Pain Treatment – Different For Diabetes, Herpes Zoster and HIV

Pain is pain is pain.  Right?  No, not quite right.  At least 3 million Americans suffer from some form of neuropathic pain, but from different causes.  More than half of these pain sufferers have an auto-immune disease such as herpes zoster, diabetes or human immunodeficiency virus (HIV).

Recognizing and treating the underlying disease can substantially reduce the degree and frequency of the pain. There are a wide variety of pharmocologic (drug) treatments availalbe to treat pain symptoms, but only certain drugs will help for specific disease related neuropathic pain.

Many physicians do not know or recognize the underlying disease condition and perhaps do not associate the particular disease with the appropriate pharmacologic treatment.  Often, people with herpes zoster, diabetes and even HIV are given nonsteroidal antiinflammatory agents or aspirin – which has very little effect in alleviating the patient’s pain.  Instead, their unique type of pain may be alleviated by the appropriate analgesic therapy, such as anticonvulsants, lidocaine patch, or tricyclic antidepressants.

In a satellite symposium held in conjunction with the January 29, 2009 Annual Meeting of the American Academy of Pain Medicine, physicians discussed what research indicates may be the best treatments for pain associated with herpes zoster, diabetes, HIV and other autoimmune diseases.  If you are being treated for neuropathic pain and the pain has not lessened, ask your doctor about the possibility of being treated with drugs that may be more specific for your particular disease. A group of physicians presented a satellite symposium to discuss this issue in conjunction with the January 9, 2009 25th Annual Meeting of the American Academy

There are several treatments available and recommended for the pain, PHN (postherpetic neuralgia),. associated with herpes zoster and also for the pain, DPN (diabetic peripheral neuropathy) associated with diabetes.  Gabapentin, pregabalin, and tricyclic antidepressants are recommended as first line therapies, while opioids, which areused to treat many different types of pain, are considered to be second or third line therapies.  However, for the neuropathic pain associated with HIV, there are few recommended treatments.  The only recommended treatment, lamotrigine, may reduce pain.