Other Ways to Relieve Postherpetic Neuralgia
Topical Local Anesthetics
Local anesthetics applied directly to the skin of the painful area affected by postherpetic neuralgia are also effective. Lidocaine, the most commonly prescribed, is available in cream, gel, or spray form. It is also available in a patch that has been approved by the Food and Drug Administration (FDA) specifically for use in treating postherpetic neuralgia. With topical local anesthetics, the drug stays in the skin and therefore does not cause problems such as drowsiness or constipation.
Capsaicin cream may be somewhat effective and is available over the counter, but most people find that it causes severe burning pain during application.
TENS for Postherpetic Neuralgia Treatment
Another method used to treat postherpetic neuralgia is transcutaneous electrical nerve stimulation, or TENS. A device that generates low-level pulses of electrical current is applied to the skin's surface, causing tingling sensations and offering pain relief in some people. One theory as to how TENS works is that the electrical current stimulates production of endorphins, the body's natural painkillers.
As a last resort, invasive procedures called nerve blocks may be used to provide temporary relief. These procedures usually involve injecting a local anesthetic into the area of the affected nerves. Injection directly into the spine is another option for relief of pain that is not easily treated. A Japanese clinical study published in the New England Journal of Medicine found that an injection of the steroid methylprednisone, combined with the anesthetic lidocaine, reduced pain by more than 70 percent in one patient group compared with groups that received lidocaine alone or an inactive substance.