[Question #7387] Follow up Question #7378

5 months ago
Hey, I recently spoke to Dr. Hook about my issue and he has greatly helped with my concerns however, I just want to clarify one thing that has been on my mind. I am on a different account as I forgot my password and it won't seem to let me reset the password.
As I mentioned to Dr Hook
"3. I also have an area where it's slightly red and hurts on my genital area but whenever I take a hot bath or go to a hot spring(super hot environment) or steam room, the pain is temporarily relieved. My question is,  when you put hot water over a HSV sore or submerge the area in a hot water environment/or are in a hot environment, is it possible for the pain to essentially go away or be heavily relieved or will it actually feel worse as I suspect this is some other problem-non-std related? I am convinced this pain is something else as there appears to be no sore there and when inspected by a clinician, everything appears to be fine besides slight redness. "
and Dr Hook replied "To my knowledge, the discomfort of genital herpes does not go away in hot/warm  environments."
Q1. You said that the discomfort does not go away in hot environments but I just want to clarify you also meant that being in a hot environment ALSO doesn't alleviate(so may still be some pain but the pain has decreased in intensity) the discomfort as well. (so discomfort doesn't go away and the discomfort isn't reduced in pain intensity in hot environment).

Q2. Furthermore, I may have forgot to add, the pain I experience is also reduced in intensity or sometimes gone when I am exercising. The pain/discomfort associated with herpes/herpes sore also doesn't get better or go away during exercise and then return after right?
Sorry if my question seems repetitive but I just wanted to clarify this as it has been bothering me.
Much appreciated! 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
5 months ago
Hot environments like a hot tub would not reduce the discomfort associated with a herpes outbreak, no, nor would it increase the pain.  I agree with Dr. Hook
Exercising also would not improve the pain associated with herpes - if anything, work out clothes rubbing against a herpes lesion would increase the pain.
If I'm not understanding your questions correctly, please - let me know and I'll help as best I can.

Terri

---
5 months ago
Hey Terri 
Thanks you for your reply.  I heard people say they have nerve pain after acquiring herpes. I believe it was called post herpatic neuralgia but I’m not sure. I was just wondering if this pain from this post herpatic neuralgia is constant and the pain intensity is also constant. I am experiencing a  discomfort in my genital area rather constantly however there are activities which reduce this discomfort(reduce pain intensity from a 7-2/3) temporarily (but doesn’t completely relieve the discomfort) e.g  being in a hot tub.  Furthermore when I sit in another position, this discomfort suddenly shifts to my glutes /buttocks area. Does post herpatic neuralgia shift locations suddenly like this or will you just feel it in one location all the time?

This doesn’t suggest post herpatic neuralgia at all right? 

Thank you for your amazing service. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
4 months ago
No, I would say that postherpetic neuralgia doesn't feel like what you are describing.  You don't mention your gender.  If you are male, I would suggest a prostate exam to rule our an inflamed prostate gland

Terri
---
4 months ago
Hey Terri
Thanks for your reply. I am a male and I haven't got my prostate checked but this nervy feeling has occured for quite a while now;I would say around 8 months. I just want to ask some questions. For additional information, sometimes this pain actually reduces in intensity at super random times. So right after I wake up I would feel good with very little pain and sometimes when I am distracted and doing something, I won't feel this pain or at least barely feel it. (It is a very nervy and burning pain). Could you please clarify a few things. My question is 
1. Can you describe what post herpatic neuralgia feels me. I am super super worried I got it despite a negative HSV IGG test.
2. Is the pain constantly the same intensity or would the pain reduce in intensity level at times e.g. hot tub or when distracted and sometimes even disappear for a bit.
3. Does the pain from post herpatic neuralgia shift around or is it only in one location all the time. It would sometimes move from my penis to my butt and sometimes even my legs. 
4. Could this be the prodrone symptoms that I am feeling even though I don't notice any sores. Would the prodrone symptoms get better at times(e.g. when in a hot tub) or do you constantly feel it before the outbreak and does it move from one place to another. I feel some nerve like pain on my butt as my genital/pubic area that would be here for a couple of days, then at times it gets better for a bit then comes back again and this has been my life for quite a while now.
I really hope it is something else as it is really making a big impact on my emotional wellbeing. Do you think I should just move on from herpes?

Thanks for your help

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
4 months ago
1.  Postherpetic neuralgia primarily happens with shingles, not HSV, but in my experience, when people with herpes experience this pain, it is primarily before an outbreak, sometimes during, and it is pain down the back of the leg, where that nerves supplies sensation.  It is not continuous and getting into a hot tub would not reduce it.  The experience of prodrome is very individual and I think some of what you experience is similar to prodrome. 

So many things in the body could cause the symptoms that you are describing - issues with discs in the back, muscle pulls, prostate issues.  You seem to have settled on herpes as the cause and you are continuously worried that you might have it.  If you were my patient, I would encourage you to get a western blot and settle this once and for all.  Asking us what this might be is nowhere near as good as just getting the best test and be done with it, one way or another.

Terri
---