Epidural Won't Lessen Long-Term Shingles Pain

Steroid injection may only work for short-term relief, study finds

THURSDAY, Jan. 19, 2006 (HealthDay News) -- A single epidural injection of steroids and local anesthetics may not ease long-term pain for people with shingles, Dutch researchers report.

Shingles, caused by the chickenpox virus (herpes zoster), occurs as a painful, blistering rash. Chronic pain is a common complication of shingles.

This study included 598 shingles patients who received either standard therapy (oral antivirals and analgesics) or standard therapy with one additional injection of steroids (methylprednisolone) plus local anesthetics (bupivacaine).

A month after the start of the study, fewer patients in the epidural group were reporting pain. However, the benefit of the epidural was strongest in the first week after treatment and did not last longer than a month, the study found.

"We conclude that one epidural injection of methylprednisolone and bupivacaine, applied in the acute phase of [shingles], has a modest effect in reducing zoster-associated pain for one month," the researchers at University Medical Center, Utrecht, the Netherlands, concluded in this week's issue of The Lancet.

But they added that this treatment doesn't prevent long-term pain. Therefore, "we suggest that an epidural injection of corticosteroid and bupivacaine only be considered for patients with severe acute pain from herpes zoster who are not responding to standard analgesic therapy," the researchers said.

More information

The U.S. National Institute of Allergy and Infectious Diseases has more about shingles.

SOURCE: The Lancet, news release, Jan. 19, 2006
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