Multidisciplinary approach for the management of post-herpetic neuralgia in elderly patients

Post-herpetic neuralgia is associated with significant distress and morbidity. The management of acute neuritis and/or post-herpetic neuralgia can be particularly difficult. A multidisciplinary approach is required. A team consisting of the primary care physician, pain specialist, neurologist, geriatrician, pain psychologist, psychiatrist, and a physiatrist with an integrated approach will provide the best results. Early interventional therapy with sympathetic nerve blocks may significantly decrease the need for long-term opioid therapy, as well as long-term use of anticonvulsants, antidepressants, or membrane stabilizers. Early referral to a multidisciplinary pain center may furthermore decrease the behavioral trauma and family disruption associated with this painful condition.