Postherpetic neuralgia (PHN) is a complication of herpes zoster, caused by the same virus as chicken pox (lat. herpes zoster virus). This disease affects the skin and nerve fibers, which manifests itself as severe burning pain after the herpetic blisters have healed.
The risk of postherpetic neuralgia increases with age; Most often this disease affects people over 60 years of age. This condition occurs in approximately 10–20% of patients who have had herpes zoster. There is no cure, but treatment for postherpetic neuralgia can relieve symptoms and relieve pain. In more than half of patients, the pain goes away on its own after some time.
At CELT you can get advice from a specialist algologist.
- Initial consultation – 4,000
- Initial consultation with the head of the Pain Clinic - 4,500
Make an appointment
Symptoms of postherpetic neuralgia are usually limited to the area of the skin where the rash first appeared - most often they surround the torso or appear on the side, but the disease can also affect the face.
Pain may last for 3 months or longer after the herpetic blisters have healed. Patients describe it as burning, sharp, piercing or deep, and occurs with even the slightest touch of the skin in the affected area, including the light touch of clothing (allodynia). Much less often, patients feel itching and numbness.
Causes of postherpetic neuralgia
Once a person has had chickenpox, the virus remains in the body for life. With age, the immune system weakens (particularly from taking medications or chemotherapy) and the virus can become more active, resulting in shingles.
Damage to nerve endings during rashes leads to postherpetic neuralgia. When damaged, nerve fibers cannot send signals from the skin to the brain as they normally do. Instead, they transmit amplified signals, and the patient feels excruciating pain that can last for months or even years.
Symptoms and diagnosis
The main symptom of intercostal neuralgia is pain in the intercostal space. The pain syndrome is paroxysmal in nature, often sharply intensifying with sudden movements. When sneezing, coughing or taking a deep breath, a patient with neuralgia feels a sharp prick between the ribs. In some patients, the presence of the disease can be determined by their posture - the body is bent to the side where there is no pain between the ribs, and the patient is in this position constantly, thus he tries to protect himself from attacks of pain.
Such pain cannot go away on its own; only qualified help and identification of the cause will help solve the problem. After accurately identifying the cause, the doctor can prescribe an effective ointment for intercostal neuralgia, which will relieve pain. And for this it is recommended to undergo a comprehensive examination.
Most often, the doctor may recommend that the patient undergo the following types of examination in order to prescribe an ointment for intercostal neuralgia:
- chest x-ray;
- CT scan or MRI examination;
- X-ray examination of the spinal cord using contrast;
- general blood analysis;
- a bacterial or immunological test, if the doctor suspects the presence of an infection or autoimmune pathology.
Drug therapy
Drug therapy involves the use of the following groups of drugs:
- Anticonvulsants (Lyrica, Neurontin, others). These drugs have shown good effectiveness against neuropathic pain. However, they have a number of side effects, the most common of which are decreased concentration, drowsiness and swelling of the legs;
- Antidepressants. Some antidepressants (Amitriptyline, Duloxetine) affect the production of special brain substances that are responsible for both depressive states and the perception of pain. Doctors often prescribe minimal doses of antidepressants in the complex treatment of postherpetic neuralgia. Their main side effects include: drowsiness, dry mouth, dizziness;
- In cases of severe pain and insufficient effectiveness of other drugs, patients may be prescribed narcotic analgesics.
What is the cause of the disease?
Intercostal neuralgia is a syndrome of reflex origin. It appears due to compression or irritation of the intercostal nerve. Most often, attacks appear in those patients who have advanced osteochondrosis - did not start treatment on time or have an intervertebral hernia that compresses the nerve roots. But besides this, pain can also appear due to the presence of other pathologies:
- spondylitis;
- progressive kyphosis;
- neoplasms on the spine;
- Bekhterev's disease.
Warming ointments for intercostal neuralgia will help well if its cause is hypothermia or a cold. In addition, pain can be caused by infections, injuries, excessive exercise and poisoning. That is why, before starting treatment, choosing the right ointment for intercostal neuralgia or tablets, you need to undergo an examination and identify the cause of the disease, only its elimination will make it easy to cope with the pain syndrome.
Epidural administration of anesthetics and steroid hormones
Spinal epidural block involves the injection of drugs into the epidural space, which leads to loss of sensation in the area of impact. This means that this procedure involves introducing the active substance directly into the source of pain. Achieving a therapeutic effect in this case is possible due to the following factors:
- analgesic properties of the drug;
- the maximum possible concentration in the affected area;
- reflex action at all levels of the nervous system.
Treatment of intercostal neuralgia at home
If the patient is diagnosed with “intercostal neuralgia” and has already received all the necessary assistance in the hospital, then he is sent for home treatment. Neuralgia takes a long time and is difficult to treat, therefore, while following all the doctor’s recommendations, it is also necessary to visit him regularly in order to make adjustments to the therapy. At home, having previously agreed on all procedures with the doctor, you can carry out therapy using the following methods:
- use warming and pain-relieving ointments;
- traditional medicine;
- use home devices for physiotherapeutic procedures, for example, Darsonval or magnetic therapy devices;
- massage.
In combination, such treatment will give good results, and pain will not bother you.
External drugs against neuralgia
Ointment for neuralgia can provide significant assistance in the treatment and relief of symptoms, because their effect is as follows:
- Relaxes tense muscle fibers.
- Improves blood circulation in the sore spot.
- Normalize metabolic processes.
- Increases the elasticity of the ligamentous apparatus.
- Warm the site of inflammation.
- Reduce pain syndrome.
Such a wide range of beneficial effects of ointments can be explained by the presence of special substances in the composition, which, through their irritating effects, have a distracting effect, causing burning and tingling in the area of the pinched nerve.
First of all, ointments warm, and only then they begin to have an analgesic or anti-inflammatory effect. The doctor prescribes external remedies only after clarifying the diagnosis and location. If there is a diagnosis of “intercostal neuralgia,” which ointments are best? Each individual case may have its own list. The form of the pathology and localization are taken into account, and then the most effective composition is selected.
Increasingly, experts opt for ointments with bee or snake venom. These are natural remedies, therefore they have minimal side effects and have fewer contraindications for use. If there is intercostal neuralgia, treatment at home with ointments with such components is often practiced.
"Voltaren"
Currently, every pharmacy will offer a huge assortment of ointments that will give excellent results in the treatment of neuralgia, but I would like to pay special attention to Voltaren. This product is recommended to be applied to the body up to 4 times a day; it has an analgesic and anti-inflammatory effect. This type of ointment contains an active ingredient such as diclofenac, which is why it has an analgesic effect on the body and also relieves inflammation.
If you combine the ointment with tablets that are part of the group of non-steroidal anti-inflammatory drugs, then together they help to quickly get rid of pain, which most often causes the greatest inconvenience to a patient with neuralgia.
Ointments for intercostal neuralgia: reviews
Intercostal neuralgia is a very serious and painful pathology that simply cannot be tolerated. Immediately when the first pain appears, you have to look for the best remedy to help relieve pain.
According to patient reviews, warming ointments are very helpful for intercostal neuralgia, which cope well with pain, and if you use painkillers in combination with them, the pain does not cause serious suffering.
Those patients who have been examined and whose cause of neuralgia has been identified cope with the disease faster, because all their therapy is based on eliminating the cause, which means that the symptoms go away. But those who self-medicate suffer from symptoms longer.
That is why it is better to immediately seek qualified help if you are diagnosed with intercostal neuralgia. Only a specialist can tell you which ointment will help best in a particular case.
"Menovazin"
Thanks to the presence of menthol in the composition, pain is relieved and you feel cool. This ointment for intercostal neuralgia contains a special complex of elements that can effectively cope with pain and inflammation. And this is precisely what is important to remove for patients who have been diagnosed with neuralgia. The ointment contains menthol, benzocaine and procaine. The last two components best block pain impulses, have an anesthetic effect, and menthol irritates nerve endings, helps dilate blood vessels and brings a feeling of coolness.
"Viprosal"
This drug, presented in the form of an ointment, according to patients, very quickly copes with pain, and it is this that causes the greatest inconvenience to the patient in neuralgia. Thanks to the unique composition of the ointment, it has several effects on the body at once and easily copes with attacks of neuralgia. It contains viper venom, camphor oil, turpentine and salicylic acid. Each of these substances has its own effect, but together they are aimed at eliminating pain, activating the body’s protective functions and removing the causes that caused the malaise. But it is worth remembering that only complex therapy will help cope with such a diagnosis as “intercostal neuralgia.” Treatment at home with ointments is allowed only after consultation with a doctor, because Viprosal has a number of serious contraindications for use: pathologies of the kidneys and liver, exhaustion of the body, brain and coronary insufficiency, and others.
This is only a small fraction of those ointments that will help get rid of the pain and inflammation that accompany neuralgia. But it is better if the doctor selects the ointment, focusing on the causes of the pathology.
"Apizartron"
After applying this ointment, a feeling of warmth appears. It contains bee venom, which improves blood flow, relieves pain and relieves inflammation. Thus, it has an analgesic effect and relieves the inflammatory process. But it is worth remembering that this ointment for intercostal neuralgia has a number of contraindications: kidney and liver pathologies, breastfeeding, pregnancy, heart pathologies and individual intolerance. That is why it is better to consult a doctor before starting therapy.
"Finalgon"
It helps dilate blood vessels, has a warming effect and fights pain. This unique product, produced in the form of an ointment, has been effectively used for the treatment of intercostal neuralgia for many years. This ointment received a lot of positive reviews from those who personally experienced its therapeutic effect. Ointment for intercostal neuralgia helps dilate blood vessels, thanks to this effect, blood flow at the site of the inflammatory process significantly improves. In addition, “Finalgon” has an irritating and warming effect, which, in harmony with the ability to dilate blood vessels, completely relaxes tense muscles; due to this effect, the pressure of muscle fibers on the nerve weakens and the pain syndrome recedes.
