CURRENT STATUS AND ISSUES OF CHRONIC PAIN IN HERPES ZOSTER BASED ON SURVEYS OF PATIENTS AND PHYSICIANS

*M. Niimura (1), H. Miyazaki (2), M. Kawashima (3), S. Ogawa (4),
A. Ozawa (5), Y. Masuda (6)

(1) Department of Dermatology, The Jikei University School of Medicine, Tokyo;
(2) Department of Anesthesiology, Juntendo University School of Medicine, Tokyo;
(3) Department of Dermatology, Tokyo Women's Medical College, Tokyo;
(4) Department of Dermatology, Tokai University School of Medicine, Isehara;
(5) Department of Dermatology, School of Medicine, Tokai University;
(6) Department of Anesthesiology, Showa University School of Medicine, Tokyo

A follow-up research of patients with shingles and a survey for physicians in the departments of dermatology, anesthesiology or pain clinic has been carried out in order to clarify the current situation of the treatment of chronic pain in shingles in Japan from both patient's and physician's point of view.

In the patient follow-up, questionnaires were sent to 394 patients who had visited the pain clinic or department of dermatology for the first time between January and March 1997 in the middle of November 1998, and 230 questionnaires were collected with comments by physicians. According to the result of this research, the physicians' assessments on first clinical examination often differ from patients' subjective symptoms. The study found that in the patients with scores of 50 or higher in VAS (Visual Analog Scale), pain remained in many cases, and preventive treatment was necessary. When the survey was conducted, approximately one-third of patients still suffered from pain.

In the physician's survey, the questionnaires were collected from 388 institutions. Physicians of pain clinics and dermatologists noted "age" as a significant factor of chronic pain in acute pain, but physicians in pain clinics also pointed out "insufficient treatment for acute pain" as another important factor. NSAIDs, antipsychotic agents and nerve block were used frequently for the treatment of chronic pain. Nerve block was expected to be effective but NSAIDs were conventionally used. As future treatments, expectation to psychotherapy by dermatologists and narcotic analgesics by physicians in pain clinic were high.

Corresponding Author: M. Niimura, M.D., Professor of Dermatology, Department of Dermatology, The Jikei University School of Medicine, 19-18, Nishishinbashi 3-Chome, Minato-ku, Tokyo 105-0003, Japan