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Post-herpetic Neuralgia


#1

I'm looking for acupuncture point and herbal suggestions for one of my elderly patients, who has post-herpetic neuralgia. The condition has persisted for about 18 months - with burning pain in his right front and top shoulder area that comes and goes continuously throughout the day. He has a number of other complications as well. The patient has been going through chemo for leukemia and just had prostate surgery several weeks ago. The patient states that the pain from post-herpetic neuralgia is very intense, and always intensifies during urination. His right front shoulder/chest area is very sensitive to the touch, which is why I never needle there directly. He is 80+ years of age and generally seems to be in good spirits despite his health conditions. Doctors have perscribed him with various anti-depressants/pain medications, which he states are no better than taking jelly beans. The patient's pulse is choppy, wiry, and strong. Additionally, his tongue is peeled on the sides and middle. He also has a midline crack. The body of the tongue is red/purple in color. I have diagnosed him with Blood Stasis, Wind Heat type of Pain, and KD Qi Def. This patient bruises very easily.

I have only treated him twice, but the patient has yet to see benefit from treatment. The points I've used are huato C3, C4 (with electrostim), LI11, SJ5, LI4, GB31, SP6, UB17, UB40, GB20, DU14. I always use the huato points with electrostim, and then pick about 6 or 8 more additional points to needle from the ones listed to move blood and dispel wind/pain.

If anyone has any additional suggestions on points or herbal formulas, that would be greatly appreciated. I'm wondering if cupping would also be appropriate. Thanks.


#2

For herpetic neuralgia, the main points: Sj5, Gb34, Sp10, Ub40. For Liver & Gallblader damp heat pattern, add Lv2, Gb43 & Sp9. For wind heat pattern, add Li11, Li4, Du14, Gb20. For Postherpetic neuralgia, add ashi Jiaji points Electronic stimulate, and local ashi points 2-3 needles, with Li4, Lv3, Sj6. Also can use plum flower needle or seven star needle make the local skin little bleeding. for Lv & Gb damp heat use Long Dan Xie Gan Tang +-, for wind heat use Yin Qiao San +-.


#3

I had shingles myself earlier this year and sadly my acupuncture treatment really only helped while the needles were in but the pain ramped up pretty quickly again when I removed them. So I go out my Japanese "elephant warmer" moxa applicator and just used that over the entire area of pain. I rubbed it (with a tissue on my skin) over the painful areas for about 20 minutes a day and this immediately took my pain levels down. By day 3 I was off all pain medication and just using the moxa. After a couple of weeks I only needed the moxa once a week at the root of the original outbreak. If I had a client with this problem I would sell them (or get them or purchase on line) an elephant warmer and the large moxa sticks and get them to do it at home and come in once a week for a root treatment.




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