Post-herpetic neuralgia: Possible mechanisms for pain relief with manual therapy

Abstract

This case report details the history, presentation, and treatment of a patient with a diagnosis of postherpetic neuralgia (PHN). The pathophysiology behind the development of PHN following infection with the varicella zoster virus (VZV) is discussed, although the exact mechanisms remain unclear. The subjective and objective findings in this patient with PHN are highlighted to alert other clinicians to the possibility of PHN as a differential diagnosis when patients attend the clinic for what they perceive to be pain of musculoskeletal origin. Following a description of the simple treatment approach that was adopted with this patient, possible mechanisms of action for this intervention are considered in relation to what is known of the underlying pathophysiology. However, it is not the author’s intention to propose manual therapy as a standard intervention for this condition.