Herpes zoster is a dermatological disease caused by the varicella virus and is characterized by painful bundles and skin herpes along the nerve paths. This virus, which is the same virus that causes pediatric chickenpox, has a strong affinity for nerve cells. When the chickenpox in childhood is cured, this virus remains latent in the nerve cells of the posterior spinal root ganglion, semilunar ganglion, and geniculate ganglion for a long time and becomes active again when the host organism’s immunity is reduced, causing herpes zoster. It is now widely believed that it is this varicella-zoster virus that infiltrates and destroys nerve cells while causing skin herpes, triggering nerve cell degeneration, resulting in abnormal nociceptive conduction and abnormal pain. It is important to understand that once the degeneration of nerve cells has occurred, it is very difficult to return to its original state. Therefore, it is not possible to predict how long the pain will last, but it is not uncommon to see people with lifelong pain for months, years, or even more than 10 years. Therefore. Early diagnosis, treatment, and prevention are the keys to preventing the development of postherpetic neuralgia. The following patients are especially prone to postherpetic neuralgia: ①
(1) people over 60 years of age; (2) people whose herpes occurs in the first distribution area of the trigeminal nerve; (3) people with a severe rash, especially those who form ulcers; and (4) people with diabetes. In young people with herpes zoster when the rash heals, the pain disappears with it, while in the elderly and immunocompromised people it tends to continue to be painful to a lesser extent than in the acute phase, and in some cases even lasts for life. Some people divide herpes zoster pain into 4 phases: 1. latent pain: pain for several days (or weeks in some cases) before the onset of the rash; 2. rash pain: pain for 1 month during the onset of the rash; 3. recovery pain: pain for 1 to 3 months after the onset of the rash; 4. postherpetic neuralgia: pain that persists 4 months after the onset of the rash. Regardless of the stage of pain, early prevention is the best option. There is no absolutely effective method for the eradication of postherpetic neuralgia. Commonly used treatments include: ① antiviral; ② hormones; ③ nerve-nourishing drugs; ④ analgesics; ⑤ sedatives; ⑥ lesion injection method; ⑦ physical factors; ⑧ anti-anxiety agents; ⑨ immunosuppressive factors; ⑩ acupuncture and psychotherapy, etc., which have therapeutic effects but are not ideal. The alteration of the organism by pain, like emotional damage, leaves indelible traces on the mind, making people more and more sensitive to pain, and the manifestations of pain become more and more abundant; and because the neurocentral pathways causing pain and depression are the same, most patients with chronic pain have concomitant anxiety and depression. Therefore, the use of one treatment alone is not effective, and a combination of treatments is the only solution. Some new treatments have also emerged in recent years: (1) transcutaneous electrical nerve stimulation for pain relief and spinal cord and brain stimulation for pain relief. (2) Nerve block and nerve destruction therapy. (3) Radiofrequency thermocoagulation.