The Emotional Toll Of Nerve Pain After Shingles
Researchers are not just looking at biological and neurological risk factors for PHN. Dworkin was also a co-author of a study looking at psychological risk factors, too. The results were published in the Journal of Pain in 2005.
“It certainly looks like psychological stress can be a potent risk factor for PHN,” Dworkin tells WebMD.
The study showed that people with shingles who went on to develop PHN were more likely to have had symptoms of personality disorders, hypochondria, intense worry about their disease, and other bodily complaints.
Dworkin says previous studies have already shown a connection between stress and shingles development.
“One study even found that the risk of developing PHN was higher in people who were living alone when they developed shingles than people living with others,” Dworkin says, perhaps indicating that social isolation increases the risks of PHN.
How Is It Treated
It is best to start treatment as soon as possible after you notice the rash. See your healthcare provider to discuss treatment with antiviral medicine, such as acyclovir. This medicine is most effective if you start taking it within the first 3 days of the rash. Antiviral medicine may speed your recovery and lessen the chance that the pain will last for a long time.
Your provider may also recommend or prescribe:
- medicine for pain
- antibacterial salves or lotions to help prevent bacterial infection of the blisters
When To Seek Medical Advice
Shingles is not usually serious, but you should see your GP as soon as possible if you recognise the symptoms. Early treatment may help reduce the severity of your symptoms and the risk of developing complications.
You should also see your GP if you are pregnant or have a weakened immune system and you think you have been exposed to someone with chickenpox or shingles and haven’t had chickenpox before.
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Prevent Shingles With Vaccination
The Centers for Disease Control and Prevention recommends that almost all people ages 60 and older be vaccinated against shingles, whether or not they had chicken pox in their youth or have had shingles before, says Dr. Oaklander.
The vaccination that prevents chickenpox in children was used to develop a similar vaccine that protects against shingles. It reduces the risk of getting shingles by about half, and shingles rashes that still develop are slightly less likely to cause postherpetic pain, or other serious complications, says Dr. Oaklander.
People with especially weak immune systems, such as those with cancer or anyone undergoing immunosuppressive treatments, should avoid Zostavax since the vaccine contains a weakened form of the live virus. Because Zostavax has only been available since 2006, it is still not yet clear if a single vaccination offers lifelong protection, but at this time, no booster is recommended.
A new shingles vaccine called HZ/su also may be helpful for older adults. A study published in The New England Journal of Medicine found that the vaccine was 97.2% effective among those ages 50 and older, and 97.9% effective for those ages 70 and older. And since HZ/su is not made from a live, weakened virus, it is safe to give to people with weak immune systems. This vaccine still needs to undergo further testing before it can be submitted for FDA approval, which may happen as early as this year.
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Preventing Nerve Pain After Shingles
But if you’re worried about PHN, don’t despair. There are medications that can cut your risks of getting the condition. There are three antiviral drugs used: famciclovir , valacyclovir , and acyclovir . These medications need to be started within two to three days of the onset of shingles.
“If you look at the clinical trials with any of these drugs in people over 50,” says Dworkin, “they cut the rate of pain at six months in half. That’s a very significant improvement.” They are also very safe and have few side effects, he says.
But who needs the drugs? Dworkin says there’s not a clear consensus yet.
There are some obvious cases. “I think everyone would agree that someone who is over 50 and has severe symptoms should get preventative treatment,” he tells WebMD.
But for younger people or those with fewer risk factors, the course is less clear.
“Some people think that everyone who gets shingles should get preventative treatment with antiviral medicines, because the medicines are so safe and have such few side effects,” he says.
Others argue that preventative treatment should only be given to those at greater risk. The main reason for this, Dworkin says, is cost.
“A full course of treatment could cost anywhere between $100 and $160,” he says. “That can add up, and insurance companies might not want to pay if the risks are very, very low.”
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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.
Who Should Be Vaccinated With Shingrix
The Shingrix vaccine is recommended for those 50 years of age and older who are in good health.
You should get the Shingrix vaccine even if:
- Youve had shingles already.
- Youve been previously vaccinated with Zostavax . If youve been vaccinated with Zostavax, wait at least eight weeks before getting vaccinated with Shingrix.
- You dont know for sure if youve ever had chickenpox.
Ask your healthcare provider, who knows your entire health history if getting this vaccine is right for you.
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Reducing Nerve Pain From Shingles
Pharmaceuticals and vaccination for herpes zoster.
Shingles is virtually synonymous with pain, whether it be from the rash itself, from postherpetic neuralgia , or postherpetic itch . Additionally, it can lead to serious complications involving the eye, including vision loss and blindness, as well as pneumonia, hearing problems, brain inflammation, and even death.
Treatment of the virus typically begins with antiviralsand the sooner the better. Acyclovir, valacyclovir, and famciclovir are most commonly used to treat shingles. They should be administered as quickly as possible after the onset of symptoms to shorten the severity and length of the illness.
Additionally, there are simple self-care steps that can be followed to help reduce the pain and discomfort of shingles.
Long-term nerve pain from PHN is the most common complication of shingles and is experienced by up to 20% of patients with shingles The risk of PHN increases with age, as does the severity and length of pain, which can persist for months or even years.
The FDA has approved the use of analgesics, anticonvulsants, and lidocaine and capsaicin topical patches for treating PHN.
PHI, which can occur in conjunction with PHN, is caused by sensory fibers in the nerves that were damaged or died during the shingles infection. The remaining isolated nerve fibers fire when they shouldn’t, generating false sensations that fool the central nervous system.
Treatment Of Pain After Shingles
Treatment for people with PHN may include:
- Nerve blocks: Local anesthetic or alcohol injected directly into the nerve affected
- Thoracic epidural injections: Local injection in the space around the spinal cord
- Antidepressant medications: Such as amitriptyline
- Membrane stabilizers: Such as gabapentin
- Capsaicinapplication: Topical cream applied to the affected area
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Does Shingles Nerve Pain Ever Go Away
If you have shingles symptoms, get treatment now and you may avoid permanent nerve pain. Shingles, a viral infection of the nerve roots, affects 1 million people in the U.S each year. Most people recover from their bout, but for as many as 50% of those over age 60 who have not been treated, the pain doesn’t go away.
Will The Pain Go Away
Without treatment, PHN typically eases gradually and goes. In about 5 in 10 people with PHN, symptoms are gone by three months. However, without treatment, about 3 in 10 people with PHN still have pain after a year. Some people have a slow improvement over a long period of time. A small number of people do not have any improvement over time without any treatment.
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Ask The Doctor: Will My Shingles Pain Ever Go Away
For the past three years, I have suffered from shingles pain. It affects my shoulders and head, and at times is very painful. Some time ago, I was told there was no cure or treatment for this condition. Is this still the case?
John Ludlow, Surrey.
The most common treatments for shingles pain are tricyclic antidepressants and anti-epileptic drugs
This can be a very disheartening condition, but dont lose hope there are treatment options available to you.
Shingles triggers a red, painful rash on one side of the body, usually the chest and abdomen, though any area can be affected.
The condition starts with a tingling or burning sensation that progresses quickly to a painful, red rash, which erupts into itchy blisters.
The whole episode usually lasts for between two to four weeks and is triggered by the same virus that causes chicken pox the herpes varicella-zoster virus.
Everyone who develops shingles would have suffered from chicken pox in childhood the virus is then locked away by your immune system in nerve tissue.
However, when the immune system becomes weakened in adulthood, perhaps through another illness or simply as a consequence of age, the virus can escape its long-term imprisonment and triggers the symptoms.
This happens to one in four of us over the age of 50 . Luckily, it usually strikes just once.
This long-term pain is associated with low mood, impaired sleep and loss of appetite.
Spinal Cord Or Peripheral Nerve Stimulation
These are often used to treat several different types of neuropathic pain. Electrodes are placed underneath the skin along the affected peripheral nerves. Before using this technique, doctors will do a test using a wire electrode to get a sense of how the patient will respond.
After the electrodes have been placed above the peripheral nerve, a weak electrical current is sent to the nerve. By stimulating a sensory pathway that doesnt cause pain, experts believe that this electrical signal to the brain can trick the brain into turning off the painful signal, bringing relief to the patient.
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How To Prevent Transmission
You cant catch shingles, and you cant give shingles to someone else. But you can give others chickenpox.
After you have chickenpox, the varicella-zoster virus stays dormant in your body. If this virus reactivates, shingles occurs. Its possible to transmit this virus to others who arent immune while the shingles rash is still active. You are contagious to others until all areas of the rash are dried up and crusted over.
To catch the varicella-zoster virus from you, a person has to have direct contact with your rash blisters.
You can help prevent your transmission of the varicella-zoster virus by:
- keeping the rash loosely covered
- practicing frequent handwashing
- avoiding contact with people who may not have had chickenpox or who havent been vaccinated against chickenpox
Last medically reviewed on August 24, 2017
- Cohen KR, et al. . Presentation and management of herpes zoster in the geriatric population.
Postherpetic Neuralgia Treatment: Soothing The Pain
Once postherpetic neuralgia occurs, antiviral drugs can’t treat the pain because ongoing infection isn’t the problem. Instead, treatment aims to soothe and quiet the misfiring nerves that are creating the pain.
There are a variety of oils and creams available at drugstores. Some turn to herbal oils and creams, such as extracts from geranium, lavender, eucalyptus, tea tree, and bergamot.
Others use capsaicin cream, made from hot chili peppers. A drug called Qutenza contains “pure, concentrated, synthetic capasaicin,” according to the FDA. Qutenza can be used every three months and is applied by a doctor via a patch or patches placed for an hour on the places on the skin that hurt. Before applying the patch, the doctor spreads a topical anesthetic on the area to be treated.
Ralph said many people find relief from the anesthetic lidocaine, available in low-concentration creams or patches over the counter, or by prescription in higher concentration patches.
“The lidocaine soaks through the skin and numbs the painful nerve endings,” says Ralph. Lidocaine patches are particularly helpful for people with allodynia, Ralph adds.
If topical creams and oils don’t provide sufficient relief, Ralph recommends asking your doctor about prescription medicines that may help, including some antidepressants, anti-convulsants, and opioids.
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How To Decrease Your Risk Of Complications
Treating shingles early can help shorten the lifespan of the virus.
If youre able to shorten the infection, youll decrease your risk for complications from the virus. Antiviral medication is recommended as a first line of treatment when youre diagnosed with shingles.
Getting a varicella vaccination can help you to avoid contracting shingles and chickenpox. Even if youve already had shingles, a vaccination against shingles can help to prevent the virus from reactivating in your system.
The most common complication associated with shingles is postherpetic neuralgia . PHN is long-term nerve pain that can occur in the area where your shingles rash appeared.
According to the Centers for Disease Control and Prevention , of people experience PHN after a shingles outbreak.
The older you are when your shingles appears, the higher your risk for long-term nerve pain.
If the virus is left untreated, your risk for other complications related to shingles
The Best Pain Doctor For Shingles Pain Treatment Is Roziermd
If you have shingles pain, you should immediately seek the care and treatment of a reputable pain doctor.
Dr. Antonio Rozier is a highly experienced and reputable pain management doctor. He is the best pain doctor for shingles pain treatment in Dallas, Mansfield & TX. He is equipped with different interventional techniques and treatments for various types of pain including shingles pain.
If you have shingles pain or you are searching for a doctor that is very experienced in the treatment of shingles pain, Dr. Rozier is highly recommended.
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Where Does Shingles Come From
When you have chickenpox as a child, your body fights off the varicella-zoster virus and the physical signs of chickenpox fade away, but the virus always remains in your body. In adulthood, sometimes the virus becomes active again. This time, the varicella-zoster virus makes its second appearance in the form of shingles.
Seek Treatment Right Away
Many people have the mistaken impression that, like poison ivy, shingles is a nuisance rash that fades on its own. But in fact a shingles rash should alert people, especially in middle or old age, to seek immediate medical help, says Dr. Oaklander.
Rapid treatment with one of three antiviral drugs, acyclovir , valacyclovir , or famciclovir , can shorten a shingles attack and reduce the risk of serious damage, such as:
- Long-term pain. Pain that lingers in the area of a healed shingles rash is called postherpetic neuralgia. This often-disabling pain can last several months to a year.
- Prolonged itching. Many people are left with an itchy area from their shingles, which can be as disabling as chronic pain. It is most common on the head or neck.
- Damage to vision and hearing. Pain and rash near an eye can cause permanent eye damage and requires an urgent ophthalmological exam. When the nerve to the ear is affected, it can permanently damage hearing or balance.
- Strokes and heart attacks. A PLOS Medicinestudy that tracked about 67,000 people ages 65 and older who were newly diagnosed with shingles found that stroke risk more than doubled in the first week after the shingles diagnosis. The same study reported an increased risk for heart attacks in the three months after shingles, but the additional risk dissipated after six months.
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Shingles And Your Eyes
If the shingles rash breaks out on the face, near the eye, the vision may be affected. An ophthalmologist should be consulted right away when pain or other symptoms of shingles affect the eye or the area near the eye.
Shingles painand other symptoms from an outbreak of herpes zosterusually lasts between three to five weeks. Most people experience shingles once, but in some instances, people will continue to experience pain. When this happens, its called postherpetic neuralgia .
When Shingles Becomes Painful Postherpetic Neuralgia
In 10% to 20% of these people, however, the pain of shingles keeps hanging on after the rash is gone. “These folks go on to get postherpetic neuralgia, and we’re not exactly sure why,” Ralph tells WebMD. “Either the pain of shingles never leaves, or it resolves, comes back, and never goes away completely.”
PHN typically occurs in the area where the shingles occurred. The pain can be intermittent or constant, and it can take on any of the diverse qualities of shingles pain. Normal touching of the skin can set it off, Ralph adds. This is called allodynia.
The pain of postherpetic neuralgia can interfere with daily activities, exercise, sleep, and sexual desire. Irritability and depression often follow. “Generally, it makes people feel terrible if it can’t be controlled,” Rumbaugh says.
Why the pain of postherpetic neuralgia persists has mystified researchers. It’s not due to ongoing infection by VZV, but is thought to be due to residual damage or inflammation in the nerve after shingles resolves. It’s also impossible to predict who’ll get shingles or postherpetic neuralgia, although age, race, and health seem to have some impact.
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