Hypnotherapy/Cognitive Behavioural Therapy
Cognitive behavioural therapy has long been used as part of the treatment for chronic pain in patients, although there are no reported studies that have specifically looked at the effect it has on post herpetic neuralgia. Pain is known to be affected by mental and emotional factors such as feelings of hopelessness, anxiety and depression and cognitive behavioural therapy can help patients control and cope with pain. Studies have shown that even 6 months after completion of treatment patients continued to show improvement in chronic pain.
Patient QI found several individual case reports of the effectiveness of hypnosis in relieving post herpetic neuralgia. Hypnosis is clearly beneficial in reducing the pain of post herpetic neuralgia but there is some evidence that the longer that the patient has suffered from the problem, the less likely the treatment is to succeed.
Laser therapy has been considered as a potentially efficacious intervention. In a case report Patient QI found, Class 4 therapeutic laser treatment was applied in 10 minute sessions, for 8 treatments. The patient reported significant reduction in postherpetic neuralgia. Further controlled clinical trials need to be carried out, however, to determine if this is an effective treatment for neuralgia after shingles.
There is considerable evidence showing stress, especially in the elderly, affects the immune system and in particular the level of antibodies against Herpes Zoster virus. The presence of depressive symptoms in older adults is associated with an increase in the risk of shingles. Recent findings have shown that administration of a relaxation response-based intervention, tai chi chih, results in improvements in health functioning and immunity to VZV in older adults as compared with a control group.