Introducción
Postherpetic neuralgia is the most common complication of shingles. The condition affects nerve fibres and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear. The chickenpox (herpes zoster) virus causes shingles. The risk of postherpetic neuralgia increases with age, primarily affecting people older than 60. There’s no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia improves over time.
Signs & symptoms
It is generally limited to the area of skin where the shingles outbreak first occurred — most commonly in a band around the trunk, usually on one side of the body.
Signs and symptoms might include:
Pain that lasts three months or longer after the shingles rash has healed. The associated pain has been described as burning, sharp and jabbing, or deep and aching.
Sensitivity to light touch. People with the condition often can’t bear even the touch of clothing on the affected skin (allodynia).
Itching and numbness. Less commonly, postherpetic neuralgia can produce an itchy feeling or numbness.
Causas
It is a complication after an attack of shingles. Greater risk for post herpetic neuralgia is present if:
- The person is older than 50.
- The pain & rashes associated with shingles are very severe.
- Other illnesses such as diabetes is present.
- The location affected by shingles is face or torso.
- The antiviral treatment was delayed for more than 72 hours after the appearance of rash.
Fisiopatología
Varicella Zoster Virus is a highly contagious DNA virus that remains latent within the sensory ganglia following resolution of chickenpox, which usually occurs during childhood. During Herpes Zoster, Varicella Zoster Virus is reactivated, travels back along the affected neurons away from the sensory ganglia, and propagates in the epidermis. A hallmark of Herpes Zoster is that it is typically unilateral (i.e., not crossing the midline), and in most cases only a single dermatome is affected. The erythematous maculopapular Herpes Zoster rash is usually accompanied by pain and dysesthesia. The rash progresses to clear vesicles similar to the original chickenpox outbreak. Then, over a period of 48–72 hours, pustules form, ulcerate, and eventually scab over. Scabs fall off in 2–3 weeks and scarring may occur.
Post Herpetic Neuralgia occurs in the same dermatomes as the Herpes Zoster rash, and stems from damage to peripheral and central neurons that may be a by-product of the immune/inflammatory response that accompanied Varicella Zoster Virus reactivation and migration. When damaged, peripheral and central nerve fibres may develop a lower threshold for action potentials, discharge spontaneously, and exhibit disproportionate responses to stimuli, resulting in peripheral sensitization and pain without painful stimuli (allodynia) Patients with PHN experience three major types of pain: 1) constant pain without a stimulus (often described as burning, aching, or throbbing), 2) intermittent pain without a stimulus (often described as stabbing, shooting, or electric shock-like), and 3) pain brought on by a stimulus but is disproportionate to the stimulus (hyperalgesia) enduring for at least 3 months after healing of the Herpes Zoster-related skin rash. In addition, patients may experience a variety of abnormal sensations (dysesthesias or paraesthesia’s).
Diagnóstico
Physical examination
Tratamientos
No single treatment relieves postherpetic neuralgia for everyone. Mostly, a combination of treatments is needed to reduce the pain.
Lidocaine skin patches – These are small, bandage-like patches that contain the topical pain-relieving medication lidocaine. The patches are applied, directly to painful skin to deliver temporary relief.
Capsaicin skin patch – It uses a patch with a numbing medication on the affected area.
Anticonvulsants – Certain anti-seizure medications, including gabapentin and pregabalin, can lessen the pain of postherpetic neuralgia. These medicines have remarkable side effects too.
Antidepressants – Certain antidepressants, such as nortriptyline, amitriptyline, duloxetine and venlafaxine, affect key brain chemicals that play a role in both depression and how the body interprets pain. Antidepressants in lower dosage are used effectively in post herpetic neuralgia
Common side effects of these medications include drowsiness, dry mouth, lightheadedness and weight gain.
Opioid painkillers – in severe cases. Opioids can cause mild dizziness, drowsiness, confusion and constipation.
Steroid injections
Pronóstico
The prognosis is good in most of the cases but they may have to take pain medications for about one to three months. For others, the prognosis is fair to poor if the pain is severe, lasts longer than three months, or markedly reduces their quality of life.
Complicaciones
Chronic pain and associated discomforts like
- Depresión
- Fatiga
- Difficulty sleeping
- Lack of appetite
- Difficulty concentrating
Disease & Ayurveda
Visarpa
Nidana
Not mentioned separately.
Causative factors of Sopha can cause the same
Vidaahi food items
Purvaaroopa
Not mentioned.
Samprapti
When the vitiated one, two or three doshas get lodged inside or outside of the body, spread very fast and causes inflammation. In baahyavisarpa, the inflammation affects skin and nerves leading to severe pain and other discomforts.
Lakshana
Sopha – swelling
Sphurana – throbbing
Nistoda – piercing pain
Bheda – stabbing pain
Arthi – severe pain
Harsha – numbness
Divisions
- Vaatika
- Paittika
- Kaphaja
- Baahya
- Aabhyantara
- Baahya-aabhyantara
Pronóstico
Krichhrasadhyam
Chikithsa
Treatment of visarpa should start with Langhana (fasting) and Rookshana (drying) therapies. After proper aamapaachana, bloodletting should be done to clean the circulation. After bloodletting, Vamana and virechana are indicated. In cases of Visarpa, snehana (use of oils/fats) therapies are contra indicated.
Samana
Lepanam with Rookshana dravyas
Parisheka with soolahara-rooksha & seethadravyas
Sodhana
Raktamokshanam
Vamanam
Virechanam
Medicamentos de uso común
Guduchyadi kashayam
Vilwadi gutika
Avipathy Churna
Naalpaamaradi kwatham
Satadhoutaghrutam
Marcas disponibles
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Remedios caseros
Shingles cause severe pain & discomforts which cannot be managed at home. No home remedy is proven to cure shingles. Following herbs may help to lessen the suffering.
Cold compresses
Essential oils
Aloe vera
Witch hazel
Oatmeal
Turmeric paste
Dieta
- A evitar
Heavy meals and difficult to digest foods – cause indigestion.
Spicy and hot food items
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- Por añadir
Comidas ligeras y alimentos fáciles de digerir
Gooseberry, pomegranate, grapes etc.
Green gram, soups, food items with cold potency.
Freshly cooked and warm food processed with minimal spices.
Comportamiento:
Protect yourself from hot climate.
Es mejor evitar la exposición a la luz solar excesiva, la lluvia o el polvo.
Maintain a regular food and sleep schedule.
Evite aguantar o forzar las ganas de orinar, defecar, toser, estornudar, etc.
Avoid sedentary lifestyle.
posturas de Yoga
Exercise is not advised in cases with severe pain and discomforts. Regular stretching and mild cardio exercises are advised in mild cases. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
El yoga puede mantener la armonía dentro del cuerpo y con el sistema circundante.
Yoga for neuropathy
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
Todos los ejercicios y esfuerzos físicos deben decidirse y realizarse únicamente bajo la supervisión de un experto médico.
Artículos de investigación
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5036669/
Estas afirmaciones no han sido evaluadas por la Food and Drug Administration, Estados Unidos. Este producto no está destinado a diagnosticar, tratar, curar o prevenir ninguna enfermedad. Por favor, consulte a su médico de cabecera antes de la ingesta.
Escritor:
El Dr. Rajesh Nair, cofundador y asesor jefe de Ayurvedaforall.Com, es licenciado por el prestigioso Vaidyaratnam Ayurveda College (afiliado a la Universidad de Calicut), Kerala, India. Además, posee un Diploma de Postgrado en Yoga Terapéutico por la Universidad de Annamalai.
El Dr. Nair ofrece consultas en dos concurridas clínicas situadas en Haripad y sus alrededores, Alleppey, Kerala, el estado meridional famoso en todo el mundo por sus auténticos tratamientos y médicos ayurvédicos. Además de ofrecer consultas sobre todos los aspectos de los tratamientos ayurvédicos, el Dr. Nair tiene un interés especial en Panchkarma, Yoga y Masaje.
A través de Ayurvedaforall, el Dr. Nair ofrece consultas en línea a pacientes de todo el mundo y ha atendido a cientos de pacientes en los últimos 20 años. Además de su consulta ayurvédica, es editor jefe de ayurveda-amai.org, el portal en línea de la Asociación Médica Ayurveda de la India, y miembro del comité estatal de la Asociación Médica Ayurveda de la India.
El Dr. Nair es ponente habitual en conferencias relacionadas con el Ayurveda y ha visitado Alemania para propagar el Ayurveda. Puede escribirle directamente
rajesh@ayurvedaforall.com
Whatsapp - +91 9446918019, +91 8075810816
URL: https://www.ayurvedaforall.com/
Para darle una idea rápida sobre Ayurvedaforall, somos un grupo de médicos ayurvédicos comprometidos con la propagación del Ayurveda en su mejor tradición en todo el mundo. Nuestra tienda en línea vende auténticas fórmulas ayurvédicas respaldadas por asesoramiento profesional. Tras diecisiete años de funcionamiento, el sitio nos ha ayudado a crear una clientela fiel que utiliza regularmente nuestros productos y servicios y nos recomienda a otras personas. Ni que decir tiene que esto se ha logrado gracias a nuestra adhesión a las normas más estrictas de atención al cliente y ética profesional.
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