Who Should Not Be Vaccinated With Shingrix
Shingrix is given by injection into the upper arm. Shingrix is generally well tolerated. In general, Shingrix is not recommended for: People who are allergic to any component of Shingrix. People with a weakened immune system. People who have a weakened immune system because of:
HIV/AIDS, or- cancer treatments
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.
Why Is Shingles Bad
Shingles is not fun for anyone, but its negative impact can be significantly worse for some.
The General Experience: Herpes zoster causes a distressing rash that typically occurs in a stripe around the left or right side of the body. This will last for weeks with pain, tingling and itchiness. Medical News Today describes the pain as being a constant dull, burning, or gnawing pain, or sharp, stabbing pain that comes and goes.
In rare cases the rash may not be limited to a single stripe and will instead appear more like a widespread chickenpox rash.
Other symptoms can include fever, headache, chills and an upset stomach.
While having one episode of the shingles rash is common, multiple episodes can happen over time in some cases.
Lasting Nerve Damage:WebMD reports that up to 50 percent of those over age 60 who havent been treated for their shingles will develop postherpetic neuralgia . The CDC states that approximately 10 to 13 percent of people who get shingles will experience PHN. PHN occurs when the varicella-zoster virus damages the nerves.
Those with postherpetic neuralgia experience mild to devastating pain when touched. The pain can be very mild or be devastating depending on the specific case. PHN can cause issues for patients for a few months, years or even for the rest of their lives.
Also Check: What’s The Best Pain Relief For Shingles
Spinal Cord Or Peripheral Nerve Stimulation
These are often used to treat several different types of neuropathic pain. Electrodes are placed underneath the skin along the affected peripheral nerves. Before using this technique, doctors will do a test using a wire electrode to get a sense of how the patient will respond.
After the electrodes have been placed above the peripheral nerve, a weak electrical current is sent to the nerve. By stimulating a sensory pathway that doesnt cause pain, experts believe that this electrical signal to the brain can trick the brain into turning off the painful signal, bringing relief to the patient.
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.
You May Like: Will The Shingles Vaccine Help With Herpes
At Risk For Shingles And Postherpetic Neuralgia
Experts explain the causes and treatments of shingles pain.
If you thought chickenpox was a “once and done” childhood illness, you’re only two-thirds right. For about one million American adults each year, that long-forgotten rash returns in a new painful form: shingles.
The pain of shingles can be excruciating, but the condition goes away in a few weeks — for most people. In some unlucky folks, shingles pain doesn’t end when the rash goes away. It goes on. And on. This is called postherpetic neuralgia , a form of neuropathic pain that can last for months or years, even after the virus is no longer active.
“Postherpetic neuralgia can make people feel truly miserable,” says Jeffrey Rumbaugh, MD, PhD, assistant professor of neurology at Johns Hopkins University and a member of the American Academy of Neurology. “For some, it’s something they live with once in a while. For others, it can be daily, severe pain that may last a lifetime.”
Some people are at higher risk for shingles and postherpetic neuralgia than others. But when used correctly, available treatments can prevent postherpetic neuralgia or at least stop it from becoming a permanent, painful companion.
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.
You May Like: How Long Do Shingles Blisters Last
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.
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.
———-
Recommended Reading: How Does A Person Get Shingles
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.
What Causes Shingles Pain
Chickenpox, shingles, and postherpetic neuralgia all result from infection with a single virus called varicella zoster virus . Most people catch the varicella zoster virus as children, itch and shiver through the rash and fever of chickenpox, and get better.
But that’s not necessarily the end of the story of varicella infection. After a bout of chickenpox, our immune systems never completely eradicate the VZV virus. They just chase it into hiding. Varicella retreats into nerve cells deep under the skin, near the spine.
For most of us, VZV lies dormant inside our bodies throughout our lives, never causing further problems. In about one-third of people, however, VZV infection has a second act. The virus emerges from hiding, travels along a nerve to the skin, and erupts in a bumpy, painful rash on one side of the body. This sneak attack is called herpes zoster, or shingles.
Recommended Reading: How Does Shingles Start On Your Body
How Is Nerve Pain Diagnosed
The main way your doctor will diagnose nerve pain is by listening to you and examining you.
In the examination, they will probably test your nerves by testing the strength of your muscles, checking your reflexes, and by seeing how sensitive it is to touch.
You may be asked to have tests like:
- blood tests to check your general health and look for underlying conditions
- nerve conduction studies which measure how quickly your nerves carry electrical signals
- a CT scan or an MRI scan to look for anything that could be pressing on a nerve
Is There A Way To Prevent Shingles
Fortunately, a vaccine is available for older adults that can prevent shingles and reduce the incidence of postherpetic neuralgia. The Zostavaxshingles vaccine was approved in 2006. In 2017, the U.S. Food and Drug Administration approved a newer vaccine, Shingrix, as the preferred vaccine. The older Zostavax is a live vaccine given as a single injection, and the newer Shingrix is a nonliving vaccine. The newer Shingrix vaccine is given in two doses two to six months apart. Shingles vaccination is recommended for use in people over 60 years of age.
Antiviral medications, including acyclovir and valacyclovir , when administered early enough in the course of the disease, can decrease the severity and duration of the outbreak, reduce the risk of eye damage if the eyes are involved, and reduce the likelihood of developing postherpetic neuralgia. It is recommended that antiviral drugs be given within 72 hours of the onset of symptoms for the best outcome.
Pain medications can also be effective in controlling shingles pain. These may be applied to the skin, like the capsaicin topical patch or lidocaine . Oral medications that can help with pain control in people with shingles include tricyclic antidepressants such as amitriptyline and certain antiseizure medications such as gabapentin .
Health Solutions From Our Sponsors
Read Also: How Long Can Nerve Pain Last After Shingles
Weighing The Risks Vs Benefits
The vaccine to prevent shingles will help you to avoid shingles symptoms, which in most cases are quite mild but may cause intense pain in some people.
Shingles symptoms come in two stages: the prodromal stage and the eruptive stage. In the first stage, your symptoms may include:
About three to five days later, you develop a prickly and painful pimple-like rash. These pimples turn into blisters during this eruptive stage, and your skin may be red and swollen. Shingles sores also can affect your mouth, which is another symptom the vaccine can prevent.
Shingles isn’t generally life-threatening. It can be, though, if your immune system is compromised. During an outbreak and after the rash clears up, some people may experience complications that require immediate medical attention.
Common ones include:
- Postherpetic neuralgia : Damaged nerves cause lingering pain for three months or more.
- Bacterial skin infections: When shingles blisters pop, bacteria can get in.
- Eye damage: One branch of the trigeminal nerve goes to the eye. Damage there can lead to eye damage, which can be severe.
While you may experience side effects with the vaccine, the benefits outweigh the risks of shingles symptoms and complications in most people.
If you were vaccinated with Zostavaxa shingles vaccine that is no longer being givenask your healthcare provider about getting the Shingrix vaccine.
What Is Shingles And What Are Its Causes
Shingles is a viral infection that causes a painful rash. The rash can appear anywhere on the body, but is most often found on the torso.
Shingles is a reactivation of the varicella-zoster virus, the same virus that causes chickenpox. Following the chicken pox, the virus lies asleep or dormant in nerve tissue. It never truly goes away though. The virus may awaken as Shingles years later. This occurs especially in times of stress or illness.
Recommended Reading: What Does Shingles On Your Legs Look Like
When Shingles Hurts Even Worse: Postherpetic Neuralgia
According to the Center for Disease Control and Prevention, a third of the population will get shingles in their lifetime. Shingles is a reemergence of the chickenpox virus, but it is much more harrowing to many. Up to 15% of those people suffer longer than the outbreak of the painful rash and blisters that signal shingles is afoot. Those unlucky patients experience postherpetic neuralgia, a complication of shingles.
Can Shingles Cause Nerve Damage
October 31, 2018 By Will Sowards
When you picture harmful infections, shingles is probably not the first one that comes to mind.
Yet, while the illness may seem to just cause an irritating rash, pain, itching and tingling, it can also cause permanent damage. Some patients may even deal with constant pain for years after infection.
Considering almost one in every three people in the United States will develop shingles in their lifetime, understanding how it works is necessary for millions.
Read Also: How Long Does Shingles On The Face Last
Seek Treatment Right Away
Many people have the mistaken impression that, like poison ivy, shingles is a nuisance rash that fades on its own. But in fact a shingles rash should alert people, especially in middle or old age, to seek immediate medical help, says Dr. Oaklander.
Rapid treatment with one of three antiviral drugs, acyclovir , valacyclovir , or famciclovir , can shorten a shingles attack and reduce the risk of serious damage, such as:
- Long-term pain. Pain that lingers in the area of a healed shingles rash is called postherpetic neuralgia. This often-disabling pain can last several months to a year.
- Prolonged itching. Many people are left with an itchy area from their shingles, which can be as disabling as chronic pain. It is most common on the head or neck.
- Damage to vision and hearing. Pain and rash near an eye can cause permanent eye damage and requires an urgent ophthalmological exam. When the nerve to the ear is affected, it can permanently damage hearing or balance.
- Strokes and heart attacks. A PLOS Medicinestudy that tracked about 67,000 people ages 65 and older who were newly diagnosed with shingles found that stroke risk more than doubled in the first week after the shingles diagnosis. The same study reported an increased risk for heart attacks in the three months after shingles, but the additional risk dissipated after six months.
Early Intervention Is The Key To Treatment
Antiviral medicines such as valacyclovir , famciclovir or acyclovir , taken orally, are usually used to treat shingles. When taken at the very beginning, Ralph says, they can improve symptoms and reduce the risk of postherpetic neuralgia.
Starting antiviral treatment for shingles more than three days after symptoms start is generally believed to be ineffective because the virus is no longer reproducing. Still, many doctors will try treating the condition with antiviral drugs after this time.
An aggressive, early approach to controlling shingles pain may also reduce a person’s chance of developing PHN. In one study, people who started taking amitriptyline for shingles pain as soon as a rash appeared had less pain after six months than those taking a placebo.
“Rapid initiation of treatment for shingles is very important,” says Rumbaugh. “If treatment is started in the first three days, it can reduce the chance of postherpetic neuralgia and make it less severe if it does occur.” This window of opportunity is often missed, however, because most people don’t get to the doctor that quickly.
Also Check: Can You Get Shingles On Your Buttocks