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Shingles, or herpes zoster, is a painful viral infection that affects millions of people worldwide.

As a pain management specialist, I often encounter patients who are grappling with the excruciating discomfort brought on by this condition. Shingles is caused by the varicella-zoster virus, which also causes chickenpox.

Once you’ve had chickenpox, the virus remains dormant in your nerve cells and can reactivate years later as shingles. In this column, we will explore the ins and outs of shingles, its risk factors, symptoms, and, most importantly, how to manage and alleviate the pain associated with it.

Risk Factors

Shingles is often associated with aging. As the title suggests, if you live long enough, you’re more likely to experience an outbreak. The risk increases significantly after the age of 50.

However, shingles can affect people of all ages, especially those with weakened immune systems. This includes individuals undergoing chemotherapy, organ transplant recipients, and people with certain chronic conditions.

Telltale Signs

The initial symptoms of shingles can be mistaken for other conditions, but a hallmark sign is a painful, burning, or tingling sensation on one side of the body or face. A rash then develops, usually in a band or stripe pattern, and progresses to blisters that scab over in 7-10 days. The rash is often accompanied by itching, fever, headache and fatigue.

Managing the pain

Shingles is notorious for the severe pain it inflicts, often described as a burning, stabbing, or shooting sensation. The pain can persist long after the rash has healed, a condition known as postherpetic neuralgia (PHN).

This persistent pain can be debilitating, affecting daily life and overall well-being. As a pain management doctor, my focus is on helping patients find relief from this distressing aspect of shingles.

Strategies to manage pain

Medications: Antiviral medications can reduce the severity and duration of shingles if administered early. Pain relievers, such as acetaminophen or ibuprofen, may help alleviate discomfort. For severe pain or PHN, stronger medications like opioids, antidepressants, or anticonvulsants may be prescribed.

Topical Treatments: Over-the-counter creams or ointments containing capsaicin may provide relief from localized pain and itching. Lidocaine patches can also be applied to numb the affected area.

Nerve Blocks: In some cases, nerve blocks may be recommended to block pain signals in the affected nerves. This can provide temporary relief.

Alternative Therapies: Techniques such as acupuncture, chiropractic care, and mindfulness meditation have shown promise in managing shingles pain for some patients.

For those with post herpetic neuralgia spinal cord stimulator is indicated.

Prevention

Vaccination is a powerful tool in preventing shingles. The shingles vaccine is recommended for adults over the age of 50, even if they’ve previously had shingles.

It’s administered in two doses, typically 2-6 months apart. Getting vaccinated not only reduces the risk of shingles but also lowers the likelihood of developing postherpetic neuralgia if shingles does occur.

Conclusion

Shingles is an unwelcome reminder of the chickenpox virus that many of us had as children. While it can be a painful and uncomfortable experience, there are ways to manage the pain and reduce the risk of complications.

If you suspect you have shingles or are at risk, consult with your healthcare provider or a pain management specialist for guidance on diagnosis, treatment, and pain relief options. Remember, if you live long enough, you’re more likely to encounter shingles, but with the right knowledge and care, you can minimize its impact on your life and well-being.

Dr. Craig Charleston is board certified in anesthesiology, subspecialty certification pain management. He is available at GTI Pain Associates, 2400 Highway, 365 Suite 104 in Nederland. Call 409-554-0545 for more information.