Herpes zoster and its posterior neuralgia

  Herpes zoster is a popular viral skin disease caused by varicella zoster virus. The virus usually first invades the body through the respiratory mucosa (mainly the nasal mucosa), multiplies and invades the bloodstream, causing chickenpox (mostly in children) or an insidious infection. The virus then invades the sensory nerve endings, spreads to the center and persists in the sensory ganglia. When the body is immunocompromised, the virus becomes active again and multiplies in the ganglion, causing an inflammatory response in the ganglion and pain along the sensory nerve distribution of the ganglion. The virus then travels down the nerve to the skin and multiplies there, causing the typical herpes cluster.  The elderly and people with chronic wasting diseases are susceptible to herpes zoster, and the disease is more severe once contracted. Herpes zoster invading the chest and waist area accounts for more than 60% of the incidence of the disease, which is folklore known as the “crosstalk dragon”, and may also invade the head and face, eyes, ears, upper and lower extremities, internal organs and perineum. Since the virus is nerve-friendly, the disease always develops along the nerves and is striped, hence the name herpes zoster.  Herpes zoster will turn into chronic pain if the early pain is not controlled in time. Postherpetic neuralgia (PHN) is a serious complication that remains after the occurrence of herpes zoster, defined as persistent spontaneous pain, light tenderness (nociceptive hyperalgesia) and sensory abnormalities (severe pain can be triggered by rubbing off clothing) at the site of the primary herpes for more than 1 month after the disappearance of herpes zoster. The nature of the pain is predominantly spontaneous knife-like or lightning-like episodes of pain or persistent burning pain. In recent years, the number of patients with postherpetic neuralgia has increased year by year, and severe pain can lead to reduced outdoor activities, sleep disturbances, social avoidance, depression, and even loss of confidence in life and suicidal tendencies; thus, patients enter a vicious cycle of unrelieved pain, severe sleep disturbances, and a sharp decrease in resistance. The patient enters a vicious cycle of unrelieved pain – severely impaired sleep – drastically reduced resistance – and constant painful outbreaks.  The duration of postherpetic neuralgia can be as short as 1 to 2 years or as long as 10 years, and without effective pain treatment, the history of the disease is usually as long as 3 to 5 years. Correct diagnosis and timely and reasonable treatment after the onset of the disease is the key to healing as soon as possible and reducing sequelae. In the past, the disease was mostly seen in dermatology because of the appearance of herpes on the body surface. Now, due to the progress in understanding the etiology and the better treatment effect of nerve block, postherpetic neuralgia has become the best indication in pain medicine.  So here comes the question! Which hospital in Fujian treats shingles and postherpetic neuralgia best?  Our department adopts oral medication, intralesional medication and spinal nerve root pulse radiofrequency modulation three-step treatment to treat postherpetic neuralgia with very good results and a treatment efficiency of over 90%. Supplemented with antiviral drugs, neuroprotective and restorative drugs and vitamins; nerve blocks include painful point blocks, paravertebral blocks and sacral blocks. It enables patients with herpes zoster to pass through the acute and chronic phases pain-free for the benefit of all patients!