Category Archives: post herpetic neuralgia

Post Herpetic Neuralgia (PHN) – Repeat Case – Pulse Radiofrequency (PRF) To Dorsal Root Ganglion Again Works

Case T7 PHN helped by PRF to dorsal root ganglion

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Topical B12 helps Canker Sore Pain and what this means for Shingles –

Triamcinolone 0.1% topical oral ointment with 500ug B12/2 mg ointment outperformed plain triamcinolone adding credulance that frequent B12 injections into active shingles area helps. Question is whether it needs to be methylcobalamin  – B12 bioactive form for best topical effect.

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Uncontrolled Post-Herpetic Neuralgia (PHN) in Elderly subject – New Measures

Using 6% gabapentin, 4% amitriptyline,  ketoprofen 10%,  lidocaine 5%, and ketamine 10% probably in Lipoderm could give some relief topically.  Ketamine 100 mg/ml with 0.1 ml spray nasally could give additional relief.  30% mannitol might be good here.

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Resistent Post Herpetic Neuralgia Treatments – IV Magnesium for Neuropathic Pains

Three IV Magnesium  1mg /k in 100 mls saline  infusions over 1 hour – one every other day or Three 1 mg/kg Ketamine in 100 mls saline infused in over 1 hour ketamine  one EOD resulted in 7/15 magnesium and … Continue reading

Posted in central & spinal, complex regional pain, Drugs, IV therapy, neuropathic, Pain Dystrophy, post herpetic neuralgia, radiculitis | 1 Comment

Post-Herpetic Neuralgia – Transforaminal Epidural Steroid Injection Might “Cure” And New Injection Rules

Several case studies have shown that transforaminal steroids could relieve Post Herpetic neuralgia (PHN) but that procedure is under heavy scrutiny because of rare strokes, paralysis and death so use of soluble dexamethasone has been edicted.

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Post Herpetic Neuralgia – Peripheral Nerve Stimulators

I have heard of peripheral nerve stimulators used in cases before but this additional one makes it more mainstream. This one captured control with high frequency

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Facial Ramsay-Hunt Shingles -Paralysis Maybe Adverted by Stellate Ganglion Block

Ramsay Hunt syndrome shingles affects ear canal and associated area about ear, and is very painful and can be associated with facial nerve damage. Two stellate ganglion blocks with “local anesthetic 0.25% bupivacaine and triamcinolone 40 mg were given daily … Continue reading

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Post Herpetic Neuralgia (PHN) Treatments – Lots More Than Just Pills

Pregabalin helps 1 in 4.93 while lidocaine patch helped 1 in 2.. Still, reliance on meds only helped 1/2 then…- there are plenty of alternatives though

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Reaching “Critical Mass” to Achieving Pain Control – Procedure Pearls

I have recently achieved (previously unattainable) control in some of my chronic pain subjects using recent innovations – but to acheive this required use of multiple modalities at once.

Posted in arm, Back Pain, Botox, complex regional pain, Drugs, Fibromyalgia, Headaches, Injection, IV therapy, Leg Pains, Manual Med, myofascial pain, Neck, neuropathic, Pain Dystrophy, piriformis, post herpetic neuralgia, radiculitis, shoulder, Uncategorized | 4 Comments

Botulinum For Post Herpetic Neuralgia (PHN)

I had a recent question on treatments for PHN…I felt I needed to add more info on Botox for PHN. (Using equivalents) Putting equivalent of 6 units Botox INTRADERMAL per 3.56 cm diameter (1.4 of an inch) diameter area, could … Continue reading

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Varizig – Zoster Immune Globulin – Forgotten in Severe Zoster

An older study found zoster immune globulin single early infusion could reduce shingles symptoms by 50% at day 42 but this appears to be forgotten. It appears in Canada to be readily available through public health as Varizig – manufactured in Winnipeg … Continue reading

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Intercostal Nerve Blocks For Shingles / Herpes Zoster

I have written extensively on how nerve root blocks are a necessary part of treatment of shingles. Came across two Chinese articles stating effectiveness – one stating you can get “markedly effective” results in 75% of cases.

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Post-Herpetic /Shingles Neuralgia – Benefits of Local B12 Injections

Two separate chinese articles discuss use of B12 in the period immediately after shingles  and also, in a separate study, later. Each shows benefit. Note should be made that they used methylcobalamin – the bioactive form of B12

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Early Fix For Herpetic Zoster/Shingles – Inject the Spots With Local and Steroid

Injecting shingles lesion in acute stage with local and steroid  reduces pain, improves sleep and purportedly reduces post-herpetic neuralgia. NOTE TO MY CHINESE VIEWERS – I only have access to the chinese abstract translation – if you could fill in gaps … Continue reading

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Post Herpetic Neuralgia / Shingles – Micro-knifing Tender Areas (Acupotomy) Reduces Pain 60% and Persists over Course of 6 – 12 Months

Previously, there was a technique involved producing 2nd degree frost burns in tender post-herpetic neuralgia areas –  as a means to reduce pains. Suzuki H, Ogawa S, Nakagawa H, et al. Cryocautery of sensitized skin areas for the relief of … Continue reading

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Herpes Zoster/Shingles – Can You Tell What Nerve Level Affected?

The back can have a wide distribution in shingles; and according to a study, is not relable at determining nerve level, as is the front distribution. I will inject dorsal nerve roots in order to shut the back distribution off; often I … Continue reading

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Upper Facial Post Shingles Pains – Blocks

A Patient wrote: “My husband has been suffering with “Opthalmic Branch Post-Herpetic Neuralgia” for more than 4.5 years. The area describe here is exactly same as his PHN area. Currently he is taking 600mg Gabapentine 3 times a day and … Continue reading

Posted in neuropathic, post herpetic neuralgia | 1 Comment

Skin Nerve Stimulation (TENS) Could Treat and Prevent Post Shingles Neuropathic Pains

Transcutaneous Nerve  Stimulation (TENS = TNS)with one pad paraspinous and one pad front at level of shingles run 30 min daily – 20-40 hertz and 1-5 milliamps ended up with no pain at 6 months one versus 10% postherpetic neuralgia in … Continue reading

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Topical Ketamine For Post-herpetic Neuralgia

I’m trying to complete my coverage of Post-herpetic Neuralgia (PHN) treatments and felt this was a rather newer innovation. 65% can achieve a significant reduction in pain.

Posted in post herpetic neuralgia | 4 Comments

Shingles Vaccine if On Immunosuppressive Agents

I had a patient on Methotrexate want the shingles vaccine. Had to look this one up…as people with Rheumatoid arthritis and related diseases are on immunosuppressives…

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Post Herpes Zoster – Repeated Nerve Blocks within 100 days Works

Repeated nerve Blocks work within 100 days of Herpes zoster – quicker results if before the first 20 days  

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Small Spot Body Pain Treatment – Pen like Electrical Skin Stimulation

In the scalp, when there are small spots of severe pain, they call it nummular headache areas – they are remarkably resistant to treatments (botox helps though). Similar painful areas the size of the palm were treated with a 2 … Continue reading

Posted in complex regional pain, Mechanical aids, neuropathic, post herpetic neuralgia, Stimulation | 1 Comment

Botulinum (Botox) in Animals – Works on Peripheral Nerve Injury and Not Radiculitis

In rodents were either afflicted with either: – peripheral nerve injury – string tied about sciatic nerve – sciatica / radiculitis – string tied about a lumbar nerve Botox injections into paw cut senstivity by 50% in the peripheral injury … Continue reading

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Treatment of Opthalmic Branch Post-Herpetic Neuralgia with Blocks

I hate forehead/eye Post-herpetic Neuralgia. Upper facial Post herpetic Neuralgia has to be the worst case scenario. Local eye drop make a difference for eye. See: Lidocaine Eye Drops For Ophthalmic Postherpetic Neuralgia A case study highlights the benefits of … Continue reading

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ASA in Ether Effective for Herpetic and Post herpetic Neuralgia

ASA in Diethylether gets good to excellent results in over 3/4 cases of herpetic and post herpetic neuralgia. Development of post- herpetic neuraliga was under 3%. However, there is a trick involved in using the suspension…

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