General Information

  • What is the source of post-herpetic neuralgia?
  • Who gets post-herpetic neuralgia?

What is Arthritis?

Arthritis is a crippling disease, affecting thousands of Australians everyday.

Arthritis refers to nearly 100 inflammatory conditions that affect joints and connective tissue, but the two most common forms are osteoarthritis and rheumatoid arthritis.

Also known as wear-and-tear arthritis, osteoarthritis is characterised by deterioration of articular cartilage, bone hypertrophy and changes in the synovial membrane. Incidence of this form of arthritis increase with age with as many as 80 percent experiencing it by age 65.

Rheumatoid arthritis is a chronic inflammatory autoimmune disorder that afflicts sufferers at a younger age and occurs more commonly in women. It appears in several joints and often in the hands and feet.

While there is no cure for osteoarthritis, there are a number of treatments that can modify the pain and inflammation associated with it.

What is Post-Herpetic Neuralgia?

Roughly 20 percent of those diagnosed with shingles go on to suffer long-lasting pain from post-herpetic neuralgia or PHN, a condition that can be more painful than shingles. Although most people suffer with shingles for about a month, the pain and skin sensitivity can continue for months or even years in some patients with PHN.

PHN pain persists long after the shingles rash heals. Although invisible, the virus of herpes zoster can cause damage to the nerves, resulting in mild to severe pain. This pain of PHN may be sharp, piercing, throbbing or stabbing and may result in intolerable skin sensitivity to even the lightest touch. PHN occurs more often in older people and can last for months and even years.

However, the good news is that for most people who develop PHN, the pain will gradually resolve with time. And today there are multiple treatment options that do result in pain relief for those suffering from PHN.

What is the source of post-herpetic neuralgia?

The pain results from damage to the nerve fibres during the shingles infection. The pain of PHN is in the same area as the pain and rash of shingles. Some PHN patients feel pain in the exact same location as the rash, others have PHN pain in smaller areas within the rash region, and others feel the PHN pain in an area larger than the original rash site.

Pain from nerve damage is among the worst types of pain. Consider a mild pain related to nerve injury: the sensation when banging the “funny bone,” the area in the elbow where a major nerve crosses. Patients who have had a spinal tap, in which a needle pierces the nerve-rich area of the back, describe this as one of the most painful procedures they have ever had.

Patients have described the pain of PHN as “deep and aching,” “fire under the skin,” “like electric shocks,” and “unbearable shooting pain.” For some PHN patients, even a light touch, like the pressure of a shirt, a gust of wind, or brushing the hair, can bring tears to the eyes. In other PHN sufferers, the painful area is sensitive to slight changes in temperature.

Because the pain can be so debilitating, it can interfere with a person’s life. For some PHN sufferers, all normal activity comes to a halt for months. Depression is common in people with PHN because of the severe pain and social isolation that can occur.

Who gets post-herpetic neuralgia?

On average, one of every five patients with shingles gets PHN. However, the risk of developing PHN increases with age – that is, the older the person is when getting shingles, the more likely that PHN will develop.

Among those over the age of 55, 1 in 4 will develop PHN. Among those over 60, about half will develop PHN. And among those over 70 and older, 3 of 4 persons have long-term pain after the herpes zoster infection disappears from the skin

What is Diabetic Peripheral Neuropathy?

People with diabetes have an abnormal elevation of their blood sugar, and lack adequate insulin to metabolise the blood sugar. As a consequence, the blood glucose (sugar) abnormally enters certain nerve tissue and damages the nerve. This can occur in any type of diabetes. It does not matter if the patient is on insulin, is taking pills, or is diet controlled. The nerve damage that occurs is considered to be permanent.

As the nerve damage occurs, the protective sensations are affected. These include a person’s ability to determine the difference between sharp and dull, hot and cold, pressure differences and vibration. These senses become dulled and/or altered. The process begins as a burning sensation in the toes and progresses up the foot in a “stocking distribution”. As the condition progresses, the feet become more and more numb. Some people will feel as though a pair of socks on their feet, when in fact they do not. Other patients will describe the feeling of walking on cotton, or a water-filled cushion. Some patients complain of their feet burn at night, making it difficult to sleep. The feet may also feel like they are cold, however, to the touch, they have normal skin temperature. Diabetic peripheral neuropathy is not reversible. The progression of the condition can be slowed or halted by maintaining normal blood glucose levels.