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Low Level Therapy for treating Herpes Zoster & Chronic Post-Herpetic Neuralgia

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Herpes zoster, more commonly known as shingles, can be treated effectively using low-intensity laser therapy. The treatment is also effective for chronic post-herpetic neuralgia. Entirely safe and non-invasive, it is effective for over 80% of patients with these painful conditions.

Herpes Zoster

Herpes zoster is caused by the varicella-zoster virus which is the same virus as that which causes chickenpox. Following a chickenpox infection, the virus can remain dormant in the body’s nervous system without causing any symptoms. It can, however, be reactivated in later life resulting in an unpleasant and painful infection of nerves and surrounding tissue.

The main symptoms are a painful and itchy rash that develops into blisters resembling those of chickenpox. The pain can vary from mild-to-severe, and while in many patients it disappears after the rash has gone, generally within two or three weeks, with some patients, pain can persist for considerably longer. The rash tends to form patterns as it follows the nerves, and it is rare for it to affect both sides of the body. Additional symptoms may include a headache, fever, and general malaise.

For most people, the condition isn’t serious, though it has the potential to affect the trigeminal nerve which can result in visual impairment. Although rare, other cranial nerves can also be affected which can result in cognitive problems, facial paralysis, encephalitis, and meningitis.

When the pain continues after the rash has gone, the condition is known as post-herpetic neuralgia. This happens with around 20% of patients, with older patients being more vulnerable, and results from long-term damage to the affected nerves. The condition is difficult to manage and for some people it can be debilitating, affecting their daily lives.

Traditional treatment

There is no known cure for shingles, through various traditional treatments are available for treating the symptoms. Analgesics such as ibuprofen and paracetamol can reduce the pain and antiviral medicines such as acyclovir, famciclovir, and valaciclovir can be used to reduce the severity of the infection, though to be effective antiviral treatment should commence within 72 hours of initial symptoms.

For more severe cases of pain, prescription NSAIDs or narcotic painkillers may be necessary. In some cases, corticosteroids can be prescribed to ease the discomfort, inflammation, pain, redness, and itching associated with shingles’ rash and blisters.

When the pain from post-herpetic neuralgia is particularly severe, codeine and other opiate drugs can bring relief, though there are potentially serious side effects. Antidepressant drugs have also proven effective. Vaccination against shingles is also available.

Low-level laser treatment

As has been extensively reported in numerous studies, low-level laser treatment provides a safe and effective treatment scheme for both herpes zoster and chronic post-herpetic neuralgia. For instance, Iijima K et.al. (1991) reported successful results on a group of 18 post-herpetic neuralgia patients using irradiation with low-power He-Ne laser and (Iijima K et.al. 1989) up to 88.9% effectiveness on another group with around 55% pain relief.

In a double-blind cross-over trial (Moore K, et.al. 1988) on post-herpetic neuralgia patients of at least 6 months duration who had shown no response to conventional treatment laser treatment provided a significant reduction in pain intensity and distribution in 74% of patients.

How low-level laser treatment relieves shingles and chronic post-herpetic neuralgia

Low-level laser therapy uses infra-red LED lasers, and the laser light produced does not heat the skin. Instead, there is a photochemical interaction between the tissue and the laser beam that occurs at a cellular level.

Although there is no clear consensus on the actual mechanism, our understanding of it is increasing constantly. Recently Kalid M.Z. (2016) studied the mechanism of laser beam interaction at both cellular and tissue levels using different light sources and dosimetry and Chung, Hoon, et al. (2012) examined the nuts and bolts of the therapy in a similar study.

Essentially, the cold laser is thought to change cell membrane permeability. Photons are absorbed in the mitochondria of the cell accelerating cellular reproduction and growth. Fibroblast development is stimulated and metabolic rate is increased. Swelling is reduced, blood flow is increased and the laser stimulates nerve cell healing and communication.

Finally

Today we are seeing excellent results from laser therapy in the treatment of acute herpes zoster and chronic post-herpetic neuralgia. The treatment is entirely safe, non-invasive and usually brings rapid relief. Some patients report immediate improvement during the first treatment.

For more information about Herpes Zoster Shingles and Herpetic Neuralgia

This article was written by our team of specialist therapists at Perfect Balance Clinic. If you would like more specific advice about how our team can help you with this condition or symptoms you may be having, please complete the contact form below and one of the team will get back to you shortly.

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    References

    Chung, Hoon, et al. (2012), The nuts and bolts of low-level laser (light) therapy. Annals of biomedical engineering 40.2: 516-533.
    Khalid M Z., (2016) Mechanism of Laser/light beam interaction at cellular and tissue level and study of the influential factors for the application of low-level laser therapy, arXiv:1606.04800 physics.med-ph
    Iijima K, et.al. (1991). Evaluation of analgesic effect of low-power He:Ne laser on postherpetic neuralgia using VAS and modified McGill pain questionnaire. J Clin Laser Med Surg. 1991;9:121?6.
    Iijima K, et.al. (1989). Effect of repeated irradiation of low-power He-Ne laser in pain relief from postherpetic neuralgia. Clin J Pain.5:271?4
    Moore K, et.al. (1988) Double blind crossover trial of low level laser therapy. Practical Pain Management,1-7.

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