The treatment of zoster-associated pain

The treatment of tester-induced pain is different according to the nature o f the physiopathological mechanisms. At the initial phase, pain is directly due to the viral action on the nervous tissue: an antivirus treatment, imm ediately prescribed with sufficient doses, diminishes the pain intensity an d the frequency of post-herpectic neuralgia but, simultaneously it's necess ary to insist upon the importance of an adjusted analgesic treatment (class II or III) to prevent functional sensibilization of the nervous central sy stem. The postherpetic pain must be treated by antidepressant and anticonvu lsivant drugs because it's a neuropathic pain without forgetting for other possibilities: topical capsaicine or lidocaine treatment, aspirin/dicthy et her mixture.... At this stage, the opiod treatment must be uncommon, based upon a global evaluation of pain and related to a real failure of the other classical treatments. Other medication are now evaluated and descended fro m the theory of the increased sensitivity of the nervous system. Ln other c ases, acupuncture, cryoanalgesia, transcutaneous neural stimulation and fun ctional neurosurgery can be proposed.