Tuesday, April 16, 2024

When Is Shingles Most Painful

When To See A Doctor

New treatment for the pain of shingles

Chronic intercostal neuralgia can greatly impact a persons quality of life.

The condition can be extremely uncomfortable. Chronic pain from intercostal neuralgia can also lead to reduced movement and poor sleep quality. It can also make it difficult for a person to breathe.

Also, intercostal neuralgia has some symptoms in common with other potentially serious health conditions. These include:

For this reason, it is important for anyone with prolonged or acute intercostal neuralgia to see a doctor immediately.

People should also see a doctor if they experience other symptoms of shingles.

Get Shingles Treatment Online

Speak to a board-certified doctor securely from your phone or computer and get medication for shingles in 15 minutes. Shingles, also known as herpes zoster, is a viral infection that causes a painful rash. Although shingles can appear anywhere on the body, it most often is a single stripe of blisters that wraps around the left or right side of your torso. With our same-day treatment service, you can meet with a top online doctor, get diagnosed, and receive the medication you need.

Who Is At Risk For Shingles

About 1 in 3 Americans will develop shingles in their lifetime, according to the Centers for Disease Control and Prevention . Cases are more common in older adults, but doctors say even children get shingles.

Shingles is caused by varicella zoster virus , the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays dormant in their body. The virus can reactivate later, causing shingles.

“Not everyone who had chickenpox will develop shingles,” Wigand-Bolling noted.

Two other things to keep in mind: You cannot get shingles from someone who has shingles, the CDC says. However, you can get chickenpox from someone who has shingles if you’ve never had chickenpox or never received the chickenpox vaccine.

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Shingles: All You Need To Know

This article was medically reviewed by Dr. Ira Gurland.

Shingles will affect about a third of all Americans at some point in their lifetime. However, while many people have heard of the disease, fewer know much about it. Because shingles is so common and has the potential to produce painful complications, its important for everyone to understand the basics of this viral infection, including its close relationship with chickenpox.

Both diseases have the same origin, but there are important differences. Understanding these distinctions can help avoid confusion:

  • Shingles and chickenpox are different infectious diseases, but both are caused by the same virus, called varicella-zoster .
  • Chickenpox symptoms are the bodys first reaction to a varicella-zoster infection, presents as a severe skin rash, is more common in adolescence, and is highly contagious.
  • Shingles symptoms are the bodys subsequent reaction to the same varicella-zoster infection that reactivates in the body, often many years later. It is more common in adults and presents as a painful rash as it strikes the nerves. You cant get shingles from someone who has shingles. However, you get chickenpox from someone who has shingles if you never had the chickenpox vaccine or chickenpox earlier in life.

How Long Does It Take For Shingles To Progress

Therapeutic Touch and the Pain that is Shingles

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.

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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.

What Are Shingles Symptoms

Common symptoms of shingles are pain and a rash in a belt-like form that stops at the midline of the body affecting only one side. Symptoms of shingles progress from burning and itching sensations to severe pain at the location of the rash. Early shingles symptoms may include burning, tingling, or a numb sensation on the skin accompanied by headache, upset stomach, and chills.

Later stages include painful fluid-filled blisters that cause severe pain, fever, and severe itching.

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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 doesnt go away. It can last for months, years, or even the rest of their lives.

These people have whats 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 peoples 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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How Can This Pain Be Managed

Shingles: What you need to know about causes, symptoms, and prevention.

If your doctor is able to identify an underlying cause for the neuropathic pain, treating it may reduce and even eliminate the pain.

For example, diabetes is a common cause of neuropathic pain. Proper diabetes care which includes a healthy diet and regular exercise may eliminate or reduce neuropathic pain.

Taking care of blood sugar levels can also prevent worsening pain and numbness.

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Key Points About Shingles

  • Shingles is a common viral infection of the nerves. It causes a painful rash or small blisters on an area of skin.
  • Shingles is caused when the chickenpox virus is reactivated.
  • It is more common in people with weakened immune systems, and in people over the age of 50.
  • Shingles starts with skin sensitivity, tingling, itching, and/or pain followed by rash that looks like small, red spots that turn into blisters.
  • The rash is typically affects just one area on one side of the body or face.
  • Treatment that is started as soon as possible helps reduce the severity of the disease.

Shingles And Chickenpox Contagiousness Comparison

Chickenpox is very contagious when in close contact with an infected person. Before the FDA approval of the chickenpox vaccine in 1995, it was a very common childhood illness. Since then, chickenpox cases have dropped by more than 99%. However, unvaccinated people who have never been infected can catch chickenpox at any age. Patients are most contagious when blisters are present, and they should isolate during this phase of the disease.

Shingles occurs most commonly in people over 50 years old, but it can strike at any age in unvaccinated people who have already had chickenpox. But you cannot get shingles if you havent had chickenpox first. The virus in shingles blisters is not as contagious as in chickenpox blisters, but the varicella-zoster virus is still present in the fluid and transmission is possible.

However, you cant get shingles from someone who has shingles. Direct contact with a person who has shingles can only spread VZV to a person who has never had chickenpox or the chickenpox vaccine. If infected with VZV, they will get chickenpox, not shingles. They can develop shingles later as the virus is now in their body.

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What Are The Symptoms Of Shingles

Usually, shingles develops on just one side of the body or face, and in a small area. The most common place for shingles to occur is in a band around one side of the waistline.

Most people with shingles have one or more of the following symptoms:

  • Fluid-filled blisters
  • Tingling, itching, or numbness of the skin
  • Chills, fever, headache, or upset stomach

For some people, the symptoms of shingles are mild. They might just have some itching. For others, shingles can cause intense pain that can be felt from the gentlest touch or breeze. Its important to talk with your doctor if you notice any shingles symptoms.

If you notice blisters on your face, see your doctor right away because this is an urgent problem. Blisters near or in the eye can cause lasting eye damage and blindness. Hearing loss, a brief paralysis of the face, or, very rarely, inflammation of the brain can also occur.

How Long Does Shingles Last

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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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What Does A Mild Case Of Shingles Look Like

Not everyone with shingles will develop a blistering rash. A mild case of shingles may include a red rash without blisters. The shingles rash and blisters are distinct characteristics of the illness. Mild cases of shingles do not usually cause headaches, fever, or fatigue.

Whether mild or severe, pain is the most common symptom of shingles. Most people describe a deep burning, throbbing, or stabbing sensation. The pain usually subsides within 30 days.

Shingles: What Triggers This Painful Burning Rash

If youre like 95% of American adults, you had chickenpox as a kid. Before the United States started its widespread vaccination program in 1995, there were roughly four million cases of chickenpox every year. So, most people suffered through an infection with this highly contagious virus and its itchy, whole-body rash.

But unlike many childhood viruses, the varicella-zoster virus that causes chickenpox doesnt clear from the body when the illness ends. Instead it hangs around, taking up residence and lying dormant in the nerves, sometimes for decades, with the immune system holding it in check. In some people, it lives there harmlessly for the rest of their life. But in others, the virus can suddenly emerge and strike again, this time appearing as a different condition known as shingles.

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How To Avoid Spreading Shingles

The most effective way for people with shingles to prevent the spread of VZV is to:

  • Frequently wash hands
  • Avoid scratching

Additionally, you should avoid contact with vulnerable people if you develop shingles. Until the rash begins to heal and crust over, you should avoid people at higher risk for VZV complications, including people with compromised immune systems and pregnant people.

A person with shingles is contagious until their rash crusts over.

Preventing The Virus Spreading

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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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New Drug Treatment Reduces Chronic Pain Following Shingles

by Sam Wong05 February 2014

A new drug treatment has been found to be effective against chronic pain in patients who have had shingles.

The researchers hope that the drug might also be effective against other causes of pain caused by nerve damage, known as neuropathic pain, such as diabetes, HIV, nerve injury and cancer chemotherapy, as it targets a mechanism that is not targeted by any existing therapies and has fewer side effects.

Drugs available now have limited success at treating neuropathic pain and often have unpleasant or disabling side effects.

It is estimated that around 190,000 people in the UK get shingles every year, most of them aged over 50. It is caused when a dormant viral infection of a nerve is reactivated, resulting in a painful rash. In most cases, the shingles rash lasts a few weeks, but in some cases the permanent nerve damage caused by the virus results in a chronic neuropathic pain called post-herpetic neuralgia. Around one in 10 people with shingles experiences post-herpetic neuralgia and, once established, it usually causes life-long suffering.

In a study involving 183 patients with post-herpetic neuralgia in six countries, the new drug EMA401 was found to reduce pain and did not cause any serious side effects. The findings are published in The Lancet.

Spinifex Pharmaceuticals, which owns the drug, now plans to conduct a larger trial, possibly testing higher doses of the drug for longer periods of time.

Focus On Prevention Doctors Say

Prevention is the best way to avoid a shingles episode.

There is a vaccine that prevents the onset of shingles in people exposed to chickenpox. The CDC recommends that people age 60 and older get one dose of the vaccine. Vaccines are readily available at a doctors office and drug stores. In 2011, the Food and Drug Administration extended the vaccine use for people aged 50 to 59.

Wigand-Bolling said the vaccine reduces the incidence of shingles by 51% and the neuralgia associated with shingles by 67%. The doctor said the vaccine is injected and once vaccinated a person is protected for life.

Unless contraindicated because of pregnancy or being an organ transplant recipient or on chemotherapy, everyone over age 50 should be vaccinated, Wigand-Bolling said. I would recommend getting vaccinated to patients who may not have had chicken pox, or those who dont remember having chicken pox.

More than 90% of those identified in the study at increased risk of stroke and heart attack after a shingles episode hadn’t been vaccinated for shingles. The people in the study who had the vaccine still got shingles, it’s worth noting.

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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 And Your Eyes

The early stages of shingles: Signs and symptoms

If the shingles rash breaks out on the face, near the eye, the vision may be affected. An ophthalmologist should be consulted right away when pain or other symptoms of shingles affect the eye or the area near the eye.

Shingles painand other symptoms from an outbreak of herpes zosterusually lasts between three to five weeks. Most people experience shingles once, but in some instances, people will continue to experience pain. When this happens, its called postherpetic neuralgia .

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How Is Postherpetic Neuralgia Treated

If shingles is caught within the first three days of its outbreak, your healthcare provider may prescribe the antiviral medication acyclovir , valacyclovir or famciclovir . These medications help the rash/blisters heal faster, keep new sores from forming, decrease pain and itching and reduce length of pain after sores have healed.

If your shingles outbreak is not caught early, your healthcare providers has many options to manage your postherpetic neuralgia symptoms.

If your pain is mild, your healthcare provider may recommend:

  • Acetaminophen or NSAIDs such as ibuprofen .
  • Creams and patches include lidocaine and capsaicin .

If your pain is more severe, your healthcare may prescribe:

  • Antiseizure drugs gabapentin and pregabalin .
  • Antidepressants, such as escitalopram , quetiapine or amitriptyline.
  • Botulinum toxin injections in the area where you are having pain.

Theres no clear-cut superior treatment for PHN. Your provider may need to try more than one medication or prescribe the use of several medications at the same time. You and your provider will discuss options and what makes sense to try for you. Contact your provider if your pain is not lessening after taking your medicine. Take all your medications exactly as prescribed.

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