Have your bottom, thigh, or leg ever started hurting before, during, or after a genital herpes outbreak? Buttock, thigh, and leg pain are 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 typically results from frequent or severe outbreaks. While the condition is common, it doesn't happen to everyone with HSV and doesn't occur with every outbreak. But, for some, the pain can continue long after herpes lesions disappear.
Postherpetic Neuralgia related to Shingles (Herpes Zoster) differs slightly from Postherpetic Neuralgia caused by genital herpes (HSV-2). Shingles is a blistering rash that typically occurs on the head or trunk (sometimes, the buttocks) due to having had Chickenpox at some point in life. Not all individuals who have had Chickenpox will go on to experience Shingles, and not all people who develop Shingles will experience Postherpetic Neuralgia. Postherpetic Neuralgia associated with Shingles presents with the following symptoms.
- Pain on one side of the body localized on the head or trunk (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. Sensory changes may also occur, such as numbness, itching, Hyperaesthesia (sensitivity to touch), or Allodynia (pain from slight touch).
- Sensitivity to temperature changes (hot or cold)
- 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.
Postherpetic Neuralgia radiating pain down the left leg caused by genital herpes is a condition many people living with genital herpes experience. It's the result of sacral nerves being irritated and inflamed by the virus during and after the prodromal phase. The prodromal phase is when herpes wakes up and travels toward the skin's surface, which is also called viral shedding.
Ongoing Postherpetic Neuralgia is likely related to miscommunication between the nerves and the brain due to the slow recovery of affected nerves. Frequent outbreaks can also make healing more of a challenge or lead to permanent nerve damage. See Peripheral Nerve Damage below.
Shingles (Herpes Zoster) vaccines reduce the chance of developing Postherpetic Neuralgia or, at the very least, minimize the duration and severity. However, there's disagreement about whether thet suit 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.
Medical doctors treat Postherpetic Neuralgia with tricyclic antidepressants, NSAIDS, nerve blocks, anticonvulsants, steroids, anesthetic pain patches and gels, and creams containing Capsaicin (a natural ingredient in a cream available over the counter). Many of these treatments have side effects. Capsaicin, even though considered a natural remedy, can cause an extreme burning sensation and even blistering on sensitive skin. I know this from personal experience, while NSAIDS contribute toward Leaky Gut.
Postherpetic Neuralgia usually clears up within six to twelve months with treatment. When untreated, about 50% of people are painless within six months. Some people experience pain for many years. The severity and duration often increases with age.
Peripheral Nerve DAMAGE
Nerve damage caused by genital herpes (HSV-2) that affects the legs is referred to as Peripheral Neuropathy. It is 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.
"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)."
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 (PNS) by reducing oxidative stress. However, it isn't without possible side effects in some people, so do your research. Eating a healthy diet (with plenty of colorful vegetables and healthy proteins) and exercising, while avoiding nicotine and alcohol, is also beneficial.
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