Introduction to the management of postherpetic neuralgia in the elderly

 How to understand the pain of patients with post-herpetic neuralgia pain department of Henan Provincial People’s Hospital Ma Songhe downstairs Wang aunt sitting on a bench in the community moaning in pain, the old partner in the side muffled, what happened to the former cheerful and smiling Wang aunt, out of professional habit to go over to see, Wang aunt said a month ago the waist shingles, now the herpes has been healed, how the pain is more powerful than before, clothes can not touch The pain is like a burning pain, but it is not understood by the family members, who think it is not sick. It turns out that Wang’s aunt is tormented by post-herpetic neuralgia. What exactly is post-herpetic neuralgia? It is persistent, severe, very persistent and intractable pain despite the fact that the lesions of herpes zoster have completely healed. The duration of the pain usually varies from several days to several months, and it occurs in the elderly and in immunocompromised people. The mechanism of pain onset: is not well understood. Possible mechanisms are: injury or regeneration of nociceptive afferent fibers – touch pain; abnormalities of injurious sensory nerve endings – soreness or tingling; inflammation of primary nociceptive afferent nerves – dorsal root ganglia causing damage to the segmental nociceptive modulation system, resulting in sensitization of peripheral nociceptive sensation and central nociceptive sensitization. Sensitization of peripheral nociceptive sensation and central nociceptive sensation. The clinical symptoms are: (1) persistent or episodic severe pain in the affected area 3 months after herpes zoster healing; marked pigmentation in the affected area; (2) marked sensory and tactile abnormalities in the affected area. Most of the patients are characterized by hyperalgesia, which can produce severe and unbearable pain with a light touch, while some patients are characterized by hyperalgesia with a pronounced sense of touch. (4) due to the fear of severe pain, patients have a heavy psychological burden, depression, and even lose confidence in life and have suicidal tendencies, which should be paid special attention to