Last summer I got shingles. You haven’t seen it for a long time, but I still suffer from stabbing pains. How long will this continue and is there anything that can be done about it?
Joris Bartstra, journalist with medical diploma
Shingles is caused by a virus. The disease damages nerves and causes the stabbing pain you experience (‘post-herpetic pain’). That pain can last for months or even years, although the latter is rare. The older you are, the longer the recovery will take. Distraction, especially being among people, often helps with the pain.
In addition, there are medicines that do something against nerve pain. These are medicines for epilepsy (such as carbamazepine and pregabalin) and for depression (amitriptyline and nortriptyline). These agents have the property that they slightly adjust the stimulus transmission between nerve cells. Usually lower doses are used than for depression or epilepsy. All these remedies can make you a little sleepy, especially in the beginning. The pain subsides, but rarely disappears completely. In addition, there is lidocaine cream. This is the same type of anesthetic as the dentist uses, but in a cream. If the pain is unbearable, you can go to a pain outpatient clinic, where they also have options such as TENS (transcutaneous electrical neurostimulation).
With TENS, you get a device on your skin that delivers electrical currents. This stimulates the nerves, which actually reduces the pain. I would start by asking the doctor for lidocaine cream and possibly try a low dose of amitriptyline. A lot is possible, but it is also a lot of hassle. The severity of the pain often determines how much the patient is willing to pay for it.
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