Even the Slightest Touch Hurts | Incheon Postherpetic Neuralgia
My skin screamed at the slightest touch, but it wasn't my fault
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"Doctor, it's really strange. The shingles blisters have all healed, but why does my skin hurt even more? It feels like sandpaper has been attached to the inside of my clothes; even the slightest brush feels like being cut with a knife. I'm experiencing shingles pain." |
The most heartbreaking moments for me when I see patients in their 40s suffering from postherpetic neuralgia in my clinic are precisely when they struggle to describe sensations that are so difficult for anyone else to understand, just like this.
The skin looks perfectly normal on the surface. But underneath, an unending war continues.
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[CASE] The Story of a Team Leader After Finishing a Project A team leader in his mid-40s who recently visited me was just like that. Immediately after successfully completing a large project that had lasted for several months, he developed severe shingles after overwork on his side. The immediate crisis was averted, but the real pain began thereafter. |
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"I'm taking the medication (gabapentin) prescribed by the neurologist. It makes me feel a bit groggy and sleepy, which is tough, but it does reduce the pain. But is this the end of shingles neuralgia treatment? I'm suddenly scared that I might have to rely on medication like this for the rest of my life." |
At this point, many people wonder, '
But the virus is gone, isn't it? My skin is clear, so why does it still hurt?'
I often liken this phenomenon to 'an oversensitive alarm system left behind in a forest ravaged by a wildfire.' A large fire (shingles) broke out, burning many trees (cells) in the forest (our body), and even damaging the surveillance system (nerves) that protected the forest.
The fire has been extinguished, but now the alarm system is so startled by a small breeze (clothing rubbing) or even a drizzle (temperature change) that it rings the emergency bell throughout the entire forest. This is the essence of neuropathic pain. It is a deep wound in the nerves left by symptoms of weakened immunity.
The shingles virus attacks not only the skin but also the sensory ganglia themselves, which are responsible for skin sensation, causing damage. It's as if only broken communication lines are left after the war has ended.
These damaged nerves distort and amplify external stimuli, continuously sending erroneous 'pain' signals to the brain.
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[Traditional Korean Medicine Perspective: Blood Stasis (瘀血)] In Traditional Korean Medicine, the concept of restoring this 'damaged battlefield' is considered important: removing 'blood stasis (瘀血)'. Here, removing blood stasis (瘀血) does not simply mean draining bruised blood. It refers to improving the condition where microscopic blood circulation around the damaged nerves is blocked, slowing down recovery, much like relief supplies cannot reach a forest where paths are cut off and it has become ruins due to a wildfire. This aligns perfectly with the modern interpretation that insufficient nutrition and oxygen supply to the nerves slow down recovery and maintain a hypersensitive state. |
Frankly, whenever I see such patients, I deeply contemplate the difficulties of treatment. What's truly interesting is that the patterns of pain vary from patient to patient, as if they are sending distress signals in their own unique languages.
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[The Beginning of a New Question] Therefore, the most important thing is not to ignore the 'language' of pain that our body sends. All those sensations—'knife-like cutting,' 'electric shocks,' 'crawling insects'—are distress signals sent by our nerves. Now, what we need to do is not just be satisfied with turning off the alarm, but to collectively ponder, "How can we stabilize this oversensitive alarm system and help it regain its self-healing power?" |