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Could this be postherpetic neuralgia?
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Could this be postherpetic neuralgia?

About a year ago, as a 42-year-old male I suffered from shingles.
In the last couple weeks, I've had started having some extremely painful areas on each foot, a finger, an elbow and and leg that inexplicably n the span of a few days with no lingering effects. The foot pain was the worst, the others tolerable.
Could this be postherpetic neuralgia?

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Avatar_f_tn
Hi. Thanks for writing in.

Your symptoms are suggestive of Post-Herpetic Neuralgia (PHN), which is the most common complication of herpes zoster or shingles. It occurs in approximately 10 - 20% of patients who have had shingles.

PHN is defined broadly as any pain that remains after healing of herpes zoster lesions or rash, usually after a three month period. However, the dividing line between acute herpes and PHN is arbitrary. Another school of thought considers the persistent pain as subacute herpetic neuralgia if it lasts between 1 - 3 months, and as PHN, if it lasts beyond 3 months. The pain sometimes can last for months and even years.

Shingles often occur in dermatomes, i.e. they follow the distribution of nerves in the skin. The pain of postherpetic neuralgia is generally limited to the area of the skin where the shingles had erupted.
The pain may be sharp, piercing, throbbing or stabbing in nature. It leads to extreme sensitivity of skin to touch and temperature.PHN is often seen in older people.

Sometimes herpes zoster reactivates subclinically, with pain in a dermatomal distribution without any rash. This is known as zoster sine herpete and may be more complicated, affecting many cranial nerves and causing multiple cranial neuropathies and polyneuritis.

You should consult you doctor for a complete clinical and neurological examination and appropriate treatment for quick relief from symptoms.

Regards

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Avatar_m_tn
I am a 54 yr old male, in pretty good shape, non-smoker, non-drinker.  For the past 2 years I have experienced pain in the left side of my chest with tingling in the left arm.  I've seen 2 cardiologists and had a complete exam including an angiogram, showing no heart disease.  Since then I've seen gastroenterologists, pulmonologists, and pain specialists.  
My new doctor suggested PHN and tested me for the virus anitbody, which I have.  But I have never had any outbreak of shingles on the skin.  I've been on 300 mg of Gabapentin for 3 weeks now, and am using Capcaicin, but still have pain.  It feels like it's getting progressively worse.
I'm not so sure about my Doctor's diagnosis.  How can I know for certain?
How long does Gabapentin need to take effect?  
Would  a nerve block positively confirm the PNH diagnosis?
Any other tests to confirm this diagnosis?
Thank you.
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