What To Do For Nerve Pain From Shingles

What Causes Postherpetic Neuralgia

Postherpetic neuralgia begins when the virus that causes chickenpox affects an individual. After having chickenpox, the virus remains in the body forever. The virus can reactivate, usually decades later, and produce shingles lesions. The reactivation of the virus is thought to be due to stress on the body from either another infection or if the patients immune system is compromised that allows the virus to escape the nerve cells.

The nerve fibers damaged from the chickenpox virus are unable to transmit normal sensation messages from the skin to the brain. Instead, the sensation messages become confused and exaggerated, causing chronic, often excruciating, pain that can last months or even years. However, postherpetic neuralgia does not occur in everyone who suffers from shingles.

I Think I Have Shingles What Should I Do

Repeat after me: Call your doctor right away, within 72 hours. The earlier the better.

You should start taking an antiviral medication, preferably valacyclovir or famciclovir, within 72 hours of your symptoms starting to help reduce the severity of the infection, how long your skin rash lasts, and how painful it gets. If its been more than 72 hours, you should still talk to your provider. Treatment can still help, especially if you still see new rashes showing up.

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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 youd expect at the start of any infection. These symptoms sometimes occur at times when youre feeling stressed or run down. They are also systemic, meaning they affect the whole body.

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

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The Details: Heres Where Postherpetic Neuralgia Gets Complicated

Postherpetic Neuralgia Causes

To help you understand how shingles can cause PHN, you need to know how you can get shingles. Shingles is caused by a viral infection called herpes zoster. The virus that causes herpes zoster is called the varicella-zoster virus, and it is the same virus that causes chicken pox in childhood. After a person recovers from chickenpox, the virus can enter the nervous system and remain dormant for many years. In some people, the virus will reactivate years later and produce shingles.4

Researchers arent exactly sure what triggers the herpes zoster virus to re-emerge after all those years, but they think it is related to age, illness, and stress.3 Shingles can be very painful, and when the virus reaches the skin, it can cause blistery rashes. These rashes usually heal in less than 3 months.

And this chain of events can lead to PHN. If the pain of shingles lingers longer than 3 months, you may have PHN.

During your bout with shingles, the virus you were fighting injured nerves in and around the skin where the rash and blisters once existed. As your immune system eventually suppressed the virus, your rash and blisters disappeared. You may have even felt less pain, and you assumed that you had won the battle with shingles.

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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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Lasting Pain After Shingles

Pain that continues for a long time after a shingles rash has disappeared is called post-herpetic neuralgia. This is the most common complication of shingles. Its still not clear how it can be prevented or what the best treatment is.

Shingles typically causes a rash accompanied by pain in the affected area. The pain normally goes away when the rash goes away. This usually happens after two to four weeks. Pain that continues for longer is referred to as post-herpetic neuralgia. The word post-herpetic means post-herpes because the pain arises after infection by the herpes zoster virus. In very rare cases pain can come back after a shingles infection, even if it had already gone away and the rash has disappeared.

The main symptom of post-herpetic neuralgia is pain in the nerves . The skin is often overly sensitive and itchy as well. This can make it difficult or painful to wash yourself, turn over in bed, or hug someone. The pain and itching can be very severe and might keep you from sleeping.

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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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Treatment For Lingering Shingles Pain

Most cases of shingles clear up within a month or so. After you have shingles, its unlikely that youll get it again. But as we mentioned above, some people develop PHN, a complication that follows shingles. Older people, women, and those who had more severe shingles symptoms seem to be at higher risk of developing PHN, but its not clear why others never develop it.

Nerve blocks are injections containing local anesthetic to numb nerves contributing to PHN pain. Other minimally invasive treatments include nerve ablation and steroid injections to treat inflammation related to shingles.

We offer several nonaddictive prescription medications for nerve pain. Oral antidepressants or membrane stabilizers can reduce symptoms of PHN. For some people, topical medication like capsaicin cream can temporarily relieve pain.

You dont have to turn to addictive opioid pain medications if you have shingles pain. Dr. Soin and our team are here to help you find relief with a personalized treatment plan, whether its nerve-blocking injections or medication.

If you still have nerve pain after shingles, you dont have to suffer in silence. in Centerville or Beavercreek, Ohio, or book an appointment online to learn more about the PHN treatment that could be right for you.

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How Long Does Nerve Pain Last After Shingles

Only approximately 9-15% of patients who get shingles develop Postherpetic Neuralgia. For those few patients who develop PHN, the length of time that it lasts usually varies. The majority of PHN patients have discomfort that lasts one to two months. About one-third of Postherpetic Neuralgia patients have symptoms that last around three months, and about one-fifth have symptoms that last a year or longer. Researchers are unsure what triggers the herpes zoster virus to re-emerge even after years of lying dormant. The virus may be obtained during youth, but it does not flare into shingles until years down the line. When the pain of shingles lingers long after the rash heals, it is considered Postherpetic Neuralgia. The bout of shingles damages the nerves. This means that the nerve damage caused by shingles affects a fully functioning nervous system. The damaged nerve will send random pain signals to the brain, which thereby causes a burning, throbbing sensation. Over time, the nerves of the skin calm, but due to the existing nerve damage, the pain can persist for years, even for the rest of the persons lifetime.

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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.”

Best Treatments For Lasting Shingles Pain

Postherpetic Neuralgia Pain: What Works, What Doesn’t

Doctors call it postherpetic neuralgia or PHN. It’s caused by nerve damage left behind by a case of shingles. Shingles itself comes from reactivation of a chickenpox virus, varicella zoster. The virus travels down nerve fibers to cause a painful skin rash.

When the rash goes away, the pain usually goes with it. But for 12% to 15% of people the pain remains. If your shingles pain lasts eight to 12 weeks after the rash goes away, you’re part of an “unfortunate minority,” says pain researcher Andrew S.C. Rice, MD, of Imperial College, London.

“Among people with PHN, some have their pain resolve in the first year to 18 months after the shingles rash goes away,” Rice tells WebMD. “But if they have pain longer than that, it is not going to go away on its own. In either case, a person must deal with the pain.”

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Can Postherpetic Neuralgia Be Prevented

The Food and Drug Administration has approved a shingles vaccine, which can reduce your chance of getting shingles and PHN. The recombinant herpes-zoster vaccine is recommended to prevent shingles in adults ages 50 and older. The vaccination is given in two doses, two to six months apart. The two-dose vaccine is 90% effective at preventing shingles and PHN. Protection lasts at least for four years after you get vaccinated.

If you have never had chickenpox or have children who have never had chickenpox, getting the chickenpox vaccine can help prevent getting this infection in the first place. If you never get chickenpox, you will not have the varicella-zoster virus in your body and will not get shingles or PHN.

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Are There Other Ways To Ease The Pain

Most people with postherpetic neuralgia use medication to control their symptoms. But there are other ways to control the pain, too. They include:

TENS : You use a device that shoots tiny electrical currents into the area of pain on the skin. This helps block the pain.

Cold packs: Try a gel-filled one to numb the area unless cooler objects make your neuralgia worse.

Comfortable clothes: Go for looser fits and fabrics such as cotton and silk.

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The 5 False Facts Your Doctor Mistakenly Promotes What To Do About Shingles Nerve Pain

The medical community is largely responsible for this misinformation being passed on to the suffering patient. In my view it is the job and responsibility of the family doctor to teach the patient about their neuropathy problem. It is also the doctors job to train the patient in what they can do to improve and manage their neuropathy case successfully.

===> How To End Peripheral Neuropathy < < <

Many neuropathy patients, suffering with foot or hand pain, tingling, numbness, burning, and other evasive and hard to describe neuropathy symptoms, dont even know the name of their condition! And while others do, that is essentially all they know. With this in mind I want to address some of the most commonly INCORRECT facts that suffering neuropathy patients have been told, or come to understand, due to the lack of patient education by the medical community.

1. Neuropathy comes with age, and there is nothing you can do about it.This statement is only partially correct, inasmuch as aging can contribute to the increased onset and intensity of the neuropathy condition. There are however, many simple techniques and procedures that any person can learn which will offset many of these effects of aging as they relate to peripheral neuropathy.

4. Neuropathy just gets worse with time, and you have to accept that you are stuck with it.

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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Who Can Get Shingles

Shingles most often occur in adults attending young children infected with the chickenpox virus. Older people are more vulnerable to this virus. As are those who have weakened immune systems.

Shingles Risk Factors

• Individuals over the age of 50.
• Patients with a disease that lowers their immunity. For example, cancer, HIV.
• People who are experiencing great stress or who have suffered a severe injury.
• Those who take medicines, such as corticosteroids, that weaken the immune system over the long-term.

What Are The Symptoms Of Nerve Pain

Nerve pain often feels like a shooting, stabbing or burning sensation. Sometimes it can be as sharp and sudden as an electric shock. People with neuropathic pain are often very sensitive to touch or cold and can experience pain as a result of stimuli that would not normally be painful, such as brushing the skin.

Its often worse at night. It might be mild or it might be severe.

People who have nerve pain often find that it interferes with important parts of life such as sleep, sex, work and exercise.

Some people with nerve pain become angry and frustrated, and may have anxiety and depression.

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Antidepressants May Offer Surprising Relief

Antidepressants may have been invented for depression, but they are also known to modulate peripheral nerves, Dr. Auwaerter says, thereby dulling PHN pain. Your physician may suggest Pamelor or Aventyl or Elavil . Dr. Auwaerter adds that these medications can sometimes cause side effects like fatigue and sluggishnessthough PHN patients usually only need a low dose, which is unlikely to cause major adverse effects.

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.

Procedures

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Can I Give Shingles To Others

No one can catch shingles from you. But the virus can be spread to a person who has never had chickenpox. The virus lives in the blisters that shingles causes. It can be spread until the blisters are completely healed. If you have blisters that have not crusted over yet, you should stay away from:

• Anyone who has never had chickenpox
• Babies under 12 months old
• Very sick people

Tell your doctor if you live with children who have not had chickenpox. They may need to be vaccinated.