How To Treat Pain After Shingles

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

The Basics Of Shingles And Postherpetic Neuralgia

Although anyone can get chickenpox, its more common in children and teens, especially those who havent received the chickenpox vaccine. Unfortunately, even after chickenpox is over, the varicella-zoster virus that caused the condition can remain dormant in the body for decades, emerging later in life as shingles. If the episode of shingles damages nerve tissue, this can result in postherpetic neuralgia.

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.

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Antidepressants May Offer Surprising Relief

Antidepressants may have been invented for depression, but they are also known to modulate peripheral nerves, Dr. Auwaerter says, thereby dulling PHN pain. Your physician may suggest Pamelor or Aventyl or Elavil . Dr. Auwaerter adds that these medications can sometimes cause side effects like fatigue and sluggishnessthough PHN patients usually only need a low dose, which is unlikely to cause major adverse effects.

New Topical Treatment For Continued Pain After Shingles

• Known sensitivity or allergy to an amide-type local anesthetic agent
• Existing conditions that make participation unsafe
• Immunocompromised
• Herpes zoster in any dermatome affecting the face or scalp
• Affected skin area is greater than 420 square cm
• Affected area includes skin breakdown or nonintact skin
• Affected area consists of more than one contiguous area

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier : NCT00566904

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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.

How To Treat Nerve Pain Caused By Shingles

This article was medically reviewed by Luba Lee, FNP-BC, MS. Luba Lee, FNP-BC is a board certified Family Nurse Practitioner and educator in Tennessee with over a decade of clinical experience. Luba has certifications in Pediatric Advanced Life Support , Emergency Medicine, Advanced Cardiac Life Support , Team Building, and Critical Care Nursing. She received her Master of Science in Nursing from the University of Tennessee in 2006.There are 31 references cited in this article, which can be found at the bottom of the page.wikiHow marks an article as reader-approved once it receives enough positive feedback. In this case, 84% of readers who voted found the article helpful, earning it our reader-approved status. This article has been viewed 88,320 times.

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What Causes Shingles Pain

Chickenpox, shingles, and postherpetic neuralgia all result from infection with a single virus called varicella zoster virus . Most people catch the varicella zoster virus as children, itch and shiver through the rash and fever of chickenpox, and get better.

But that’s not necessarily the end of the story of varicella infection. After a bout of chickenpox, our immune systems never completely eradicate the VZV virus. They just chase it into hiding. Varicella retreats into nerve cells deep under the skin, near the spine.

For most of us, VZV lies dormant inside our bodies throughout our lives, never causing further problems. In about one-third of people, however, VZV infection has a second act. The virus emerges from hiding, travels along a nerve to the skin, and erupts in a bumpy, painful rash on one side of the body. This sneak attack is called herpes zoster, or shingles.

Natural Remedies For Shingles

Shingles is a viral infection that causes a painful rash. The varicella zoster virus causes this viral infection. Its the same virus that causes chickenpox.

If you had chickenpox as a child, the shingles virus lies dormant in your body. The virus can reactivate later in life and cause a shingles rash. The rash can occur on any part of your body but typically only affects small sections.

Pain is usually the first symptom of shingles. The rash and fluid-filled blisters form within a couple of days after the onset of pain. Some people with shingles also have a fever, sensitivity to light, and fatigue.

According to the Centers for Disease Control and Prevention , about 1 in 3 people in the United States will develop shingles at some point in their lifetime.

The shingles virus can last between two and six weeks. Shingles isnt life-threatening, but some people experience postherpetic neuralgia. This is when nerve fibers become damaged, causing shingles pain that lasts for weeks or months after the rash clears.

Theres no cure for shingles, but your doctor can prescribe antiviral medication to help shorten the duration of the virus and reduce symptoms.

Although an antiviral is an effective treatment for shingles, its not the only option. Several natural remedies may also reduce pain and discomfort.

Dry your body completely and then wash your towel to avoid spreading the virus to others.

• orange and yellow fruits

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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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Soak In A Colloidal Oatmeal Bath

This DYI option hasnt been tested for shingles specifically but experts say it may provide some skin relief while your rash is still acting up. Colloidal oatmeal is made by grinding oats into a fine powder . A study in the Journal of Drugs in Dermatology found that this natural remedy has antioxidant and anti-inflammatory properties which can make it helpful in treating irritated skin. Add colloidal oatmeal to a bath of cool or lukewarm water and soak for about 10 minutes, once per day, for as long as your rash lasts.

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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.

Shingles And Postherpetic Neuralgia: What Are The Risk Factors

You can’t control whether you’ll catch the chickenpox virus. Fully 99.5% of adults in the U.S. carry it, whether or not they remember having had chickenpox. But why do one-third of those people get shingles — and some of them go on to develop postherpetic neuralgia?

The risk of postherpetic neuralgia also goes up with age. More than 80% of cases of postherpetic neuralgia occur in people over 50 years old. “It’s likely that the natural decline of immunity with age is responsible,” says Ralph.

The results of one study showed that age had a huge effect on the risk for postherpetic neuralgia after shingles:

• Among people under 60 years old who had shingles, less than one in 50 developed postherpetic neuralgia.
• In people aged 60 to 69, about 7% of shingles sufferers developed postherpetic neuralgia.
• In those age 70 and older, almost 20% developed postherpetic neuralgia after a bout of shingles.

Race seems to matter, too. For unknown reasons, white Americans get shingles and postherpetic neuralgia at more than twice the rate of African-Americans in their age group.

“People whose immune systems are impaired by drugs or diseases like AIDS are also more prone to zoster and PHN,” adds Ralph.

Exposure to someone with chickenpox or shingles does not increase your personal risk, however. In fact, experts believe that the slight immune stimulation may boost natural defenses, making you less likely to develop shingles or PHN.

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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.

Are There Treatments I Can Put On My Skin

You might find relief with topical treatments. You can talk to your doctor about:

Creams: Some of these contain capsaicin, the ingredient in cayenne pepper that gives it a kick. Examples are Capsin and Zostrix. You can buy this over the counter but make sure your doctor knows if you plan on using these.

Patches: Capsaicin is also in Qutenza, which is applied via a patch for one hour every 3 months. You need to visit the doctorâs office for this.

Lidoderm is a patch that has a numbing agent called lidocaine. Itâs applied directly to the painful area of skin. You need a prescription.

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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.

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.

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Treat Your Body And Mind

You can get worn down mentally when youâre in constant pain. Stress can make it seem even worse. Self-care starts with treating your rash, but donât stop there. Your mind and emotional state need to be cared for as well.

5. Stick with good habits: Your bodyâs working hard to fight the varicella-zoster virus that causes shingles. To give it the right support, you can:

• Eat nutritious food and have regular meals. Ask someone to make a run to the grocery store for fresh fruit and such if youâre not up for it.
• Try to get a good nightâs sleep and rest anytime you need to.
• Do gentle exercises, such as walking or stretching. Light activity can help take your mind off the pain. Keep it simple though, and check with your doctor if youâre trying something new.

6. Distract yourself: Sometimes, the best thing you can do is to put your focus elsewhere. Here are a few things to try:

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.

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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.

What Are The Complications Of Shingles

Symptoms of shingles usually dont last longer than 3 to 5 weeks. However, complications can happen. The main complications that can result from shingles include:

• Postherpetic neuralgia . The most common complication of shingles is called postherpetic neuralgia . This continuous, chronic pain lasts even after the skin lesions have healed. The pain may be severe in the area where the blisters were present. The affected skin may be very sensitive to heat and cold. If you had severe pain during the active rash or have impaired senses, you are at increased risk for PHN. The elderly are also at greater risk. Early treatment of shingles may prevent PHN. Pain relievers and steroid treatment may be used to treat the pain and inflammation. Other treatments include antiviral drugs, antidepressants, anticonvulsants, and topical agents.
• Bacterial infection. A bacterial infection of the skin where the rash happens is another complication. Rarely, infections can lead to more problems, such as tissue death and scarring. When an infection happens near or on the eyes, a corneal infection can happen. This can lead to temporary or permanent blindness.

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