Friday, April 12, 2024

Why Do Shingles Hurt More At Night

What Is Nerve Pain

Pain relief from shingles

Nerve pain, also called neuralgia or neuropathic pain, occurs when a health condition affects the nerves that carry sensation to the brain. It is a particular type of pain that feels different from other kinds of pain.

There are different types of nerve pain, including:

  • post-herpetic this can happen after you’ve had shingles and affects the same area as the shingles rash
  • trigeminal causing pain in the jaw or cheek
  • occipital causing pain at the base of your skull that can spread to the back of your head
  • pudendal causing pain in the saddle area between the legs

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:

  • Intercostal nerve blocks: A local anesthetic can be injected between two ribs.
  • Thoracic epidural injections: Anti-inflammatory medicine can be injected into the space around the spinal cord to decrease nerve root inflammation and reduce pain.
  • Tricyclic antidepressants: Medications such as amitriptyline may be used to relieve pain.
  • Membrane stabilizers: Medications such as gabapentin can be used to reduce the pain associated with PHN.
  • Capsaicin cream: This topical cream can be applied to the affected area to relieve pain temporarily.
  • 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.

    What Are The Symptoms Of Shingles

    The symptoms of shingles include:

    • Localized burning, tingling, itching, prickling pain that starts days days to weeks before the rash appears. The pain varies by person but can be constant or come and go.

    • Days after these symptoms appear, a group of fluid-filled blisters appears on a red, inflamed base of skin the blisters typically crust over in a week.

    • The rash may be accompanied by fever, fatigue, or headache.

    • The rash will not cross the mid-line of your body.

    • You may have swollen lymph nodes on one side of your body

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    How To Sleep Better With Chronic Pain

    You and your pain management specialist may have to take an experimental approach to sleeping better. What works well for one kind of chronic pain may not work well for another, and your body will respond in its own unique way. Here are some strategies that may help you reduce your nighttime pain and get better sleep.

    Take One Night At A Time

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    Its easier said than done to not think about the pain. The goal is to try. You have the ability to rethink how you perceive pain. It will take some time and effort, but its worth it.

    Tonight, before you go to bed, turn off the television, lights and all electronic devices. Take deep breaths in and visualize something wonderful. Lets try to shut off the brain and calm the body for a peaceful nights rest.

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    What Not To Do If You Have Itchy Skin At Night

    If your skin itches at night, here are a few triggers to avoid:

    • Try not to go to bed in anything itchy. You can wear pajamas made from soft, natural fibers like cotton or silk.
    • Keep the temperature in your room cool around 60 to 65°F. Overheating can make you itch.
    • Avoid caffeine and alcohol before bed. They widen blood vessels and send more blood to warm your skin.
    • Try not to use any cosmetics, perfumed creams, scented soaps, or other products that might irritate your skin.
    • Try not to scratch. You can irritate your skin even more. Try to keep your fingernails short in case you do feel the urge to scratch at night.

    What Are Some Common Treatments For Shingles

    The CDC recommends that adults 50 years or older receive two doses of the shingles vaccine. Additionally, several antiviral medicines like acyclovir, valacyclovir, and famciclovir are available to treat shingles and shorten the length and severity of the illness. These medicines are most effective when taken immediately after the rash appears.

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    Review Medication Options With Your Physician

    If painsomnia has begun to seriously disrupt your ability to sleep and function in daily life, talk to your doctor about your symptoms. It helps to keep a journal to help track the severity of your symptoms and how much youve been sleeping each night. This will help your doctor find the right medications and pain management strategy for you.

    Why Is Shingles Pain Worse At Night

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    Those experiencing shingles pain typically feel it gets worse as the day goes on, making it the worst at night. Peak pain time tends to be around 8 p.m., which may be when theyre getting ready for bed.

    Another reason why the pain may be worse at night is because there are fewer distractions. During the day, patients can get caught up in work and daily demands. However, once theyre lying in bed, its easy to become more aware of how their body feels.

    Lastly, temperature tends to play a factor in shingles pain. At night those with shingles may keep their room cool to help them sleep, but this can interfere with the bodys perception of pain. When its cool, the peripheral nerves may send signals to the brain that its in pain.

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    Good Sleep For Better Health

    Whatever you do, dont suffer sleeplessly in silence. Chronic poor sleep will only make your chronic pain worse, and it robs you of a better quality of life. Less nighttime pain and better sleep will help you feel better all day long.

    If youd like some help managing your pain for better rest and health, you can make an appointment with any United Physician Group Pain Management practice. We offer effective treatments that bring lasting relief. Well help you rest well and get your life back.

    The Emotional Toll Of Nerve Pain After Shingles

    Researchers are not just looking at biological and neurological risk factors for PHN. Dworkin was also a co-author of a study looking at psychological risk factors, too. The results were published in the Journal of Pain in 2005.

    “It certainly looks like psychological stress can be a potent risk factor for PHN,” Dworkin tells WebMD.

    The study showed that people with shingles who went on to develop PHN were more likely to have had symptoms of personality disorders, hypochondria, intense worry about their disease, and other bodily complaints.

    Dworkin says previous studies have already shown a connection between stress and shingles development.

    “One study even found that the risk of developing PHN was higher in people who were living alone when they developed shingles than people living with others,” Dworkin says, perhaps indicating that social isolation increases the risks of PHN.

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    Preventing The Virus Spreading

    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.

    How To Stop Neuropathy Pain At Night

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    There are options we can explore if your neuropathy pain seems to be worsening at night, explains Dr. Claytor. There might be oral or topical medications we can prescribe, or maybe its getting your stress under control and being more mindful.

    Cognitive behavioral therapy, physical therapy and meditation may be complementary tools to reduce pain as well.

    Dr. Claytor stresses the importance of talking to your doctor sooner rather than later. Often times people will wait so long to see their physician that theres permanent nerve damage that might have been avoided.

    I think one of the most important things I can discuss with a patient who comes in with neuropathy pain at night is getting to the root cause of what is actually driving it, says Dr. Claytor. Depending on what the underlying cause is, treating that first and foremost can usually help reduce the pain overall especially at night.

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    How Is Nerve Pain Treated

    There are many ways to treat nerve pain. Treating the underlying cause, if there is one, is the first step.

    Painkillers and a range of different medicines can help, as can non-drug treatments like exercise, acupuncture and relaxation techniques.

    Nerve pain can be difficult to treat. Any underlying conditions such as diabetes and vitamin B12 deficiency can be managed. Otherwise, treatments aim to directly ease the pain. Options include medicines and non-medicine strategies.

    Other Signs Of Inflammatory Back Pain

    Back pain at night is one of the more obvious clues for inflammatory back pain, but there are other key signs to keep in mind as well. There are slightly different sets of criteria for inflammatory back pain, but generally speaking they include the following:

    • Back pain improves with exercise or activity
    • Back pain gets worse with rest
    • Back pain in the morning that lasts more than 30 minutes
    • Gradual, not sudden, onset

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    How Is It Treated

    It is best to start treatment as soon as possible after you notice the rash. See your healthcare provider to discuss treatment with antiviral medicine, such as acyclovir. This medicine is most effective if you start taking it within the first 3 days of the rash. Antiviral medicine may speed your recovery and lessen the chance that the pain will last for a long time.

    Your provider may also recommend or prescribe:

    • medicine for pain
    • antibacterial salves or lotions to help prevent bacterial infection of the blisters
    • corticosteroids

    What Increases The Risk Of Long

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    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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    What Are The Complications Of Shingles

    Symptoms of shingles usually dont last longer than 3 to 5 weeks. However, complications can happen. The main complications that can result from shingles include:

    • Postherpetic neuralgia . The most common complication of shingles is called postherpetic neuralgia . This continuous, chronic pain lasts even after the skin lesions have healed. The pain may be severe in the area where the blisters were present. The affected skin may be very sensitive to heat and cold. If you had severe pain during the active rash or have impaired senses, you are at increased risk for PHN. The elderly are also at greater risk. Early treatment of shingles may prevent PHN. Pain relievers and steroid treatment may be used to treat the pain and inflammation. Other treatments include antiviral drugs, antidepressants, anticonvulsants, and topical agents.
    • Bacterial infection. A bacterial infection of the skin where the rash happens is another complication. Rarely, infections can lead to more problems, such as tissue death and scarring. When an infection happens near or on the eyes, a corneal infection can happen. This can lead to temporary or permanent blindness.

    What You Can Do About Nerve Pain That Lingers After Shingles

    Chronic pain that continues after a case of shingles is called postherpetic neuralgia . It is estimated that about 20% of patients will experience this type of nerve pain as a complication of shingles.

    Those who have had chickenpox are at risk of developing shingles later in life. People who develop PHN are generally age 60 and older. Although there is no cure for PHN, there are several methods of pain management that can ease symptoms. Fortunately, the type of pain that arises from postherpetic neuralgia improves over time.

    Neuralgia affects the nerves, causing structural and functional damage. It can feel like a stabbing or burning pain that radiates along the affected nerve.

    Neuropathic pain is not caused by an external injury or stimuli but originates from inside the nervous system. When the herpes-varicella zoster virus is reactivated in the form of shingles, scar tissue forms alongside nerves, creating pressure, and sending pain signals to the brain.

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    The Most Important Tip For Shingles

    I know that this is a lot of information so give yourself time to take it all in. Perhaps, more importantly take this one piece of advice: RELAX. Shingles is usually brought on by stress in your life. While I didnt think I had a lot of stress , when I listed everything on my plate its easy to see how my body was overburdened.

    The biggest lesson learned through this process is how important it is to really, truly support your body. People often mentioned how lucky I was to be able to have a job that works from home, but when youre sick its easy to just reach for your phone in bed or work on a project while recovering on the couch. The boundaries are less clear. Though I did the bare minimum I needed to do, I mostly took a lot of time to rest, nap, journal, watch TV and essentially do nothing.

    I would have loved to have gone on walks or been outside but the pain of the wind on my face made it impossible. I was upset over this but C reminded me that compassion is a big part of the recovery process. So even though I felt stir crazy, I also knew that going outside actually created more stress in my life. Acknowledging those stressors and putting in plans of action to eliminate or diffuse them is the key to getting over shingles.

    * * * * *

    Overall I can tell Im drastically improved from where I was and also have learned one of lifes most important lessons: STRESS IS REAL and it can manifest physically, so dont ignore it!

    Avoid The Pain Of Shingles

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    Anyone who has recovered from chickenpox can develop shingles

    Shingles is a painful infection. Some people have the virus hiding in their nerve tissue, and if conditions are right, the virus “awakens.” This may cause a few blisters on the skin or a big rash that is only on one side of the body. The rash may be on the chest and back, at the waist, on the upper arm, or the side of the face and scalp. In healthy people, the rash goes away in 2 to 4 weeks.

    Shingles is not likely to spread, but it may cause chickenpox. The same virus that causes chickenpox causes shingles. However, not everyone who had chickenpox will develop shingles.

    What are the risk factors for shingles?

    Anyone who has had chickenpox can develop shingles. But your risk is greater if you:

    • Are age 50 or older

    • Have an illness that weakens your immune system, such as HIV infection

    • Have cancer, especially leukemia or lymphoma

    • Take medicines that suppress your immune system, such as steroids or those given after an organ transplant

    Can shingles be prevented?

    A vaccine reduces your risk of getting shingles. Half as many people get shingles after being vaccinated. Among those who are treated and then develop shingles, only one third develop after-shingles pain. If you’re older you when you’re vaccinated and you get shingles, your outbreak will be less severe.

    How do you know when shingles is coming on?

    What is the treatment for shingles?

    What causes after-shingles pain?

    How serious is after-shingles pain?

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    Is The Condition Curable

    There is no cure for shingles, but attacks can be rendered less severe and their duration shortened with the use of prescription antiviral drugs.

    Several antiviral medicinesacyclovir, valacyclovir, and famciclovirare available to treat shingles and shorten the length and severity of the illness. These medicines are most effective if you start taking them as soon as possible after the rash appears. If you think you have shingles, contact your healthcare provider as soon as possible to discuss treatment.

    Pain medicine, either over-the-counter or a prescription from your doctor, may help relieve the pain caused by shingles. Wet compresses, calamine lotion, and colloidal oatmeal baths can also help relieve itching.

    Shingles Complications Can Be Mercilessly Painful

    Q. I’m 81, and nine months ago I developed pain on the left side of my face and neck that was so excruciating it made me scream. A doctor told me I had shingles that would last six to eight weeks. I was given Neurontin and Percocet and told to take them three times a day. The doctor stopped the Percocet, but I’m still on Neurontin and still in pain. What can I do?

    –M.B., Austin, Minn.

    A. Shingles, or herpes zoster, is a viral infection of the nerves. It is a reactivation of the dormant chicken pox virus, Varicella, so only those who have had chicken pox get shingles.

    Shingles is common more than 1 million North Americans have it at any one time, and it is seen more often in older adults. The symptoms begin with pain and itching in the skin along infected nerve pathways, usually on the trunk or face.

    Shingles typically lasts two to six weeks, but the virus never leaves the body, so it may be reactivated even years later. Shingles returns in about 1 in 24 people.

    The reason for reactivation is unknown in most cases, but the virus can be reactivated when the immune system is impaired by disease, such as with AIDS or lymphomas, or by certain drugs.

    Antiviral drugs, such as famciclovir or valacyclovir, taken for seven days in a row, are helpful in treating shingles. But they do not eliminate the shingles virus.

    Neurontin is an effective adjunctive treatment sometimes prescribed for seizures.

    ———-

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