Painkillers for shingles: effective drugs that will relieve pain. Treatment of pain during and after the transferred herpes zoster Herpes zoster after treatment, pain remained

The viral nature of herpes zoster is manifested by disturbing a person skin rashes. This process is accompanied by quite severe pain. In childhood, the defeat of the virus, which among doctors is known as the Zoster virus, passes like chickenpox. The virus then takes a dormant form. In the adult generation, who had never encountered this type of virus before, the disease often begins with sharp pain attacks and fever, and a pronounced rash can occupy only a small area.

Sometimes the disease is cured spontaneously. But ongoing therapy can prevent complications. This is essential for immunodeficiency. Famciclovir, valaciclovir and aciclovir will help here.

Painkillers for herpes are important drugs. Ibuprofen, ketoprofen can be noted. Skin itching can be slightly soothed if the affected area is kept as open as possible and contact with clothing is kept to a minimum. Painkillers for herpes zoster are analgin, aspirin, paracetamol, indomethacin, butadione. Herpetic neuralgia is treated with medicines containing capsaicin. When the patient experiences long enough pain, he is offered stronger painkillers. The use of antidepressants will also have a positive effect on the patient.

Inflammation and itching are reduced by corticosteroids. medicines. Newborns will also benefit from acyclovir. And if conjunctivitis appears in babies, use idoxuridine. Pregnant women should not be allowed to reduce immunity. They will need a multivitamin complex. They will need to refrain from bad habits. It is important that during the outbreak of SARS and other diseases to remain stay at home and avoid crowded places. For prevention, do hardening, in order to maintain weak immunity, do not exclude herbal medicine or physiotherapy. If you abstain from alcohol, then in this way you will wonderfully facilitate the task of your body in the fight against an insidious disease.

Herpes refers to serious illnesses which are considered incurable. However, good conditions conducive to the life of people will significantly increase the remission period. Maybe everything will be fine, and the problem will not return and will never bother you again.

Shingles is a severe infection, which is caused by the herpes virus. With this disease, not only the skin is affected, but also the nervous system. Exacerbation of herpes zoster occurs against the background of hypothermia, hypovitaminosis or chronic infection any localization. People at risk are old age, pregnant women and patients who have undergone long-term antibiotic treatment.

With herpes zoster, a person suffers from severe pain that appears even from a light touch on the skin. This is due to the fact that the virus disrupts the functioning of nerve cells, while increasing the sensitivity of nerve endings. These pains can be compared with the pain that a person experiences with burns.

Attempts to endure pain without taking medication can lead to an increase in the threshold pain sensitivity. In some cases chronic pain haunt a person for months and years.

After confirming the diagnosis, the doctor may prescribe antiviral drugs or painkillers for shingles.

Ibuprofen

If the pain is not severe, the doctor will suggest the pain medication Ibuprofen.

Ibuprofen has anti-inflammatory and analgesic effects. The drug reduces pain in shingles.

Indications for its use are the following conditions:

• inflammatory diseases of the joints;
• pain of medium and low intensity of various origins;
• fever.

Children and adults take one tablet of Ibuprofen at a dosage of two hundred milligrams three times a day. Doctors recommend taking the first daily dose in the morning before meals. The following doses should be taken within 24 hours after meals. The duration of treatment depends on the condition of the patient and the course of the disease.

Ibuprofen has the following contraindications for use:

• hypersensitivity to Ibuprofen;
• diseases of the stomach;
• children's age up to twelve years;
• pathology of the liver and kidneys;
• third trimester of pregnancy.

The drug should not be taken simultaneously with other non-steroidal anti-inflammatory drugs.

Ketorolac

Ketorolac has an analgesic and anti-inflammatory effect. The drug is prescribed to eliminate pain in such conditions:

• hepatic and renal colic;
• pain after childbirth;
• sciatica;
• osteoarthritis;
• arthrosis;
• radiculitis;
• osteochondrosis.

Ketorolac is taken one tablet every six hours. Treatment lasts no more than seven days. Patients weighing up to fifty kilograms, as well as patients over sixty-five years of age, Ketorolac is prescribed in reduced doses.

The drug should not be used to treat herpes zoster in such cases:

• hypersensitivity to Ketorolac;
• severe or moderate renal failure;
• bronchial asthma;
• stomach diseases;
• period of pregnancy and lactation;
• nasal polyposis;
• under the age of sixteen;
• blood clotting disorders.

During the period of treatment with this drug, you can not engage in activities that require increased attention.

Paracetamol

Paracetamol has an analgesic and anti-inflammatory effect. This drug is prescribed for such conditions:

• neuralgia;
• migraine;
• myalgia;
• pain from injuries and burns;
• toothache.

Adults and adolescents weighing more than sixty kilograms take one tablet of Paracetamol at a dosage of five hundred milligrams up to four times a day. Treatment lasts five to seven days.

Children from three months to a year are prescribed Paracetamol in the form of a suspension of one teaspoon. Children from one to six years old take two teaspoons of the suspension. The multiplicity of reception is four times a day. The treatment lasts five days.

Paracetamol should not be used for herpes zoster in the following cases:

• blood diseases;
• hypersensitivity to one of the components of the drug;
• pathology of the liver and kidneys.

During treatment with this drug, the use of alcoholic beverages is prohibited. During pregnancy and lactation Paracetamol is prescribed with caution after evaluating the benefits to the mother and the risk to the unborn child.

Baralgin M

Analgesic Baralgin M belongs to the group of non-narcotic nonsteroidal drugs. The active substance of the drug metamizol has an analgesic, anti-inflammatory and antipyretic effect.

Indications for the use of Baralgin M are the following conditions:

• renal and hepatic colic;
• pain with neuralgia, sciatica, arthritis, myalgia;
• spasms of the bladder;
• toothache and headache.

With shingles, adults take one tablet of Baralgin M twice a day. Tablets are washed down with plenty of water. Treatment lasts no more than five days.

Baralgin M is contraindicated in such pathologies:

• individual intolerance to metamizole;
• bronchial asthma;
• diseases of the liver and kidneys;
• age up to fifteen years;
• first and third trimester of pregnancy.

Baralgin M is prescribed with caution for hypotension and circulatory disorders.

Naproxen

The non-steroidal anti-inflammatory drug Naproxen has analgesic, analgesic and antipyretic effects. Main active substance this drug is naproxen sodium.

According to the instructions for use, Naproxen is prescribed for such diseases:

• osteoarthritis;
• arthritis;
• radiculitis;
• bursitis;
• neuralgia;
• myalgia;
• migraine.

Adults take one Naproxen tablet twice a day. For children, the drug is prescribed in the form of a suspension. The dosage is determined individually, depending on the weight of the child. From the cure

Naproxen should be discontinued in such cases:

• "aspirin" asthma;
• hypersensitivity to naproxen sodium;
• diseases of the stomach;
• age up to one year.

The drug is prescribed with caution during pregnancy.

Pentalgin

Pentalgin is an anti-inflammatory, analgesic and antispasmodic drug. it medicine used for pain syndromes.

The composition of Pentalgin includes such active substances:

• naproxen;
• drotaverine;
• paracetamol;
• caffeine;
• pheniramine.

Pentalgin is prescribed for such conditions:

• pain in the joints;
• toothache;
• renal colic;
• migraine;
• postoperative syndrome.

For shingles pain, dermatologists recommend taking one to three tablets a day. The daily dose of Pentalgin should not exceed four tablets. To achieve an analgesic effect, tablets are taken no more than five days.

2014-06-20 10:13:06

Julia asks:

After herpes zoster, the places where the rashes were terribly sore and itchy, even if you don’t scratch the acyclovir drank, I still smear the acyclovir ointment ..... the pain is unbearable, what should I do?

Responsible Agababov Ernest Danielovich:

Good afternoon. This therapy is effective only in the acute period, postherpetic neuralgia is not sensitive to such treatment, therapy must be changed, contact a neurologist at the place of residence.

2016-02-06 19:19:21

Anya asks:

Hello! I beg you for help. A couple of months ago I suffered from herpes zoster (it went along my arm and up to my back), then it became inflamed on the same side sciatic nerve I don't know how related. It was quite difficult, with fever and terrible pain, but I seemed to be cured. And recently, after a lot of stress, I had another problem - itching and pain in the coccyx area, as if inside, the problem is VERY uncomfortable. I observe hygiene well, I didn’t hit anywhere, there are no discharges from this area. And since I found a small spot on my back, similar to the same herpes, I had a question, could this be related to that disease? And if not, please tell me what these symptoms look like? Thank you!

2013-11-06 06:04:18

Foxy asks:

Hello! My husband was ill with herpes zoster in September (he had become very cold the week before). During the acute phase (temp, pain) of the disease, he donated blood for HIV. The result just killed me .... it turned out to be positive! Then I found out that he cheated on me 3 months ago (there was unprotected sex). By all logic, antibodies to the virus should already be produced .... I also donated blood for HIV, but I have a negative one !!! (3 months have just passed after the first dangerous contact). How is this possible? Can a husband have a false positive result due to herpetic infection?

Responsible Oleinik Oleg Evgenievich:

Good afternoon! Any infection is confirmed exclusively (!) by positive DNA (herpes) or RNA (HIV) by PCR analysis. HIV in Ukraine, due to the poverty of the country's budget, is first verified by a cheap screening method - enzyme immunoassay(ELISA) - the presence of antibodies to the virus, which in some situations (for example, suppression in the humoral link of immunity, may remain below the norm or within the normal range and, if the infectious process is active, will show a false negative result). When positive reaction(detection of antibodies) - by PCR analysis. Therefore, after a positive ELISA, your spouse needs to examine the blood for HIV RNA. Cross-reaction with herpes is excluded!
The incubation period for HIV infection can be up to 6 months, so you need to repeat the test 3 months after the first negative result. Use antiseptic irrigation (miramistin, chlorhexidine) and/or condoms immediately after unprotected sex with your husband. Be healthy!

2013-05-30 17:50:58

Catherine asks:

Good afternoon! My husband and I are planning a pregnancy, we have not been using protection for the 3rd month. The next period should come in 2 weeks.
Two days ago I found out that I have herpes zoster. Eruption on the back the size of 3 coins, no pain, slight itching. This disease worries me for the first time, although herpes on the lip happens once every 1-2 years. I had chicken pox as a child.
The doctor prescribed treatment with acyclovir and Zelenka topically, Valtrex and milgamma-composite internally. Started treatment right away.
Questions: in case of pregnancy, what are the consequences for the fetus?
And is it possible to continue planning a pregnancy after the cure?
Thanks in advance.

Responsible Wild Nadezhda Ivanovna:

2012-10-20 17:10:19

Elena asks:

It's been a month and a half since we've treated shingles on my dad's face. The strongest headaches do not give rest! Shoots into eye, ear along the course of the nerve. Everything above the lip is numb. The neuropathologist has told or said, that nerve small knots are inflamed. Has written out nyxes and tablets, but pains do not pass or take place. Dad falls asleep only after taking nimesil. Before that, I drank Neuralgin (it doesn’t help anymore). Is there nothing you can do to help? They say look for a good neurologist, but where can you find him? Tell me how to help dad. He was completely exhausted from pain (and his mother along with him). Thank you in advance.

Responsible Maykova Tatyana Nikolaevna:

Elena, pain disorders are treated by specially trained neuropathologists. Your task is to find a doctor who has a certificate of training in the international headache school. In Ukraine, this is done in medical center"Headache" (there is a website, look).

2012-09-15 16:56:21

Michael asks:

I am 65 years old.
He had been ill with herpes zoster on the right forearm. He was treated in the hospital.
- Virolex 0.25 dropper 10 days
-Ointment herpevir, brilliant green 10 days
-tablets gerpevir 0.2 10 days
-Dexalgin intramuscularly for 10 days
After the treatment, the pain decreased to tolerable, but the arm did not recover.
After discharge:
- pills gerpevir 10 days
- tablets Amizon 10 days, 2 tablets, 10 days - one.
It has now been 20 days since I was discharged.
The hand did not fully recover, the pain, although weak, remained.

Question.
What prophylaxis against relapse do I need and what measures should I take to restore the functions of my hand?
Thank you in advance.

Responsible Kachanova Victoria Gennadievna:

Hello Michael. The question is not for correspondence consultation. The format of our portal does not provide for the appointment of correspondence treatment.

2012-06-17 17:26:44

Angelina asks:

Herpes zoster was three years ago, treatment was carried out, the rash on the skin disappeared. Periodically, there was pain at the site of the rash in the arms and back. 15 days ago, an operation was performed to remove a tumor of the uterus, and to remove the rest of the genital organs. After anesthesia, the pain in the back and arms intensified. Could anesthesia provoke the resumption of herpes? And is it possible to conduct a course of radiation?

Responsible Agababov Ernest Danielovich:

Theoretically, the surgical intervention itself could be a provoking factor, from all of the above, I did not see any contraindications to radiation, but in any case, the issue should be resolved at an internal appointment.

2010-12-07 18:24:37

Elena asks:

Hello! Help to understand the situation! I got sick with herpes zoster, the rash was on my leg, treatment was started on the 5th day of the disease, I took a weekly course of acyclovir! But not so long ago (after the course) the other leg and a little arm started to hurt in the same place. Strange pimples appeared on the leg where the rash was. What could it be? Why is pain in the other leg possible (after all, lesions are often one-sided)? And these pimples - can be a continuation of herpes after the drunk course?? I can't see a doctor in person!

Responsible Agababov Ernest Danielovich:

Hello Elena, yes, the probability that the pain is caused again by herpes is low, this is not typical for herpes, but this does not exclude such a diagnosis. In any case, it is not possible to tell you anything specific without seeing and examining it. The symptom is rather non-specific. Therefore, look for any opportunity to get to the doctor for an appointment.

2009-05-04 12:37:35

asks Kornilova Tatiana:

Dear doctor!
Almost all my life I have been haunted by seizures for which doctors do not find the cause. Suddenly, regardless of positive or negative emotions, first in my lower abdomen, and then, rising to the solar plexus, chest and moving to my back, I have sensations very similar to those that arise in negligent schoolchildren or students before an important exam, when they understand that no "boom-boom" on the subject. It starts to “twist” me so that it becomes simply unbearable, everything turns into sobs, throwing around the bed, strong tension in the muscles of the face, similar to convulsions, a desire to hurt myself in order to somehow distract from these sensations. Calming agents (valerian, corvalol, etc.) do not bring relief. Such an attack lasts from an hour or more, the last one lasted about 7 hours. Ambulance crews ask: what hurts you? - and when I answer that this is not pain, something else - they shrug their shoulders, give an injection of demidrol, papaverine (because with such attacks, the pressure rises from crying), I take sleeping pills and fall asleep. In my youth, such attacks might not occur for years, sometimes they happened two or three times a year, but they always "hung" over me. This year I had herpes zoster on my arm, and after two months my condition worsened dramatically. The attack could have occurred just out of the blue. Suddenly, for no apparent reason, there is a desire to cry. A simple phone call, a joyful event in the family or a small annoyance, a crowd of people in a store or market, the need to do something homework- everything provokes these terrible sensations, anger, irritability, unmotivated sobs from which you simply do not want to live and from which you are terribly ashamed in your soul.
I passed full examination all internal organs, thyroid gland, hormone tests. No pathologies were found and, on the advice of one of the doctors, she was referred to a psychiatrist. She passed all the necessary tests and a course of treatment of blood vessels (vegetovascular dystonia). I started taking a Paxil tablet in the morning, and an injection of Amitriptyline at night. After ten injections, when her sleep stabilized, she switched to tableted Amitriptyline. She was treated according to this scheme for 7 months. The improvement of the state is expressed in the fact that my sensations have become muffled, but do not disappear. My husband and I went to rest in Karlovy Vary for 20 days, continuing to take the prescribed drugs. I felt there as if I were reborn into the world - not a single attack and even a hint of it - a complete perception of all the joys of life. Upon returning home, although my doctor gradually canceled Amitriptyline and Paxil, a withdrawal syndrome began (very similar to drug withdrawal), which lasted about a month. Now I take one tablet of Gidazepam and Melitor at night. Sleep does not stabilize in any way, then I wake up at two in the morning and cannot fall asleep, then early in the morning. Sometimes there is a feeling that I feel in my body all my "tree" nerve fibers. Sometimes holding the breath helps, sometimes, as in the Middle Ages, I start whipping myself on the back with a belt and the physical pain interrupts the mental one. I feel that antidepressants are “not my” medicine, I don’t want to go back to them, but the whole thing is completely upset nervous system. How to restore it?
They found angina pectoris in me, but the cardiologist canceled the medicines two years ago, I regularly drink only Nebilet once in the morning for pressure. For 15 years, I have been taking Klimonorm as a hormone replacement therapy, so I still have regular periods.
At 22, she gave birth to a daughter, the birth was difficult.
In early childhood, in front of my eyes, a little boy, playing with his father's pistol, accidentally shot my friend, which became a psychological trauma for me. As a child, it seems to me now, my parents could not understand my hypersensitivity to all sorts of injustices and subtle perception of the world, which I "suffer" to this day.
I am 62 years old, I am married. The family has complete well-being, mutual understanding and prosperity, grandchildren. Among my close relatives, no one suffered from such manifestations of an unknown disease, my mother is now 91 years old. My father died of a heart attack at the age of 79, he is my copy in character.
I ask you, if possible on the basis of the symptoms I have described, to answer whether the treatment is going through in the right way and whether there are any other ways to deal with my illness.

With respect and hope, Tatyana Ivanovna Kornilova. Donetsk.

date of birth: 9 July 1947 1 hour 20 minutes
place of birth: Donetsk
Question 2: Correctly determine the path of treatment
question 3: C early childhood when they didn't understand me.
Question 4: No. never experienced such feelings.
question 5: When it is completely unbearable during attacks, but I know that I will never go for it, because I love life and my loved ones very much.
figure 1: 4
figure 2: 7

Responsible Stovburg Yaroslav Vladimirovich:

Dear Kornilova Tatyana, according to your descriptions, we can judge the presence panic attacks. I think the appointment of antidepressants is justified. Paxil is by far the best for these disorders. When you had a withdrawal syndrome, I think this testified to the "undertreatment" and the need to continue treatment. Apparently you are impressionable and too vulnerable by nature, but discomfort in the state is observed from youth. Therefore, I believe that 7 months of treatment is a good time, but perhaps not enough. You yourself acknowledge that complete breakdown mental activity" - so these disorders must be treated! Another thing is if you do not want to return to antidepressants - this is your choice. I advise you to contact a psychiatrist and find an effective treatment.

Postherpetic neuralgia is the most frequent complication shingles. The disease, although not dangerous to human life, is very painful. Postherpetic neuralgia does not allow a person to sleep, work, causes depression and drastically reduces the quality of life. Theoretically, it can occur after any episode of herpes zoster, although there are some predisposing factors. The duration of the disease is different: on average, it is about 12 months, but in some cases this pathology can persist for years. Various groups of drugs are used to treat the disease. Currently, preference is given to anticonvulsants. In this article, we will talk about the causes of postherpetic neuralgia, symptoms and treatments.

Postherpetic neuralgia belongs to a whole class of pain sensations: neuropathic pain, which has its own characteristics. So, among all existing species of neuropathic pain, postherpetic neuralgia ranks 3rd in prevalence, yielding the palm only to pain in the lower back and diabetic pain.

Shingles - what is it?

(herpes) is the result of reactivation of the herpes virus type 3 (Varicella zoster). Reactivation, because the first encounter with this virus ends for a person with development chickenpox. After chickenpox, the virus hides in nerve ganglia. With a decrease in immunity, it leaves the “shelter”, multiplies and causes damage to the nerve conductors and skin, which is called shingles.

Herpes zoster lasts about 3-4 weeks. The disease is characterized by the appearance of blisters on the skin, which then dry out and form crusts. When the crusts fall off, pigmentation remains for a while. Rashes are located in the area of ​​the affected nerve ganglion: in the form of transverse stripes on the trunk, longitudinal stripes on the limbs and in the zone of innervation of the cranial nerves on the face and head. At the same time, the very appearance of the rash and all stages of its development are accompanied by itching, burning, pain. different intensity and character (shooting, boring, dull and aching, burning, and so on), as well as fever and intoxication. With a favorable outcome, shingles passes without a trace. In some cases, it leaves behind postherpetic neuralgia. When does it occur and why? Let's find out.

Causes of postherpetic neuralgia

In medicine, it is generally accepted that postherpetic neuralgia occurs as a result of inflammatory process in nerve ganglia and peripheral nerves. Inflammation provokes a multiplying virus. The interaction and reasonable balance between the pain and pain systems in the body are disturbed, the mechanism of control over the excitability of pain neurons in the central nervous system suffers.

However, neuralgia complicates not all cases of herpes zoster. Risk factors for its development are:

• elderly age. According to statistics, the incidence of postherpetic neuralgia in people over 60 years of age is 50%, that is, every second case ends painfully for the patient. While in the age group from 30 to 50 years this complication occurs with a frequency of 10%. After 75 years, the disease affects 75% of patients. The numbers speak for themselves. Presumably, the main role in this is played by the ability to regenerate (that is, heal), the rapid elimination of the inflammatory process in young people and the decrease in immunity in old age;
• location of the rash. Postherpetic neuralgia often develops when the rash is localized on the trunk;
• massive rash. The larger the affected area, the more likely the development of neuralgia. Indirectly, this may be due to a low immune response, the inability of the body to localize the lesion by one or two ganglia;
• the severity of the pain syndrome in the acute period (during the appearance of a rash). The stronger the pain in this period, the higher the likelihood of developing postherpetic neuralgia;
• the time to start taking antiherpetic drugs that block the reproduction of the virus. The later specific treatment is started, the higher the likelihood of complications.

Separately from this list, it is worth noting the more frequent occurrence of postherpetic neuralgia in females, which has not yet been explained.

Symptoms of postherpetic neuralgia

Postherpetic neuralgia is commonly understood as pain that persists after the rash has healed. The pain can be felt by the patient from 3-4 weeks to several years. On average, this type of neuropathic pain lasts for about a year.

What is the nature of the pain? It can be of several types:

• constant. The pain usually has a dull, pressing, deep character with a touch of burning;
• periodic. This kind of pain manifests itself as shooting, stabbing, acting like an "electric shock";
• allodynic. This pain is sudden, burning in nature, which occurs in response to a slight touch, as an inadequate reaction to an external stimulus. For example, touching clothing can cause similar sensations.

One patient may experience all three types of pain at the same time.

The pain spreads along the affected nerve conductors, that is, it is felt where the rash was localized, although there are no manifestations on the skin.

In addition to pain, other sensory sensations may occur in the affected area, which, however, also deliver discomfort. It can be:

• numbness;
• tingling, goosebumps, having foreign body(“some insect is sitting”, “something stuck”, and so on).

The affected area usually has hypersensitivity to any touch (although the numbness of the skin itself may be felt).

Although the main manifestation of the disease is only pain, it causes changes in other areas of a person's life, harming him. Pain is provoked by:

• decreased physical activity;
• insomnia;
• chronic fatigue;
• loss of appetite and, in this regard, even body weight;
• a state of anxiety and constant anxiety, which in some cases ends in depression;
• decrease in social activity.

As you can see, postherpetic neuralgia leads to a decrease in the quality of life of a sick person. Therefore, it is necessary to actively fight against it. To do this, resort to the help of drugs.

Treatment of postherpetic neuralgia

In order to reduce the risk of postherpetic neuralgia, it is necessary to start treatment of herpes zoster with antiherpetic drugs (from the Acyclovir group) within the first 72 hours from the onset of the disease. In this way, active reproduction (and hence the spread) of the virus is blocked and the area of ​​\u200b\u200brashes decreases. Therefore, risk factors for postherpetic neuralgia that can be influenced are eliminated.

To date, the following means are used to combat postherpetic neuralgia:

• anticonvulsants;
• tricyclic antidepressants;
• patches with lidocaine;
• capsaicin;
• opioid analgesics.

Conventional analgesics and non-steroidal anti-inflammatory drugs (Ibuprofen, Diclofenac, Nimesulide and others) are ineffective in combating neuropathic pain.

Anticonvulsants

From this group of drugs, Gabapentin (Gabagamma, Tebantin, Neurontin, Convalis, Catena) and Pregabalin (Lyrica, Algerica) are used. A feature of the use of Gabapentin is the need to titrate the dose to an effective one. It looks like this: on the first day of admission, the dose is 300 mg 1 time in the evening; in the second - 300 mg in the morning and evening; in the third - 300 mg 3 times a day; fourth, fifth, sixth day - 300 mg in the morning, 300 mg in the afternoon, 600 mg in the evening; seventh, eighth, ninth, tenth day - 300 mg in the morning, 600 mg in the afternoon, 600 mg in the evening, and so on in increasing order. Usually the effective dose is 1800-3600 mg/day. When the pain stops, the person should take a maintenance dose of about 600-1200 mg/day. Pregabalin is administered at a dose of 150-300 mg/day divided into 2-3 doses. These drugs are very well tolerated, rarely cause side effects(dizziness, drowsiness), which is important for elderly people with concomitant diseases. Their disadvantage is their relative high cost.

Tricyclic antidepressants

From this group it is customary to use Amitriptyline and Nortriptyline. Moreover, in the elderly, it is preferable to use Nortriptyline due to its better tolerability. They are indicated for patients with concomitant mental disorders(depression). The dose of Amitriptyline is from 12.5 to 150 mg / day, Nortriptyline - from 25 to 100 mg / day. It should be borne in mind that these drugs are contraindicated in myocardial infarction, prostatic hypertrophy, glaucoma. Therefore, their appointment requires a careful study of the anamnesis of the patient's life and taking into account the state of health in general.

patches with lidocaine

Such patches have become quite popular in recent years due to their ease of use and exceptional topical application. The plaster (Versatis) is glued to the affected area and left for 9-12 hours. The maximum number of patches that can be used during the day is three. In addition to the direct analgesic effect, the patch protects the skin from external influences (touch, friction of clothing), which in itself reduces pain. The advantage of patches is the absence of systemic effects, since lidocaine is absorbed locally, with virtually no effect on other organs and tissues.

capsaicin

Capsaicin is a substance derived from red hot peppers. It is used in the form of an ointment (capsaicin ointment, Nikoflex and others). Not suitable for everyone, since the application of the ointment itself can be accompanied by a significant burning sensation. The mechanism of action of the drug is based on the depletion of pain impulses, that is, the anesthesia phase does not occur immediately. The ointment must be applied 3-5 times a day.

Opioid analgesics

This group of drugs should, if possible, be used to a limited extent. Basically, this line of funds is prescribed for unbearable pain for a short period of time and, of course, only by a doctor. They can be combined with Gabapentin or Pregabalin. The most commonly used drugs from this group are Oxycodone, Tramadol, Morphine, Methadone.

Another remedy, but already non-drug assistance for postherpetic neuralgia, is considered to be acupuncture. In some cases, it can independently help in getting rid of excruciating pain.

There are also folk methods treatment of postherpetic neuralgia. The most common of them are:

• rubbing from black radish juice;
• garlic oil rubbing (for example, dilute 1 tablespoon of oil in 500 ml of vodka, rub 2-3 times a day);
• herbal compresses (from the leaves of wormwood, geranium);
• ointments based on propolis and beeswax.

It should be said that for the treatment of postherpetic neuralgia it is often necessary to combine various methods, because when used separately, they give an insufficient effect.

Postherpetic neuralgia refers to those diseases that are easier to prevent than to treat. Of course, this is not always possible, but timely treatment of herpes zoster in most cases helps to avoid this painful complication. It should also be remembered that postherpetic neuralgia often ends in recovery and very rarely persists for many years, so if symptoms of postherpetic neuralgia occur, do not despair. Time and proper treatment will do their job, and the disease will recede.

The herpes virus varicella-zoster, which has settled in the body after chicken pox, is capable of re-revival in the form of shingles. Despite lifelong immunity against the chickenpox form, the surviving herpes population is preserved in nerve cells, waiting in the wings to reactivate. As soon as immunity fails, skin rashes appear along the lines of nerve fibers.

Without early treatment there is a persistent pain syndrome that does not disappear with the onset of remission. The period of excruciating pain stretches from 3 months to a year or more. It is not easy to achieve their relief, since there is no radical painkiller for herpes zoster. Alleviate suffering with a complex of individually selected pharmaceuticals and folk remedies.

What causes severe pain

With herpes zoster, the pain symptom may appear in the initial phase and end with the cessation of new waves of blistering rash (1.5-2 weeks). In other cases, the pain does not let go for about a month - until the final healing of erosions (ulcers). Prolonged neuralgia after shingles is not always manifested. The occurrence of persistent pain is due to several reasons:

• decreased immunity and compensatory forces in aged patients;
• the appearance of a herpes rash on the back - in the area of ​​the paravertebral ganglia (nerve bundles), where the concentration of the virus is maximum;
• high rate of reproduction of the pathogen, a vast area of ​​the affected skin, the density of rashes;
• intense pain during an active rash.

Delayed treatment will also result in a significant prolongation of the pain syndrome.

The nature of herpes pain

During the period of the disease and after it, patients complain of several types of pain:

• constant (superficial and deep) burning, dull, pressing nature;
• arising from seizures with stabbing, pulling, shooting sensations;
• contact, provoked mechanical pressure on the affected area, including contact with clothing, bedding.

In the phase of papules and erosions, the pain often worsens at night, as well as in conditions that are uncomfortable for the sick body - in heat and cold.

Postherpetic neuralgia trigeminal nerve pierces the lower part of the face with an electrical discharge, sometimes penetrates the eye. The intercostal form is characterized by girdle pain during inhalation and movement.

In all cases, a person sleeps poorly, feels tired, overwhelmed. Without proper treatment not long before depressive disorders, reducing the quality of life.

Medical therapy

To stop attacks with herpes zoster, drugs of several types of exposure are used:

The treatment program includes ointments for shingles with a local antiviral, analgesic, healing effect - Acyclovir, Zovirax, Vivorax. For the extermination of the virus in deep tissues, the treatment of shingles involves injections of Acyclovir, Famciclovir. These drugs also have an analgesic effect.

The virus creates the conditions for the reproduction of others pathogenic bacteria that cause inflammation of the heart muscle, kidneys, throat, and sometimes the brain (meningitis). To relieve pain during complications, antibiotics are prescribed - Ciprofloxacin, Amoxicillin, Flemoxin Solutab, Erythromycin.

Folk recipes

Home remedies cannot relieve the intractable pain of shingles on their own, but they enhance the effect of pharmaceuticals and increase the body's resistance.

Pain relief in the acute phase

When the skin is covered with herpes vesicles, drying up sores, means and methods are used that do not threaten their integrity and sterility.

1. Ice compresses can quickly reduce burning, stabbing, cutting pain. Ice cubes are placed in a bag, wrapped in a clean ironed towel and applied for 10 minutes, avoiding severe numbness of the skin.
2. In some cases, warm applications help. You can use decoctions of analgesic herbs: elecampane, oregano, St. John's wort, nettle. To prepare the product, a tablespoon of the plant should be poured with boiling water (220-250 ml), after boiling, keep in a water bath for 5-7 minutes, carefully filtered. A clean cloth is required to be wetted with a slightly cooled liquid and applied to the painful area.
3. Aloe arborescens heals and soothes pain well. The lower mature leaf is washed, the lateral spines are removed, they are flattened along and placed along the line of rashes. If the affected area is large, it is better to smear it with fresh juice, and after soaking, rinse off the residue with warm water. The procedure is repeated every 4 hours.

Elimination of residual neuralgic pains

After cleansing the skin from the rash, the choice of analgesic folk remedies becomes wider. It should not be neglected to pre-test each drug in order to avoid an allergic reaction.

1. In the treatment and pain relief of postherpetic neuralgia, applications with natural unpurified propolis cakes are recognized as effective.
2. Intense pain can be significantly reduced with Aspirin paste. Pour the crushed tablet into vaseline (2 tablespoons), mix thoroughly. The paste is distributed in the zone of neuralgic manifestations no more than 4 times during the day. The expected result comes in 20 minutes.
3. Ease the pain of rubbing fir oil. It is dripped onto a cotton swab and gently rubbed into the skin.
4. Chamomile tea relieves pain from the inside. For one dose, a tablespoon of pharmacy chamomile is infused in a glass of boiling water for 20 minutes. Drink 3 servings a day.
5. A collection of equal parts of rue and valerian is infused for 30 minutes in the proportion: 1 tablespoon of dried herbs per glass of boiling water. The indicated dose is taken once for several days to anesthetize neuralgia.

All prescriptions are discussed with the doctor, he will select the remedy and draw up an individual regimen.

The pain syndrome will disappear faster if you strictly adhere to medical prescriptions for treatment, dietary nutrition, and hygienic care for the affected skin. Contribute to a speedy recovery rehabilitation measures to strengthen immunity in sanatorium-resort conditions, with the help of exercise, long walks in the fresh air, psychological self-regulation.