Know Your Risk Of Getting Shingles And Complications
About 1 out of every 3 people in the United States will develop shingles during their lifetime.
If you’ve had chickenpox, you are at risk for shingles. More than 99% of Americans born before 1980 have had chickenpox, even if they don’t remember it.
Your risk of getting shingles and having serious complications increases as you get older.
About 1 in 10 people who get shingles develop nerve pain that lasts for months or years after the rash goes away. This is called postherpetic neuralgia and is the most common complication of shingles.
Shingles may lead to other serious complications involving the eye, including blindness. Very rarely, it can also lead to pneumonia, hearing problems, brain inflammation or death.
Shingles: Postherpetic Neuralgias Stubborn Mother
PHN is triggered by shingles which is triggered by chicken pox. Some think of shingles as adult chicken pox and while it’s true both shingles and chicken pox are caused by varicella-zoster virus—a common infection of the nerves—that’s pretty much where the similarity ends.
If you had chicken pox as a kid the varicella-zoster virus has been residing in your body ever since. It didn’t leave when your chicken pox resolved. Instead, it took up residence and remained a low-maintenance tenant until either age, a weakened immune system, stress, or some sort of cruel combination transformed the varicella-zoster virus into the herpes virus causing shingles—a much more demanding occupant.
Shingles typically starts with a variety of sensations–burning, tingling, and itching. Within days a blistery rash appears, usually on one side of the body typically around the torso, and the sensations may get more severe and painful. Within weeks the rash disappears and with it, those sensations.
How Are Shingles Usually Treated
Antiviral drugs such as , , and are commonly used to treat shingles but may also come with side effects including nausea, vomiting, diarrhea, dizziness, and more.
There’s no cure for shingles, but prompt treatment can help shorten its duration and diminish the risk of complications. Most doctors will also prescribe painkillers, numbing agents, steroids, or even local anesthetic to mitigate the severe pain associated with the shingles rash.
Shingles generally last for two to six weeks with proper treatment. Most people only get shingles once, though it is possible to contract it more than this. For the majority of patients, pain management is the most important facet of shingles treatment—and new suggests CBD may be able to help.
Antiviral Drugs May Help Relieve Nerve Pain Related To Shingles
- JAMA and Archives Journals
- A small trial suggests that treatment with intravenous and oral antiviral medications may reduce the nerve pain that occurs following shingles, according to a study posted online today that will appear in the July 2006 print issue of Archives of Neurology, one of the JAMA/Archives journals.
A small trial suggests that treatment with intravenous and oral antiviral medications may reduce the nerve pain that occurs following shingles, according to a study posted online today that will appear in the July 2006 print issue of Archives of Neurology, one of the JAMA/Archives journals.
Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox, according to background information in the article. The virus lays dormant in the nervous system for decades after infection with chickenpox. When it becomes reactivated, the virus causes a rash and nerve pain . Postherpetic neuralgia can that lasts for months or years and affects as many as one million people in the United States.
One month after therapy, eight patients reported that their pain had reduced significantly . This was similar to the percentage of patients who reported such an improvement after day 15 and after day 45 . Most patients tolerated the treatment well, although five dropped out of the study early, three of them because of complications related to the therapy.
. Available pre-embargo to the media at )
What Are The Risk Factors For Postherpetic Neuralgia
Age is a high-risk factor for postherpetic neuralgia. The older a person is when shingles develops, the more likely it is that the individual will develop postherpetic neuralgia. People over 60 years of age have about a 60% chance, while people 70 or older have about a 75% chance, of developing postherpetic neuralgia after getting shingles.
People with a family history of close relatives who developed postherpetic neuralgia are at a higher risk of developing this painful condition.
Will The Pain Go Away
Without treatment, PHN typically eases gradually and goes. In about 5 in 10 people with PHN, symptoms are gone by three months. However, without treatment, about 3 in 10 people with PHN still have pain after a year. Some people have a slow improvement over a long period of time. A small number of people do not have any improvement over time without any treatment.
Antidepressants May Offer Surprising Relief
Antidepressants may have been “invented for depression, but they are also known to modulate peripheral nerves,” Dr. Auwaerter says, thereby dulling PHN pain. Your physician may suggest Pamelor or Aventyl or Elavil . Dr. Auwaerter adds that these medications can sometimes cause side effects like fatigue and sluggishness—though PHN patients usually only need a low dose, which is unlikely to cause major adverse effects.
Symptoms Of Postherpetic Neuralgia
People who develop PHN can experience a range of symptoms usually in the area of the skin affected by shingles, commonly around the torso and typically only on one side of the body. PHN symptoms include:
- Pain: Intense pain is often described as burning, stinging, jabbing, or sharp shooting. For some people, the pain can interfere with daily living from putting on clothes to sleeping.
- Extreme sensitivity to touch: Some people with PHN report that the feeling of clothing next to affected skin is painful. Others are sensitive to temperature changes and feel pain from a slight breeze.
- Numbness, tingling, and/or itching is less common than pain or sensitivity to touch.
- Headaches: If the shingles rash affected your head or face, you may experience headaches.
- Weakness and/or paralysis: Although rare, muscle weakness and/or paralysis can be the result of PHN if the nerves involving muscle control are involved.
Rash, fever, and general lethargy are fairly common symptoms.
Your doctor can diagnose you and provide you with treatment options for the immediate pain. However, you should expect a few weeks or months of moderate pain before you start to notice dramatic improvements.
Can I Prevent It
The FDA has approved two shingles vaccines, and . A is now recommended for everyone 60 and older. People from 50 to 59 may want to talk to their doctor about it if they have ongoing pain or skin issues or have a weakened immune system.
The s cut the chance of shingles by at least 50%. Even if you still get shingles, the painful period is shortened and you reduce your risk of postherpetic neuralgia.Â
Early treatment for shingles can also lower your chances of getting this complication. So if you think you have it, call your doctor right away. The main treatment is with antiviral drugs during the early stages of shingles, within 2 to 3 days of symptoms coming on. Medications used include:
NIH. National Institute on Aging: â€œShingles: How Long Does Shingles Last?â€?
UCLA Health: â€œAbout Postherpetic Neuralgia,â€? â€œPostherpetic Neuralgia: Symptoms.â€?
Mayo Clinic: â€œPostherpetic Neuralgia: Symptoms,â€? â€œPostherpetic neuralgia: Definition,â€? â€œShingles: Causes,â€? â€œPostherpetic neuralgia: risk factors,â€? â€œPostherpetic neuralgia: Causes.â€?
National Health Service : â€œPost-herpetic neuralgia — Treatment,â€? â€œPost-herpetic neuralgia: Signs and Symptoms.â€?
American Academy of Family Physicians: â€œShingles.â€?
Center for Shingles and Postherpetic Neuralgia: “Surgical options for treating postherpetic neuralgia,” “Treating shingles with tricyclic antidepressants to lessen the risk of PHN.”
BMJ: â€œTreatment of herpes zoster and postherpetic neuralgia.â€?
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.
Natural Remedies For Shingles
is a viral infection that causes a painful rash. The varicella zoster virus causes this viral infection. It’s the same virus that causes .
If you had chickenpox as a child, the shingles virus lies dormant in your body. The virus can reactivate later in life and cause a shingles rash. The rash can occur on any part of your body but typically only affects small sections.
Pain is usually the first symptom of shingles. The rash and fluid-filled blisters form within a couple of days after the onset of pain. Some people with shingles also have a , sensitivity to light, and .
According to the Centers for Disease Control and Prevention , about 1 in 3 people in the United States will develop shingles at some point in their lifetime.
The shingles virus can last between two and six weeks. Shingles isn’t life-threatening, but some people experience postherpetic neuralgia. This is when nerve fibers become damaged, causing shingles pain that lasts for weeks or months after the rash clears.
There’s no cure for shingles, but your doctor can prescribe antiviral medication to help shorten the duration of the virus and reduce symptoms.
Although an antiviral is an effective treatment for shingles, it’s not the only option. Several natural remedies may also reduce pain and discomfort.
Daily cleansing of the blisters reduces the risk of spreading the infection. Take a cool bath or shower to soothe skin. The coolness of the water can ease pain from shingles blisters and calm itchiness.
What Are The Risk Factors For Internal Shingles
Many of the risk factors for internal shingles are the same as those for the skin rash of shingles. They include:
- Having a weakened immune system. Diseases and conditions such as , organ transplant, and autoimmune conditions like lupus, rheumatoid arthritis, or inflammatory bowel disease can make you more susceptible to shingles.
- Undergoing cancer treatment. Cancer, along with radiation and , also weaken your immune system and can increase your risk of a herpes zoster infection.
- Being older than 60. Shingles can occur in people of any age. However, it’s more common in older adults. About half the cases of shingles develop in people over 60 .
- Taking certain medications. Drugs that lower your chance of rejecting an organ transplant or treat autoimmune diseases will increase your risk of shingles. Examples include cyclosporine and tacrolimus . Extended use of steroids will also increase your risk. These medications suppress your immune system, making your body more vulnerable to infection.
Not receiving the shingles will also increase your chances of getting the condition. Even if you don’t remember ever having chickenpox, you should get the shingles vaccine. Studies have shown that 99 percent of people over 40 have had chickenpox. According to the
‘how Can I Reduce Nerve Pain Caused By Shingles’: Dr Martin Scurr Answers Your Health Questions
I’ve had shingles for six weeks. It’s no longer contagious but is very painful. My doctor has prescribed medications but they all make me sick. Is there anything that can reduce the nerve pain?
Jenny Johnson, Chesterfield, Derbyshire
How miserable for you to be suffering still with nerve pain. But fortunately, it is treatable.
Long-term pain following shingles becomes more common with age, with more than 18 per cent of over-70s with shingles experiencing it.
Herpes zoster is caused when the virus that leads to chickenpox is reactivated. This can lie dormant in nerve tissue, typically in an area of nerves just outside the spinal cord, for many years following initial infection.
As well as causing a painful rash of blisters, the virus triggers severe inflammation where it is lurking and eventually scars the nerve tissue, causing ongoing pain in many cases.
Painkillers don’t work for shingles nerve pain. Instead, we usually prescribe the anticonvulsant drugs gabapentin and pregabalin, or a tricyclic antidepressant, says DR MARTIN SCURR
For the first 30 days, this is described as acute herpetic neuralgia — it can be severely distressing, preventing sleep. In many cases, including your own, the pain continues long after this . If it persists after four months, it’s known as post-herpetic neuralgia.
This can lead to symptoms related to touch, with some experiencing numbness in the area while others find the opposite, that even the lightest touch is extremely painful.
Preventing Nerve Pain After Shingles
But if you’re worried about PHN, don’t despair. There are that can cut your risks of getting the condition. There are three antiviral drugs used: , , and . 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.”
Treatment For Lingering Shingles Pain
Most cases of shingles clear up within a month or so. After you have shingles, it’s unlikely that you’ll get it again. But as we mentioned above, some people develop PHN, a complication that follows shingles. Older people, women, and those who had more severe shingles symptoms seem to be at , but it’s not clear why others never develop it.
Nerve blocks are injections containing local anesthetic to numb nerves contributing to PHN pain. Other minimally invasive treatments include nerve ablation and steroid injections to treat inflammation related to shingles.
We offer several nonaddictive prescription medications for nerve pain. Oral antidepressants or membrane stabilizers can reduce symptoms of PHN. For some people, topical medication like capsaicin cream can temporarily relieve pain.
You don’t have to turn to addictive opioid pain medications if you have shingles pain. Dr. Soin and our team are here to help you find relief with a personalized treatment plan, whether it’s nerve-blocking injections or medication.
If you still have nerve pain after shingles, you don’t have to suffer in silence. in Centerville or Beavercreek, Ohio, or book an appointment online to learn more about the PHN treatment that could be right for you.
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Steroids Can Sometimes Help
Dr. Auwaerter notes that some older research done in the early 2000s supports the use of the steroid prednisone taken with an antiviral for short-term shingles pain relief, as well as a decreased risk of developing the more serious PHN. Steroids may be especially beneficial for people over 50, who are at higher risk for PHN. However, they can increase your risk of immunosuppression over time, so they’re generally used for shingles for just one to two weeks. If you’re trying this approach, work closely with your doctor to manage the appropriate dosing.
Is It Possible To Prevent Postherpetic Neuralgia
Zostavax, the herpes zoster vaccine , has been shown to significantly decrease the risk of shingles. The vaccine is approved by the Food and Drug Administration for adults age 50 and older, and is recommended for all adults 60 and older who aren’t allergic to the vaccine and who don’t take immune-suppressing medications.
People age 50 to 59 may want to talk to their doctor about the shingles vaccine, if they are having ongoing pain or skin issues or have a weakened immune system. The vaccination is not a guarantee that shingles will not occur; however, those who get the vaccine usually experience a shorter period of pain.
Pain Management For Postherpetic Neuralgia
Postherpetic neuralgia is a complication of , which is caused by the chickenpox virus. The condition affects nerve fibers and skin, causing a burning pain that lasts long after the rash and blisters of shingles disappear. There is no known cure for postherpetic neuralgia, but the pain management experts at Novus Spine & Pain in Lakeland, Florida can help you manage the pain.
Determining The Right Amount Of Cbd Oil For Shingles
Some patients may prefer to ingest CBD as an, , or for shingles pain relief. If you’re interested in one of these options, it can take some experimentation to find the serving size that’s right for you. There’s no set amount of CBD to use, and most experts recommend starting with the lowest possible amount and working upward gradually until you see the desired effects. Many patients find 20-25mg effective for daily pain relief. You could also use a ratio of 1 to 6mg per 10 pounds of body weight for a conservative starting amount.
You might also choose a topical treatment in the form of CBD cream. A CBD intensive creamcan provide immediate, targeted relief to areas of discomfort, and it may be particularly effective to reduce the inflammation, redness, and swelling associated with the shingles rash.
If you’re interested in trying out a CBD topical cream, you can simply apply it to any area affected by shingles. Make sure the skin is clean, dry, and free of any other substances so the cream can absorb effectively. For best results, massage the cream gently into the skin for a few seconds to encourage deeper absorption. You can use a CBD-infused cream as often as you like for topical relief from shingles pain.
These statements have not been evaluated by the Food and Drug Administration. Products discussed are not intended to diagnose, treat, cure, or prevent any disease.
How Is Internal Shingles Treated
Even though shingles is a virus, this is a case where there are antiviral medications available by prescription. That’s why it’s important to see your doctor right away if you suspect you have shingles. Early treatment may reduce the risk of complications, like PHN. Serious complications require hospitalization.
Common antiviral medications for shingles include:
Depending on the location and severity of the shingles infection, steroids may also help. Anti-inflammatory medications like ibuprofen and pain-relieving medication such as acetaminophen or other prescription pain medication can help in easing pain experienced from shingles.
A Word About The Shingles Vaccine
If you are age 60 or over and have not had shingles, talk to your doctor about getting the shingles vaccine. Not only will it reduce your risk of developing shingles, but if you do develop shingles, you’ll be more likely to have a mild case. And, just as important, you’ll be much less likely to develop PHN if you’ve had the vaccine.
What Can I Do For The Pain
Not everyone has the same amount of pain from shingles. Over-the-counter pain medicine like acetaminophen and ibuprofen can help ease the pain. A liquid medicine that you put on your skin can help cool the rash and stop the itching. Your doctor can give you pain medicine if your rash hurts a lot.
Sometimes the pain does not go away with the rash. This is called postherpetic neuralgia .
What Are Possible Complications Of Shingles
Shingles often goes away with no lasting effects. But some people have complications during or after the infection comes out:
Postherpetic neuralgia. This is the most common complication. It’s more likely as people age, especially after age 60. It’ is nerve pain at the place where the rash used to be. It can range from mild to severe. It can last for only a few days, or for months or even years after you have had shingles. Antiviral medicines given during the first 72 hours of the rash can reduce the chance of postherpetic neuralgia. Other medicines can be prescribed to help ease the pain and improve quality of life.
Bacterial infection. Shingles blisters may get infected with bacteria. Depending on the severity of the infection, topical, oral or IV antibiotic medicine is used to treat the infection.
Eye problems. If you have shingles on the face, see your healthcare provider right away. Shingles can cause serious problems with vision, and even blindness.
In very rare cases, shingles can also lead to pneumonia, hearing problems, brain inflammation, or even death.
When Chronic Pain Comes From The Nerves These Nerve Pain Medications Can Help When Added To Other Pain Relievers
For chronic muscle and joint pain, effective therapies include rest, ice and heat, anti-inflammatory medications, and time. Usually, the pain calms down and you feel better.
However, muscle and joints may be only part of the picture. For instance, pain can be coming primarily from irritated nerves, along with the injured and inflamed muscle or joint.
Often the discomfort is only arising from nerve pain. Typical signs of this “neuropathic” pain include sharp, stinging pain or pain that radiates from one part of the body to adjacent areas. One of the most common causes is diabetes, although it can also be brought on by injury, infection, and some medications.
“People say things like, ‘My knee hurts and I feel like it’s coming up to the middle of my thigh and down to my shin,” says Dr. Padma Gulur, a pain medicine specialist at Harvard-affiliated Massachusetts General Hospital. “In those cases, the nerve may be involved.”
In neuropathic pain, the nerve that was the mere messenger of pain now becomes the actual source. Narcotic pain relievers don’t often help and even when they do, they should not be used as a long term solution. Fortunately there are other options. Certain drugs that were originally developed to treat depression and seizure disorders also damp down inappropriate or excessive pain signaling in the nerves.
Treatment Of Pain After Shingles
Treatment for people with PHN may include:
- Nerve blocks: Local anesthetic or alcohol injected directly into the nerve affected
- Thoracic epidural injections: Local injection in the space around the spinal cord
- Antidepressant medications: Such as amitriptyline
- Membrane stabilizers: Such as gabapentin
- Capsaicinapplication: Topical cream applied to the affected area
Duration Of Postherpetic Neuralgia
So how long does postherpetic neuralgia last? Researchers are unsure what triggers the herpes zoster virus to re-emerge after years of lying dormant. The virus may be obtained during youth but it will not flare into shingles until years down the line. The pain of shingles usually persists for around three months. When this pain lingers long after the rash heals, it is considered PN.The bout of shingles damaged the nerves. This means that the nerve damage caused by shingles brings on a fully functioning nervous system. The damaged nerve will send random pain signals to the brain, and it causes a burning, throbbing sensation. Over time, the nerves of the skin calm, but with the nerve damage existing, the pain can persist for years, even for the remainder of a person’s lifetime.