Postzosterneuralgia

In shingles (herpes zoster), herpes viruses are reactivated, usually as a result of a weakening of the immune system, e.g. as part of a flu-like infection, and then attack a spinal cord nerve. Although the typical skin rash on the trunk usually disappears within 2-3 weeks with adequate treatment, the characteristic pain in some patients (approx. 10-20%) remains for months afterwards.

These complaints are based on damage to the nerve by the herpes viruses and are called post-zoster neuralgia. In most patients, it manifests itself as a burning, constant pain, which is supplemented by recurring, shooting, electrifying pain attacks. The therapy of post-zoster neuralgia is usually carried out in a drug form. Antidepressants such as amitriptyline or anticonvulsants such as gabapentin have proven to be effective, and pregabalin is also often used successfully. In addition, pain-relieving gels with local anaesthetics (especially lidocaine) can be used.However, as is often the case, the best therapy is prevention: early and adequate treatment of shingles can significantly reduce the risk of developing post-zoster neuralgia.

Is there also a psychosomatic neuralgia?

This question can be answered with a “yes”. Neuralgia in a narrower sense actually describes a disease in which damage to a nerve causes characteristic pain attacks. Consequently, according to this definition, there can be no psychosomatic neuralgia.

Nevertheless, there are psychosomatic illnesses in which attacks of shooting pain occur, which can hardly be distinguished from those of “real” neuralgia. For this reason it is not completely wrong to speak of psychosomatic neuralgia. However, the distinction is important for the treatment: in psychosomatic neuralgia, learning relaxation techniques and psychotherapy play an important role, which is not the case in organic neuralgia (i.e. when there is a clearly detectable trigger such as a herniated disc).

What is the difference between neuralgia and neuritis?

Although the terms neuralgia and neuritis are sometimes used synonymously, there are some differences in their meaning. Neuritis is first of all only the technical term for an inflammation of the nerves. It usually manifests itself in the form of prolonged, pulling, swelling and decongesting pain.

Neuralgia, on the other hand, describes a disease in which nerve pain is caused by damage to or irritation of a nerve. Since the possible causes of nerve damage include mechanical irritation and inflammation, neuralgia can be the result of neuritis. In contrast to neuritis, however, neuralgia usually manifests itself in the form of recurrent, shooting pain attacks lasting from a few seconds to a few minutes.