Internal Medicine

Answer 5 Intrathecal corticosteroid injection. Small clinical trials have shown that intrathecal methylprednisolone is effective in relieving the pain of refractory postherpetic neuralgia; however, because of risks of corticosteroid-induced arachnoiditis, further confirmation and long-term follow-up is needed. No trials support the efficacy of acupuncture, capsaicin, hypnosis, or transcutaneous electrical nerve stimulation for persistent, unresponsive postherpetic neuralgia.3 REFERENCE 3. Alper BS, Lewis PR. Treatment of postherpetic neuralgia: a systematic review of the literature. J Fam Pract 2002;51:121-8. Click here to return to the questions

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