Postherpetic Neuralgia

In chronic PHN (over one year), nerve damage is fixed, so a multi-modal approach is recommended over monotherapy. The standard steps are: ① Optimization of neuropathic pain medication (pregabalin + antidepressant combination), ② Local treatment (lidocaine patch, high-concentration capsaicin patch), ③ Intervention (nerve block, spinal cord stimulation), and ④ Concurrent psychological and rehabilitation therapy. Spinal cord stimulation (SCS), an interventional procedure, has been reported to reduce pain by more than 50% in drug-refractory chronic PHN. Korean Medicine Clinic Perspective

Dongjedang’s three-step treatment for chronic neuralgia is as follows: Step 1 (Weeks 1–4): Acupuncture and pharmacopuncture are used to gently dissolve hardened blood stagnation and open the meridians. Shallow needling and small amounts of pharmacopuncture are used to regulate remaining heat toxins and local inflammation. Step 2 (Weeks 5–10): When a pain response occurs, thread embedding is used to promote the regeneration of tissues surrounding the nerve pathway, and acupuncture techniques are applied to separate adhesions if necessary. Step 3 (Weeks 11 onwards): Herbal medicine tailored to the patient's constitution is used to replenish blood and body fluids—the foundation of recovery—and to recharge vital energy, aiming for a state free from recurrence. Even patients with slow responses follow each step without skipping any, while adjusting their goals accordingly.