Risk Factors For Nerve Pain After Shingles
Researchers have long known that older people are more likely to get PHN, the nerve pain after shingles, but recent studies have found other factors that increase risks.
In one study published in the journal Neurology, researchers — including Dworkin — looked at data from 965 people with shingles. The researchers identified five risk factors for developing PHN in people who had been recently diagnosed with shingles:
- Presence of symptoms before the rash appeared, like numbness, tingling, itching, or pain
- Severe pain during the illness’s initial stages
Importantly, the researchers found the more risk factors you have, the greater the risk of developing PHN.
For instance, 17% of women with shingles and 26% of those who had severe pain went on to get PHN. But 50% of women who were over age 60 and had symptoms before the rash, severe rash, and acute pain went on to get PHN.
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.
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.
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How Is Shingles Diagnosed And Treated
If you think you might have shingles, talk to your doctor as soon as possible. Its important to see your doctor no later than three days after the rash starts. The doctor will confirm whether you have shingles and can make a treatment plan. Most cases can be diagnosed from a visual examination. If you have a condition that weakens the immune system, your doctor may order a shingles test. Although there is no cure for shingles, early treatment with antiviral medications can help the blisters clear up faster and limit severe pain. Shingles can often be treated at home.
Rebooting The Nervous System
Its like restarting a computer, Dr. Rosenquist says. When its running slowly or acting weird, you restart it. We are trying to turn that nerve off. When it comes back on, hopefully, it will send an appropriate transmission as opposed to a pain transmission.
Treatmentoptions for PHN patients include:
Patientswith refractory PHN rarely need opioid pain medication. However,you should be evaluated by a physician. We cant make a blanket statement abouttreatment. It is individualized, she says.
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When Should I Get The Shingles Vaccine
The current shingles vaccine is a safe, easy, and more effective way to prevent shingles than the previous vaccine. In fact, it is over 90% effective at preventing shingles. Most adults age 50 and older should get vaccinated with the shingles vaccine, which is given in two doses. You can get the shingles vaccine at your doctors office and at some pharmacies.
You should get the shingles vaccine if you:
- Have already had chickenpox, the chickenpox vaccine, or shingles
- Received the prior shingles vaccine called Zostavax
- Dont remember having had chickenpox
Medicare Part D and private health insurance plans may cover some or all of the cost. Check with Medicare or your health plan to find out if it is covered.
You should not get vaccinated if you:
- Currently have shingles
- Are sick or have a fever
- Had an allergic reaction to a previous dose of the shingles vaccine
If you are unsure about the above criteria or have other health concerns, talk with your doctor before getting the vaccine.
Can Shingles Be Prevented
There are 2 vaccines available to reduce the likelihood of developing shingles, Zostavax and Shingrix. If you are over 50, you can talk to your doctor about whether you need it. It is recommended for everyone over 60 and is given free of charge in Australia to people aged 70 to 79.
Vaccination will not guarantee that you will not get shingles, but it will reduce your chance of developing the condition. The vaccine used to protect against shingles is not the same as the vaccine used to protect against chickenpox. Read more about the chickenpox vaccine here.
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Questions To Ask Your Doctor
- Ive had chickenpox. Am I at risk of developing shingles?
- What is the best treatment for my shingles?
- The pain from shingles isnt going away. What can I do to make myself more comfortable?
- Im on treatment for shingles. When should I call my doctor if things dont get better?
- I have shingles and my children havent had the chickenpox vaccine. Should I get them vaccinated?
- Is the shingles vaccine right for me?
- Are there any risks associated with the shingles vaccine?
- Will my post-herpetic neuralgia ever go away?
- If Ive never had the chickenpox, should I still get the shingles vaccination?
How Is Shingles Treated
Specific treatment for shingles will be determined by your healthcare provider based on:
- Your age, overall health, and medical history
- How long the shingles have been present
- Extent of the condition
- Your tolerance for specific medicines, procedures, or therapies
- Expectations for the course of the condition
- Your opinion or preference
There is no cure for shingles. It simply has to run its course. Treatment focuses on pain relief. Painkillers may help relieve some of the pain. Antiviral drugs may help lessen some of the symptoms and reduce nerve damage. Other treatments may include:
- Creams or lotions to help relieve itching
- Cool compresses applied to affected skin areas
- Antiviral medicines
- Anticonvulsants
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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:
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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Where Does Shingles Come From
When you have chickenpox as a child, your body fights off the varicella-zoster virus and the physical signs of chickenpox fade away, but the virus always remains in your body. In adulthood, sometimes the virus becomes active again. This time, the varicella-zoster virus makes its second appearance in the form of shingles.
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 Drugs Are Prescribed For Shingles
- An injection including corticosteroids and local anesthetics
If postherpetic neuralgia develops, similar medications are used to treat PHN pain.
While it may seem strange for your doctor to prescribe drugs for shingles that are commonly used to treat depression and prevent seizures, shingles is at root a nerve disorder, and these drugs work in different ways to calm overactive nerves.
Antiepileptics in general are thought to reduce the ability of the neurons to fire at high frequency, says Sangeetha Kodoth, MD, an allergist and immunologist with Allergy Specialists of Knoxville in Tennessee.
Its believed that tricyclic antidepressants an older class of antidepressants work by increasing the levels of the neurotransmitters serotonin and norepinephrine, which then modify pain response.
Antibacterial agents may also be prescribed if a bacterial infection occurs with the shingles rash.
Before taking any medication for shingles, be sure to talk to your doctor about possible side effects.
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How To Treat Shingles
This article was co-authored by Lydia Shedlofsky, DO. Dr. Lydia Shedlofsky is a Resident Dermatologist who joined Affiliated Dermatology in July of 2019 after completing a traditional rotating internship at Larkin Community Hospital in Miami, Florida. She earned a Bachelor of Science in Biology at Guilford College in Greensboro, North Carolina. After graduation, she moved to Beira, Mozambique, and worked as a research assistant and intern at a free clinic. She completed a Post-Baccalaureate program and subsequently earned a Master’s Degree in Medical Education and a Doctorate of Osteopathic Medicine from the Lake Erie College of Osteopathic Medicine.There are 10 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. This article received 16 testimonials and 100% of readers who voted found it helpful, earning it our reader-approved status. This article has been viewed 611,298 times.
Shingles, also known as herpes zoster, is a distressing skin rash caused by the varicella zoster virus . This is the same virus that causes chickenpox. After a person has had chickenpox, VZV stays in the body. Usually the virus causes no problems. However, now and again the virus reappears, causing nasty blisters called shingles. The following article will describe the treatments for shingles.
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Who Is At Risk For Getting Shingles
People who have had chickenpox who are more likely to develop shingles include those:
- With a weakened immune system .
- Over the age of 50.
- Who have been ill.
- Who have experienced trauma.
- Who are under stress.
The chickenpox virus doesnt leave your body after you have chickenpox. Instead, the virus stays in a portion of your spinal nerve root called the dorsal root ganglion. For the majority of people, the virus stays there quietly and doesn’t cause problems. Researchers aren’t always sure why the virus gets reactivated, but this typically occurs at times of stress.
Can You Still Develop Shingles If Youve Been Vaccinated For Chickenpox
Yes. Despite being vaccinated for chickenpox, you can still get shingles. No vaccine is 100% protective, and the effectiveness of vaccines lessens with time. However, people who get the chickenpox vaccine are significantly less likely to develop shingles later in life compared with people who never received the chickenpox vaccine. One recent 12-year study found that the number of shingles cases was 72% lower in children who had received the chickenpox vaccine compared with those who didnt.
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Should I See A Doctor For Shingles
It is usually worth seeing a doctor to be certain about the diagnosis and to see if you need treatment or not. Ideally you should see a doctor as soon as possible after the rash appears.
The rash of shingles can be very painful. So even if the doctor doesn’t think you need an anti-shingles medicine, they may be able to give you stronger painkillers than those you can buy over the counter from the chemist.
Do You Always Get The Typical Rash If You Have Shingles
Occasionally, some people dont get a rash. If you have any of the other symptoms of shingles , see your healthcare provider sooner rather than later. There are effective treatments you can take early for shingles. Even if you dont have shingles, seeing your healthcare provider will help you get your condition diagnosed and treated.
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How Long Does It Take For Shingles To Progress
Shingles progresses into blisters over three to five days and begins to crust over after seven to ten days. The rash is preceded by a prodromal phase lasting 48-72 hours or longer, consisting of throbbing pain and numbness in the area affecting the nerve. Once the rash blisters, it can last another three to five days before the lesions scab over.
After the lesions crust over, it may take two to four weeks to heal completely. At this time, pain may still be present. The most painful stage of shingles is when you have fluid-filled blisters. This usually occurs three to five days after the rash first appears.
What If I Have Shingles And A Poor Immune System
If you have a poor immune system and develop shingles then see your doctor straightaway. You will normally be given antiviral medication whatever your age and will be monitored for complications. People with a poor immune system include:
- People taking high-dose steroids. per day for more than one week in the previous three months. Or, children who have taken steroids within the previous three months, equivalent to prednisolone 2 mg/kg per day for at least one week, or 1 mg/kg per day for one month.)
- People on lower doses of steroids in combination with other immunosuppressant medicines.
- People taking anti-arthritis medications which can affect the bone marrow.
- People being treated with chemotherapy or generalised radiotherapy, or who have had these treatments within the previous six months.
- People who have had an organ transplant and are on immunosuppressive treatment.
- People who have had a bone marrow transplant and who are still immunosuppressed.
- People with an impaired immune system.
- People who are immunosuppressed with HIV infection.
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How Do Dermatologists Treat Shingles
An antiviral medication can:
-
Reduce the amount of time that you have a shingles rash
-
Lower your risk of developing long-lasting nerve pain and other health problems
One of three antiviral medications is usually prescribedacyclovir, famciclovir, or valacyclovir.
To treat your symptoms, dermatologists typically recommend the following:
Pain: Medication that you can buy without a prescription can help, such as:
If you have severe pain, your dermatologist may prescribe a medication that reduces inflammation, such as a corticosteroid.
How Long Does Shingles Last
Most cases of shingles last three to five weeks.
- The first sign is often burning or tingling pain sometimes it includes numbness or itching on one side of the body.
- Somewhere between one and five days after the tingling or burning feeling on the skin, a red rash will appear.
- A few days later, the rash will turn into fluid-filled blisters.
- About one week to 10 days after that, the blisters dry up and crust over.
- A couple of weeks later, the scabs clear up.
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Will Shingles Go Away Without Treatment
Shingles, or herpes zoster, is a painful rash caused by the varicella-zoster virus . This is the same virus that causes chickenpox.
This virus remains dormant in a part of your nervous system called the dorsal root ganglion. It can be reactivated during times of stress or illness, or when the immune system is weakened by an autoimmune disease or cancer.
The risk of developing shingles is relatively low for healthy young adults about 4 out of 1,000 people in the United States, according to the Centers for Disease Control and Prevention . Its much higher for those above age 60. Shingles affects about 1 out of 100 people in this older age group, the CDC says.
Generally, a case of shingles rash resolves within 3 to 4 weeks. It can resolve without treatment, but antiviral treatment can shorten both the duration and severity of the rash.
If You Have Shingles Symptoms Get Treatment Now And You May Avoid Permanent Nerve Pain
Shingles, a viral infection of the nerve roots, affects 1 million people in the U.S each year. Most people recover from their bout, but for as many as 50% of those over age 60 who have not been treated, the pain doesn’t go away. It can last for months, years, or even the rest of their lives.
These people have what’s called postherpetic neuralgia , the result of the shingles virus damaging the nerves of the skin. In some cases, the pain is mild. In others, even the slightest touch — from clothing or even a breeze — can be excruciating.
“PHN causes a great deal of suffering and high social costs,” says Robert H. Dworkin, PhD, a professor in the department of anesthesiology at the University of Rochester Medical Center in Rochester, N.Y. “It can severely disrupt people’s lives.”
But the good news is that there are drugs that can help treat and even prevent PHN, and doctors are learning more about who is at greatest risk of developing this debilitating condition.
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