Post-Herpetic Neuralgia Treatment in PA & NJ
Post-herpetic neuralgia (PHN) is a complication of shingles (herpes zoster) in which nerve pain persists for months or years after the shingles rash has healed. The varicella-zoster virus damages nerve fibers, causing them to send confused and exaggerated pain signals. PHN affects approximately 10-15% of shingles patients and is more common and more severe in older adults.
At DVPSI, we offer interventional treatments that specifically target damaged nerve pathways, providing relief that oral medications such as gabapentin or pregabalin often cannot fully achieve.
Common Symptoms
- Burning, sharp, or jabbing pain in the area where shingles rash occurred
- Allodynia where light touch, clothing, or air movement causes significant pain
- Itching or numbness mixed with pain
- Pain that persists more than three months after shingles rash heals
- Sensitivity to temperature changes in the affected area
- Sleep disruption from constant or intermittent pain
Common Causes
- Varicella-zoster virus reactivation causing nerve fiber damage
- Nerve inflammation during acute shingles damaging pain-transmitting fibers
- Central sensitization where the spinal cord amplifies pain signals
- Age as a major risk factor for developing PHN after shingles
- Severe acute pain during shingles predicts higher PHN risk
Treatment Options at DVPSI
Our board-certified physicians use a stepwise, minimally invasive approach, always starting with the least invasive effective treatment and escalating only when necessary.
Intercostal Nerve Blocks
Targeted injections along the affected intercostal nerves to interrupt PHN pain signals.
Epidural Steroid Injections
Anti-inflammatory injections at the affected spinal level for thoracic or lumbar PHN.
Spinal Cord Stimulation
For refractory PHN, neuromodulation can provide significant long-term relief.
Sympathetic Nerve Blocks
Stellate ganglion or thoracic sympathetic blocks for upper body PHN.
Ketamine Infusion
IV ketamine for central sensitization-driven PHN that has not responded to other treatments.
Medication Management
Optimized regimens using membrane stabilizers, topical agents, and TCAs.
Why Choose DVPSI for Post-Herpetic Neuralgia Treatment
Post-herpetic neuralgia is a neuropathic pain condition requiring the specialized expertise of both a neurologist and an interventional pain physician. Dr. Bromberg's dual training makes DVPSI uniquely equipped to offer the most advanced PHN treatment available in the region.