Postherpetic Pain: More Than Sensory Neuralgia?
Version of Record online: 19 MAY 2006
Volume 7, Issue 3, pages 243–249, May 2006
How to Cite
Weiner, D. K. and Schmader, K. E. (2006), Postherpetic Pain: More Than Sensory Neuralgia?. Pain Medicine, 7: 243–249. doi: 10.1111/j.1526-4637.2006.00151.x
- Issue online: 19 MAY 2006
- Version of Record online: 19 MAY 2006
- Postherpetic Neuralgia;
- Myofascial Pain;
- Older Adults
Objective. To describe a series of older adult patients with postherpetic myofascial pain, a heretofore rarely described complication of herpes zoster.
Design. Case series.
Setting. Outpatient older adult pain clinic.
Patients. Five older adults are presented with myofascial pain that developed as a complication of herpes zoster.
Results. Pain duration at the time of presentation ranged from 4 months to 7 years. All patients reported functional impairment from pain despite oral analgesics. Myofascial pathology was diagnosed by the presence of taut bands and trigger points in the affected myotome. Upon successful treatment of the myofascial pain with nonpharmacologic modalities (e.g., physical therapy, trigger point injections, dry needling, and/or percutaneous electrical nerve stimulation), all patients reported symptomatic improvement, and four out of five were able to significantly reduce or discontinue their opioids.
Conclusion. Postherpetic pain is traditionally conceptualized as a purely sensory phenomenon. Identification of the intrusion of a myofascial component may be worthwhile, both from the standpoint of enhanced pain relief and reduction in the need for oral analgesics. Formal exploration of this phenomenon is needed.