Analgesic Treatment Approach for Postherpetic Neuralgia: A Narrative Review

J Pain Palliat Care Pharmacother. 2023 Jun;37(2):184-193. doi: 10.1080/15360288.2023.2174632. Epub 2023 Feb 2.

Abstract

Post-herpetic neuralgia (PHN) is an entity derived from peripheral nerve damage that occurs during the reactivation of the Varicella Zoster Virus (VZV), which manifests itself through pain with neuropathic characteristics. This can prove to be very difficult to manage in the chronic stages of disease reappearance. There currently exists a multitude of treatment alternatives for PHN, however, prevention through the early initiation of antiviral regimens is vital. There are various pharmacological options available, but it is important to individualize each patient to maximize efficacy and minimize adverse effects. Interventional procedures have become a cornerstone in difficult-to-manage cases, and have shown promising outcomes when used in a multimodal approach by experienced specialists. It is necessary to make an objective diagnosis of PHN and start early treatment. Additionally there is current evidence that vouches for interventional therapies as well as individualization, with a clear establishment of therapeutic objectives according to the needs of each patient.

Keywords: Acute herpetic pain; Varicella zoster; continuous analgesia; herpes zoster; interventional pain management; postherpetic neuralgia.

Publication types

  • Review

MeSH terms

  • Analgesics / therapeutic use
  • Herpes Zoster* / complications
  • Herpes Zoster* / drug therapy
  • Herpes Zoster* / prevention & control
  • Herpesvirus 3, Human
  • Humans
  • Neuralgia, Postherpetic* / drug therapy

Substances

  • Analgesics