Shingles is an extremely painful rash that occurs on a segment of skin anywhere on your body but most commonly appears on the torso. Shingles is caused by a virus called Varicella Zoster or sometimes called Herpes Zoster virus. Most people have the virus in their body from having chickenpox as children. After the chickenpox goes away, the virus moves to the nerves just outside of the spine and stays there for decades without any symptoms.

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Who is at risk for getting shingles?

The Varicella Zoster virus stays in the nerves until something weakens the immune system enough for it to take advantage of. Some common conditions that can weaken the immune system include:

• Diabetes

• Stress

• Age

  • People over 50 years old have a higher chance of getting shingles​

• Cancer

• Medications that suppress the immune system

  • Cancer medications, medications for organ transplants to prevent rejection​

• HIV/AIDS​

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What is post-herpetic neuralgia?

Post-herpetic neuralgia is one of the most common complications from shingles especially if antiviral medications are not started immediately after getting shingles. It is characterized as severe pain and sensitivity to touch over the area where the shingles rash occurred long after the shingles rash has gone away. This happens when nerves that were affected by the shingles continue to cause pain because they are irritated and damaged. 

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What type of pain can you experience with shingles pain?

• Headaches

• Chills and muscle pain

• Itching

• Rash over a strip or segment of skin

• Blisters

• Burning pain

• Sharp pain

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What type of pain can you experience with post-herpetic neuralgia pain?

Post-herpetic neuralgia is diagnosed when the pain over the shingles region continues for at least 3 months after the shingles rash has gone away. These symptoms occur without the rash being present and include:

• Burning pain

• Sharp pain

• Achy pain

• Sensitivity to touch

  • Unable to lightly touch the area without significant discomfort or pain​

  • Unable to tolerate fabric like clothing or bed sheets touching the affected area

• Numbness and tingling over region

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How can our St. Louis pain doctors help diagnose your shingles pain or post-herpetic neuralgia?

• Thorough history and physical exam

  • Diagnosing shingles is done clinically by evaluating the rash and the pattern the rash makes on the skin. Additional tests or imaging are usually unnecessary

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What are your treatment options?

Our pain management doctors are highly knowledgeable about the proper diagnosis and treatment of shingles and post-herpetic neuralgia pain. Antivirals are an important part of the treatment plan and can significantly decrease the development of complications such as post-herpetic neuralgia if given within 3 days of getting shingles. In addition to antiviral medications, other treatments include:

• Oral steroids (steroid pills)

• Anticonvulsants

• Antidepressants

  • Specific antidepressants have been shown to block pain signals from damaged or irritated nerves​

• Skin ointments, creams, and patches

• Intracutaneous injections

  • Help decrease irritation around the nerve affected by shingles

• Epidural injections

• TENS

  • Also helps decrease pain signals from affected area

 

What can you do to avoid or decrease shingles pain?

• Chickenpox vaccine

  • The vaccine is given at an early age and significantly decreases the chance of getting the chickenpox. If a person does not get chickenpox, then the shingles virus is never stored in their body​

• Shingles vaccine

  • This vaccine is recommended for people over 60 years old that have a good immune system​

• Monitor blood sugars

  • Uncontrolled diabetes can put significant stress on your body, causing a weakened immune system

• Be cautious

  • If you are not immune to chickenpox (have not been vaccinated or had chickenpox at any point in your life), you can get the Varicella Zoster virus from someone that has shingles rash. 

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For more information or to discuss an appropriate treatment plan for your shingles pain with one of our specialized pain management physicians, call Saint Louis Spine and Joint Pain Specialists today.

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