Can Postherpetic Neuralgia Spread?

Reviewed on 3/18/2021

If you were diagnosed with shingles and the rash has gone away but pain has not, you may have postherpetic neuralgia. The pain of postherpetic neuralgia may spread along the nerve pathways from its original place.
If you were diagnosed with shingles and the rash has gone away but pain has not, you may have postherpetic neuralgia. The pain of postherpetic neuralgia may spread along the nerve pathways from its original place.

If you were diagnosed with shingles and the rash has gone away but pain has not, you may have postherpetic neuralgia. 

Symptoms of postherpetic neuralgia follow a bout of shingles, and may include pain that: 

  • Tends to have a stabbing, sharp, or burning quality
  • Can range from mild to severe
  • May be constant or sporadic
  • Usually remains even after the shingles rash, though in rare cases the pain may occur months to years later
  • Can happen even from a light touch (allodynia)
  • May be so severe it interferes with daily activities, sleep, appetite, and sex drive
  • Is often worse in older adults than in younger people
  • There may also be areas of numbness

The pain of postherpetic neuralgia may spread along the nerve pathways from its original place. This pain is a result of damage to the nerves caused by the virus spreading through the sensory nerves to the skin or mucus membranes. The more intense the spread of the shingles rash, the more severe and frequent postherpetic neuralgia symptoms will be.

What Is Postherpetic Neuralgia?

Postherpetic neuralgia is a complication of shingles, a painful rash caused by the varicella-zoster virus (the same virus that causes chickenpox). 

When the pain associated with shingles does not go away when the rash disappears, it is called postherpetic neuralgia.

What Causes Postherpetic Neuralgia?

Postherpetic neuralgia is caused by nerve damage due to shingles. Shingles is caused by the varicella-zoster virus. After a person has chickenpox, the varicella-zoster virus remains dormant in the body but can become reactivated later in life, causing shingles. When the pain of shingles persists, it is postherpetic neuralgia.

Shingles is caused by the varicella-zoster virus. Once a person has had chickenpox, the varicella-zoster virus remains dormant in the body and may be reactivated later in life, causing shingles. 

Shingles itself is not spread from person-to-person, however, a person who never had chickenpox or the chickenpox vaccine can get chickenpox from a person who has shingles.

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How Is Postherpetic Neuralgia Diagnosed?

Postherpetic neuralgia is usually easy to diagnose because it results from pain that persists after a documented case of shingles. The diagnosis is made based on the clinical presentation alone. 

What Is the Treatment for Postherpetic Neuralgia?

Up to half of all patients with postherpetic neuralgia will not respond to treatment.

Treatments for postherpetic neuralgia pain include: 

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Reviewed on 3/18/2021
References
https://www.uptodate.com/contents/shingles-beyond-the-basics?search=postherpetic%20neuralgia&source=search_result&selectedTitle=3~60&usage_type=default&display_rank=3

https://www.uptodate.com/contents/postherpetic-neuralgia?search=postherpetic%20neuralgia&source=search_result&selectedTitle=1~60&usage_type=default&display_rank=1

https://www.aafp.org/afp/2005/0215/p808.html

https://www.cdc.gov/vaccines/vpd/shingles/public/zostavax/index.html

https://www.cdc.gov/vaccines/vpd/shingles/public/shingrix/index.html

https://www.epainassist.com/nerves/can-postherpetic-neuralgia-spread-and-how-do-you-stop-it-from-spreading