Herpes zoster has no blisters but is very painful. Depending on the course of the disease, it is considered to be tonic herpes zoster or postherpetic neuralgia, and treatments include medication and interventional therapy.
If the disease is in its early stages and there is no rash such as blisters, and the pain is simple, it is considered to be tonic herpes zoster, and systematic antiviral and nutritive therapy, including ganciclovir, phosphonate, and methylcobalamin, is still needed.
If the pain persists even after the rash has completely disappeared (about 1 month), postherpetic neuralgia is considered, and the treatment includes:
(1) Pharmacological treatment: preferred drugs include calcium channel modulators (pregabalin and gabapentin), tricyclic antidepressants (amitriptyline), and 5% lidocaine patches, followed by opioids and tramadol depending on the condition. It should be noted that the drugs should be used in full dosage according to the treatment program, and should avoid stopping the drugs immediately after the pain is relieved.
(2) Minimally invasive interventional therapy: It mainly includes neuro-interventional technology and neuromodulation technology, in which instruments or drugs are placed into the lesion tissue under the guidance of image to treat it.
(3) Other treatments: can be combined with acupuncture therapy, ozone therapy and other techniques according to the situation, and studies have shown a certain effect.
Postherpetic neuralgia should be treated in a standardized manner under the guidance of a specialist, and the above medications should be used under the guidance of a doctor.