What You Can Do About Nerve Pain That Lingers After Shingles
Chronic pain that continues after a case of shingles is called postherpetic neuralgia . It is estimated that about 20% of patients will experience this type of nerve pain as a complication of shingles.
Those who have had chickenpox are at risk of developing shingles later in life. People who develop PHN are generally age 60 and older. Although there is no cure for PHN, there are several methods of pain management that can ease symptoms. Fortunately, the type of pain that arises from postherpetic neuralgia improves over time.
Neuralgia affects the nerves, causing structural and functional damage. It can feel like a stabbing or burning pain that radiates along the affected nerve.
Neuropathic pain is not caused by an external injury or stimuli but originates from inside the nervous system. When the herpes-varicella zoster virus is reactivated in the form of shingles, scar tissue forms alongside nerves, creating pressure, and sending pain signals to the brain.
How To Use Valtrex
Read the Patient Information Leaflet if available from your pharmacist before you start taking valacyclovir and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take valacyclovir by mouth, with or without food, as directed by your doctor. Drink plenty of fluids while taking this medication to lower the chance of side effects.
The dosage and length of treatment are based on your type of infection, medical condition, and response to treatment. For treating chickenpox in children, the dosage is also based on weight.
This medication works best when started at the first sign of an outbreak, as directed by your doctor. It may not work as well if you delay treatment. For shingles or chickenpox, start taking valacyclovir at the first symptom or as soon as possible after the rash appears. For cold sores or genital herpes, start taking this medication at the first sign or as soon as you feel tingling, itching, or burning.
Valacyclovir works best when the amount of medicine in your body is kept at a constant level. Take this drug at evenly spaced intervals. To help you remember, take it at the same time each day.
Continue to take this medication until the full prescribed amount is finished. Do not change your dose, skip any doses, or stop this medication early without your doctors approval.
Tell your doctor if your condition persists or worsens.
Causes Of Shingles Pain
Causes of Shingles Pain
The main cause of shingles pain is a viral infection of the nerve root. If you ever had chickenpox, the virus will remain dormant in your body for the rest of your life. As you grow older, your immune system becomes weaker and suppressed from medications or other procedures such as chemotherapy. When your immune system gets weak, the virus can reactivate, causing shingles pain.
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Drug Interactions Of Acetaminophen
The popular blood thinner warfarin may interact with acetaminophen. An increased bleeding risk has been linked to using acetaminophen and warfarin. Alcohol use with acetaminophen has been linked to an increased risk of bleeding.
Interactions between acetaminophen and the antibiotic isoniazid have been reported.¹ Taking acetaminophen while taking isoniazid increases the risk of liver damage.
What If You Have Shingles Around Or In Your Eye
Community Eye Health
If shingles are in the eye, they most often show up inside the eyelid and on the surface or the eyeball, says Rebecca Taylor, MD, an ophthalmologist with Nashville Vision Associates in Tennessee.
On the surface, says Dr. Taylor, they mainly show up on the cornea, which is the clear dome of tissue that covers your iris , and the conjunctiva the clear tissue that covers the whites of your eye and the inside of your eyelid.
If shingles is in these places, she says, youll be prescribed eye drops with steroids to calm the lesions, and lubricating tears for comfort.
If you have had shingles in your eye, says Taylor, your eye doctor will monitor you for 3 to 12 months to make sure that your eye is returning to health and that no new developments have occurred. You may also be encouraged to have a yearly eye exam until otherwise instructed by your eye doctor.
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Is There A Way To Prevent Shingles
Fortunately, a vaccine is available for older adults that can prevent shingles and reduce the incidence of postherpetic neuralgia. The Zostavaxshingles vaccine was approved in 2006. In 2017, the U.S. Food and Drug Administration approved a newer vaccine, Shingrix, as the preferred vaccine. The older Zostavax is a live vaccine given as a single injection, and the newer Shingrix is a nonliving vaccine. The newer Shingrix vaccine is given in two doses two to six months apart. Shingles vaccination is recommended for use in people over 60 years of age.
Antiviral medications, including acyclovir and valacyclovir , when administered early enough in the course of the disease, can decrease the severity and duration of the outbreak, reduce the risk of eye damage if the eyes are involved, and reduce the likelihood of developing postherpetic neuralgia. It is recommended that antiviral drugs be given within 72 hours of the onset of symptoms for the best outcome.
Pain medications can also be effective in controlling shingles pain. These may be applied to the skin, like the capsaicin topical patch or lidocaine . Oral medications that can help with pain control in people with shingles include tricyclic antidepressants such as amitriptyline and certain antiseizure medications such as gabapentin .
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What To Do If You Think You Have Shingles
If you suspect that you have shingles, its important to visit a healthcare professional as soon as possible. According to the American Academy of Dermatology , treating shingles within the first 72 hours gives you the best chance of minimizing complications like nerve pain.
Antiviral medications or other medications only available by prescription can shorten the duration of your shingles or lessen the severity.
If a cream or other topical isnt reducing your pain, its a good idea to visit your doctor again. They may recommend trying another treatment like capsaicin cream instead of lidocaine.
If a product is making your symptoms worse, its important to stop taking it right away.
You may be able to reduce your symptoms using home remedies while youre waiting to see a healthcare professional. These include applying a wet cold compress or taking a cool bath.
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What Are The Possible Side Effects Of Shingrix
Studies show that Shingrix is safe. The vaccine helps your body create a strong defense against shingles. As a result, you are likely to have temporary side effects from getting the shots. The side effects might affect your ability to do normal daily activities for 2 to 3 days.
Most people got a sore arm with mild or moderate pain after getting Shingrix, and some also had redness and swelling where they got the shot. Some people felt tired, had muscle pain, a headache, shivering, fever, stomach pain, or nausea. Some people who got Shingrix experienced side effects that prevented them from doing regular activities. Symptoms went away on their own in about 2 to 3 days. Side effects were more common in younger people.
You might have a reaction to the first or second dose of Shingrix, or both doses. If you experience side effects, you may choose to take over-the-counter pain medicine such as ibuprofen or acetaminophen.
Guillain-Barré syndrome , a serious nervous system disorder, has been reported very rarely after Shingrix. There is also a very small increased risk of GBS after having shingles.
If you experience side effects from Shingrix, you should report them to the Vaccine Adverse Event Reporting System . Your doctor might file this report, or you can do it yourself through the VAERS websiteexternal icon, or by calling 1-800-822-7967.
If you have any questions about side effects from Shingrix, talk with your doctor.
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Higher Intensity Of Pain With Internal Shingles
While both regular shingles and internal shingles can cause preherpetic neuralgia, this condition has been found to be more severe in the latter case.
One study found that at the onset of symptoms, after one month, and after three months, internal shingles patients had consistently more severe and persistent pain. Overall, however, preherpetic neuralgia occurs much more frequently in regular herpes zoster patients.
What Is The Best Medication For Pain Relief Of Shingles
Question posted by jtomrai1 on 24 April 2010
Last updated on 14 February 2012 by ashokamin
ashokamin
I am taking additional 50mg ASPIRIN at interval of 3 hrs and no pain.I dont know I am doing right but my doctor allowed such small dose of aspirin along with Gabapentin keeping interval of 3 hrs.
click on the drug name for detailed information.
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Knowing What To Watch For And Getting Vaccinated May Prevent This Painful Condition From Recurring
Shingles is a painful condition caused by the varicella-zoster virus, the same virus that causes the chickenpox. After a person has chickenpox, the virus stays in the nerve tissue near the spinal cord and brain. For reasons that are not fully understood, years later, the virus may reactivate and cause shingles.
Shingles often causes a rash, which usually develops on one side of the body. The rash forms blisters that scab over in a 7 to 10 days. However, some people dont develop these telltale symptoms. It doesnt always have a rash. And it isnt always on one side of the body. Those are two reasons shingles can be delayed in its diagnosis and treatment, says Houman Danesh, MD, director of Integrative Pain Management for Mount Sinai Hospital in New York.
Shingles pain can feel like burning or tingling. Some people describe it as being like ants crawling on their skin, Dr. Danesh says. The pain can last for up to four months.
According to the US Centers for Disease Control and Prevention , almost one out of every three people in the United States will develop shingles in their lifetime. There are an estimated 1 million cases of shingles each year in the United States.
Not everyone who had chickenpox will develop shingles. Those individuals with lowered immunity to infections are at increased risk. Shingles is also more common in older adultsabout half of all cases occur in men and women age 60 or over.
Early Treatment Is Key
Preventing Shingles Through a Vaccine
What Are The Complications Of Shingles
The most common complication of shingles is long-term nerve pain called postherpetic neuralgia. Long term nerve pain occurs in the areas where the shingles rash was, even after the rash clears up. It can last for months or years after the rash goes away. The pain can be very severe and can interfere with daily life. Read more about pain after shingles.Shingles on the face may lead to complications involving the eye, including blindness. Very rarely, it can also lead to pneumonia , hearing problems, or brain inflammation .
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What Are The Best Over
Choosing the right OTC shingles cream is largely a matter of personal preference. There is a range of ingredients, effectiveness, and cost of the different creams. Some creams contain natural ingredients, while others have analgesics that control pain.
There isn’t a lot of research on which creams are most effective. Online reviews may be the best place to get unbiased information on OTC cream results. Expense is another consideration some are quite expensive.
Best Pain Relief For Shingles: Creams And Antiviral Medication
If you’ve ever had chickenpox, youve been infected with the varicella-zoster virus . As a child, the concept of the virus remaining in your body forever may not seem very interesting. However, if the virus does reactivate later in life and causes shingles, it can be very painful and serious.
Your doctor may refer to shingles as herpes zoster , as the virus is one of the herpes variations that can affect humans, specifically Human Herpesvirus 3 . But no matter what it’s called, the virus lives in your nerve cells, and when it’s reactivated, it can cause a painful skin rash. About 30% of the adult population in the US will have shingles at some point.¹
There is medication to treat shingles, but one of the worst characteristics of the disease is the sometimes debilitating pain that can persist months after the rash has healed. If you catch a shingles outbreak early, your doctor can prescribe antiviral medication to ease the acute symptoms and lower your chances of developing persistent postherpetic neuralgia .
If you’re over 50, the shingles vaccine is recommended to combat the VZV virus it significantly lowers your risk for both HZ and PHN.
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How Long Does Shingles Last
The shingles virus lasts a lifetime. However, it may remain inactive for many years at a time. A shingles attack or episode may last between two and four weeks. Here is an average timeline:
Whats The Difference Between Cream Lotion And Ointment
Ointments, lotions, and creams are three types of substances you can apply to your skin to help manage shingles.
These topicals are similar, but there are slight differences in their makeup. The primary difference is the amount of water and oil they contain.
According to this 2016 primer, creams are made up of about equal parts oil and water and often have moisturizing properties. Theyre thicker than lotions but thinner than ointments.
Lotions are similar to creams, but they are made up mostly of water. They have less oil and have a thinner consistency. Because theyre thinner, your skin absorbs them more quickly. Some lotions are oil-free.
Ointments are the thickest of the three. They are made to stay on top of your skin instead of being absorbed immediately. Ointments are made up of at least 80 percent oil.
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What You Should Know About Shingles
You may not remember having the itchy, painful welts caused by chickenpox. But according to the Centers for Disease Control and Prevention , 99.5 percent of people born before 1980 were infected at one point or another. Anyone who has been infected is at risk for shingles.
When chickenpox infections fade, the virus that caused them does not. Chickenpox is caused by the varicella-zoster virus , and its a member of the herpes family. Like most herpes-based illnesses, VZV never really goes away. Instead, it lies dormant within your body.
VZV rests within your nerves, and during a shingles outbreak, the virus triggers inflammation and pain along a nerve band. The CDC says one in three people will get shingles. Most have just one outbreak, but some have repeated problems.
Mayo Clinic says shingles can cause more than pain. The condition can also cause:
- Persistent fatigue.
- Sensitivity to light.
Typically, people with shingles will experience blisters along just one small area that wraps around the torso. But any part of the body served by nerves can get hit with shingles. Symptoms last for about two weeks before fading away.
Management Of Herpes Zoster And Postherpetic Neuralgia
SETH JOHN STANKUS, MAJ, MC, USA, MICHAEL DLUGOPOLSKI, MAJ, MC, USA, and DEBORAH PACKER, MAJ, MC, USA, Eisenhower Army Medical Center, Fort Gordon, Georgia
Am Fam Physician. 2000 Apr 15 61:2437-2444.
Patient information: See related handout on shingles, written by the authors of this article.
Herpes zoster results from reactivation of the varicella-zoster virus. Unlike varicella , herpes zoster is a sporadic disease with an estimated lifetime incidence of 10 to 20 percent. The incidence of herpes zoster increases sharply with advancing age, roughly doubling in each decade past the age of 50 years. Herpes zoster is uncommon in persons less than 15 years old. In a recent study,1 patients more than 55 years of age accounted for more than 30 percent of herpes zoster cases despite representing only 8 percent of the study population. In this same study, children less than 14 years old represented only 5 percent of herpes zoster cases.
The normal age-related decrease in cell-mediated immunity is thought to account for the increased incidence of varicella-zoster virus reactivation. Patients with disease states that affect cell-mediated immunity, such as human immunodeficiency virus infection and certain malignancies, are also at increased risk. Chronic corticosteroid use, chemotherapy and radiation therapy may increase the risk of developing herpes zoster.
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Coping With Shingles Pain
If you have shingles, you may be wondering how to cope with the pain:
- Be sure to get plenty of sleep and eat a healthy diet to help boost your immune system.
- Wear comfortable, loose clothing with natural fiber .
- Establish or maintain a regular exercise routine.
- Utilize home remedies to help soothe pain from blisters.
- Engage in activities that help take your mind off of the pain.
- Establish a routine to help manage stress.
- Seek out support when needed from family and friends as well as professional supportive services.