NEW YORK  - A new approach could bring much-needed relief to people suffering from severe nerve pain following a bout of shingles.
Shingles is caused by reactivation of chickenpox virus, which lies dormant in nerve fibers until stress or illness triggers a resurgence. The resulting rash can damage nerves, causing sometimes-excruciating pain, called postherpetic neuralgia.
Now researchers report in the Archives of Neurology that a course of intravenous treatment with the antiviral drug acyclovir, followed by oral treatment with a similar drug, valacyclovir, helps at least some patients with shingles pain. Dr. Donald H. Gilden and co-investigators at the University of Colorado Health Science Center in Denver studied this strategy in 15 patients with moderate to severe postherpetic neuralgia.
All the patients were older than 50 years of age, had neuralgia for three months or more, and rated their pain as four or higher on a 10-point pain scale. They were given intravenous acyclovir every 8 hours for 14 days followed by oral valacyclovir three times a day for one month.
Eight of the 15 patients reported an improvement of two or more points on the pain scale. Gilden and colleagues explain that a two-point reduction on the rating scale is approximately equal to a 30 percent reduction in pain, and is "clinically meaningful." The treatment was well tolerated, they report.The researchers acknowledge that intravenous acyclovir could be expensive, but the costs might be offset by reductions in the use of other healthcare services.