News about shingles and PHN

The new online petition launched by Jean Gaffin, Pain UK’s Pain Champion for 2013, is calling the UK Department of Health and the organisations responsible for setting standards of care to ensure that health and social care professionals help people living with pain by asking about their pain, measuring it, recording it, treating it and managing it at every opportunity.

Please sign a campaign to encourage the medical world to take long-term pain seriously.  This is a Europe-wide campaign organised by Pain EU.  The more people who sign, the more seriously the request is taken.

 

 

A vaccine for the prevention of shingles is available.  However, the manufacturers can only supply 800,000 doses and it has been decided to initially target only people who are 70 or 79 on 1st September 2013.

The campaign to vaccinate eligible people started in September 2013. The vaccine (known as Zostavax®▼) is provided through NHS GPs, pharmacists or private healthcare providers.  We encourage anyone who is offered this vaccine to take it up.  It is a booster to the antibodies already in your body which were created when you first had chickenpox.  This means the vaccine is relatively side-effect free with only headache or soreness at the site of the injection reported.

Public Health England has issued this statement:

"There will be a shingles vaccination programme introduced for people aged 70, with a catch-up programme for those aged up to, and including, 79 years. Shingles is an infection of a nerve that causes pain and a rash along a band of skin over the affected nerve.  The infection is caused by the herpes varicella-zoster virus, which also causes chickenpox. Following chickenpox infection, the virus lies dormant in the nervous tissue but may reappear following reactivation as shingles. The programme will begin in September 2013 and it is estimated that around 800,000 people in the UK will be eligible for the vaccine in the first year."

When the manufacturers can make 4.5 million doses for the UK, then the NHS plans to offer this vaccine to all 70-79 year olds.

People over 60 who would like to buy a vaccine privately should contact a Nuffield or a BUPA hospital and the pharmacy team should hopefully be able to source the Zostavax from their wholesalers.  It is possible that travel clinics that offer vaccines might also have Zostavax available. 

If you are finding it difficult to get the right medication to help with your PHN or if your doctor seems to have run out of ideas, you can ask to be referred to an NHS Pain Clinic.  There are also private pain clinics.  If you are not sure if there is a pain clinic near you, we suggest that you go to the website and click on the 'For Patients' tab and select "pain clinic".
If there is no pain clinic nearby, or if there is a long waiting list, it is worth bringing this matter to the attention of your local council's 'Overview and Scrutiny' committee.  Many councils already take a keen interest in the health provision of their residents and current government proposals will mean that every town or county council will soon be given powers to monitor healthcare and ask searching questions.  If the service you need is not being provided, make a fuss, starting with one of your local councillors.  Ask for your concerns about lack of provision to be raised by the Overview and Scrutiny Committee.  Local health administrators can be summoned and asked why they are not providing services that are needed.

 

Researchers from Queen's University in Kingston, Ontario, have found that an anti-seizure drug gabapentin and an antidepressant nortriptyline taken together is a more effective treatment than either of the medications alone.

While patients sometimes get pain relief from morphine and other of the strongest pain relievers, the Queen's team says a better option might come from combining the gabapentin and nortriptyline.

 Dr. Ian Gilron, director of Clinical Pain Research for Queen's Departments of Anesthesiology, and Pharmacology & Toxicology and an anesthesiologist at Kingston General Hospital, found that not only do patients report pain relief, they also report better sleep - something not seen in morphine treatments.

"That's a very important issue for this group of patients, whose debilitating, unrelenting pain often interferes with normal sleep," Gilron said in a news release, announcing the study's findings which are published in The Lancet.

Each of the drugs has been recommended for neuropathic pain relief on their own. However, the drugs rarely reduce pain by more than 60 per cent and only about half of patients find they work at all, in part because the dosages have to be capped because they carry serious side effects at high doses.

But Gilron found that combining the two allowed more people to report relief. In his randomized controlled trial, he tried the combo on 56 patients with diabetic neuropathy or postherpetic neuralgia (the chronic pain from shingles). All the patients reported their daily pain as at least a 4 on a scale of 0 to 10.

There were three daily treatment plans: gabapentin, nortriptyline, or their combination. All patients got to try all three treatments over three 6-week periods. Overall, more people reported good pain relief when the drugs were combined:

There were few side effects from the combination, though some complained of dry mouth.