Friday, July 12, 2024

Where Does Shingles Pain Occur

Can You Get Shingles In The Eye

How to treat shingles

Yes. Shingles in or around the eye can be serious. This form of shingles is estimated to account for 20 percent of cases. If you have the shingles rash around your eye, or even felt a shingles-like pain in the area, it’s important to see an eye doctor right away.

Shingles in the eye tends to show up either inside the eyelid or on the surface of the eyeball. The cornea is a common place to see shingles, says Rebecca Taylor, MD, a spokesperson for the American Academy of Opthalmology and an ophthalmologist in private practice in Nashville, Tennessee. Its the clear domed tissue that you put your contacts on.

Shingles also often appears on the conjunctiva, she adds, which is the clear tissue that covers the whites of your eye and the inside of your eyelid.

Theres also a pattern in the rash to look out for, says Dr. Taylor. If you have blisters on the tip of your nose, thats a strong predictor of there being inflammation inside the eye.

With early treatment, such as antiviral medication, steroid eye drops, and regular eye exams in the months and years after the episode, shingles on the surface of your eye should go away without residual effects.

But in some cases, shingles in the eye can go deeper than the surface and lead to permanent vision problems, like glaucoma, a disease that damages your optic nerve. In very rare cases, it could lead to blindness. This is why you should see an eye doctor as soon as possible if you notice a rash in this area.

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.

Who Should Be Vaccinated With Shingrix

The Shingrix vaccine is recommended for those 50 years of age and older who are in good health.

You should get the Shingrix vaccine even if:

  • You have had shingles already.
  • You have been previously vaccinated with Zostavax .
  • You do not know for sure if youve ever had chickenpox.

Ask your healthcare provider, who knows your entire health history, if getting this vaccine is right for you.

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What Are The Risks Associated With Shingles

Some people experience pain around the rash site for a month or morepain that is severe enough to interfere with daily activities.

Scratching the rash can also cause a secondary infection if harmful bacteria get into the sores.

Shingles on the face can involve the eyes, which is serious because it can cause scarring and blindness.

The occurrence and severity of shingles and its complications increase with age.

If Ive Been Vaccinated For Chickenpox Can I Still Develop Shingles Later In Life

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Unfortunately, yes, despite being vaccinated for chickenpox, you can still get shingles. No vaccine is 100% protective and the effects of vaccines lessen 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 did not.

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Does Shingles Increase The Risk Of Heart Attack

Yes. In the months after an episode, some may be at a higher risk for having a stroke or a heart attack. In a study published in 2017 in the Journal of the American College of Cardiology, shingles was found to raise the risk of cardiovascular events, such as heart attacks and strokes, by 41 percent. Those younger than 40, say the researchers, were at highest risk for a stroke.

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
  • Pregnant women
  • Very sick people

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

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When Shingles Becomes Painful Postherpetic Neuralgia

In 10% to 20% of these people, however, the pain of shingles keeps hanging on after the rash is gone. “These folks go on to get postherpetic neuralgia, and we’re not exactly sure why,” Ralph tells WebMD. “Either the pain of shingles never leaves, or it resolves, comes back, and never goes away completely.”

PHN typically occurs in the area where the shingles occurred. The pain can be intermittent or constant, and it can take on any of the diverse qualities of shingles pain. Normal touching of the skin can set it off, Ralph adds. This is called allodynia.

The pain of postherpetic neuralgia can interfere with daily activities, exercise, sleep, and sexual desire. Irritability and depression often follow. “Generally, it makes people feel terrible if it can’t be controlled,” Rumbaugh says.

Why the pain of postherpetic neuralgia persists has mystified researchers. It’s not due to ongoing infection by VZV, but is thought to be due to residual damage or inflammation in the nerve after shingles resolves. It’s also impossible to predict who’ll get shingles or postherpetic neuralgia, although age, race, and health seem to have some impact.

The First Symptoms Of Shingles

What Is Shingles?

Early symptoms of shingles can appear several days before the more obvious symptoms. However, some people will not have early symptoms before a rash appears.

The most common early symptoms occur on one part of the body or face. This often happens in the abdominal area.

These symptoms many include:

The pain can worsen as shingles develops. The pain can be sharp, stabbing, and intense.

It may also cause hypersensitivity, or an excessive reaction to touch.

There are also other early symptoms of shingles.

Although not every person with shingles will experience them, early symptoms include:

  • tiredness
  • general feeling of being unwell
  • fever

Your doctor can often diagnose shingles based on these symptoms. Your doctor may prescribe medication to speed up recovery.

Medication also reduces the chance of complications, so seeking early intervention is important.

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Symptoms During The Prodromal Stage

Among the systemic symptoms that may appear in the first few days of the prodromal stage of shingles are:

  • Fever
  • A headache
  • Sensitivity to light

Whether or not it feels like flu in the very beginning, the most telling first symptom of shingles typically is the pain. Often excruciating, the discomfort has been described as burning, stinging, tingly, prickly, itchy, numbing, achy, or shooting. It can be persistent or intermittent but will be limited to one side of the body. This symptom can be deceiving, though.

Because the pain from shingles is localized, it can be mistaken for other conditions depending on where it’s focused. For example, a stabbing or persistent pain on one side of the lower back may be attributed to sciatica or a kidney problem when, in fact, it’s the early sign of a shingles outbreak in that area. Similarly, shingles pain around the lips could suggest a cold sore coming on, while pain focused on the eye or ear might seem like the start of a migraine.

How Do Health Care Professionals Diagnose Shingles

Shingles can often be diagnosed by your doctor based upon the distinctive appearance and distribution of the characteristic shingles rash. A painful, blistering rash that is localized to defined dermatomes is a sign highly suggestive of shingles. Blood work or other testing is usually not necessary. Diagnosing shingles before the appearance of the rash or in cases of zoster sine herpete can be challenging. In cases where the diagnosis is unclear, laboratory tests are available to help confirm the diagnosis. Depending on the clinical situation, testing can be done using either blood work or by specialized testing of skin lesion samples.

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If I Have Disseminated Zoster/shingles What Can I Expect For My Hospital Stay

It is important to note that most people with shingles do not need to be in a hospital, but if you do:

  • You will be in an airborne-contact isolation room.
  • The door will be kept closed.
  • A sign on your door will remind people who have never had chickenpox or the vaccine not to enter.
  • The sign will also remind staff to wear gowns and gloves when entering the room.

Who Is At Risk For Getting Shingles

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People who have had chickenpox who are more likely to develop shingles include:

  • People with a weakened immune system .
  • People over the age of 50.
  • People who have been ill.
  • People who have experienced trauma.
  • People who are under stress.

After having chickenpox, your body does not rid your system of the virus. Instead, the virus stays in a portion of the spinal nerve root called the dorsal root ganglion. For the majority of people, the virus stays there quietly and doesn’t cause problems. We aren’t always sure why the virus gets reactivated, but this typically occurs at times of stress.

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How Long Does Shingles Last

Most cases of shingles last three to five weeks. Shingles follows a pattern:

  • 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 a week to 10 days after that, the blisters dry up and crust over.
  • A couple of weeks later, the scabs clear up.

Most people get shingles only one time. But, it is possible to have it more than once.

Shingles Chickenpox And Pregnancy

An attack of shingles during pregnancy will not harm the unborn baby. The mother is already carrying the varicella zoster virus before developing shingles and there is no increase in the risk of passing it on to the fetus if shingles develops. However, an attack of chickenpox during pregnancy can be serious and requires urgent medical attention.

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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.

What Are The Pain Complications Of Shingles

New treatment for the pain of shingles

Many sufferers have described the pain as extremely severe, and some even require narcotic pain-relief medications.

A blistering rash usually accompanies the outbreak. New blisters continue to appear for several days, and the entire outbreak can take weeks to heal. Blisters may cover the entire path of the affected nerve, or the involvement may be patchy. Involvement of the eyes during a shingles outbreak can be particularly serious, since scarring of the cornea and permanent vision loss can result.

Another debilitating complication of shingles is known as postherpetic neuralgia. In postherpetic neuralgia, the pain of shingles persists even after the rash has healed. The diagnosis is made when pain lasts for over 30 days after an outbreak. This pain can last for weeks, months, or even years. Up to 15% of people with shingles have this persistent pain, and it is not understood why the pain persists in some people, but it is likely that some type of nerve damage or inflammation occurs during the outbreak that leads to continued pain.

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How Do People Get Shingles

People get shingles when the virus that causes chicken pox, varicella zoster, is reactivated in their body. The varicella zoster virus doesn’t leave the body, even after a person has recovered from chicken pox. It can flare up again, causing shingles, often many years after a person has had chicken pox. The virus tends to reactivate when a person’s immune system is weakened because of another health problem.

What Increases The Risk Of Long

The risk of developing post-herpetic neuralgia increases with age. Four weeks after getting shingles,

  • 27% of 55- to 59-year-olds and
  • 73% of over 70-year-olds had nerve pain.

Women seem to be more likely to have longer-lasting nerve pain than men. Post-herpetic neuralgia is also more likely to develop if your eyes were affected by shingles.

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How Can I Take Care Of Myself

  • Take a pain-relief medicine such as acetaminophen. Take other medicine as prescribed by your healthcare provider.
  • Put cool, moist washcloths on the rash.
  • Rest in bed during the early stages if you have fever and other symptoms.
  • Try not to let clothing or bed linens rub against the rash and irritate it.
  • You develop worsening pain or fever.
  • You develop a severe headache, stiff neck, hearing loss, or changes in your ability to think.
  • The blisters show signs of bacterial infection, such as increasing pain or redness, or milky yellow drainage from the blister sites.
  • The blisters are close to the eyes or you have pain in your eyes or trouble seeing.
  • You have trouble walking.

Why Does Shingles Appear Mostly On One Side Or In One Area Of The Body

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The virus travels in specific nerves, so you will often see shingles occur in a band on one side of the body. This band corresponds to the area where the nerve transmits signals. The shingles rash stays somewhat localized to an area it does not spread over your whole body. The torso is a common area, as is the face.

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What Are Complications Of Shingles

Though shingles often resolve without any major problems, several potential complications can arise from shingles.

  • Postherpetic neuralgia : This is the most common complication of shingles. PHN is characterized by persistent pain and discomfort in the area affected by shingles. The pain can last for months to several years after the rash has cleared up. This complication is thought to occur because of damage to the affected nerves. The pain can sometimes be severe and difficult to control, and the likelihood of developing postherpetic neuralgia increases with age. This chronic post-herpetic pain can sometimes lead to depression and disability. In people 60 years of age and older with shingles, postherpetic neuralgia will develop in approximately 15%-25% of cases. It rarely occurs in people under 40 years of age. Timely treatment with antiviral medication during a shingles outbreak may help reduce the incidence of developing postherpetic neuralgia. If postherpetic neuralgia develops, there are various treatment options available including topical creams such as capsaicin , topical anesthetic lidocaine patches , antiseizure medications such as gabapentin , pregabalin , tricyclic antidepressant medications, and opioid pain medications. Intrathecal glucocorticoid injections may be useful for select patients with postherpetic neuralgia who do not respond to conventional medications and treatment measures.

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