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pain from post herpetic neuralgia

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Hello there, in last year i have been diagnosed as postherpetic neuralgia, i have been getting pain since from one year. The pain persists at muscle at lower left abdomen also around the chest. The pain is just like burning and continues pain. I have done ultrasound of abdomen and everything ok in the scan reports. 

i need to know when it will be cured or what should i take for the medication or is there any specific diagnosis? Currently i have tried the Tab -gabapentin and pregabalin , but they are not working on me.

The pain will be returns on every 2 or 3 month or alternatively. I m in great fear of having some other kind diseases which might be associated with this. 

And the new thing is that if i rub my skin a little bit around the place like chest, abdomen... it turns red immediately (not itching or not painful) as my physician say its vascular instability. Is this also associated with neuralgia ?please help me to know this thing better.


Category: Internal Medicine Specialist

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Category: Internal Medicine Specialist
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Expert:  Dr. Steve Merris replied 4 Days.

Hello,

Thank you for asking the query.

From the description of the symptom, it does look like a post herpetic neuralgia (PNH). No other obvious diagnosis appears to be plausible at this moment. But please considering my limitation in offering an online diagnosis.

I understand this is a difficult situation for you. PHN can be really troublesome and it seems so in your case. There are a number of drugs available for treatment, but there are no data to say one is better than the other. Other than Gabapentin and Pregabalin there are  tricyclic antidepressants, opioids, topical capsaicin, and topical lidocaine. Intrathecal methylprednisolone may be of benefit for patients refractory to the above measures.

You should really discuss these options with your Doctor. And I think especially the Tricyclic Anti-depressants may work well in these kind of conditions. The skin condition (a variation of dermographism ) could be due to a side effect of the medications. PHN is not known to cause this.

Hope this helps. Please feel free to ask followup questions.


Patient replied :

Hello doctor,
thank you for the consultation. i would like to know about this disease.

1) is this harm myself anything serious in future ? or is just returning pain ?
2) is this prolonged pain damage the nerves ? 
3) till now i never used to do physical excises, and also i m very thin (46Kg, as my age is 26). someppl told me to workout some excise so i could easily diminish this pain !!. is this true ?
4) is there any specific food to have better resistance ?

and i will take the medication as per your concern and i surely meet with this aspects with my doctor.


Expert:  Dr. Steve Merris replied 3 Days.

Thank you for asking the followup questions.

1. It per se is not harmful. But the pain can affect your quality of life and productivity.

2. Yes this can damage nerves, but this is not a very big concern as the nerves are superficial nerves, which does not supply any muscles or tendons or internal organs.

3. There is no solid evidence for this, but this cannot do any harm. Nutritious diet and exercise should may help.

4. Nope. Although it is prudent to include a B complex vitamin once every day, especially if you are a vegetarian.

Hope this helps. Thank you.


Dr. Steve Merris
Category: Internal Medicine Specialist
Experience: 
Medical School - New York University
Internship in Internal Medicine - Beth Israel Medical Center
Residency in Internal Medicine - Beth Israel Medical Center
Fellowship in Pulmonary and Critical Care Medicine - Columbia University Medical Center
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