Severe Back Pain From Shingles

See A Pain Management Specialist

Sometimes the nerve pain is just too intense to manage on your own. If youre experiencing moderate to severe shingles pain, see a pain management specialist for treatment options to help you stay comfortable while you heal.

If youre suffering from shingles related pain and nerve damage, we can help. For more information, contact Republic Spine and Pain to schedule an appointment at one of our locations in Austin, Georgetown, or Lakeway, Texas.

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Where A Shingles Rash Forms

A shingles rash typically occurs on the face, neck, or chest, on just one side of the body.

The affected area of skin is called a dermatome, a region supplied by the sensory fibers of a specific spinal nerve. Outbreaks can involve two adjacent dermatomes, but rarely two non-adjacent dermatomes.

The exception may be in people whose immune systems are severely comprised, such as those with advanced HIV infection. They’re often at risk of disseminated shingles , shingles of the eyes or internal organs, and a recurrence of shingles within six months.

Is Shingles Contagious

People cannot catch shingles from another person but it is possible for someone to catch chickenpox from a person with shingles. This can only happen if someone has not had chickenpox or received the chickenpox vaccine.

The varicella-zoster virus present in shingles blisters can be spread if someone comes into direct contact with the fluid. It remains contagious until the last blister has dried up and scabbed over.

The risk of spreading the virus is low if the rash is kept covered. Individuals with shingles should avoid contact with anyone who has not already had chickenpox. This is particularly important in the following cases:

• Infectious Diseases / Bacteria / Viruses

10 sourcescollapsed

• Gilden, D., Cohrs, R. J., Mahalingam, R., & Nagel, M. A. . Neurological disease produced by varicella zoster virus reactivation without rash. Current Topics in Microbiology and Immunology, 342,, 243253

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How Is It Treated

It is best to start treatment as soon as possible after you notice the rash. See your healthcare provider to discuss treatment with antiviral medicine, such as acyclovir. This medicine is most effective if you start taking it within the first 3 days of the rash. Antiviral medicine may speed your recovery and lessen the chance that the pain will last for a long time.

Your provider may also recommend or prescribe:

• medicine for pain
• antibacterial salves or lotions to help prevent bacterial infection of the blisters
• corticosteroids

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

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Tips For Managing Shingles Pain

Shingles is caused by a virus, so it cant be treated with antibiotics or other medications you would take to treat a bacterial infection. The virus typically lasts between two to four weeks for most people, but there are many steps you can take to manage the rash and keep yourself comfortable as you heal.

What Is Postherpetic Neuralgia

Did you have chicken pox when you were younger? After you get chickenpox as a child, the virus never leaves your body. As an adult, the virus may return in the form of shingles. Shingles is a painful condition that damages your nerves and skin. It typically appears as a rash on the abdomen or back.

Unfortunately, the damage from shingles can cause long-lasting pain, called postherpetic neuralgia. You are more likely to experience both shingles and postherpetic neuralgia after age 60. To reduce your risk of developing the condition, you should receive a shingles vaccination at age 60. If you do develop shingles, receiving treatment within three days after your symptoms appear can reduce your chances of developing postherpetic neuralgia.

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Avoid The Pain Of Shingles

Anyone who has recovered from chickenpox can develop shingles

Shingles is a painful infection. Some people have the virus hiding in their nerve tissue, and if conditions are right, the virus “awakens.” This may cause a few blisters on the skin or a big rash that is only on one side of the body. The rash may be on the chest and back, at the waist, on the upper arm, or the side of the face and scalp. In healthy people, the rash goes away in 2 to 4 weeks.

Shingles is not likely to spread, but it may cause chickenpox. The same virus that causes chickenpox causes shingles. However, not everyone who had chickenpox will develop shingles.

What are the risk factors for shingles?

Anyone who has had chickenpox can develop shingles. But your risk is greater if you:

• Are age 50 or older

• Have an illness that weakens your immune system, such as HIV infection

• Have cancer, especially leukemia or lymphoma

• Take medicines that suppress your immune system, such as steroids or those given after an organ transplant

Can shingles be prevented?

A vaccine reduces your risk of getting shingles. Half as many people get shingles after being vaccinated. Among those who are treated and then develop shingles, only one third develop after-shingles pain. If you’re older you when you’re vaccinated and you get shingles, your outbreak will be less severe.

How do you know when shingles is coming on?

What is the treatment for shingles?

What causes after-shingles pain?

How serious is after-shingles pain?

Facial Pain And Eye Damage

Between 10% and 15% of the time, shingles affects the trigeminal gangliona triple-branched nerve that provides sensation to structures in the face. The medical term for head or facial pain due to shingles is “painful trigeminal neuropathy attributed to herpes zoster.”

Specifically, the trigeminal ganglion involves the eye the cheek and the mandibular branch . Of these, the ophthalmic branch is the one most commonly affected by herpes zoster.

According to the American Academy of Ophthalmology , 25% of the 300,000 to 500,000 cases of shingles that occur each year are herpes zoster ophthalmicus .

HZO can affect any part of the eye, from the optic nerve to the conjunctiva . Without antiviral treatment, almost half of people who have shingles near the eye will experience eye damage or even lose an eye, so it’s vital to see an ophthalmologist immediately.

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The Stages Before And After Rash Development

• If You’ve Had Chickenpox, You Could Be At Risk of Shingles

The most well-known symptom of shingles is a severe skin rash. However, before any signs of blisters, you may feel as if you’re only coming down with the flu.

You may experience chills and fever, as well as intense pain. It’s not until a few days later that a rash finally joins these shingles symptoms, with clusters of tiny, pimple-like blisters progressing quickly once they appear.

If you’re familiar with the signs and symptoms of shingles, you’ll be able to recognize what’s going on, get a diagnosis quickly, and deal with it without delay. Doing so makes you less likely to develop complications, such as nerve issues or bacterial skin infections.

This article reviews the symptoms of shingles and what you need to know about potential complications.

How Long Will The Effects Last

The rash from shingles will heal in 1 to 3 weeks and the pain or irritation will usually go away in 3 to 5 weeks. When shingles occurs on the head or scalp, the symptoms usually go away eventually, but it may take many months.

If the virus damages a nerve, you may have pain, numbness, or tingling for months or even years after the rash is healed. This is called postherpetic neuralgia. This chronic condition is most likely to occur after a shingles outbreak in people over 50 years old. Taking antiviral medicine as soon as the shingles is diagnosed may help prevent this problem.

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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.

A Decrease In Quality Of Life In People With Shingles

A 2010 Canadian study looked at the impact of herpes zoster on peoples quality of life. It followed 261 persons with shingles, aged 50 years or older, over a period of six months. The study found that pain interfered with sleep in 64% of the participants it interfered with the enjoyment of life in 58% of the participants and prevented general activities in 53%. Pain usually lasted 32 days.

However, the pain lasted much longer in people who developed postherpetic neuralgia. This is a severe, burning pain that affected one in four people with shingles. In fact, the largest changes in the enjoyment of life, mood, and sleep were seen in people who suffered from postherpetic neuralgia.

The study supported a need for early treatment of herpes zoster and adequate pain control in people with postherpetic neuralgia.

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What You Can Do About Nerve Pain That Lingers After Shingles

Chronic pain that continues after a case of shingles is called postherpetic neuralgia . It is estimated that about 20% of patients will experience this type of nerve pain as a complication of shingles.

Those who have had chickenpox are at risk of developing shingles later in life. People who develop PHN are generally age 60 and older. Although there is no cure for PHN, there are several methods of pain management that can ease symptoms. Fortunately, the type of pain that arises from postherpetic neuralgia improves over time.

Neuralgia affects the nerves, causing structural and functional damage. It can feel like a stabbing or burning pain that radiates along the affected nerve.

Neuropathic pain is not caused by an external injury or stimuli but originates from inside the nervous system. When the herpes-varicella zoster virus is reactivated in the form of shingles, scar tissue forms alongside nerves, creating pressure, and sending pain signals to the brain.

Mayo Clinic Minute: Learn More About Eye Shingles

Shingles is caused by the varicella-zoster virus the same virus that causes chickenpox. If youve had chickenpox, the virus can lie dormant in your bodys nerve tissue for years when suddenly its triggered by stress or a weakened immune system, and manifests as shingles. A shingles vaccine called Shingrix is recommended for anyone over 50. It helps prevent the disease and reduces the severity of symptoms.

Ophthalmic shingles is one particular version of the disease that can have some serious side effects that ultimately can cause permanent damage to your vision.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video is in the downloads at the end of this post. Please Courtesy: Mayo Clinic News Network. Read the script.

Youre probably familiar with shingles, a viral infection that causes a painful rash usually on the bodys torso. But did you know that shingles also can affect the eye?

Shingles around the eye typically involves the skin of the forehead and the skin of the upper lid. It can also involve the side of the nose or the tip of the nose, says Dr. Keith Baratz, a Mayo Clinic ophthalmologist.

The virus lies dormant for years, but, when triggered by stress or a weakened immune system, it travels along nerve pathways to the skin and usually affects only one side of the face.

You can almost draw a line right down the middle of the forehead when you get the rash, says Dr. Baratz.

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When To Seek Care

Early shingles symptoms, such as pain or flu-like feelings, are not obvious signs of a shingles outbreak.

Once a rash appears, you should see your primary care physician or a dermatologist. A trained eye can often diagnose shingles by visually inspecting the rash.

If you have shingles, you may never experience the extreme pain that can often come with it. You may only feel itching and some minor discomfort.

Even without the painful symptoms of shingles, its recommended that you see a healthcare professional and start antiviral treatment within 72 hours of a rashs appearance.

Its especially important to seek prompt medical care if a rash forms near one or both eyes. Shingles in the eye may cause permanent vision loss.

Shingles Symptoms And Treatment Options

Shingles is a viral infection that causes a painful rash, usually in a stripe pattern around one side of your chest or back. This infection is caused by the varicella-zoster virus, the virus that causeschickenpox. Over 95% of people are infected, with the virus remaining silent inside their nerve cells. An estimated one in three people may eventually develop shingles in their lifetime, when the virus becomes active again.

Shingles is common in people whose immune systems are weakened by stress, a disease, or advanced age. Ideally, these people receive booster vaccinations in order to minimize the risk for shingles. However, a vaccine does not always prevent outbreaks.

If prevention of shingles through vaccination is not possible, early treatment is your next best option. Your primary care or emergency room doctor is likely to start treatment with antiviral medications and light analgesics. However, this may not adequately control your pain. You will benefit by continuing your treatments with a pain specialist. A pain specialist can treat postherpetic neuralgia, a common and disabling type of pain that can last for months after a shingles outbreak.

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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.

How Do Shingles Reactivate In The Nervous System

The shingles virus stays dormant in the nerve tissues. If your immune system grows weaker, the virus reactivates.

As the virus becomes active, it spreads through the spinal cord nerves to the skin. These nerves convey messages of pressure, itching, and pain.

These messages transfer from the spinal cord to the brain. Once the varicella-zoster virus gets to the nerve endings, it shows up as a skin rash.

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When To See A Doctor

If you suspect you have shingles, you should see a doctor right away. You can then begin appropriate treatment that will help relieve your symptoms, speed your recovery, and lower your risk of complications. This is especially important if you:

• Are over age 60
• Have a condition that has caused you to have a weakened immune system, such as HIV
• Take medication that may diminish your body’s immune response
• You share a home with someone who has a weakened immune system
• The rash is on your face: Blisters near your eye could lead to serious eye damage or even cause you to lose sight in that eye.

Shingles Doctor Discussion Guide

If while you’re dealing with shingles you experience any of the following, let the doctor who’s treating you know right away:

• You aren’t getting relief from the pain with treatment.
• The pain doesn’t go away after three to four weeks.
• The rash spreads beyond the initial area.
• You begin to have symptoms of a secondary infection, such as a very high fever, chills, and severe headache.

Your healthcare provider will help you determine the right treatment for you. This may include antiviral drugs, antidepressant medications, and pain medications.

Shingles Symptoms Before Rash

Shingles develops in two stages. The first is called the prodromal period.

Shingles is a reactivation of the varicella virus, which is what causes chickenpox. After an initial infection, the virus lays dormant in the body. Once reactivated, which can happen years down the line, shingles results.

Often, the earliest signs this is occurring are similar to what you’d expect at the start of any infection. These symptoms sometimes occur at times when you’re feeling stressed or run down. They are also systemic, meaning they affect the whole body.

You may assume you’re just overtired or coming down with a cold when you actually have shingles.

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