Inhibition Of Inflammatory Response
Inhibition of the inflammatory response promotes nerve regeneration by preventing SCs from apoptosis , and magnesium supplements have also been reported to prevent motor neuron death in neonatal sciatic nerve injury . Magnesium ion can promote peripheral nerve repair by inhibiting inflammation.
Pan et al. found that a high magnesium diet significantly increased magnesium concentrations in plasma and nerve tissue, which improved neurobehavioural and electrophysiological functions and reduced the deposition of inflammatory cells and inflammatory cytokines expression. High magnesium supplementation inhibits the expression of MCP-1 and RANES, thereby inhibiting macrophage deposition and myelin clearance . Meanwhile, macrophages are a principal source of many inflammatory factors. However, it should be noted that the low magnesium environment might exert an opposite effect of enhancing inflammation in the damaged nerves compared with high concentration. Meanwhile, Pan et al. also found that high magnesium supplementation could reduce the apoptosis of SCs by promoting the expression of bcl-2 and bcl-XL and then down-regulating active caspase-3 and cytochrome expression.
Why Is Shingles Bad
Shingles is not fun for anyone, but its negative impact can be significantly worse for some.
The General Experience: Herpes zoster causes a distressing rash that typically occurs in a stripe around the left or right side of the body. This will last for weeks with pain, tingling and itchiness. Medical News Today describes the pain as being a constant dull, burning, or gnawing pain, or sharp, stabbing pain that comes and goes.
In rare cases the rash may not be limited to a single stripe and will instead appear more like a widespread chickenpox rash.
Other symptoms can include fever, headache, chills and an upset stomach.
While having one episode of the shingles rash is common, multiple episodes can happen over time in some cases.
Lasting Nerve Damage:WebMD reports that up to 50 percent of those over age 60 who havent been treated for their shingles will develop postherpetic neuralgia . The CDC states that approximately 10 to 13 percent of people who get shingles will experience PHN. PHN occurs when the varicella-zoster virus damages the nerves.
Those with postherpetic neuralgia experience mild to devastating pain when touched. The pain can be very mild or be devastating depending on the specific case. PHN can cause issues for patients for a few months, years or even for the rest of their lives.
What Is Postherpetic Neuralgia
Postherpetic neuralgia is a complication of shingles infection . Shingles is caused by the reactivation of the varicella-zoster virus, which is the same virus that causes chickenpox.
Shingles causes a painful, blistering rash and other symptoms. The rash most commonly occurs in a band pattern on one side of your body, usually on your trunk . The rash turns into blisters. As the rash/blisters go away, pain may remain. When pain remains, the condition is called postherpetic neuralgia.
Also Check: How Long Does Shingles Last With Medication
Shingles & Postherpetic Neuralgia
It stays dormant for decades, waiting for the right time to reactivate or awaken. When the virus wakes up, it will spread along and within the closest major nerve to its sleeping place causing a painful condition we call shingles. Shingles usually begins with fever and headache, accompanied by itchiness and oversensitivity in a distinct and limited area of your skin. This resolves into a characteristic stripe, or belt like rash in which small blisters form. The pain can be intense and even last for years after the rash disappears, a condition referred to as postherpetic neuralgia . PHN is notoriously difficult to treat, so choosing the right pain management doctor is crucial.
At the Ainsworth Institute of Pain Management, we are uniquely trained and specialized in treating shingles and PHN. Our board certified pain management specialists can offer a combination of treatment options, many not available anywhere else.
What causes the varicella zoster virus to reactivate is not fully understood. It is known, however, that shingles are likely to appear when someones immune system is impaired, either by age, disease or psychological stress.
You May Like: How Much Does A Shingles Shot Cost At Walgreens
Who Is At Risk Of Getting Postherpetic Neuralgia
Factors that increase the risk of developing postherpetic neuralgia include:
- Older age: The chance of developing postherpetic neuralgia increases with age. If youre older and develop shingles, youre more likely to develop PHN and have longer lasting and more severe pain than a younger person with shingles. About 10 to 13% of people over age 50 who have had shingles will get PHN. People under age 40 rarely get PHN.
- Weakened immune system: Your immune system weakens as you get older, which allows the inactive varicella-zoster virus to become active again and cause shingles in some people. Medical conditions that can weaken your immune system include cancer, chronic infectious diseases , being an organ transplant recipient or taking medications that weaken your immune system .
- Severity of your shingles: If you have a severe rash, you have a greater chance of PHN.
- Painful, itchy or tingly feeling before shingles rash: If you had these symptoms in an area of skin a few days before your shingles rash broke out, you are at higher risk of PHN.
- Waiting to see your healthcare provider after shingles rash: If you wait longer than three days after your rash appeared missing the window to receive antiviral drugs you have an increased chance of PHN.
Don’t Miss: What Causes The Disease Shingles
Who Gets Postherpetic Neuralgia
About 1 out of 5 people who have shingles will have these sharp, ongoing pains afterward. Certain things can increase your chances of getting it:
- Age: Most people who get postherpetic neuralgia are older than 60.
- Gender: Women seem to get it more than men.
- Early symptoms: People who have numbness, tingling, or itching before a shingles rash even appears tend to get the lingering pain later.
- Pain at the start: If you had severe pain or a rash during the beginning of your outbreak, you have a greater chance of the neuralgia later.
- Other health problems: People with ongoing conditions that can weaken the immune system, like HIV and cancer, seem more likely to get it.
Help Is Available For Phn
Fortunately,early treatment for shingles can lower your chances of getting PHN.
For some people, the pain becomes refractory, or resistant to treatment, explains Dr. Rosenquist. So we want to treat shingles as fast as we can ideally as soon as somebody feels a tingling or burning sensation, even before a rash develops.
Sheadds that whenever nerve pain is involved, some people respond to treatment andsome dont.
However,medications taken orally or injected that can target the affected nerves may beable to stun the nervous system into behaving properly. That meanstransmitting the appropriate signal to the brain.
Read Also: What To Eat If You Have Shingles
Surface Modification Of Magnesium And Its Alloys
Although magnesium alloy and Mg-based metallic glass can significantly improve the corrosion resistance of magnesium and slow down the degradation rate, the long-term neurotoxicity of zinc, calcium, and other ions released from magnesium alloys in vivo still needs to be considered, and its corrosion resistance also needs to be further improved. Therefore, the surface modification of magnesium and its alloys become the focus of research and application of peripheral nerve regeneration now.
Surface modification methods of magnesium and its alloys mainly includes conversion coating, anodization, micro-arc oxidation and others. In contrast, in terms of biomedical and neural application, the frequently used way of surface modification of magnesium and its alloys is polymer coating by electrospinning, electrochemical deposition, dip-coating, spray-coating, spin-coating, and other ways. Moreover, it will lead to differences in the coating performance if different coating ways are applied .
There are some other coatings to be studied. Monfared et al. coated Mg70Zn26Ca4 ribbons with tannic acid /poly . They investigated the corrosion resistance, and biocompatibility was higher than the uncoated and significantly higher than pure Mg. What is more, SCs had an excellent initial attachment with typical morphology on the surface of coated ribbons in vitro.
A Word About The Shingles Vaccine
If you are age 60 or over and have not had shingles, talk to your doctor about getting the shingles vaccine. Not only will it reduce your risk of developing shingles, but if you do develop shingles, youll be more likely to have a mild case. And, just as important, youll be much less likely to develop PHN if youve had the vaccine.
Recommended Reading: When Are You Not Contagious With Shingles
What Does Postherpetic Neuralgia Feel Like
You usually have pain on one side of your body, where you had the blisters. The feeling is described as shooting, sharp, or stabbing. Other signs you have neuralgia include:
- It hurts to be touched: Sometimes, you canât bear clothing rubbing on your skin. You might feel discomfort from a light breeze.
- Long-lasting pain: This condition can last 3 months or longer after the shingles rash has healed. In some people, itâs permanent. For most, it gets better over time.
- Other sensations: Sometimes, you might feel burning, itching, tingling, or aching along with the shooting feelings. Some people feel numb or get headaches.
- You may also get a fever and generally feel worn-out.
Rebooting The Nervous System
Its like restarting a computer, Dr. Rosenquist says. When its running slowly or acting weird, you restart it. We are trying to turn that nerve off. When it comes back on, hopefully, it will send an appropriate transmission as opposed to a pain transmission.
Treatmentoptions for PHN patients include:
Patientswith refractory PHN rarely need opioid pain medication. However,you should be evaluated by a physician. We cant make a blanket statement abouttreatment. It is individualized, she says.
Recommended Reading: Cvs Pharmacy Shingles Vaccine
You May Like: How Can I Get Shingles Vaccine Free
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 youre still experiencing the pain of active shingles, sans rash, youre 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, youre more likely to develop PHN.
- Other health conditions: People who have suppressed immune systems are more likely to get PHN.2,3
Also Check: Cost Of Shingles Vaccine Walgreens
What Can I Take To Feel Better
Your doctor has a host of ways to treat your pain after shingles, including a variety of medications. They include:
Anticonvulsants: These medications were developed to control seizures, but they can also help reduce the pain of postherpetic neuralgia. Examples are:
Talk to your doctor or pharmacist about side effects of any new prescription or over-the-counter medication.
Recommended Reading: What Antiviral Is Used For Shingles
How Is Shingles Diagnosed
To diagnose shingles, your doctor will ask you about your symptoms and also do an examination. Some people may have pain with no rash or rash with no pain. In such cases, a blood test may be needed to confirm the diagnosis. See your doctor as soon as you think you may have shingles. This should be within 4872 hours of the rash first appearing, so you can be given antiviral medication to reduce the risk of complications. The earlier that antiviral medication is given, the more effective it is. If it is a holiday period, go to an afterhours clinic.
Go With Gabapentin For Phn
If you do have the lasting nerve pain of PHN, some doctors will prescribe anti-seizure medications, including Neurontin or Lyrica . Even though they were developed as anti-seizure medicines, they can help modulate the nerve pain until the nerves can heal, Dr. Auwaerter explains. These treatments can reduce pain signaling from the nerves to the brain by calming your neurotransmitters for a short time. They are FDA-approved as an effective treatment for PHN. Like antivirals, they require frequent daily dosing, usually three times per day.
Recommended Reading: Shingles Shot Cvs
Don’t Miss: How Long Should Shingles Pain Last
The Corrosion Of Magnesium
The ideal degradation rate of magnesium should match the growth rate of nerve tissue, but in reality, the degradation rate of magnesium is faster than the growth rate of tissue, which fails to provide long-term physical support and play the biological function of promoting nerve regeneration . In vivo, magnesium mainly undergoes electrochemical reaction, which is affected by the properties of the material itself and the local microenvironment such as pH and protein. Magnesium mainly undergoes pitting corrosion in vivo, which is more likely to lead to material fracture and is not conducive to nerve regeneration .
The corrosion process of magnesium can be divided into the following two steps: In electrolyte solution, magnesium acts as anode to occur galvanic cell reaction, losing electrons and generating Mg2+, while water gets electrons and generates H2 and OH. Then Mg2+ reacts with OH and forms Mg2, which is deposited on the surface of the material and has a certain protective effect on magnesium As time goes on, Mg2 reacts with Cl in body fluid to form MgCl2 which is more soluble in water, resulting in Mg2 falling off and magnesium corrosion. In order to have a better application in magnesium promoting peripheral nerve regeneration, the improvement of material properties can provide enough support to maintain sufficient strength and be gradually degraded and absorbed by the human body .
Table 1. The corrosion resistance improvement of Magnesium.
When Should You Contact A Doctor
If you recently had shingles and the pain continues past the 24 week mark, tell your doctor. They can evaluate your symptoms and medical history and discuss next steps. There are treatment options for postherpetic neuralgia, even if you did not treat the shingles outbreak.
You May Like: How Much Is The Shingles Shot At Walmart
Can Postherpetic Neuralgia Be Prevented
The Food and Drug Administration has approved a shingles vaccine, which can reduce your chance of getting shingles and PHN. The recombinant herpes-zoster vaccine is recommended to prevent shingles in adults ages 50 and older. The vaccination is given in two doses, two to six months apart. The two-dose vaccine is 90% effective at preventing shingles and PHN. Protection lasts at least for four years after you get vaccinated.
If you have never had chickenpox or have children who have never had chickenpox, getting the chickenpox vaccine can help prevent getting this infection in the first place. If you never get chickenpox, you will not have the varicella-zoster virus in your body and will not get shingles or PHN.
Risk Factors For Nerve Pain After Shingles
Researchers have long known that older people are more likely to get PHN, the nerve pain after shingles, but recent studies have found other factors that increase risks.
In one study published in the journal Neurology, researchers — including Dworkin — looked at data from 965 people with shingles. The researchers identified five risk factors for developing PHN in people who had been recently diagnosed with shingles:
- Presence of symptoms before the rash appeared, like numbness, tingling, itching, or pain
- Severe pain during the illness’s initial stages
Importantly, the researchers found the more risk factors you have, the greater the risk of developing PHN.
For instance, 17% of women with shingles and 26% of those who had severe pain went on to get PHN. But 50% of women who were over age 60 and had symptoms before the rash, severe rash, and acute pain went on to get PHN.
Recommended Reading: Is The Shingles Shot Covered By Medicare
What Are The Complications Of Postherpetic Neuralgia
PHN itself is a complication of shingles. A serious complication of PHN is addiction to pain medications. Some patients may have an inability to live a normal lifestyle because of constant pain, while others have sleep and activities limited or even prohibited by touching the affected area, including just having contact with their own clothing. Patients taking opioids may become very constipated. In a few cases of PHN, muscle weakness can be an additional complication.
Also Check: How Much Is Shingles Shot At Walgreens
Consider The Benefits Of Capsaicin
Another topical treatment is made from chili peppers, and research has shown that it can help with shingles pain reduction. Capsaicin comes in OTC and prescription forms, and it can be applied topically as a cream or by wearing a patchbut its tricky to administer properly. A report in Molecules noted that capsaicin can cause a burning sensation on the applied area, especially if applied in frequent dosages. In rare cases, it can also cause blood vessel constrictions. Be sure to get your doctors guidance before trying this method on your own.
Specific treatment for shingles will be determined by your healthcare provider based on:
- Your age, overall health, and medical history
- How long the shingles have been present
- Extent of the condition
- Your tolerance for specific medicines, procedures, or therapies
- Expectations for the course of the condition
- Your opinion or preference
There is no cure for shingles. It simply has to run its course. Treatment focuses on pain relief. Painkillers may help relieve some of the pain. Antiviral drugs may help lessen some of the symptoms and reduce nerve damage. Other treatments may include:
- Creams or lotions to help relieve itching
- Cool compresses applied to affected skin areas
- Antiviral medicines
You May Like: Shingles Rash Pictures On Back