Postherpetic neuralgia is a common complication that occurs following an outbreak of shingles. The affected nerve fibers can cause a painful, aching, stabbing-like sensation that can last long after the initial presentation of shingles disappears. These painful areas can cause limitations with sleep, daily activities, and may reduce productivity.
Recently, ASAP saw a 78-year-old male in the office for three-month history of right-sided facial pain. He was diagnosed with postherpetic neuralgia. He described his pain as an aching, stabbing, throbbing, like sensation, which would come and go in waves. He reported that the pain limited his activities and eating, talking, and even laying on his side aggravated his symptoms. The patient reported that due to his pain he would go to the emergency room only to receive medications to reduce his pain temporarily, but his pain always returned.
After a thorough examination and imaging studies, a treatment plan was recommended for a stellate ganglion block. This is a procedure that uses a local anesthetic to block the sympathetic nerves found on either side of the neck. After the procedure, the patient noted approximately 70-80 percent improvement and stated he could twist turn and move his neck and jaw more comfortable. He noted being able to talk and eat at ease. The patient is grateful for the reduced pain and excited for the new things in life that he gets to experience!