Is it possible to completely treat pain after Zona?

This is an automatically translated article.

The article was written by Doctor Bui Hanh Tam - Department of Anesthesiology and Anesthesia - Vinmec Times City International Hospital.
Shingles is caused by the Herpes virus. The virus enters the nervous system and resides in the sensory ganglia throughout the life of the body. When there are favorable conditions (weakening of the immune system, acute and chronic infections, poisoning, stress...), the virus reactivates, destroying A-alpha sensory nerve fibers under the skin, causing a seizure. pain occurs. To date, this post-herpetic shingles pain remains a major difficulty and challenge for treatment.

1. Why is the skin damage gone but still hurts?

Herpes zoster virus has a special protein structure that makes it easy to attach to sensory nerve endings under the skin. The variable property of this viral protein sets it apart from other viruses in that it invades and travels along the nervous system and uses the nervous system as a home, dwelling in it and living within it. It can cause serious damage to the nervous system if not treated properly and in time.

Shingles is a disease caused by the Herpes zoster virus, the same virus that causes chickenpox. When there are active conditions, especially for the elderly, people with reduced resistance, people who are often stressed or overworked, this virus is hiding in the nerve ganglia coming out from the dorsal horn of the spinal cord. The activity causes damage to the skin, and the sensory nerves under the skin are also damaged. Manifestations are red, itchy, painful, white pus (if there is a bacterial superinfection). The disease is easily confused with the symptoms of "shingles", "three-compartment ants" or some other insects. Due to the misrepresentation of the disease manifestations, many people have suffered from terrible nerve pain as a result of not taking timely measures to prevent chronic pain of nerve causes after herpes virus infection. .
Like other viruses, if there is no bacterial superinfection, after 7-10 days, the skin manifestations will disappear with or without specific treatment with antiviral drugs.
However, the difference is that the damage left on the nervous system is extremely severe and very difficult to control later. Therefore, when the skin has healed but the patient is in pain, it is worth emphasizing and paying due attention in this disease. Post-shingles pain lasts up to 3 months after skin wound healing. Chronic pain occurs from 3 months onwards, lasts many months, even years later if not timely intervention.
If persistent pain is not well controlled, the risk of chronic pain is very high. At this time, the treatment of pain after shingles is a challenge with current medicine even in countries with modern medicine such as the US, Switzerland, Japan, Korea...

2. Painful manifestations of shingles

Recognizing persistent post-shingles pain, or the risk of persistent/chronic pain, is extremely important. On that basis, patients need to see a doctor promptly to find ways to minimize the risk of chronic pain.
Pain right at the injured skin heals spontaneously, pain on one side of the body. Severe pain even with normal stimuli such as light touch, wind blowing, clothing touching, bathing, Pain occurs at any time of the day, but is more painful at night. Pain is described as electric shock, like a knife, like a gun shot, like an ant sting... Pain makes it impossible to sleep, or wakes up in the middle of sleep, making the patient extremely tired and depressed all the time. day. Sometimes the pain is of a migratory nature to an area that does not correspond to the previous skin lesion.

With a pain scale based on facial expressions or intensity of pain on a 10-point scale.
In addition, doctors also have other scales to assess chronic pain, from which they can think of the cause of pain.
In the acute phase of shingles: If pain > 6 points is not well controlled with conventional pain relievers, the next risk is persistent pain and even longer chronic pain. Chronic pain caused by shingles, appearing 3 months after the acute shingles episode. Pain after shingles is associated with an existing chronic pain such as back pain, joint pain, headache ...., especially in the elderly, the risk and severity of chronic pain will increase more than that of young people. and people without chronic pain. At that time, solving the chronic pain caused by shingles in the elderly is a difficult problem, even living with the disease. The quality of life of patients with chronic pain after shingles is very low with insomnia, depression, and general weakness that cannot be controlled by any medication.

3. What's new in the treatment of pain after shingles in Vinmec?

Pain management is one of the strengths of Vinmec International General Hospital.
Treatment of pain after shingles includes steps in sequence, based on the lesion, clinical symptoms and severity of pain, as well as the effects of pain on the patient's daily life. The pain specialist will examine and evaluate to make a decision.
With an acute episode of shingles, most pain can be controlled with conventional pain relievers in the course of treatment with antiretroviral drugs. viruses, anti-inflammatory drugs, pain relievers and topical medications or antiseptic solutions to limit the superinfection that aggravates the damage.
Effective treatment of acute shingles is the most important factor for shingles including: anti-viral drugs, anti-inflammatory drugs, common pain relievers, prevention of bacterial superinfection on the skin by daily hygiene day
However, depending on the degree of response to the drug, with the active treatment of each patient, pain symptoms are not the same.
If pain interferes with daily activities of sleeping, resting, walking, eating, consider using procedures to prevent pain from being transmitted from the periphery through the spinal cord and to the brain by inhibiting pain. The selective inhibition of the part of the sensory nerve that innervates the pain area is called a nerve blockade technique.
At Vinmec International General Hospital, under the guidance of today's most specialized and modern neuro-ultrasound machine (LOGIQ-S8 of GE ultrasound machine), leading experts in pain intervention will directly perform examination and treatment. The patient can go home the same day. After the procedure, the patient can go home and rest at home. In particular, this procedure not only provides immediate pain relief but also has a long-term effect, preventing persistent pain, chronic pain that can occur even after the skin damage has healed.
Recently, chronic pain is recognized by the World Health Organization (WHO) as a disease and needs to be treated. With the approach to the most modern and up-to-date medicine today to bring the highest quality of life to patients, even when they are old and have chronic diseases at Vinmec, patients can rest assured. , trust in the quality of treatment.

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