Tuesday, February 27, 2024

How Long Does Shingles Pain Last

Why Doesnt Having Chickenpox Earlier In Life Provide Immunity Against Having Shingles Later

How to Treat and Prevent Shingles with Dr. Mark Shalauta | San Diego Health

After having chickenpox, your body does not rid your system of the virus. Instead, the virus stays in a portion of the spinal nerve root called the dorsal root ganglion. In most people, the virus simply stays there quietly and doesnt cause problems. Scientists arent always sure why the virus gets active again, but they know stress can be a cause.

I Think I Have Shingles What Should I Do

Repeat after me: Call your doctor right away, within 72 hours. The earlier the better.

You should start taking an antiviral medication, preferably valacyclovir or famciclovir, within 72 hours of your symptoms starting to help reduce the severity of the infection, how long your skin rash lasts, and how painful it gets. If its been more than 72 hours, you should still talk to your provider. Treatment can still help, especially if you still see new rashes showing up.

When Do You Start To Feel Tired After Shingles

Often, with shingles, you can have exhaustion, fatigue, malaise, irritability etc anytime 2 weeks before, during, and usually up to 2 weeks after the rash has cleared. It is important to remember that you are infected with the Herpes Varicella virus, that you had a viral infection that for some is excruciating, and is a serious infection.

Also Check: What Is The New Shingles Shot

How Does It Occur

If you have had chickenpox, you are at risk for later developing shingles. After you recover from chickenpox, the chickenpox virus stays in your body. It moves to the roots of your nerve cells and becomes inactive . Later, if the virus becomes active again, shingles is the name given to the symptoms it causes.

What exactly causes the virus to become active is not known. A weakened immune system seems to allow reactivation of the virus. This may occur with normal aging, immune-suppressing medicines, or another illness, or after major surgery. It can also happen as a complication of cancer or AIDS or treatment of these illnesses. Chronic use of steroid drugs may trigger shingles. The virus may also become active again after the skin is injured or sunburned. Emotional stress seems to be a common trigger as well.

What Are The Pain Complications Of Shingles

How long does shingles last? Timeline and treatment

Many sufferers have described the pain as extremely severe, and some even require narcotic pain-relief medications.

A blistering rash usually accompanies the outbreak. New blisters continue to appear for several days, and the entire outbreak can take weeks to heal. Blisters may cover the entire path of the affected nerve, or the involvement may be patchy. Involvement of the eyes during a shingles outbreak can be particularly serious, since scarring of the cornea and permanent vision loss can result.

Another debilitating complication of shingles is known as postherpetic neuralgia. In postherpetic neuralgia, the pain of shingles persists even after the rash has healed. The diagnosis is made when pain lasts for over 30 days after an outbreak. This pain can last for weeks, months, or even years. Up to 15% of people with shingles have this persistent pain, and it is not understood why the pain persists in some people, but it is likely that some type of nerve damage or inflammation occurs during the outbreak that leads to continued pain.

Read Also: How Long Does Shingles Pain Usually Last

Treatment Of Postherpetic Neuralgia

Apply to affected area every 4 to 12 hours as needed.

Tricyclic antidepressants

Amitriptyline

10 to 25 mg orally at bedtime increase dosage by 25 mg every 2 to 4 weeks until response is adequate, or to maximum dosage of 150 mg per day.

Nortriptyline

10 to 25 mg orally at bedtime increase dosage by 25 mg every 2 to 4 weeks until response is adequate, or to maximum dosage of 125 mg per day.

Imipramine

25 mg orally at bedtime increase dosage by 25 mg every 2 to 4 weeks until response is adequate, or to maximum dosage of 150 mg per day.

Desipramine

25 mg orally at bedtime increase dosage by 25 mg every 2 to 4 weeks until response is adequate, or to maximum dosage of 150 mg per day.

Anticonvulsants

Phenytoin

100 to 300 mg orally at bedtime increase dosage until response is adequate or blood drug level is 10 to 20 g per mL .

Carbamazepine

100 mg orally at bedtime increase dosage by 100 mg every 3 days until dosage is 200 mg three times daily, response is adequate or blood drug level is 6 to12 g per mL .

Gabapentin

100 to 300 mg orally at bedtime increase dosage by 100 to 300 mg every 3 days until dosage is 300 to 900 mg three times daily or response is adequate.

*Additional modalities include transcutaneous electric nerve stimulation , biofeedback and nerve blocks.

So What Is Postherpetic Neuralgia Exactly

Most people with shingles will not develop PHN but certain factors, like age, may place you at a higher risk of developing it.

If you’re still experiencing the pain of active shingles, sans rash, you’re likely experiencing PHN, a complication of shingles. Pain in the aftermath of shingles that persists for longer than 3 months, is PHN. Unfortunately, for some people that pain is chronic and can linger for years.

According to the Centers for Disease Control and Prevention , an estimated 10% to 18% of shingles patients will develop PHN.1 You may be at higher risk of developing it if you have one or more of the following risk factors:

Risk Factors for Developing Postherpetic Neuralgia

  • Age: People older than 60 years of age are at increased risk of developing PHN and experiencing longer lasting, more severe pain. According to the CDC, about 10% to 13% of adults aged 60 years or older with shingles develop PHN, whereas PHN is rare in people younger than 40 years old. 1 Older people who have shingles have about a 50% chance of developing PHN.
  • Severity of your shingles symptoms: If your shingles symptoms are severe, or if shingles affects your eyes, you’re more likely to develop PHN.
  • Other health conditions: People who have suppressed immune systems are more likely to get PHN.2,3

Read Also: What Age Can You Get Shingles

Can I Prevent Shingles

Shingrix is a vaccine against the varicella-zoster virus that causes shingles. Its for people over 50 and consists of a series of two vaccines given 2 to 6 months apart. The vaccine is about 96% effective against shingles. Thats your best way to keep from getting shingles.

What worked for you?

Dr O.

When Should I See A Doctor Because Of The Side Effects I Experience From Shingrix

Shingles Pain withDallas Pain Specialist Dr. George Farhat

In clinical trials, Shingrix was not associated with serious adverse events. In fact, serious side effects from vaccines are extremely rare. For example, for every 1 million doses of a vaccine given, only one or two people may have a severe allergic reaction. Signs of an allergic reaction happen within minutes or hours after vaccination and include hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness. If you experience these or any other life-threatening symptoms, see a doctor right away.

Shingrix causes a strong response in your immune system, so it may produce short-term side effects more intense than you are used to from other vaccines. These side effects can be uncomfortable, but they are expected and usually go away on their own in 2 or 3 days.

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What Everyone Should Know About The Shingles Vaccine

Shingles vaccination is the only way to protect against shingles and postherpetic neuralgia , the most common complication from shingles. CDC recommends that healthy adults 50 years and older get two doses of the shingles vaccine called Shingrix , separated by 2 to 6 months, to prevent shingles and the complications from the disease. Your doctor or pharmacist can give you Shingrix as a shot in your upper arm.

Shingrix provides strong protection against shingles and PHN. Two doses of Shingrix is more than 90% effective at preventing shingles and PHN. Protection stays above 85% for at least the first four years after you get vaccinated.

If Ive Been Vaccinated For Chickenpox Can I Still Develop Shingles Later In Life

Unfortunately, yes, despite being vaccinated for chickenpox, you can still get shingles. No vaccine is 100% protective and the effects of vaccines lessen with time. However, people who get the chickenpox vaccine are significantly less likely to develop shingles later in life compared with people who never received the chickenpox vaccine. One recent 12-year study found that the number of shingles cases was 72% lower in children who had received the chickenpox vaccine compared with those who did not.

Read Also: When Should You Get A Shingles Shot

Lasting Pain After Shingles

Pain that continues for a long time after a shingles rash has disappeared is called post-herpetic neuralgia. This is the most common complication of shingles. Its still not clear how it can be prevented or what the best treatment is.

Shingles typically causes a rash accompanied by pain in the affected area. The pain normally goes away when the rash goes away. This usually happens after two to four weeks. Pain that continues for longer is referred to as post-herpetic neuralgia. The word “post-herpetic” means “post-herpes” because the pain arises after infection by the herpes zoster virus. In very rare cases pain can come back after a shingles infection, even if it had already gone away and the rash has disappeared.

The main symptom of post-herpetic neuralgia is pain in the nerves . The skin is often overly sensitive and itchy as well. This can make it difficult or painful to wash yourself, turn over in bed, or hug someone. The pain and itching can be very severe and might keep you from sleeping.

When You Should See Your Doctor

How long does shingles last? Timeline and treatment

Go to your doctor as soon as you see the rash, as treatment is most effective if its started early.

Your doctor may prescribe antiviral medicine, which may help you recover faster and will reduce the chance that the pain will last for a long time.

Your doctor may also give you medicine for pain relief.

See your doctor again if:

  • you get any blisters on your face
  • your fever or pain gets worse
  • your neck gets stiff, you cant hear properly or you feel less able to think clearly
  • you develop new symptoms such as drooping or weakness to one side of your face
  • the blisters show signs of infection or if you see milky yellow drainage from the blister sites.

Call Healthline if you are unsure what you should do.

Recommended Reading: How Do I Get Rid Of Shingles Scars

Which Antiviral Medication Is Best For Shingles

The antiviral medications used to treat shingles are , , and . They are all effective at helping shingles rashes crust over and heal, and they help reduce pain as you are healing.

In head-to-head studies, a 7-day course of valacyclovir worked faster than a 7-day course of acyclovir at reducing pain. Famciclovir is equivalent to valacyclovir for healing shingles rashes and reducing pain from them. Acyclovir needs to be taken 5 times a day, while Famciclovir and valacyclovir both need to be taken 3 times a day.

Its worth noting that these antiviral medications dont prevent postherpetic neuralgia, which can happen to some people with shingles. And antiviral ointments like Zovirax will do nothing for the rash from shingles.

How Common Is Shingles

Shingles affects 1 out of every 3 people in the United States. More than 1 million cases of shingles are diagnosed every year. The risk of shingles increases as you get older, with about half the cases occurring in people over the age of 50. Shingles develops in about 10% of people who have had chickenpox at an earlier time in their life.

Read Also: How To Treat Shingles Virus

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