Best Treatment For Shingles Pain and Itching

Without treatment for shingles, many older patients develop postherpetic neuralgia (PHN), which is a severe, excruciating painful rash. Doctors estimate that 1 in 4 patients with shingles will develop this condition, even if they are treated quickly with antiviral medication. However, if they do not seek treatment right away at the sight of the rash, then the odds increase to 1 in 2. For this reason, initial treatment is critical. Today there are several courses of action doctors may advocate for their patients.

Treatment for shingles pain ranges greatly, depending on the doctor and the patient's response, says Dr. Anne Louise Oaklander MD, PhD of Massachusetts. "Some people may find that over the counter anti-inflammatory and pain relief is adequate, such as acetaminophen, aspirin, or ibuprofen," she explains, "but substantial numbers of people will need prescribed pain medications by their physician. Some patients, in fact, with severe pain may require admission to the hospital and treatment with intravenous or intraspinous pain medications." Most people are lessening the pain of shingles at home with nerve-targeting prescription medications like Percocet, Vicodin, Gabapentin, Nortriptyline, Despiramine or Amitrityline. Not everyone feels comfortable taking such drugs, which are known to have side effects like drowsiness and nausea.  

A May 2009 study found that a new surgical procedure provides pain management for sufferers of PHN. In a 45-minute procedure, surgeons implanted a hockey puck sized pump system under the skin in the abdomen, with a small tube inserted into the spine to deliver medicine, like morphine. This treatment for shingles pain resulted in a "dramatic improvement in pain" for all five patients, says Andrew J. Fabiano MD, senior resident at the University of Buffalo. "All patients showed a greater than 50% improvement in pain control," he adds. No side effects were reported.

In addition to the pain pump, Oxycodone has proven to be a fairly promising form of treatment for shingles, says a study published in the April issue of the journal Pain. Of the 87 shingles patients treated, those taking the Oxycontin medication treatment were more than twice as likely to experience at least a 30% reduction in pain, compared to those taking a placebo. The most serious side effect of the drug was constipation, which caused nearly a third of the patients to withdraw from the study. Yet, most patients agreed that, compared to the burning, shooting pain of PHN, the side effects of the drug were tolerable.

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