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Post Herpetic Neuralgia- Ayurvedic Treatment, Diet, Exercises, Research Papers, Yoga & Pranayama

Introduction

Postherpetic neuralgia is the most common complication of shingles. The condition affects nerve fibres and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear. The chickenpox (herpes zoster) virus causes shingles. The risk of postherpetic neuralgia increases with age, primarily affecting people older than 60. There’s no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia improves over time.

Signs & symptoms

It is generally limited to the area of skin where the shingles outbreak first occurred — most commonly in a band around the trunk, usually on one side of the body.

Signs and symptoms might include:

Pain that lasts three months or longer after the shingles rash has healed. The associated pain has been described as burning, sharp and jabbing, or deep and aching.

Sensitivity to light touch. People with the condition often can’t bear even the touch of clothing on the affected skin (allodynia).

Itching and numbness. Less commonly, postherpetic neuralgia can produce an itchy feeling or numbness.

Causes

It is a complication after an attack of shingles. Greater risk for post herpetic neuralgia is present if:

  • The person is older than 50.
  • The pain & rashes associated with shingles are very severe.
  • Other illnesses such as diabetes is present.
  • The location affected by shingles is face or torso.
  • The antiviral treatment was delayed for more than 72 hours after the appearance of rash.

Pathophysiology

Varicella Zoster Virus is a highly contagious DNA virus that remains latent within the sensory ganglia following resolution of chickenpox, which usually occurs during childhood. During Herpes Zoster, Varicella Zoster Virus is reactivated, travels back along the affected neurons away from the sensory ganglia, and propagates in the epidermis. A hallmark of Herpes Zoster is that it is typically unilateral (i.e., not crossing the midline), and in most cases only a single dermatome is affected. The erythematous maculopapular Herpes Zoster rash is usually accompanied by pain and dysesthesia. The rash progresses to clear vesicles similar to the original chickenpox outbreak. Then, over a period of 48–72 hours, pustules form, ulcerate, and eventually scab over. Scabs fall off in 2–3 weeks and scarring may occur.

Post Herpetic Neuralgia occurs in the same dermatomes as the Herpes Zoster rash, and stems from damage to peripheral and central neurons that may be a by-product of the immune/inflammatory response that accompanied Varicella Zoster Virus reactivation and migration. When damaged, peripheral and central nerve fibres may develop a lower threshold for action potentials, discharge spontaneously, and exhibit disproportionate responses to stimuli, resulting in peripheral sensitization and pain without painful stimuli (allodynia) Patients with PHN experience three major types of pain: 1) constant pain without a stimulus (often described as burning, aching, or throbbing), 2) intermittent pain without a stimulus (often described as stabbing, shooting, or electric shock-like), and 3) pain brought on by a stimulus but is disproportionate to the stimulus (hyperalgesia) enduring for at least 3 months after healing of the Herpes Zoster-related skin rash. In addition, patients may experience a variety of abnormal sensations (dysesthesias or paraesthesia’s).

Diagnosis

Physical examination

Treatments

No single treatment relieves postherpetic neuralgia for everyone. Mostly, a combination of treatments is needed to reduce the pain.

Lidocaine skin patches – These are small, bandage-like patches that contain the topical pain-relieving medication lidocaine. The patches are applied, directly to painful skin to deliver temporary relief.

Capsaicin skin patch – It uses a patch with a numbing medication on the affected area.

Anticonvulsants – Certain anti-seizure medications, including gabapentin and pregabalin, can lessen the pain of postherpetic neuralgia. These medicines have remarkable side effects too.

Antidepressants – Certain antidepressants, such as nortriptyline, amitriptyline, duloxetine and venlafaxine, affect key brain chemicals that play a role in both depression and how the body interprets pain. Antidepressants in lower dosage are used effectively in post herpetic neuralgia

Common side effects of these medications include drowsiness, dry mouth, lightheadedness and weight gain.

Opioid painkillers – in severe cases. Opioids can cause mild dizziness, drowsiness, confusion and constipation.

Steroid injections

Prognosis

The prognosis is good in most of the cases but they may have to take pain medications for about one to three months. For others, the prognosis is fair to poor if the pain is severe, lasts longer than three months, or markedly reduces their quality of life.

Complications

Chronic pain and associated discomforts like

  • Depression
  • Fatigue
  • Difficulty sleeping
  • Lack of appetite
  • Difficulty concentrating

Disease & Ayurveda

        Visarpa

Nidana

        Not mentioned separately.

Causative factors of Sopha can cause the same

Vidaahi food items  

Purvaaroopa

        Not mentioned.

Samprapti

        When the vitiated one, two or three doshas get lodged inside or outside of the body, spread very fast and causes inflammation. In baahyavisarpa, the inflammation affects skin and nerves leading to severe pain and other discomforts.

Lakshana

Sopha  – swelling

Sphurana – throbbing

Nistoda – piercing pain

Bheda  – stabbing pain

Arthi    – severe pain

Harsha – numbness

Divisions

  • Vaatika
  • Paittika
  • Kaphaja
  • Baahya
  • Aabhyantara
  • Baahya-aabhyantara

Prognosis

Krichhrasadhyam

Chikithsa

Treatment of visarpa should start with Langhana (fasting) and Rookshana (drying) therapies. After proper aamapaachana, bloodletting should be done to clean the circulation. After bloodletting, Vamana and virechana are indicated. In cases of Visarpa, snehana (use of oils/fats) therapies are contra indicated.

Samana

Lepanam with Rookshana dravyas

Parisheka with soolahara-rooksha & seethadravyas

Sodhana

Raktamokshanam

Vamanam

Virechanam

Commonly used medicines

Patolakadurohinyadi Kashayam

Drakshadi kashayam

Guduchyadi kashayam

Vilwadi gutika

Avipathy Churna

Naalpaamaradi kwatham

  Naalpaamarachoorna lepam

Satadhoutaghrutam  

Brands available

AVS Kottakal

AVP Coimbatore

SNA oushadhasala

Vaidyaratnam oushadhasala

Home remedies

Shingles cause severe pain & discomforts which cannot be managed at home. No home remedy is proven to cure shingles. Following herbs may help to lessen the suffering.

Cold compresses

Essential oils

Aloe vera

Witch hazel

Oatmeal

Turmeric paste

Diet

  • To be avoided

Heavy meals and difficult to digest foods – cause indigestion.

Spicy and hot food items

Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine

Carbonated drinks – makes the stomach more acidic and disturbed digestion

Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)

Milk and milk products – increase kapha, cause obstruction in channels and obesity

Curd – causes vidaaha and thereby many other diseases

  • To be added

Light meals and easily digestible foods

Gooseberry, pomegranate, grapes etc.

Green gram, soups, food items with cold potency.

Freshly cooked and warm food processed with minimal spices.

Behaviour:

Protect yourself from hot climate.

Better to avoid exposure to excessive sunlight wind rain or dust.

Maintain a regular food and sleep schedule.

Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.

Avoid sedentary lifestyle.

Yoga

Exercise is not advised in cases with severe pain and discomforts. Regular stretching and mild cardio exercises are advised in mild cases. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.

Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.

Yoga can maintain harmony within the body and with the surrounding system.

Yoga for neuropathy

Pavanamuktasana

Nadisudhi pranayama

Bhujangasana

Simple exercises for lungs and heart health

All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.

Research articles

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5036669/

 

These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.

Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.

Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.

Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.

Dr. Nair is a regular speaker at Ayurveda-related conferences and has visited Germany to propagate Ayurveda. You can write directly to him-
rajesh@ayurvedaforall.com

Whatsapp – +91 9446918019, +91 8075810816

URLs: https://www.ayurvedaforall.com/
https://www.ayurvedaforall.co.uk/

To give you a quick idea about Ayurvedaforall, we are a group of ayurvedic practitioners committed to propagating Ayurveda in its best tradition around the world. Our online store sells authentic ayurvedic formulations backed by professional advice. Now into the seventeenth year of operation, the site has helped us build a dedicated clientele which regularly uses our products and services as well as refers others to us. Needless to say, this has been achieved through our adherence to the highest standards of customer service and professional ethics.

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Dr. Rajesh Nair
Licensed Ayurvedic doctor focused on providing individual Ayurvedic consultation services. Specialized in work related stress, Womens’ issues, diabetes, Pecos, arthritis, male and female sexual problems and infertility. Interested in academic work as well. Now working with www.ayurvedaforall.com as senior consultant, Ayurveda.

Dr. Rajesh Nair

Licensed Ayurvedic doctor focused on providing individual Ayurvedic consultation services. Specialized in work related stress, Womens’ issues, diabetes, Pecos, arthritis, male and female sexual problems and infertility. Interested in academic work as well. Now working with www.ayurvedaforall.com as senior consultant, Ayurveda.

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