Have your bottom, thigh, or leg ever started hurting before, during, or after a genital herpes breakout? Leg pain is more common than you think when living with genital herpes (HSV-2). Other sensations include numbness, tingling, skin sensitivity, overall leg weakness, and shooting pains. For example, when you have skin sensitivity, it can hurt the back of your thighs to sit on a cold toilet. These sensations are much the same as symptoms caused by sciatica and can spread as far as your feet. It's caused by irritated nerves that have become sensitized as the herpes virus travels through your nerve ganglia. When these symptoms persist, it is called Postherpetic Neuralgia and is considered a complication of the Herpes Simplex Virus.
Postherpetic neuralgia can continue long after herpes lesions disappear. It typically results from severe breakouts. While the condition is common, it doesn't happen to everyone with HSV and doesn't occur with every breakout.
Postherpetic neuralgia related to Shingles (Herpes Zoster) differs slightly from postherpetic neuralgia caused by HSV-2 (genital herpes). Shingles are a blistering rash that typically occurs on the body's torso due to having had Chickenpox at some point in one's life. Not all individuals who have had chickenpox will go on to experience shingles, and not all people experience postherpetic neuralgia after a bout of shingles. Postherpetic neuralgia associated with shingles presents with the following symptoms.
- Pain on one side of the body localized on the trunk or torso (occasionally, pain is felt on both sides)
- The pain is often described as a burning sensation that is constant or intermittent.
- Stabbing pains are not uncommon. There may be sensory changes, such as numbness, itching, Hyperaesthesia (sensitivity to touch), or Allodynia (pain from slight touch).
- Sensitivity to temperature changes
- Chronic pain can lead to anxiety, poor sleep, and depression.
Risk factors for postherpetic neuralgia include age (over 50), immunosuppression by HIV, chemotherapy or systemic steroids, and severe or prolonged infection. Females and those with other sensory disorders may be at more risk.
More difficult to research is information on postherpetic pain radiating down the left leg caused by HSV-2 (genital herpes), which presents with these symptoms. However, it is a condition many people living with genital herpes experience.
So, what causes the pain?
Postherpetic neuralgia is caused by nerves irritated and inflamed by the virus during and after the prodromal phase. The prodromal phase is when herpes wakes up, also called viral shedding.
Ongoing postherpetic neuralgia is likely due to slow recovery and the involvement of the Central Nervous System (CNS). These nerves are hypersensitive and perceive pain more acutely because they can't send correct messages to the brain. However, these mechanisms still need to be understood entirely.
Shingles (Herpes Zoster) vaccines have been proven to reduce the chance of developing postherpetic neuralgia or, at the very least, minimize the duration and severity. However, this vaccination doesn't work as well for immunocompromised individuals. For example, a vaccine (Zostavax) is available for older adults, but there's disagreement about whether it suits immunodeficient or immune-suppressed individuals. From what I understand, antiviral medications, such as Acyclovir, reduce the risk of postherpetic neuralgia caused by shingles even less than the vaccination does.
Postherpetic neuralgia is treated with tricyclic antidepressants, NSAIDS, nerve blocks, anticonvulsants, steroids, anesthetic pain patches and gels, and creams containing capsaicin (a natural ingredient). Many of these treatments have side effects, even if it's natural. Capsaicin can cause an extreme burning sensation and even blistering on sensitive skin and NSAIDS can cause Leaky Gut.
Postherpetic neuralgia, with treatment, usually clears up within six to twelve months. When untreated, about 50% of people are painless within six months. Some people experience pain for many years. The severity and duration increase with age.
Peripheral Nerve DAMAGE
Nerve damage caused by genital herpes (HSV-2) that affects the legs is referred to as peripheral neuropathy, caused by damage to the nerves in the sacral area of the spine closer to the tailbone. A variety of conditions and injuries can cause peripheral neuropathy. However, regardless of the cause, it's treated the same way.
In addition to the therapies used for postherpetic neuralgia, alternative treatments that may offer some benefits for relieving leg pain are acupuncture, herbalism (often used for those with diabetic neuropathy), and supplements. For example, alpha-lipoic acid benefits the peripheral nervous system by reducing oxidative stress. However, it is not without possible side effects in some people, so do your research.
Other considerations are eating a healthy diet (with plenty of colorful vegetables and healthy proteins) and exercising. Avoiding nicotine and alcohol is also recommended by experts.
Peripheral Neuropathy or HSV-2 Radiculopathy
"Radiculopathy caused by HSV-2 infection typically affects the lumbar or sacral nerve roots and is often recurrent. In addition to radicular pain, paresthesias, urinary retention, constipation, anogenital discomfort, and leg weakness may be observed. The disorder is typically self-limited, resolving after days or weeks, but recovery appears to be hastened by using antiviral medications (read more here)."
Back to HSV Q & A.
Add comment
Comments