Transcutaneous Electrical Nerve Stimulation for Prevention and Treatment of Post-Herpetic Neuralgia: A Narrative Review

Abstract

The present investigation evaluated transcutaneous electrical nerve stimulation (TENS) for the non-pharmacological treatment of post-herpetic neuralgia (PHN). PHN is the most common complication of the Herpes Zoster virus, affecting one in every five patients with shingles, and presents as intense neuropathic pain that can persist for 90 days or longer after the initial onset of symptoms. Current pharmacological treatment options are mainly limited to symptom management, including oral medications such as tricyclic antidepressants and gabapentinoid preparations, as well as topical options such as lidocaine or capsaicin. TENS is a minimally invasive, non-pharmacological electrical nerve stimulation device currently approved for the treatment of neuropathic pain in adults, providing patients with an alternative or adjunct treatment option to medication with a reduced potential for unwanted side effects, drug-drug interactions or potentially life-threatening toxicity. Current indications for the use of TENS in the treatment of PHN are recommended only after therapeutic goals are attempted and unsuccessfully met by current mainstay medications. More research into the efficacy and safety of TENS for treating PHN should be conducted to clarify further its role as a mainstay treatment for this condition.

Keywords: electrical nerve stimulation; neuropathic pain; post herpetic neuralgia; shingles; transcutaneous.