Study Assesses Relief Options Against Shingles Pain
- Study Assesses Relief Options Against Shingles Pain
The painkiller oxycodone is effective at treating the acute pain of shingles, an illness that often causes severe pain which can become long-lasting and sometimes even permanent.
The study, published in the April issue of the journal Pain, is one of the first to carefully evaluate different methods to relieve pain during a course of shingles, which many patients say causes the worst pain they have ever experienced. Effective pain treatment is crucial. Not only can the pain of shingles disrupt peoples quality of life, but it is also possible that the less effectively the pain is treated, the more likely it will become a long-term problem that can change a persons life forever.
Shingles is caused by reactivation of the varicella zoster virus, the same bug that causes chicken pox, and only people who have had chicken pox are vulnerable to shingles. About 20 to 30 percent of people will get shingles at some point in their lives the odds climb to 50 percent for people who live to the age of 85.
For most patients, the first symptom of the infection is pain, quickly followed by a rash where the pain first appeared. The rash appears most often on one side of the chest or face, oftentimes causing dozens of small pimple-sized lesions. Some patients also get flu-like symptoms like a headache and lethargy. The illness usually lasts about three or four weeks.
How Could Cannabis Help
If you have had chickenpox, then you could get shingles and it would be wise to go out right now and make sure you are fully stocked with topical products. The amount of pain relief that a cannabis cream can give is miraculously effective and instantaneous the second its on the rash, the bad burn pain drops from an excruciating level 9 to a 2.
I dont think I would ever be able handle a shingles outbreak without high THC, edible cannabis. The type of pain I described as electric shocks throughout the nerves can literally cause severe anxiety because its so weird and uncomfortable. Like hitting a mute button, the moment I felt the the edible starting to take effect, it was like it sent all the shocks and pain far away to someplace else.
With such a large concentration of pain receptors residing in the intestines, using edible cannabis to effectively treat the pain caused by shingles, makes sense and it works.
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Is It Possible To Prevent Postherpetic Neuralgia
Zostavax, the herpes zoster vaccine , has been shown to significantly decrease the risk of shingles. The vaccine is approved by the Food and Drug Administration for adults age 50 and older, and is recommended for all adults 60 and older who arent allergic to the vaccine and who dont take immune-suppressing medications.
People age 50 to 59 may want to talk to their doctor about the shingles vaccine, if they are having ongoing pain or skin issues or have a weakened immune system. The vaccination is not a guarantee that shingles will not occur however, those who get the vaccine usually experience a shorter period of pain.
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Nerve Blocks For Shingles Pain
The same virus responsible for chicken pox during childhood causes shingles pain as an adult. The virus becomes active in nerve tissue causing severe pain usually on one side of the body. This occurs more frequently in people older than 60, but can occur in younger individuals. Shingles usually presents in sharp pain followed by a rash. The more likely areas to be affected include the chest or abdomen, and less frequently, the face, the arms, or the legs.
Reasons for treatment
A shingles infection causes a very severe nerve inflammation that if left untreated can evolve into a more severe form of the disease called post-herpetic neuralgia. This disease is a complication of shingles where nerves and their blood supply have been severely damaged from inflammation. Typically. the older you are and the more pain you have during your shingles episode, the more likely it is for you to develop permanent pain. Blocking the pain in the affected nerves using strong numbing medicines and anti-inflammatories will shorten the actual shingles pain and may decrease the chance of developing severe nerve damage and chronic pain.
What Is The Outcome For Someone Who Has Shingles
Most people get shingles once, but its possible to get it again.
If you have a healthy immune system, the blisters tend to clear in 7 to 10 days. The rash tends to go away completely within 2 to 4 weeks. The pain may last longer, but usually stops in 1 or 2 months.
For some people, the pain will last longer than the rash. When it does, its called postherpetic neuralgia , which can come and go or be constant. PHN can last for months, years, or the rest of your life. Treatment can help reduce the amount of pain you feel.
Be sure to tell your doctor if you continue to have pain. Treatment can help you feel more comfortable.
For anyone who has a shingles rash, the right self-care can help ease your discomfort. Youll find out what dermatologists recommend at, Shingles: Self-care.
ReferencesCenters for Disease Control and Prevention . About shingles. Page last reviewed 10/17/2017. Last accessed 4/1/2019.
Dooling KL, Guo A, et al. Recommendations of the Advisory Committee on Immunization Practices for Use of Herpes Zoster Vaccines. Morb Mortal Wkly Rep 2018 67:103-8.
Madkan V, Sra K, et al. Human herpes viruses. In: Bolognia JL, et al. Dermatology. . Mosby Elsevier, Spain, 2008: 1204-8.
Straus SE, Oxman MN. Varicella and herpes zoster. In: Wolff K, Goldsmith LA, et al. Fitzpatricks Dermatology in General Medicine . McGraw Hill Medical, New York, 2008: 1885-98.
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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.”
Treatment For Shingles Pain Including Postherpetic Neuralgia
There is no cure for shingles. However, starting treatment with antiviral drugs early on, can speed the healing process. A pain specialist will treat you if you are experiencing a long lasting type of shingles pain, known as post-herpetic neuralgia. Postherpetic neuralgia is nerve pain. It feels like burning, tingling, or stinging over the area of the outbreak. It may last for weeks or months after the rash has disappeared.
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Can Shingles Be Prevented Or Avoided
The best way to prevent shingles is through vaccination. Vaccinate your children for chickenpox. This vaccine reduces their risk for getting chickenpox. You cant get shingles unless youve had chickenpox first.
When you are older, get the shingles vaccine. It is recommended for adults 50 years of age and older. It can prevent shingles. People who have had shingles should get the vaccine to help stop the disease from reoccurring. Common side effects of the vaccine are headache, plus redness, swelling, itching, and soreness at the injection site.
The shingles vaccine is not recommended for anyone who:
- Has had an allergic reaction to gelatin or the antibiotic neomycin
- Has an allergy to any component of the shingles vaccine
- Has a weakened immune system due to conditions such as leukemia, HIV, or AIDS
- Is receiving treatment for cancer
- Is being treated with drugs that suppress their immune system, including high-dose steroids
- Is pregnant or might become pregnant within 4 weeks of getting the vaccine
Why Does Shingles Hurt
Anyone whos had chickenpox and recovered from it, still harbors the virus deep in their nerves, close to the spinal cord. In this regard, chickenpox resembles the viruses that cause cold sores and genital herpes. Although chickenpox is not the same as sexually transmitted herpes, it is in the same family and it is therefore named herpes zoster.
Your immune system keeps the herpes zoster virus in check until you experience some stress. This allows the virus to multiply and travel along the entire length of the nerve, all the way to the skin. On the skin, it creates painful blisters that can readily ooze, allowing the virus to infect its next victim. You are highly infectious at this point and should avoid contact with people who arent vaccinated.
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What Are The Symptoms Of Postherpetic Neuralgia
The signs and symptoms of postherpetic neuralgia are generally limited to the area of your skin where the shingles outbreak first occurred. The most common areas are in a band around the trunk of the body, usually on one side. It may also occur on the face.
The pain associated with postherpetic neuralgia is varied. It can range from discomfort to very severe. The pain is often described as burning, stabbing, or gnawing.
Patients with the condition often cant bear the slightest touch, even clothing on the affected skin can be painful. In some cases, the sensation may be in the form of either hypersensitivity or decreased sensation. It is rare, but patients may also experience muscle weakness, tremors, or paralysis if the nerves involved also control muscle movement.
What Are The Symptoms
The first sign of shingles is often burning, sharp pain, tingling, or numbness in your skin on one side of your body or face. The most common site is the back or upper abdomen. You may have severe itching or aching. You also may feel tired and ill with fever, chills, headache, and upset stomach or belly pain.
One to 14 days after you start feeling pain, you will notice a rash of small blisters on reddened skin. Within a few days after they appear, the blisters will turn yellow, then dry and crust over. Over the next 2 weeks the crusts drop off, and the skin continues to heal over the next several days to weeks.
Because shingles usually follows nerve paths, the blisters are usually found in a line, often extending from the back or side around to the belly. The blisters are almost always on just one side of the body. Shingles usually doesn’t cross the midline of the body. The rash also may appear on one side of your face or scalp. The painful rash may be in the area of your ear or eye. When shingles occurs on the head or scalp, symptoms can include headaches and weakness of one side of the face, which causes that side of the face to look droopy. The symptoms usually go away eventually, but it may take many months.
In some cases the pain can last for weeks, months, or years, long after the rash heals. This is called postherpetic neuralgia.
Can You Prevent Shingles
Prevention of shingles is a challenging topic because very few known modifiable factors change susceptibility.
A two-dose vaccine, Shingrix, can be administered to those aged 50 and older. The reported effectiveness is up to 97% in preventing shingles in 50-69-year-olds and up to 91% in the 70+ age group. According to the CDC, if you currently have shingles, have a moderate or severe illness, or are pregnant, you should wait to receive the vaccine. All pharmaceutical interventions have risks and benefits, requiring an informed decision based on your personal health considerations.
Household exposure to a child with chickenpox decreased the likelihood of developing shingles by 33% in the two years following exposure and 27% in the 10-20 years following exposure.
The below table summarizes what is known about shingles prevention and susceptibility:
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How Do Nerve Blocks Work
Nerve blocks, or neural blockades, are injections we use to deliver pain medication directly into the affected nerves, stopping pain signals from getting to the nervous system. They are used to both diagnose and treat pain.
There are several types of nerve blocks depending on the area thatâs being treated. We can use this procedure to treat pain in different parts of the body. They are useful in managing both chronic pain conditions and short-term pain, allowing people to improve their quality of life.
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Preventing Nerve Pain After Shingles
But if you’re worried about PHN, don’t despair. There are medications that can cut your risks of getting the condition. There are three antiviral drugs used: famciclovir , valacyclovir , and acyclovir . These medications need to be started within two to three days of the onset of shingles.
“If you look at the clinical trials with any of these drugs in people over 50,” says Dworkin, “they cut the rate of pain at six months in half. That’s a very significant improvement.” They are also very safe and have few side effects, he says.
But who needs the drugs? Dworkin says there’s not a clear consensus yet.
There are some obvious cases. “I think everyone would agree that someone who is over 50 and has severe symptoms should get preventative treatment,” he tells WebMD.
But for younger people or those with fewer risk factors, the course is less clear.
“Some people think that everyone who gets shingles should get preventative treatment with antiviral medicines, because the medicines are so safe and have such few side effects,” he says.
Others argue that preventative treatment should only be given to those at greater risk. The main reason for this, Dworkin says, is cost.
“A full course of treatment could cost anywhere between $100 and $160,” he says. “That can add up, and insurance companies might not want to pay if the risks are very, very low.”
Home Remedies And Lifestyle
In addition to triggering an uncomfortable rash, shingles can cause symptoms that are similar to those of other viral infections.
While prescription and over-the-counter drugs can help, one of the most important things you can do while dealing with the illness is to take good care of yourself. If you’re caring for someone else who has shingles, “creature comforts” can be enormously soothing.
Verywell / Laura Porter
Integrate these basic tactics into even the busiest daily routine:
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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.
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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Being Vaccinated Against Shingles Is The Best Way To Prevent Postherpetic Neuralgia Lingering Pain From The Shingles Virus Heres What You Should Know About The Causes Symptoms And Treatments For This Painful Chronic Condition
Postherpetic neuralgia , also known as shingles, most commonly occurs as a rash on one side of the torso.
This is no ordinary rash but the itchy blisters arent even the worst part.
A painful condition known as postherpetic neuralgia is the horrible gift that keeps on giving for more than 10% of people who develop it following a bout of shingles.
Oh yeah and the pain? It can be significant. People familiar with the burning, relentless feeling of PHN have likened it to passing a kidney stone mothers have described it as pain worse than labor.
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What Can I Do For The Pain
To help with the pain of shingles, your doctor might have you take an over-the-counter pain medicine. This could include acetaminophen or ibuprofen .
Applying a medicated anti-itch lotion to the blisters might reduce the pain and itching. Placing cool compresses soaked in water mixed with white vinegar on the blisters and sores might also help.
If shingles causes severe pain, your doctor might prescribe a stronger pain medicine.