Who Is At Risk Of Getting Shingles
Shingles typically affects older people, but it can also occur in healthy younger persons and even in children. Those whose immune systems have been weakened by cancer, HIV infection, AIDS, or treatment with certain medicines are also at increased risk of getting shingles.
- Anyone who has had chickenpox is at risk of getting shingles later in life. About 1 in 3 people who have not been immunised against chickenpox or shingles will get shingles in their lifetime.
- Shingles usually affects older people. The older you are if you get shingles, the higher your risk of getting serious disease. People who have a weakened immune system are also at risk of getting more severe disease, even if they are young.
- Women have a higher risk of getting shingles than men.
- Most people who develop shingles have only 1 episode during their lifetime. However, you can have shingles more than once.
An attack of shingles during pregnancy will not harm the unborn baby. The mother is already carrying the varicella zoster virus before developing shingles and there is no increase in the risk of passing it on to the fetus if shingles develops. However, an attack of chickenpox during pregnancy can be serious and requires urgent medical attention.
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What Are The Potential Side Effects
There are a few potential side effects of trigeminal nerve blocks for shingles, but they are generally rare and not overly serious. The most common side effect is temporary numbness or tingling in the area where the block was injected. This usually goes away within a few hours. Other potential side effects include:
-Bleeding or bruising at the injection site
-Infection
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.
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Have Shingles Get Treatment Take Action
If you have shingles, it’s important to talk to your doctor about your risk for developing PHN. Ask whether preventative treatment with antiviral drugs makes sense. If your doctor says it’s not necessary, ask why.
The full implications of the psychological risk factors for PHN aren’t clear yet, says Dworkin. But he suggests that people with shingles should try to stay active and connected.
“If psychological distress is a risk factor for PHN,” he says, “then we think that people who have shingles might benefit from getting out and not being isolated and homebound.”
You might make an effort to stay connected to family and friends and not to dwell on your symptoms. Also, keep in mind that even if you do develop PHN, there are treatments that can help.
“We have about a half dozen types of drugs that are used as first-line treatments for PHN,” says Dworkin. They include lidocaine patch , pregabalin , gabapentin , capsaicin , carbamazepine , tricyclic antidepressants, and painkillers.
The most important thing is to get prompt medical attention if you think you might have shingles.
“If you have a one-sided rash — especially if you’re over 50 — see your doctor right away,” says Dworkin. “It could be shingles. And we know that prompt treatment can dramatically reduce the likelihood of developing long-term pain.”
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What Are The Symptoms Of Nerve Pain
Nerve pain often feels like a shooting, stabbing or burning sensation. Sometimes it can be as sharp and sudden as an electric shock. People with neuropathic pain are often very sensitive to touch or cold and can experience pain as a result of stimuli that would not normally be painful, such as brushing the skin.
Its often worse at night. It might be mild or it might be severe.
People who have nerve pain often find that it interferes with important parts of life such as sleep, sex, work and exercise.
Some people with nerve pain become angry and frustrated, and may have anxiety and depression.
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What Are Typical Symptoms Of Post
The symptoms of PHN are very often limited or localised to the area of skin where the shingles outbreak first occurred.1 This is why PHN is often referred to as being a type of localised neuropathic pain.3
The chronic pain associated with PHN can be described as burning pain, stabbing pain, itching or aching. Patients with PHN often have hypersensitive skin, like a bad sunburn, and may feel severe pain from the touch of clothing on the affected area, a condition doctors call allodynia.1,4
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.
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Steroids Can Sometimes Help
Dr. Auwaerter notes that some older research done in the early 2000s supports the use of the steroid prednisone taken with an antiviral for short-term shingles pain relief, as well as a decreased risk of developing the more serious PHN. Steroids may be especially beneficial for people over 50, who are at higher risk for PHN. However, they can increase your risk of immunosuppression over time, so theyre generally used for shingles for just one to two weeks. If youre trying this approach, work closely with your doctor to manage the appropriate dosing.
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What Causes Nerve Pain
Nerve pain can be due to problems in the central nervous system , or in the nerves that run from there to the muscles and organs. It is usually caused by disease or injury.
Common causes include:
- trapped nerves, such as in carpal tunnel syndrome
There are other conditions associated with nerve pain.
Sciatica is pressure on the nerves of the lower back that causes pain down the leg. The pain can be accompanied by pins and needles, numbness or weakness in the leg.
Fibromyalgia is a chronic pain syndrome associated with burning or aching pain in different parts of the body. The cause is not well understood, but it can be triggered by emotional distress and poor sleep. There may be genetic factors, too.
Peripheral neuropathy occurs when the peripheral nerves that connect the brain and spinal cord to the rest of the body are damaged. Its caused by diabetes, autoimmune diseases and other conditions.
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What Types Of Nerve Blocks Can Alleviate Shingles Pain
Intercostal nerve blocks for shingles pain: Intercostal nerves are located below the ribs, going from the back to the chest . In our pain clinic, we often treat pain conditions affecting this area, like PHN, with intercostal nerve blocks. These nerve blocks help alleviate the pain, stimulate circulation, and reduce inflammation in the area.
Sympathetic nerve blocks: Different types of sympathetic blockades can be applied depending on the affected area: lumbar sympathetic block , stellate ganglion block, and sphenopalatine block .
Trigeminal nerve blocks: The trigeminal nerve is located in the face. Although not common, sometimes shingles affect the face. When this happens, we can use trigeminal nerve blocks to help alleviate shingles pain in the area.
Can Shingles And Postherpetic Neuralgia Be Prevented
Shingles can only be prevented if you never have chickenpox, or if you have very good immunity against the chickenpox virus . Most people in the UK have chickenpox as a child. However, immunity to the chickenpox virus reduces as you become older.
There is a vaccine against the varicella-zoster virus which is now offered routinely to people in the UK aged 70-79 years. The efficacy of the vaccine declines with age and so it is not recommended for people aged 80 years or older. This vaccine is the most effective way of preventing the development of PHN. It is a very effective and safe vaccine.
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How Effective Are Nerve Blocks In Treating Shingles Pain
Nerve block therapy is one of the safest and most effective strategies to treat shingles pain. The effects vary from patient to patient and depend on the type of nerve block.
Nevertheless, remember your doctor must analyze your case before deciding which is the best treatment for you. At our pain center, one of our specialists will create a comprehensive pain management plan for you depending on your personal needs.
What Are The Symptoms Of Postherpetic Neuralgia
Common postherpetic neuralgia symptoms include:
- Burning, sharp, jagging or aching pain in the area where the shingles rash appeared.
- Itchiness or numbness at or near the area of the former rash.
- Pain that is constant or comes and goes. Pain typically lasts, on average, for three months after the rash has healed, but can last for more than a year or longer.
- Pain at affected skin area can be brought on even with a light touch .
- Pain gets worse at night or in heat or cold temperatures.
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Who’s At Greatest Risk For Lasting Shingles Nerve Pain
Persistent nerve pain after a shingles infection is more common than you might think. Around 10 to 18% of people who get shingles will experience PHN. In most people, shingles nerve pain goes away on its own after a few months. But when this pain lingers, it can be challenging to manage.
Risk factors for this complication include:
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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.
What Causes Shingles
If you have had chickenpox, you were infected with the varicella zoster virus. In the past, nearly every child would become infected by the time they were an adult, but now we have a vaccine that protects against chickenpox. When you recover from chickenpox, the virus hides out in nerve cells and stays dormant . You develop shingles when this dormant virus reactivates. This can happen if your immunity is lowered by getting older, during times of stress or by having cancer treatment or other conditions, eg, HIV, rheumatoid arthritis or type 2 diabetes.
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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.
What Is A Tens Unit
Transcutaneous electrical nerve stimulation, or TENS, is a method of pain relief that involves the use of a moderate electrical current. It is a small machine, and it is battery-operated. It has leads that are connected to sticky pads called electrodes.
A TENS unit is a non-invasive method used for relieving pain. Some people are able to reduce the intake of pain medications thanks to the TENS unit.
The unit is also very convenient because it is quite small, portable, and discrete. You can carry it in your pocket, or clip it onto a belt to ensure that you have instant access to pain relief throughout the day.
It has controls that allow people to apply an appropriate level of pain relief. This can be achieved by altering some aspects of the electrical current, such as intensity, frequency, and duration.
The frequency refers to the number of electrical impulses per second. High-frequency pulses range from 80 to 120 cycles per second, and they are believed to help acute pain.
Low-frequency pulses range from 1 to 20 cycles per second and are more suitable for the treatment of chronic pain.
Need to know how to use the settings on your TENS unit? Click here
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How Can I Make The Neuropathic Pain Go Away
Neuropathic pain occurs biochemically, making it a very fluid system that can often be quickly modified, resulting in pain relief. Many different chemicals in your body may be involved in your pain, and therefore it is worth trying different types of medications to see which ones work best in your case.
For many, treating the nutritional and thyroid deficiencies and eliminating the muscle spasms, which are compressing your nerves, may be enough to eliminate your pain. Others may need to take medications to suppress the pain while we look for ways to eliminate the underlying cause.
The best way to tell which chemicals are involved in your nerve pain is to simply try different medications to see what eases your pain. Basically, it is like trying on different shoes to see what fits best. The good news is that we have a large assortment of shoes that you can try on and that are likely to help you.
It is, of course, critical to begin by eliminating the underlying causes of neuropathy and giving the nerves what they need to heal. This includes the nutritional support weve discussed. In addition, the involvement of free radicals in nerve excitation was found in 1995, supporting the use of antioxidants in nerve pain. Since that time, the antioxidant lipoic acid has been shown to be helpful in diabetic neuropathy and should be tried in other neuropathies as well. You will be amazed at how much benefit you may get over time simply from optimizing nutritional support.
How Is Postherpetic Neuralgia Diagnosed
Its imperative that people suffering from shingles be under the care of a doctor. Follow-up care should include appointments to determine any lasting complications. The patient should share any and all symptoms with the doctor, who can determine if the length of time and combination of symptoms should lead to the diagnosis of postherpetic neuralgia.
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How Common Is Postherpetic Neuralgia
PHN is unusual in people aged under 50 and if it does occur it tends to be mild. PHN is more likely to develop and is more likely to be severe in people aged over 60. About 1 in 4 people aged over 60 who have shingles develop PHN that lasts more than 30 days. The older you are, the more likely it is that it will occur. It is also more common in those people who have had more severe shingles.
What Outcome Can I Expect If I Have Postherpetic Pain
Theres no standard treatment for the symptoms of postherpetic pain . Depending on the severity of your pain, you may start with over-the-counter products. If your pain is more severe, one or more prescription medications may be tried. PHN is difficult to treat. Achieving a complete symptom-free state was achieved in less than half the patients with PHN, according to one study.
PHN tends to happen in older individuals who may have other health conditions, which can complicate treatment and results. Pain can last weeks, months and even longer than a year. In some people, the pain can be debilitating. In most people, PHN lessens with time.
A note from Cleveland ClinicThe best way to not get postherpetic neuralgia is to prevent it from happening in the first place. Varicella-zoster virus causes both chickenpox and shingles. Vaccines are available to protect against developing both of these viral infections.
Once you develop chickenpox, the varicella-zoster virus remains in your body for life. If the virus reactivates and causes shingles, you have a few days around the rash outbreak to see your provider and get an antiviral medication, which can significantly lessen your symptoms. Still, if you develop PHN, your provider has many medications available to manage your symptoms.
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