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Herpes Zoster Pain Management and Post Herpetic Neuralgia

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Herpes zoster is the medical term for shingles. It is a viral infection that typically causes acute pain in most patients who are affected with it. One of the main problems with herpes zoster is that even when the virus settles down a bit it can still leave substantial residual pain in a lot of patients. This is called postherpetic neuralgia.

Herpes zoster results after a chickenpox infection which is the same virus. Even when chickenpox resolves, the virus still stays in the body in a latent fashion. It can become reactivated in adults for any number of reasons.Post herpetic neuralgia

About 1 million people annually are affected by herpes zoster, with a lifetime incidence of 20 to 30% of the population. It is especially common in those who have immunosuppression such as those who have organ transplants, HIV and certain cancers.

The presentation of pain with herpes zoster is variable. Usually there is some pain over the skin which comes on before a rash appears on one side of the body. 50 to 70% of zoster cases take place in the thoracic region. 10 to 20% occur in the cervical and lumbar region and about 8% occur in the sacral area.

At times, an individual may have the severe pain without a rash appearing. There can be additional issues besides just a rash and severe pain. Individuals can sustain a stroke, complications with the eyes, motor neuropathy, transverse myelitis and glaucoma.

Treatment of herpes zoster

Antiviral medications should be given as first-line treatments to those with herpes zoster who are age 50 or older. Even in those younger if severe rash or pain is present, then a medication such as Acyclovir and others in the same family can help to heal the rash, decrease the pain and prevent postherpetic neuralgia.AZ pain center

About 20% of those over the age of 50 with zoster pain end up with continued pain for six months after their rash heals despite taking antiviral medications. Opioid medications are often added to the mix, and some doctors will use Neurontin as well because in some smaller studies that showed benefit.

Multiple studies have looked at epidural steroid injections for the treatment of zoster pain. One study showed acute pain relief during the zoster phase but did not reduce the risk of developing postherpetic neuralgia. Other studies have looked at multiple epidural injections or continuous epidural infusions which have shown a reduction of the incidence of Pain clinic Phoenixpostherpetic neuralgia.

First-line treatment should definitely be antivirals plus opiates. It is unclear if the addition of an oral corticosteroid is beneficial. If these are not quite managing the pain, then the AZ pain management doctor can perform epidural injections.

The actual definition of Post Herpetic Neuralgia is defined as pain that lasts for at least six months after the onset of the rash. Unfortunately, the condition can last for years and lead to a significant reduction in a person’s quality-of-life. The pain can wax and wane is typically described as being sharp and stabbing along with burning.

When it comes to treatment for postherpetic neuralgia, first-line therapy should consist of tricyclic antidepressants and maybe Neurontin, Lidocaine patches, opiates, Tramadol and maybe a capsaicin patch.Pain Management Mesa AZ

Unfortunately, a significant number of patients will not respond well to medication management for postherpetic neuralgia. Interventional pain management for the problem may consist of sympathetic nerve blocks. These are often very effective for temporary relief but not so great for longer lasting relief. Studies looking at spinal cord stimulation showed long-term benefits in over 80% of patients with postherpetic neuralgia. The study included 28 patients and was very promising.

Arizona Pain Specialists has been providing successful relief for chronic pain conditions for years, and recently received its 5th Consecutive Patient’s Choice Award. The Pain Management doctors work closely with Phoenix chiropractors at the clinics to provide comprehensive relief options.Pain Clinics AZ

If you or a loved one is suffering from chronic pain due to post herpetic neuralgia or a condition such as failed surgery, help is available at Arizona Pain. Call (602) 507-6550 today for treatment with the best pain management doctors in Arizona.

6 Ways to Avoid Surgery for Spinal Stenosis

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As people age, pain can result in the legs due to spinal stenosis. This refers to spinal arthritis over growing areas and pinching on spinal nerves as they tried to leave the spinal Spinal Stenosis Treatmentcanal. It’s one of the most common diagnoses as an individual in the 50 to 85 age range develops pain in the lower extremities.

Once the diagnosis is made and is deemed not to be a vascular issue, the question is how to avoid surgery for symptomatic spinal stenosis. The surgery that is done to relieve the pain is called a laminectomy and is purely an elective procedure.

Here are the 7 most effective ways to treat stenosis to avoid going under the knife.

1. Over-the-counter anti-inflammatories and Tylenol. This sounds very simple and it is. These medications are low risk when taken according to manufacturer’s recommended dosing. In addition, they can be extremely effective for mild to moderate symptoms of spinal stenosis. As a nerve roots gets pinched from the overgrown tissue with arthritis, inflammation can result, which is what the anti-inflammatories can reduce.

2. Physical therapy. PT can be extremely helpful for reducing stenosis pain,

Pain Clinics in Phoenix

Physical therapy can be great for spinal stenosis symptoms.

strengthening up the muscles in the back, along with core strengthening, flexibility and relieving pressure on nerves. In addition, there are treatments including electrical stimulation and ultrasound which may also relieve symptoms.

3. Chiropractic treatment. While not a permanent solution, spinal stenosis can be helped with Phoenix chiropractor manipulations. This may temporarily decompress nerve roots and hence reduce pain.

4. Spinal decompression therapy. This treatment became FDA cleared back in the late 1990s and involves intermittent spinal traction. Continuous spinal traction has been shown not to be helpful for spinal stenosis or degenerative disc disease. However, individuals with spinal stenosis often can obtain 3 to 6 months of pain relief with a series of decompression therapy.

The treatment is noninvasive and most individuals fall asleep during the treatments as it is Pain Doctors in Phoenixnot painful.

5. Additional medications. Pain management doctors in Arizona may treat stenosis with medications including nerve membrane stabilizers such as Lyrica or Neurontin. It is unclear how these medicines work, but they can help a lot with sciatica type pain from stenosis. For periods of acute exacerbation, narcotics may be indicated to relieve bad symptoms. Over the long-term, the risks start to outweigh the benefits however.

6. Epidural steroid injections. These have long been a gold standard treatment for spinal stenosis treatment. The injection places cortisone medication around the inflamed nerve roots. Phoenix pain clinic

Modern Arizona pain management involves the usage of fluoroscopy, which is a real-time form of x-ray for increased accuracy. There are multiple different ways of performing epidural injections, including intralaminar epidurals, transforaminal epidurals or caudal injections. A person may need a series of injections to obtain maximum pain relief, and this can be repeated every few months.

If you or a loved one is experiencing spinal stenosis type symptoms, help is available. Arizona Pain Specialists offers comprehensive pain treatments for spinal stenosis, which are performed by an Award Winning team of Board Certified pain management doctors Phoenix pain doctorsand chiropractors. There are 4 locations throughout the Valley, including a new Phoenix pain clinic.

Arizona Pain accepts over 50 different insurances. The clinics have Arizona pain doctors accepting Medicare, Medicaid, major medical, Personal Injury, Worker’s Compensation and self pay. For more information and scheduling, call (602) 507-6550 today!

An Overview of Platelet Rich Plasma Therapy (PRP) – video

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Platelet rich plasma (PRP) therapy is an exciting new regenerative medicine treatment. The injection involves a simple blood draw with the blood then being centrifuged down into platelets and growth factors. Stem cells are called in with the treatment too. Hear David Greene, CEO of the Arizona Pain Network, describe the revolutionary treatment for pain management Phoenix and Scottsdale are excited about.

If you would like to learn more about this exciting new treatment, call Arizona Pain today at (602) 507-6550.

These pain clinics in Phoenix and surrounding areas are offering the treatment along with chiropractic, acupuncture, spinal decompression therapy, medication management and interventional pain treatments.