HSV Leg Pain?

[ben30]

I was diagnised with HSV 1 and 2 about a month ago. Along with a sore, raw area, that has not healed (and I have been on Valtrex for two weeks),I have had almost continual inner leg pain on both sides. I have gotten mixed messages as to if this leg pain is related to my condition, others have experienced similar symtoms. Will the Valtrex eventually take this away, along with the continual raw soar area(very small bumps)? How long must I wait?  I have read this could be Neorological?  Any thoughts, I am desperate at this point...

[H. Hunter Handsfield, M.D.]

The continuing sore, raw area is almost certainly not due to herpes; if it were, it would have cleared up by now on valacyclovir (Valtrex).  In addition, your symptoms don't sound much like herpes.

As to the inner leg pain, I can't say much.  The neuropathic pain caused by HSV usually isn't symmetrical, i.e. would be unlikely to involve both thighs.

So I am skeptical of the herpes diagnosis.  How was it made?  If not confirmed by a reliable lab test, I would return to your health care provider (or a different one) for proper testing.

Good luck-- HHH, MD

[Dlux]

I also had a question about the leg pain symptoms of herpes. I'm going to get a test for HSV-2 soon by the way (just waiting a bit longer so that test results might be more accurate), but I have noticed some pain in my right thigh area but also my left at times as well and some times even joint pain...however, the pain definitely isn't continual and it doesn't really hurt, you just kind of notice it, if that makes sense. It's kind of odd because I just talked to one of my friends who had a herpes scare a while back and he said the doctor asked if he had any leg pain or pain going down his thigh or something like that because that was a sign that differentiates herpes from other things...how much truth is there to this? Is there any other STD's, bacterial infections etc. that also cause leg pain?
Thanks

[H. Hunter Handsfield, M.D.]

Herpes zoster (shingles) is often associated with neuropathic pain.  Much less often, herpes simplex virus type 1 is associated with neurologic disease, especially Bell's palsy (paralysis of one side of the face) and tic doloreux, characterized by horribly severe shooting pains in the face.  So it makes sense that HSV-2 might also be associated with neuropathic pain involving the sacral nerves, i.e. in the back, down the legs, etc.  However, this has never been well studied and the truth isn't know with certainty.  But HSV-2 causes other nervous system manifestations, such as numbness or tingling before an outbreak, and occasionally "aseptic" viral meningitis.  So I think some cases of shooting pains in the legs, buttocks, or back may be due to genital herpes, but it probably isn't very common.

The antiherpetic drugs are very benign, with almost no side effects (except on the wallet).  So if your HSV-2 blood test is positive and the symptoms are bothersome, it might be reasonable to ask your doctor to prescribe suppressive therapy with acyclovir, famciclovir, or valacyclovir for 2-3 months and see if the pain improves. But don't expect a magical response.

HHH, MD