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Post-Herpetic Neuralgia is simple to diagnose. Any patient who develops chronic
pain at the site of the shingles rash has post-herpetic neuralgia . The area
of pain of post-herpetic neuralgia may be smaller than the shingles rash or
may spread several inches larger than the shingles rash. The medical assessment
should evaluate the pain completely, ensure that there are no other factors
that are contributing to the pain (or predisposed to shingles), and evaluate
concerns such as physical dysfunction, mood, pain-coping strategies and social
support (Haythornwaite, 2001).
There is growing evidence that treatment of shingles with anti-viral drugs
can lessen the duration of shingles and lower the risk for post-herpetic neuralgia
. One study also suggested that early treatment with low-dose tricyclic antidepressants
(amitryptiline or nortriptyline) from the time of diagnosis of acute shingles
can reduce the incidence of post-herpetic neuralgia by about 50% (Bowsher,
1997).
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