Practice Good Sleep Habits
While the days stimulations may distract you from your pain, they wont help you sleep. Develop a sleep routine that helps prepare your body for rest. This might include turning off the TV and other screens 1-2 hours before bedtime, reading a book, or taking a warm bath. Anything that helps you relax and unwind before you head to sleep.
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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What Causes Postherpetic Neuralgia
Postherpetic neuralgia results from damage to nerve fibers during shingles infection. The nerve fibers at the skin in the affected area send exaggerated pain signals to your brain. Postherpetic neuralgia means nerve pain after herpes. Shingles is also called herpes zoster.
Shingles is caused by the varicella-zoster virus, the virus that causes chickenpox. Once youve had chickenpox, the virus remains in your body for your entire life, but is dormant or silent for years. When the virus becomes reactivated, it causes shingles. A certain percentage of people who get shingles develop PHN.
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Burning Feeling And Red Rash
Between 1 and 5 days after you start to feel the tingling or numb feeling, a red rash will develop on the same area of your skin. Most often, the rash appears on one side of your torso, but it can show up anywhere on your body.
You may also have other symptoms along with the rash, such as:
When the rash starts, you should see a doctor for treatment as soon as possible. Starting antiviral medication treatment within 3 days of the rash first appearing can lower your risk of developing complications, like long-term pain.
What Are The Symptoms
The first sign of shingles is often burning, sharp pain, tingling, or numbness in your skin on one side of your body or face. The most common site is the back or upper abdomen. You may have severe itching or aching. You also may feel tired and ill with fever, chills, headache, and upset stomach or belly pain.
One to 14 days after you start feeling pain, you will notice a rash of small blisters on reddened skin. Within a few days after they appear, the blisters will turn yellow, then dry and crust over. Over the next 2 weeks the crusts drop off, and the skin continues to heal over the next several days to weeks.
Because shingles usually follows nerve paths, the blisters are usually found in a line, often extending from the back or side around to the belly. The blisters are almost always on just one side of the body. Shingles usually doesn’t cross the midline of the body. The rash also may appear on one side of your face or scalp. The painful rash may be in the area of your ear or eye. When shingles occurs on the head or scalp, symptoms can include headaches and weakness of one side of the face, which causes that side of the face to look droopy. The symptoms usually go away eventually, but it may take many months.
In some cases the pain can last for weeks, months, or years, long after the rash heals. This is called postherpetic neuralgia.
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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.
How Common Is Postherpetic Neuralgia
Varicella-zoster virus causes both chickenpox and shingles. About 99% of Americans over age 40 have had chickenpox. About one in three people in the U.S. develop shingles in their lifetime. Some 10 to 18% of people who get shingles will develop postherpetic neuralgia. Postherpetic neuralgia is the most common complication of shingles.
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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.
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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Have Shingles Get Treatment Take Action
If you have shingles, it’s important to talk to your doctor about your risk for developing PHN. Ask whether preventative treatment with antiviral drugs makes sense. If your doctor says it’s not necessary, ask why.
The full implications of the psychological risk factors for PHN aren’t clear yet, says Dworkin. But he suggests that people with shingles should try to stay active and connected.
“If psychological distress is a risk factor for PHN,” he says, “then we think that people who have shingles might benefit from getting out and not being isolated and homebound.”
You might make an effort to stay connected to family and friends and not to dwell on your symptoms. Also, keep in mind that even if you do develop PHN, there are treatments that can help.
“We have about a half dozen types of drugs that are used as first-line treatments for PHN,” says Dworkin. They include lidocaine patch , pregabalin , gabapentin , capsaicin , carbamazepine , tricyclic antidepressants, and painkillers.
The most important thing is to get prompt medical attention if you think you might have shingles.
“If you have a one-sided rash — especially if you’re over 50 — see your doctor right away,” says Dworkin. “It could be shingles. And we know that prompt treatment can dramatically reduce the likelihood of developing long-term pain.”
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Shingles Linked To Stroke Heart Attack
Shingles flare-ups hurt, but now new research finds that they can also increase your short-term risk of heart attack and stroke following the virus outbreak.
Examining the records of more than 67,000 seniors on Medicare, researchers found that that patients newly diagnosed with shingles more than doubled their risk for stroke and nearly doubled their risk for heart attack in the month following an episode. The risk for both returned to normal after 6 months, according to the study.
Its been known for a while now that zoster causes stroke, said Dr. Gwen Wigand-Bolling , an internist at Novant Health Forsyth Internal Medicine. The inflammation causes heart attack and stroke and shingles causes increased blood clotting in the arteries, the doctor added.
Almost one-third of all Americans will develop shingles in their lifetime, according to the Centers for Disease Control and Prevention. About half of all cases are in people 60 or older.
Seniors are most vulnerable, Bolling said, because as we age we lose immunity to zoster.
Shingles, also known as zoster or herpes zoster, affects approximately 1 million people each year. The condition is common because anyone who has had chickenpox has been exposed to the virus that causes shingles.
Shingles is extremely painful, said Bolling. On a scale from one to 10, most patients will say the pain ranges from six to 10.
Prevention is the best way to avoid a shingles episode.
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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.”
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 Long Does Postherpetic Neuralgia Last
Postherpetic neuralgia can last for weeks, months, or in some people, years after the shingles rash goes away. In most people, shingles pain goes away in one to three months. However, in one in five people, pain lasts more than one year.
The pain from PHN can be so severe in some people that it disrupts their life. Researchers dont know why some people have severe or long-lasting pain and others do not.
How Does It Occur
If you have had chickenpox, you are at risk for later developing shingles. After you recover from chickenpox, the chickenpox virus stays in your body. It moves to the roots of your nerve cells and becomes inactive . Later, if the virus becomes active again, shingles is the name given to the symptoms it causes.
What exactly causes the virus to become active is not known. A weakened immune system seems to allow reactivation of the virus. This may occur with normal aging, immune-suppressing medicines, or another illness, or after major surgery. It can also happen as a complication of cancer or AIDS or treatment of these illnesses. Chronic use of steroid drugs may trigger shingles. The virus may also become active again after the skin is injured or sunburned. Emotional stress seems to be a common trigger as well.
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The Best Sleeping Position For Shingles
There is no one-size-fits-all solution to sleeping with shingles. Because the location of ones shingles can vary, the best sleeping position for shingles can vary as well. As a rule of thumb, you will want the unaffected area of your body to be the up side. For example, if a rash caused by shingles has appeared on the right side of your torso, you will want to either sleep on your left side or on your back.
Talking With A Doctor
Its important to talk with your doctor if you have symptoms of shingles or PHN. Your doctor can work with you to develop a treatment plan that can help to address your symptoms.
Antiviral medications can help to treat shingles. When these are started shortly after symptoms appear, they can reduce your symptoms and the duration of your illness.
There are also several types of medications that may help with PHN pain. Some examples include tricyclic antidepressants , antiseizure drugs, and topical pain medications.
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You Arent Distracted From The Pain
Another reason why neuropathy may seem worse at night is that youre no longer distracted from the pain. Youre not focused on work, television, reading, playing with your kids, or any other activity. Once you notice that your legs, hands, feet, or arms hurt, you may start to hyper-focus on the pain since you dont have anything to distract you. You may also notice this increased pain on the weekends or at other times when you dont have anything else to focus on.
If you have insomnia or another condition that makes it difficult to sleep, it can make the pain even worse. Youre already tired from not sleeping well, so you may be hyper-focused on anything that is contributing to keeping you awake.
Shingles Worse Before Better
Has anyone found that their shingles get worse before it gets better like reaching its peek then being to get better or is it just me getting worse
1 like, 8 replies
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Posted 4 years ago
Totally true. Good and bad days. I thought I was getting better so many times only to back slide again. It is still happening 4 months later.
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4 years ago
Hello yogi
I am also in the 4 months of this horrible virus! I thought it would be gone but after four months I saw one small blister appear and with burning pain! When will this leave? The CDC says it could only be a few weeks or months but rarely comes back!! How can they say that with so many people here getting reoccurrences?
I will visit my doctor on Monday the 18 and tell her about this second bout! I got anti viral at the hospital last week!
They told me about a home remedy, chamomile! You boil it with some seeds and then left overnight to cool and the next day you pour it threw a coffee filter and keep it refrigerated! You take a cotton ball and wet the rash with it and it helps the pain!
Try it! It helps. Its like putting cold compressors over it and it calms the itch and burning pain!
Let me know if you try it out ok!
Get well
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Postherpetic Neuralgia Treatment: Soothing The Pain
Once postherpetic neuralgia occurs, antiviral drugs can’t treat the pain because ongoing infection isn’t the problem. Instead, treatment aims to soothe and quiet the misfiring nerves that are creating the pain.
There are a variety of oils and creams available at drugstores. Some turn to herbal oils and creams, such as extracts from geranium, lavender, eucalyptus, tea tree, and bergamot.
Others use capsaicin cream, made from hot chili peppers. A drug called Qutenza contains “pure, concentrated, synthetic capasaicin,” according to the FDA. Qutenza can be used every three months and is applied by a doctor via a patch or patches placed for an hour on the places on the skin that hurt. Before applying the patch, the doctor spreads a topical anesthetic on the area to be treated.
Ralph said many people find relief from the anesthetic lidocaine, available in low-concentration creams or patches over the counter, or by prescription in higher concentration patches.
“The lidocaine soaks through the skin and numbs the painful nerve endings,” says Ralph. Lidocaine patches are particularly helpful for people with allodynia, Ralph adds.
If topical creams and oils don’t provide sufficient relief, Ralph recommends asking your doctor about prescription medicines that may help, including some antidepressants, anti-convulsants, and opioids.