more, researchers found SCS to be very successful for relieving pain.