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Integrative Approach Helps Post-Herpetic Pain

What the Study Showed
How it was Done
Why its Important

What the Study Showed
Many people with post-herpetic neuralgia, a painful complication of shingles (herpes zoster), can benefit enormously from combining prescription medications with traditional alternative therapies, such as acupuncture and Chinese herbs. That was the finding of this study recently reported in The Alternative Medicine Review.

How it was Done
The 56 participants in this study, most of them over age 65, were patients in a family medicine practice. All had post-herpetic neuralgia (PHN), meaning they still suffered from related pain more than a month after the onset of the shingles rash. Some had endured pain for a full year or more.

Aside from this illness, the participants were healthy and had fully functioning immune systems. None suffered from illnesses that could potentially weaken their ability to fight off a shingles flare-up or PHN (such as HIV infection or cancer). Nor did any take high doses of painkillers, or drugs that could suppress the immune system.

In addition to conventional antiviral medications such as acyclovir, the participants were "treated" daily with each of the following nontraditional techniques:

Acupuncture: Needles were inserted for approximately 10 minutes in acupoints individualized to each patient's area of pain and according to traditional Chinese medicine (TCM) symptomology (e.g., dryness or heat).

German neural therapy: A local anesthetic was applied to the area to block pain signals from the affected nerve root.

Cupping and bleeding: After pricking the skin with a needle to start the bleeding, a cup with vacuum suction was placed over the bleeding area. The technique was designed to stimulate circulation, among other things.

Meditation: Participants were given a take-home meditation tape to use twice daily for 20 minutes.

Chinese herbs: Everyone was prescribed Chinese herbal formulas or single herbs based on an individualized diagnosis (as practiced in traditional Chinese medicine). The formulations were taken every day for as long as the participants continued with the acupuncture sessions.

Patients went for daily treatments, some for as few as 3 days and others for as many as 34 (the average for the whole group was 12.5 days). The patients themselves decided when they were satisfied with the level of pain relief they had achieved.

Why its Important
New and more effective approaches for treating post-herpetic neuralgia are badly needed. After all, hundreds of thousands of people are affected with this often debilitating complication of shingles, particularly older people whose immune systems are naturally less robust. Conventional approaches frequently fail to adequately treat the lingering pain.

While powerful antiviral medications (such as acyclovir and famciclovir) can accelerate healing and reduce discomfort, they often aren't taken in time (within 48 to 72 hours of the shingles rash reappearing) to make much of a difference. Powerful narcotics like codeine can blunt pain but are limited by the side effects and potential dependence that they produce.

Few alternative modalities have been specifically studied for PHN, but ancient strategies for lessening pain, such as acupuncture, have certainly demonstrated their effectiveness through the ages. Meditation, when practiced conscientiously, has been shown to alleviate stress, a known culprit in weakening immune system health that is so crucial to fighting off viruses like herpes.

The present study illustrates how effective the combination of conventional and alternative treatments can be for PHN. Although there was no control group to compare the results against, the findings here are notable: A remarkable two-thirds of the patients reported 75% to 100% pain reduction.

Those who had been suffering with PHN for more than a year had the most pain reduction overall.

Source: Hui F, et al. Integrative Approach to the Treatment of Postherpetic Neuralgia: A Case Series. Alternative Medicine Review 1999;4(6):429-435.

Date Published: 04/19/2001
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