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 drug treated or no treatment groups. Bizarrely, addition of anti-viral drugs to TNS prevented the beneficial effects.
Swiss Med Wkly. 2012 Jan 17;141:
TENS – an alternative to antiviral drugs for acute herpes zoster treatment and
postherpetic neuralgia prevention.
Kolsek M. free article here
- 4 groups: – antivirals (28); TENS (29); no therapy (21); combined antivirals and TENS (24)
- TENS – one pad paraspinous and one pad anteriorly along the level of the nerve; 20-40 hertz at 1-5 milliamps – 30 minutes 5x week for 2 weeks
- They had no idea why the combined group did poorly as this group had no greater proportion of intense pain cases.
- This was only a retrospective – chart review study so all they could suggest is a better case controlled study prospectively.
Comment – Have shingles and too late for anti-virals? – Don’t despair – TENS might be better for you anyway. Nerve blocks and vitamin C are essentials treatment measures as well. Antivirals have not been shown to prevent post herpetic neuralgia and this is an example – Post herpetic neuralgia in 9.5% of controls and 10.7% of anti-viral group. I once had a nice (“tigger” puppet in my office. One day a child with chickenpox came in to my office and grabbed it. I asked if he liked it and he nodded – well, it was his now…). I’m wondering if subjects would have to get their own TENS machines – though in the study this obviouly was not happening ( 5 days a week smacks of weekday physio rx).
There was a recent article published that said most sites offering info on post shingles pains are just trash – I protest – I have worked very hard to give options to patients suffering from this condition. See for yourself: