What Is Shingles And Postherpetic Neuralgia
Shingles is caused by the varicella-zoster virus, the virus that also causes chickenpox. In a person who has been exposed to chickenpox — or its vaccine — the virus never really goes away. It can lie dormant in the body’s nerves.
In most cases, it stays that way. But in some — especially people with immune systems weakened by disease or treatment — the virus can reappear. This is likely to happen years or decades after the person had chickenpox.
When it comes back, the virus can cause shingles, a rash that often appears as a band on one side of the body. Early shingles symptoms can include:
- Flu-like symptoms
Itching, tingling, or extreme pain where the rash is developing may come next, and the pain can be moderate to severe.
Are you contagious? Though people who haven’t had chickenpox can catch that condition from you, the shingles itself isn’t contagious.
For reasons that experts don’t really understand, the pain of shingles lingers for some. If the pain lasts for at least 3 months after the shingles rash has healed, a person is diagnosed with PHN. In some people, the pain will subside. In others, it won’t.
“We don’t have any idea why the pain goes away in some people and not others,” says Dworkin. But the longer you have PHN — especially after a year — the less likely it is to resolve, he says.
Homeopathic Medicines For Shingles
Homeopathic treatment for shingles works in a gentle, yet effective manner to reduce the severity of the symptoms and also help clear up the infection rather than suppressing it. These medicines have no side effects and work very well for post-herpetic neuralgia.
There is no cure for shingles in the conventional system of Medicine medications are aimed to reduce the duration of shingles episode and to minimize the intensity of pain. Some commonly used medicines include
Antivirals: These do not treat shingles but are meant to reduce the severity and duration of the disease. They are not effective for postherpetic neuralgia. Side effects of antiviral medicines include nausea, dizziness, pain in stomach, mild skin rashes, joint pains, and they can also cause a sore throat.
Analgesics: Pain medications are used to treat mild to moderate pains in shingles. When the pain is severe, excessive intake of painkillers can cause side effects and trigger anxiety in a person.
Corticosteroids: Corticosteroids are indicated along with antivirals to reduce the pain and for postherpetic neuralgia. Prolonged usage of corticosteroids can cause immunosuppression.
New Drug For Lingering Shingles Pain
FDA Approves Qutenza for Postherpetic Neuralgia
Nov. 17, 2009 â The FDA has approved a new treatment for postherpetic neuralgia , the nerve pain that sometimes lingers after an attack of shingles.
The new PHN drug is Qutenza. Itâs made by Lohmann Therapie-Systems AD of Andernach, Germany, and distributed by NeurogesX Inc. of San Mateo, Calif.
PHN is excruciating, and is often described as a burning, stabbing, or gnawing pain. It starts with an attack of shingles, in which the herpes zoster virus â the chickenpox virus, lying dormant at nerve roots â reactivates.
PHN is pain that persists after the shingles scales heal. It affects 10% to 15% of people who have shingles. It may get better over time. It may not. Treatments include prescription pain medications, anticonvulsants, and antidepressants.
Now thereâs Qutenza, a radically different approach. The active ingredient in Qutenza is synthetic capsaicin, the chemical that makes chili peppers burn. There are over-the-counter capsaicin products, but the FDA notes in a news release that âQutenza is the first pure, concentrated, synthetic capasaicin-containing prescription drug to undergo FDA review.â
âThe product can provide effective pain relief for patients who suffer from PHN,â Bob Rappaport, MD, FDA director of Anesthesia, Analgesia, and Rheumatology Products, said in a news release.
Patients may receive an opioid pain drug before or after treatment.
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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 .
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.
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Topicals Are Not A Substitute For Medical Treatment
Topical products can help you manage your symptoms. But they arent a substitute for proper medical treatment.
Its important to visit your doctor if youre dealing with shingles. Your doctor can prescribe antiviral drugs and other medications that can shorten the duration of your infection and help you avoid severe complications.
The following creams may be able to help you manage shingles symptoms.
What To Do If You Think You Have Shingles
If you suspect that you have shingles, its important to visit a healthcare professional as soon as possible. According to the American Academy of Dermatology , treating shingles within the first 72 hours gives you the best chance of minimizing complications like nerve pain.
Antiviral medications or other medications only available by prescription can shorten the duration of your shingles or lessen the severity.
If a cream or other topical isnt reducing your pain, its a good idea to visit your doctor again. They may recommend trying another treatment like capsaicin cream instead of lidocaine.
If a product is making your symptoms worse, its important to stop taking it right away.
You may be able to reduce your symptoms using home remedies while youre waiting to see a healthcare professional. These include applying a wet cold compress or taking a cool bath.
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Other Treatment Recommendations For Shingles
If you think you have shingles, see your doctor as soon as possible. This increases the effectiveness of any treatment your doctor will prescribe for you. The treatment doesnt cure shingles. Its meant to help you manage the pain.
Besides acupuncture, you can use other methods to manage your pain. These include:
- antiviral drugs such as Famvir, Zovirax, and Valtrex
- over-the-counter and prescription pain relievers
- calamine lotion, colloidal oatmeal, andwet compresses
Two vaccines are available for adults ages 50 years and older. The Food and Drug Administration approved Shingrix and Zostavax for use. These vaccines reduce the risk of getting shingles. If an older adult still gets shingles after being vaccinated, the symptoms may be less intense.
Shingrix, made from a dead germ, is the preferred vaccine. People with weakened immune systems can get it. Its risky for this group to get the Zostavax vaccine, which contains a live but weakened germ.
Zostavax has not been sold in the United States since November 18, 2020. If you received this vaccine, the
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.
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What Helps With Back Pain From Shingles
Start on antiviral medications as soon as you notice symptoms of shingles to help reduce your risk of developing shingles back pain. Pain medications such as tricyclic antidepressants and ‘gastroretentive gabapentin’ are prescribed for pain caused by outbreaks and PHN. Capsaicin 8% patches, cold compresses, stress-reducing activities, extra sleep, proper diet, and over-the-counter lidocaine numbing creams can also help you manage these symptoms.
Shingles Back Pain: Symptoms Causes And Treatment
As an adult, the infections that we had in childhood can sometimes rear our heads again as we grow older. Shingles are one such condition. As with many activities and health issues that affect the back as we age, shingles back pain is a common challenge among those who develop the condition.
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Types Of Pain: Nociceptive Vs Neuropathic
- Nociceptive pain comes from damaged tissues outside the nervous system, such as muscles and joints. People say the pain feels aching and throbbing.
- Neuropathic pain comes from the nerves that transmit pain signals from the body to the brain. People describe the pain as burning, stinging, or shooting. It may radiate from one area of the body to another. It may be accompanied by numbness and tingling.
Image: Thinkstock
Doctors usually try one type or the other , although they can be combined. They are taken daily in addition to conventional pain relievers.
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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How Should I Take Gabapentin
Take gabapentin exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take in larger or smaller amounts or for longer than recommended.
If your doctor changes your brand, strength, or type of gabapentin, your dosage needs may change. Ask your pharmacist if you have any questions about the new kind of gabapentin you receive at the pharmacy.
Both Gralise and Horizant should be taken with food.
Neurontin can be taken with or without food.
If you break a Neurontin tablet and take only half of it, take the other half at your next dose. Any tablet that has been broken should be used as soon as possible or within a few days.
Swallow the capsule or tablet whole and do not crush, chew, break, or open it.
Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device .
Do not stop taking this medicine suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctors instructions about tapering your dose.
In case of emergency, wear or carry medical identification to let others know you have seizures.
This medicine can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using gabapentin.
Store both the tablets and capsules at room temperature away from light and moisture.
Store the liquid medicine in the refrigerator. Do not freeze.
Why Does The Pain Persist In Some People
The symptoms of PHN can last for several months in some people. Shingles causes inflammation of the nerve. Pain can be expected whilst the rash and inflammation occur. However, it is not clear why some people continue to have pain when the inflammation has gone. It is thought that some scar tissue next to the nerve, or in the nearby part of the spinal cord, may be a factor. This may cause pain messages to be sent to the brain.
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Lidocaine Cream And Patches
2017 study suggests that its one of the best-tolerated treatments for PHN.
PHN is a complication of shingles characterized by long-term nerve pain after your rash disappears. The CDC says that about 10 to 18 percent of people experience PHN after shingles.
Lidocaine is often administered in patches. The study linked above notes that up to 3 patches can be applied in a 12-hour window.
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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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.
Mezereum: For Shingles With Blisters With Scabs
Mezereum is prepared from a plant called Daphne Mezereum . This plant belongs to the vegetable kingdom. The bark of the shrub is used to prepare Mezereum. This plant is native of hilly woods of nearly whole of Europe and Russian Asia.It is indicated for Herpes Zoster with burning pains. Eruptions ooze out with a discharge of acrid, gluey moisture from thick crusts. Scab formation over herpetic blisters with pus beneath it, itching over affected skin rash that gets worse by warmth, a sensation of insects crawling are some symptoms. The eruptions are crusty with white scabs and can bleed when touched. The skin becomes cold in those places where there is intense itching.
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How Long Does Postherpetic Neuralgia Last
Postherpetic neuralgia can last for weeks, months, or in some people, years after the shingles rash goes away. In most people, shingles pain goes away in one to three months. However, in one in five people, pain lasts more than one year.
The pain from PHN can be so severe in some people that it disrupts their life. Researchers dont know why some people have severe or long-lasting pain and others do not.
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.
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