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Dr. Andrew Rynne

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What causes severe nerve pain after shingles?

Answered by
Dr. Dariush Saghafi


Practicing since :1988

Answered : 2034 Questions

Posted on Fri, 16 Oct 2015 in Brain and Spine
Question: My wife has been having severe nerve pain after shingles,last September 2014,we have tried everything and the pain is very severe 20 hours a day,how about some help. Thank You
Answered by Dr. Dariush Saghafi 2 hours later
Brief Answer:
Postherpetic neuralgia

Detailed Answer:
Good evening. My name is Dr. Saghafi and I am an adult neurologist. Post herpetic shingles is challenging to confront but it is treatable and manageable without having to go to the Mayo Clinic. If what you've listed is the best option the doctor was able to try on your wife then, I can understand your frustration. On the other hand I can sympathize with the poor doctor who landed up with a real doozy of a problem. This can be miserable for both patient and doctor. Every time I see a case it seems like I get creative all over again. I almost never treat anybody the same way as I treated the person before.

In your wife's case I wouldn't waste the money nor her liver on useless Tylenol. It's not helping and it's just overloading her hepatic enzymes unnecessarily with chemicals that she'd be better off not taking.

If you have a compounding pharmacy in your area I would ask the doctor to recommend a compounded cream of Amitriptyline (4%) /Ketamine (2%)/Neurontin (10%). Another preparation of Ketoprofen (5%) and Neurontin (5%) is said to be effective in at least 50% of patients who report reduction in pain by at least 50%. Unfortunately, it's not a panacea but it does help.

There are other medications that could be tried as well such as PREGABALIN, NORTRIPTYLINE, Zostrix, and Oxcarbazepine,

I hope these suggestions satisfactorily address your questions and give some additional information you can discuss with your NEUROLOGY DOCTOR regarding the concerns you have. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?

Also, if there are no other comments, may I ask you not forget to CLOSE THE QUERY on your end so the question can be transacted and archived for further reference by colleagues as necessary?

You are invited to direct more comments or inquiries to me in the future by going to my web address at:

I would be honored to answer you quickly and comprehensively.

Please keep me informed as to the outcome of your situation.

The query has required a total of 21 minutes of physician specific time to read, research, and compile a return envoy to the patient.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Dariush Saghafi 41 hours later
Well,there is nothing there,that helps,so I would appreciate a refund of $15.00. I checked that out with Walmart and the Pharmacist, said that will not work. thank you
Answered by Dr. Dariush Saghafi 1 hour later
Brief Answer:
Neither Compounding pharmacies nor Doctors are found in Walmart

Detailed Answer:
As a highly trained and dedicated neurologist with over 25 experience treating patients with these regimens I must respectfully decline even entering into a discussion with a pharmacist who's never treated a patient in his life and who has likely never even compounded any of what I very specifically detailed for you as the ingredients to medications I've used quite successfully in many people with your wife's problem over the decades.

However, more interestingly is that you would be so ready to dismiss my suggestions (easily found in medical textbooks and professional journals) if you don't even want to discuss them with the DOCTOR who could write the script and tell you where the proper pharmacy is to get this prepared if your true intent is that your wife not suffer in pain.

I encourage you to follow through with these very appropriate and clinically proven suggestions for your wife's benefit and recall in the future that pharmacists are not clinicians.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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