Back Pain Of The Shingles
After a strenuous weekend of yard work I noticed the skin on parts of my back and legs had become very sensitive to touch. The best way to describe it was like mild sunburn. There were even a couple places around my waist that felt like they had been scratch, but there were no visible scratch marks.
On Friday night of that week my lower back started to hurt. This was right above the lumbar region where the kidneys are located, primarily on the right side. The sensitivity and pain radiated from the spine area, around my waist. It was difficult to sleep and I did lots of tossing and turning. On Saturday morning I got up, had some coffee, read the morning paper and felt better, ready for another weekend of tackling the backyard.
The back pain returned Saturday night, only worse. In the morning the pain would subside. I learned that just standing or walking around made the back pain go away and the more coffee I drank, the better I felt. But I still had the skin sensitivity.
Sunday night was the worse. I figured I had tweaked my back with all the bending over building the raised garden beds. On Monday morning the pain wasnt going away, even with copious amounts of really strong coffee. I then surmised that maybe I had a kidney stone. I started drinking lots of water, and coffee. I started feeling like I had the flu. I was achy, cold, fatigued, and not happy.
A Typical Case Of Herpes Zoster On Lower Limb
Amol Madhav Deshpande, Mayuri Amol Deshpande
Corresponding author: Amol Madhav Deshpande, Department of Rachana Sharir, Mahatma Gandhi Ayurved College Hospital and Research Centre, Datta Meghe Institute of Medical Sciences Salod , Wardha, Maharashtra, India
Received: 24 Jul 2022 – Accepted: 27 Jul 2022 – 25 Aug 2022
Domain: Dermatology,Infectious disease
Keywords: Herpes simplex, herpes zoster, shingles
©Amol Madhav Deshpande et al. Pan African Medical Journal . This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Amol Madhav Deshpande et al. A typical case of herpes zoster on lower limb. Pan African Medical Journal. 2022 42:313.
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The Pain From Shingles On The Legs
If youve ever queried what it looks like and viewed pictures of a shingles rash on the legs you already grasp that it looks terrifyingly, exceedingly, and horrifically arduous. Sometimes, the pain from shingles on the legs is so severe that patients cant wear trousers because of the slight chafing of the dermis by fabric.
You can also get postherpetic neuralgia after the outbreak has dematerialized. Its long term pain caused by the CNS being permanently affected by the shingles rash. If the pain lasts post-shingles rash on the leg, telephone your primary care physician.
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How To Tell If It Is Shingles
Though it may not always be easy to tell whether a rash is shingles, there are a few symptoms to be aware of.
According to the AAD, before the rash appears, a person will likely experience itching, tingling, or pain on the affected area of skin. This can happen several days before the rash develops.
The rash is typically painful and consists of blisters. Some people may develop the blisters before the rash appears.
The note that the blisters will scab over in 710 days and will fully resolve in 24 weeks.
A person may develop additional symptoms such as:
Several other conditions may cause a rash that looks similar to shingles on the leg. In some cases, it may be difficult for a person to determine what is causing the rash.
Possible causes of a rash on the legs include:
- Irritant or contact dermatitis: This is a type of eczema that develops as a result of contact with a substance that irritates the skin or causes an allergic reaction.
- Jock itch: This is a fungal infection that may appear as a raised, half moon-shaped rash on the inner leg, near the groin.
- Heat rash: This occurs when sweat gets trapped against the skin, causing small, discolored bumps to appear.
Preventing The Virus Spreading
If you have the shingles rash, do not share towels or flannels, go swimming, or play contact sports. This will help prevent the virus being passed on to someone who has not had chickenpox.
You should also avoid work or school if your rash is weeping and cannot be covered.
Chickenpox can be particularly dangerous for certain groups of people. If you have shingles, avoid:
- women who are pregnant and have not had chickenpox before as they could catch it from you, which may harm their unborn baby
- people who have a weak immune system, such as someone with HIV or AIDS
- babies less than one month old, unless it is your own baby, in which case your baby should have antibodies to protect them from the virus
Once your blisters have dried and scabbed over, you are no longer contagious and will not need to avoid anyone.
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Shingles Symptoms: After The Rash
Just like the blisters of chickenpox, the blisters in shingles eventually burst, and the area starts to ooze. The blisters will then crust over and heal. Before the blisters crust over, the VZV virus can be spread to anyone who is not immune to chickenpox through vaccination or previous infection. Herpes zoster spreads when a person who lacks immunity has direct contact with the blisters of someone who has the virus. The scabs eventually fall off, and the rash disappears. Sometimes scarring may result.
Home Care For Shingles
Colloidal oatmeal baths are an old standby for relieving the itch of chickenpox and can help with shingles, as well. To speed up the drying out of the blisters, try placing a cool, damp washcloth on the rash If your doctor gives you the green light, stay active while recovering from shingles. Gentle exercise or a favorite activity may help keep your mind off the discomfort.
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What Does Shingles Look Like
The appearance of shingles can depend on:
- The severity of your infection
- Pigmentation of your skin
- Where the infection occurs on your body
Shingles may be reddish in appearance on fair skin, but may look brown or simply like darker colored pigmentation on more melanated skin tones. Shingles most commonly appears in these two stages:
- Clusters of fluid-filled blisters
Eczema Causes Oozing Bumps Like The Shingles Virus
Eczema is a rash that occurs when the skin has an exaggerated inflammatory response to an irritant. Eczema can result in red, dry, and extremely itchy patches on the skin. In some people, eczema will cause oozing bumps, a condition that could be mistaken for the shingles rash. Eczema cannot be cured, but most people can control it by identifying and avoiding the allergic triggers that cause the condition.
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What Are The Symptoms Of Shingles
Shingles is infamous for the pain it causes. This is the first symptom to typically appear. Not always will pain be present, especially in the young. Rather a mild itching or burning sensation can develop in the affected area.
When pain is present, it usually tends to stay localized. It can be mild to severe. The pain may include a tingling, aching or burning sensation. A rash develops a few days following the onset of pain. A fever and/or headache may follow.
What About Vaccines For Shingles
There are two vaccines available to help prevent shingles: Zostavax, a live vaccine, and the newer Shingrix, a nonliving vaccine that was approved by the FDA in 2017.
Shingrix is now preferred over Zostavax. It is recommended for people age 50 and older, including those who have rheumatoid arthritis . Its given in two doses, with two to six months between doses.
According to the CDC, Shingrix may be used for adults who are taking low-dose immunosuppressive therapy, are anticipating immunosuppression, or have recovered from an immunocompromising illness.
Though Shingrix has been shown to be more effective at preventing shingles than Zostavax, some experts question whether its safe for people with inflammatory arthritis. The Shingrix vaccine was studied in HIV patients, cancer patients, and transplantation patients, who all did fine, Elizabeth Kirchner, MSN, CNP, from the Cleveland Clinic told MedPage Today.
But patients with immune-mediated inflammatory diseases such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and lupus were all excluded from those trials. The concern: kicking up the immune system in autoimmune patients who already have an overactive immune system, she told MedPage.
Getting the shingles vaccine does not guarantee you wont get the disease its only used as a prevention strategy. You should ask your doctor if Shingrix is safe for you.
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Research And Statistics: Who Gets Shingles
Almost one out of every three people in the United States will develop shingles at some point, according to the CDC.
Of an estimated one million U.S. cases of shingles each year, about half of them occur in people age 60 or older.
In fact, about half of people over 80 have had shingles.
The chicken pox vaccine was introduced in 1995 and has reduced incidence of the virus by up to 85 percent. Theoretically, this should reduce the incidence of shingles as people who were vaccinated as children grow up, but its too soon to know if this is the case.
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Can You Get Shingles From The Covid
There have been a few reports of shingles happening in people who were vaccinated against COVID-19. The varicella-zoster virus was reactivated in these people.
A note from Cleveland Clinic
If youve had chickenpox, youre at risk of developing shingles later in life. Shingles causes a rash that is contagious and painful. The disease can have serious complications. The best thing you can do to reduce your risk is to get the shingles vaccine. The vaccines are safe and effective.
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What Are The Signs And Symptoms Of Shingles
Shingles causes a painful, blistering rash on your skin. If you get shingles, you may notice the following:
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Before the rash appears: For 1 to 2 days before the rash appears, you may have pain, burning, or tingling on an area of skin where the rash will develop. Some people say they felt an electrical sensation on their skin before getting the rash.
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Rash appears: A painful, blistering rash appears. It usually appears on one side of your body, often on the torso however, it can appear anywhere on your skin. Some people get more blisters after the rash appears, so it can seem that the rash is spreading.
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Rash starts to clear: As the rash clears, the blisters may crack open, bleed, and scab over. For most people, the rash will clear within 2 to 4 weeks.
Although the rash will clear on its own, treatment is important. Taking medication within 3 days of getting the shingles rash can:
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Reduce your risk of developing other health problems, such as long-lasting nerve pain, pneumonia, or hearing loss
Shingles rash on the face
If you have a shingles rash on your face, immediately seeing a doctor for treatment could save your eyesight.
When To See A Doctor
If your lower leg rash persists despite the home remedies above, make an appointment with your doctor. If your itching is caused by an underlying metabolic, hematologic or neurologic condition, your doctor will focus on treating that condition first. If your symptoms are due to another cause, he or she may suggest the following treatments that may help relieve your itchy skin:
- Corticosteroid creams: If your itching is due to a rash or skin disorder such as eczema or dermatitis, corticosteroids are helpful given their anti-inflammatory effect in addition to their immunosuppressive role.
- Antihistamines: If your itching is due to an allergic reaction, your doctor may prescribe medications that fight the immunologic response causing your inflammation and itching.
- Light therapy : This treatment involves exposing the skin to specific wavelengths of ultraviolet light in order to help get the itching sensation under control.
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What Is The Treatment For Shingles
Momentarily, the remedies are limited and far between. Customarily, keeping the skin void of moisture, lack of tight clothing, and topical cremes. Antiviral drugs, like Zovirax and Valtrex , can often aid in recovery.
The treatment for shingles leg pain is usually just analgesics like paracetamol and ibuprofen. With more severe pain and PHN, intenser analgesic meds can be prescribed and even corticosteroids and antidepressants.
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Treatment can vary though, depending on each case. Some individuals are more likely to get shingles and are prone to more complications, especially people with suppressed immune systems. These can include cancer, lupus, and acquired immune deficiency syndrome patients.
Is The Zostavax Vaccine Still Being Used
Yes. The CDC, however, recommends Zostavax for adults age 60 and older, but not routinely for people aged 50 to 59. Zostavax is given as a single-dose shot versus the two-dose shot for Shingrix. Zostavax is less effective than Shingrix in preventing shingles and postherpetic neuralgia .
You can consider Zostavax if you are allergic to Shingrix or if Shingrix is unavailable because of supply shortage and you want some immediate protection from a possible case of shingles and/or postherpetic neuralgia. Because its a weakened live vaccine, it may be dangerous if you have cancer, HIV, or take steroids, chemotherapy or other medications that suppress your immune system. Ask your healthcare provider if the Zostavax vaccine is an option for you.
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Shingles Treatment: Home Remedies
Bathing is generally allowed, and the affected area can be washed with soap and water. Cool compresses and anti-itching lotions such as calamine lotion may also provide relief from symptoms. An aluminum acetate solution can be used to help dry up the blisters and oozing. Application of petroleum jelly can also aid in healing. Over-the-counter antihistamines, such as diphenhydramine and pain medicines can also help provide relief.
Wearing loose clothing can help avoid extra pain from clothing rubbing against the rash. Avoid close skin-to-skin contact with others who have not had chickenpox, are ill, or who have a weakened immune system to avoid spread of the virus. People who do not have immunity to the virus may catch varicella by having direct contact with the lesions. In this way zoster is similar to cold sores, which are caused by a virus in the same family as varicella.
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Do You Always Get The Typical Rash If You Have Shingles
Occasionally some patients dont get the rash. If you have any of the other symptoms of shingles , see your healthcare provider sooner rather than later. There are effective treatments that can be given early in the disease. If it turns out you dont have shingles, seeing your healthcare provider allows any condition that you do have to be discovered and treated early in its course.
The shingles rash appears on the abdomen and face, neck and shoulders.
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Can I Get Shingles If I Havent Had Chickenpox
No. You cant get shingles if youve never had chickenpox, but you can get chickenpox from someone who has shingles. If youve never had chickenpox and you come into direct contact with the oozing, blister-like rash of someone with shingles, the varicella-zoster virus can infect you and you would develop chickenpox.
Once youve had chickenpox, you could develop shingles at some point in your life. This is because the varicella-zoster virus never fully goes away after youve had chickenpox. It lies quietly inactive in your nerve tissue. Later in life, the virus may become active again and appears as shingles.
Shingles Or Something Else
Small blisters that appear only on the lips or around the mouth may be cold sores, sometimes called fever blisters. Theyre not shingles, but are instead caused by the herpes simplex virus. Itchy blisters that appear after hiking, gardening, or spending time outdoors could be a reaction to poison ivy, oak, or sumac. If you arent sure whats causing your rash, see your healthcare provider.
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Hives Caused By Infection
Heather L. Brannon, MD
Hives are considered to be idiopathic, meaning that an outbreak can happen spontaneously and the cause isnt always known. If a cause can be found, the most common cause is an infection. This photo is an example of hives caused by a viral infection.
Other possible causes include an allergic reaction, stress, exercise, sun exposure, pressure on the skin, scratching, and chemical exposure.
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Why Doesnt Having Chickenpox Earlier In Life Provide Immunity Against Having Shingles Later
After having chickenpox, your body doesnt rid your system of the virus. Instead, the virus stays in a portion of the spinal nerve root called the dorsal root ganglion. In most people, the virus simply stays there quietly and doesnt cause problems. Scientists arent always sure why the virus gets active again, but they know stress can be a cause.
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