Which therapies are effective in reducing acute pain in herpes zoster (shingles)?

Updated: Jan 25, 2019
  • Author: Camila K Janniger, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

The oral narcotic oxycodone and the oral anticonvulsant gabapentin, as well as the topical analgesics aspirin and lidocaine, proved capable of reducing acute zoster-associated pain in double-blind, placebo-controlled studies. [89, 90, 7, 91, 92] On the other hand, the oral anticonvulsant pregabalin had no statistically significant effect in relieving acute zoster pain in a small double-blind, placebo-controlled study. However, other controlled studies showed this medication to be effective in treating the pain of PHN. [93]

Corticosteroids (see above) and antiviral agents (see below) have also been shown to accelerate the resolution of zoster-associated pain. [45, 1, 94, 95, 96, 97, 86, 98]

Nonpharmacologic therapies that may be considered for acute zoster-associated pain include sympathetic, intrathecal, and epidural nerve blocks and percutaneous electrical nerve stimulation. Although well-controlled studies are few, meta-analyses and clinical trials suggest that these treatments are effective in treating acute zoster-associated pain. [4, 99, 100]


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