Could This Be Delayed Postherpetic Neuralgia?
I’m a 33-year-old male experiencing a range of discomforts including sharp, dull, and burning sensations radiating from my lower left back, extending to my hip and buttocks, and occasionally shooting down to my groin or leg. This has fluctuated for over two years. At 17, I contracted shingles, during which the rash and pain affected areas that are now experiencing these symptoms. I don’t remember the specifics of the treatment I received, but it likely involved antiviral medication or steroids along with pain relief options for about six weeks. The doctors were surprised by the severity of my condition at such a young age. A few years post-shingles, I developed psoriasis; however, none of the plaques are located near the painful areas, and I haven’t had a shingles outbreak since then, to my knowledge. About a year ago, I consulted a urologist who performed a CT scan with contrast, an ultrasound, blood tests, and a urinalysis, but all results were unremarkable. Six months back, my general practitioner conducted similar tests, and once again, everything came back normal. Recently, I’ve started visiting a chiropractor and a massage therapist, which has occasionally alleviated my discomfort. I also incorporate a baseball for self-massage, mobility exercises, and yoga twice a week into my routine. Could this pain be attributed to delayed Postherpetic Neuralgia or nerve damage from the shingles infection I experienced 15 years ago? I’m reaching out because I’ve been perplexed by this issue and am yearning for some relief. Over-the-counter medications like Ibuprofen, Tylenol, and Lidocaine barely make a dent in my pain, and since I’m recovering from Substance Use Disorder and alcoholism (celebrating over ten years of sobriety), I avoid opiates. This persistent pain is becoming a significant nuisance, affecting my mobility—simple tasks like walking my dog feel daunting. If there’s a chance this is something I should discuss with a neurologist, I’d like to explore that option first. Thank you for your assistance!
Answers (1)
9/8/2025, 9:11:01 AM
OpenHealth AI
It sounds like you are experiencing significant discomfort that is impacting your daily life, and your history with shingles could be relevant to your current symptoms. Your pain may indeed be related to delayed Postherpetic Neuralgia (PHN), which can occur following a shingles infection. Here’s a clearer breakdown of the situation and some actionable steps:
Main Points:
- Your symptoms might be linked to delayed Postherpetic Neuralgia or nerve damage from shingles.
- Recent evaluations by specialists have not revealed any immediate physical issues.
- You’ve made commendable lifestyle adjustments, but the pain persists, affecting your mobility.
Explanation:
Postherpetic Neuralgia is a condition characterized by lingering pain in areas where shingles (herpes zoster) has occurred. It is caused by damage to the nerves during the shingles infection, leading to ongoing discomfort long after the rash has healed. Your symptoms, including the variety of pain sensations and their distribution, could match this diagnosis, especially given your shingles history.
Even though you’ve undergone tests that came back normal, the nature of nerve pain can sometimes mean that standard imaging and tests may not fully capture the underlying issues. Additionally, the chronic pain you face is valid, and it's understandable that you seek effective solutions.
Next Steps:
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Track Your Pain: Keep a detailed log of your pain—note when it occurs, its intensity, any associated activities, and responses to treatments. This will provide valuable insight for any healthcare provider you consult.
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Consider Neurology Consultation: Given your ongoing issues and the history of shingles, discussing your symptoms with a neurologist can be beneficial. They can assess for nerve-related issues and potentially recommend specific treatments or therapies designed for neuropathic pain.
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Explore Alternative Pain Management: Since standard over-the-counter remedies have limited effectiveness, consider discussing options such as:
- Topical treatments (like capsaicin cream, if not already tried).
- Antidepressants or anticonvulsants (such as gabapentin or duloxetine), which can help manage nerve pain.
- Cognitive Behavioral Therapy (CBT) for coping strategies, which can also reduce the perception of pain.
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Reassess Physical Therapy: Given that chiropractic and massage therapy have provided some relief, consider a targeted physical therapy regimen focusing on stretching and strengthening the lower back, hips, and legs. A specialized physical therapist can tailor exercises for nerve pain management.
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Stay Active with Caution: Continue your mobility exercises and yoga, as these are important for maintaining physical function. Ensure you adjust movements to avoid exacerbating symptoms.
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Monitor Lifestyle Factors: Stress and fatigue can amplify pain sensations. Continue utilizing healthy coping mechanisms, such as mindfulness or relaxation techniques, to help manage these aspects.
Conclusion:
Your pain shouldn’t overshadow your quality of life, and it’s okay to seek further evaluations and alternative treatments. You are not alone in feeling this way, and addressing your symptoms with healthcare providers who understand chronic pain can lead to better management. Please keep tracking your symptoms and advocating for your health needs as you explore these next steps.
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