Shingles is a viral infection caused by the varicella-zoster virus.
You can only get shingles (also known as herpes zoster) if you've previously had chickenpox.
Shingles is an infection in the nerves and the areas of skin supplied by the nerves. It's more common in adults, especially older people and people with poor immune systems.
Pain is a very common symptom of shingles. The pain can be in one spot or over a larger area. A rash usually appears within one to three days after the pain starts, but it can take up to 10 days for the rash to appear.
With shingles, you may also have a headache and fever, and generally feel unwell.
The symptoms usually go away in two to three weeks, though for older people it can take three to four weeks. Pain can continue after the rash has gone.
The Zostavax vaccine is used to protect adults against shingles.
Zostavax is funded for 65-year-olds. This means you can get a free vaccination at your general practice.
Until 31 December 2021, you can also get a free vaccination at your general practice if you were between 66 and 80 on 1 April 2018 and you're currently under 81.
If you're between 50 and 65, or 81 or older, you can get the vaccination at your general practice and some pharmacies, but you'll have to pay for it.
You can have a vaccination even if you've previously had shingles as it can help stop you getting shingles again.
The treatment for shingles aims to reduce the symptoms. It includes rest and paracetamol for the pain.
If you're at a higher risk of developing complications from shingles, your doctor may give you antiviral drugs such as valaciclovir and aciclovir. They may also prescribe a steroid cream.
Getting help for shingles
If the shingles rash is close to one of your eyes, it can sometimes affect your eye. This is called ophthalmic herpes zoster. If this happens, it's important to see your doctor quickly.
You should also see a doctor if:
- you aren't sure what the pain or rash is
- you're very unwell
- you're pregnant
- you have a weakened immune system.
HealthInfo recommends the following pages
Written by HealthInfo clinical advisers. Page created May 2018.
The information in this section comes from the following sources, some of which may be clinically complex or not available to the general public.
Ministry of Health – Chickenpox, retrieved November 2017.
Ministry of Health – Shingles, retrieved November 2017.
DermNet NZ – Herpes zoster, retrieved November 2017.
Page reference: 513140
Review key: HISHI-513140
Shingles (Postherpetic Neuralgia) Specialist
What causes shingles?
Shingles, also called herpes zoster, develops from the virus that causes chickenpox. After you have chickenpox, the varicella-zoster virus stays in your body. It settles in nerves, where it stays dormant for years until it suddenly reactivates and causes shingles.
Older adults and people with a weak immune system are most likely to develop shingles. Other triggers that may increase your risk for shingles include:
- Emotional stress
- Taking immunosuppressants
- Acute or chronic illness
- Developing cancer
When the virus reactivates, it replicates and travels from the nerve to the area of skin that’s served by that nerve.
What symptoms develop due to shingles?
The symptoms usually begin as a severe, burning pain along the length of the nerve. Patients may also feel a tingling sensation and develop a fever and fatigue.
In a few days, a red rash develops along the nerve, which is followed by fluid-filled blisters. The rash usually stays on one side of your body or face.
The area covered by the rash is extremely painful and hypersensitive. The rash lasts about 2-4 weeks, but your pain can continue.
What is postherpetic neuralgia?
Postherpetic neuralgia is a common complication of shingles in which your pain lasts after the rash heals. Whether your pain feels sharp, burning, or aching, it’s usually severe. Many patients find the pain to be debilitating.
You may also become hypersensitive and find that even the light touch of clothing is painful. Though not as common, postherpetic neuralgia can also cause itching and numbness.
How is shingles treated?
It’s important to get medical attention for shingles as quickly as possible. Antiviral medications can reduce your pain and may lower your risk of postherpetic neuralgia, but they’re most effective when you take them before or shortly after the rash appears.
As an expert in pain medicine, Dr. Amin offers several treatments that can help patients with shingles or postherpetic neuralgia find relief from their symptoms, including:
- Steroid injections
- Botox® injections
- Spinal cord stimulation
- Stellate ganglion block
- Pulsed radiofrequency
- Cold laser therapy
- Transcutaneous electrical nerve stimulation
Dr. Amin practices integrative medicine, so he considers a range of potential treatments that can relieve the pain of shingles or postherpetic neuralgia. For example, he may recommend acupuncture, a safe treatment that often reduces the pain.
If you need relief from the severe pain of shingles or postherpetic neuralgia, call American Pain Experts or schedule an appointment online.
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Post-Shingles Pain Treatment Questions and Answers
Do you have nerve pain from shingles? Reach out to our team of healthcare professionals at Ramos Center today as we can help offer treatment. Call us today or visit us online to book an appointment. We have convenient locations in Bradenton FL, Englewood FL, Sarasota FL, and Venice FL to serve you.
What does nerve pain from shingles feel like?
Shingles typically result in a rash accompanied by pain in the affected area. The pain typically goes away whenever the rash goes away. This usually happens after two to four weeks. However, pain that continues for longer is known as postherpetic Neuralgia. The word “postherpetic” comes from “post-herpes” since the pain arises after infection by the herpes zoster (shingles) virus. In sporadic cases, pain even comes back after a shingles infection, even if it had already gone away and the rash had disappeared.
The main symptom of Postherpetic Neuralgia is a pain in the nerves. The pain can either be spontaneous (burning and ongoing), paroxysmal shooting, or electric shock-like pain, or the patient can experience evoked sensations in response to light touch or other mechanical stimuli. The type and intensity of pain generally vary from patient to patient. The skin is often overly sensitive and itchy. This can make it difficult or painful to turn over in bed, wash, or even hug someone. The affected area may also feel intensely itchy, be more sensitive to pain than usual, and feel pain due to something that would not usually hurt, such as a light touch or cool breeze. Postherpetic Neuralgia also affects the quality of life as well as that of sleep. Patients often report much pain and suffering due to the condition, which leads to loss of sleep. Functional status is also affected by the pain, which leads to a limited range of movement of the chest region due to discomfort.
How long does nerve pain last after shingles?
Only approximately 9-15% of patients who get shingles develop Postherpetic Neuralgia. For those few patients who develop PHN, the length of time that it lasts usually varies. The majority of PHN patients have discomfort that lasts one to two months. About one-third of Postherpetic Neuralgia patients have symptoms that last around three months, and about one-fifth have symptoms that last a year or longer. Researchers are unsure what triggers the herpes zoster (shingles) virus to re-emerge even after years of lying dormant. The virus may be obtained during youth, but it does not flare into shingles until years down the line. When the pain of shingles lingers long after the rash heals, it is considered Postherpetic Neuralgia. The bout of shingles damages the nerves. This means that the nerve damage caused by shingles affects a fully functioning nervous system. The damaged nerve will send random pain signals to the brain, which thereby causes a burning, throbbing sensation. Over time, the nerves of the skin calm, but due to the existing nerve damage, the pain can persist for years, even for the rest of the person’s lifetime.
How do I know if Post-Shingle Pain is healing?
For most patients who develop Postherpetic Neuralgia, the prognosis is good, although they may have to take pain medications for about one to three months. For others, the prognosis is fair to poor if the pain is severe, lasts longer than three months, or significantly reduces their quality of life. Postherpetic Neuralgia occasionally results in permanent nerve damage. However, the disease is not fatal. There is currently no disease-modifying therapy for PHN. Treatment is based mainly on symptom control. Because pain may persist for years or the rest of the patient’s life, medication is often used over prolonged periods. Randomized controlled trials support the use of topical as well as oral agents to treat PHN. Topical therapy is the first treatment for mild pain. It is used in combination with systemic drugs if the pain is moderate or severe. The patches have 5% lidocaine, which is an analgesic agent. In a meta-analysis of studies, this treatment resulted in at least 50% pain relief. Capsaicin cream also has proven effective. It must be applied several times daily and is proven to be effective as a low-concentration patch. Certain drugs are also used for nerve-related pain. For Postherpetic Neuralgia, drugs proven effective are tricyclic antidepressants and antiepileptics. Many studies regarding PHN, amitriptyline, nortriptyline, and desipramine were shown to help treat the same. Gabapentin and pregabalin are two anticonvulsants that offer some benefit in the treatment of postherpetic Neuralgia.
For more information, call us now. We serve patients from Bradenton FL, Sarasota FL, Palmetto FL, Laurel FL, Venice FL, Englewood FL, Memphis FL, Cortez FL and Port Charlotte, FL.
Shingles Post-Herpetic Neuralgia
Shingles or post-herpetic neuralgia is a condition that causes intense pain. The pain can be localized to one side of the body or a general region, such as the head and neck. The condition is also identified by a rash or stripe of blisters that lines up in an area of the body, usually around the torso. Shingles is most common in people over the age of 50 and in people who have disorders of the immune system, such as an autoimmune disease, HIV/AIDS, or cancer. Shingles is also more likely to develop in someone who is on a long-term treatment that involves the use of steroids.
Shingles is the result of infection with varicella zoster, or chickenpox. Varicella zoster is one of the human herpes viruses and most often infects people as children, although today’s generation of youngsters can be vaccinated against chickenpox. Anyone who had chickenpox can get shingles later in life. After the chickenpox illness resolves, some of the viruses remain hidden away in the body’s nerve endings. A person who has an active shingles infection can spread the virus to someone else, causing them to get chickenpox. So a grandparent with shingles should avoid contact with a newborn baby who has not yet been vaccinated for the disease.
The most common symptoms of shingles include a feeling of pain, burning, numbness, or tingling of the skin. These feelings are usually localized to a specific part of the body, such as the right side of the head and face. Sensitivity to touch, including a touch from a person and the touch of fabric of a person’s clothing are also common symptoms. A person with shingles may also go on to develop a rash and fluid filled blisters which become increasingly painful. A few people experience fever, itching, headaches and sensitivity to light. People who have shingles may have fatigue that can last for several weeks or even months after the rash and blisters have gone away.
There is no cure for shingles once a person has it, but there are many treatments that can help to shorten the duration of the illness and lessen its symptoms to make the pain more bearable. Some medications may be prescribed to treat shingles and post-herpetic neuralgia.
Some patients cannot take these medicines or prefer other forms of treatment. One option to consider is percutaneous electronic nerve stimulation (PENS). This is a procedure in which the physician uses electronic nerve stimulation to reduce the perception of pain. Another good method to try is acupuncture, as this helps to balance the body’s energy and is a proven reliever of both chronic and acute pain. Acupuncture can also help to reduce stress, and a reduction of stress can help to minimize the perception of pain from shingles. Injections of anti-inflammatory drugs such as steroids are also helpful for combating the intense pain of shingles.
If you suffer from pain due to shingles, contact us today to schedule an appointment at Allied Pain & Spine Institute.
On wrist shingles
Shingles (herpes zoster)
What is shingles?
Shingles is a painful blistering rash caused by the reactivation of the virus that causes chickenpox, known as the varicella zoster virus.
The virus is called herpes zoster when it causes shingles and herpes varicella when it causes chickenpox. They were named before it was known that a single virus was responsible for both conditions.
Keep up to date with the latest research about shingles (herpes zoster) and all things skin related with our newsletter.
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What causes shingles?
After a person has had chickenpox, the virus lies inactive in the nervous system. When the virus reactivates it multiplies and moves along the nerve fibres to the area of skin supplied by those particular nerves; shingles then appears in this area. Shingles can appear anywhere on the body.
Anyone that has previously had chickenpox may subsequently have an outbreak of shingles.
About 1 person in 5 will develop shingles at some time. Most outbreaks of shingles occur for no obvious reason, but are more likely if the individual:
- is elderly,
- is experiencing physical or emotional stress,
- has an illness that weakens the immune system, such as leukaemia, lymphoma (e.g. Hodgkin’s disease) or HIV infection,
- is taking treatments that suppress the immune system, includingradiotherapy for cancer, chemotherapy, steroid drugs, and drugs taken to prevent organ rejection.
Is shingles contagious?
Shingles is not caught from someone who has shingles or from someone who has chickenpox. It develops when the inactive herpes zoster virus awakens, for example when a person’s immune defences are weaker than normal. However, a person affected by shingles can give chickenpox to someone who has never previously had chickenpox. A person with shingles is infectious from the point of the first blister until the blisters crust over (approximately 7 days).
Is shingles hereditary?
What are the symptoms of shingles?
Before the blisters appear, the first obvious symptom is pain in the area where the virus is reactivating. However, it is important to note that not all people affected by shingles will experience pain. For example, many young people will only experience an itching or mild burning sensation in the affected area.
For those who do experience pain, it is usually in one small area. The pain can range from mild to severe and could be a constant dull, tingling, aching or burning pain/sensation. The rash usually appears a day or two after the onset of pain, and a fever and/or a headache may develop.
What does shingles look like?
Shingles appears as a group of red spots on a pink-red background which quickly turn into small fluid-filled blisters. Some of the blisters burst, others fill with blood or pus. The area then slowly dries, crusts and scabs form. The scabs will fall off over the next two to three weeks.
The rash usually covers a well-defined area of skin on one side of the body only (right or left) and will not cross to the other side of the body.The position and shape of the rash will depend on which nerves are involved. Shingles can affect any area, but the most common areas include the body or down an arm or leg. Less commonly, shingles can affect one side of the face, and occasionally can cause complications affecting one eye.
How is shingles diagnosed?
A diagnosis is usually straightforward, based on the presence of pain, tingling, itching, followed by the rash and the typical appearance/shape of the rash.
If there is doubt about the diagnosis, scrapings may be taken from a blister by the doctor to then be examined under a microscope, or a viral swab test can be taken.
Can shingles be cured?
Shingles usually resolves on its own within a few weeks. Oral antiviral treatment may help clear the rash sooner and can reduce its unpleasant effects.
Rare complications which could occur when the outbreak is on the face:
- Shingles affecting the face (forehead and nose) may spread to the eye leading to inflammation and ulceration in the eye, and later to scarring, which if untreated could lead to vision problems or blindness. Blisters coming up on the side of the nose will alert your doctor to this risk, and you should also get urgent advice from an eye specialist (ophthalmologist).
- Muscles in the area affected by shingles occasionally become weak and there may be temporary facial paralysis on the shingles-affected side of the face.
The pain caused by shingles may persist long after the rash has cleared, particularly in the elderly. This is called postherpetic neuralgia and may persist for a long time. Postherpetic neuralgia requires a very different kind of treatment and the GP will be able to advise the best treatment for this.
To shorten the outbreak
- Antiviral drugs, such as Aciclovir tablets are safe and may shorten the duration, but work best if they are given within the first three days (72 hours) of onset of the outbreak. Therefore, it is very important to get an early diagnosis from the GP as soon as shingles is suspected.
To make it less painful
Rest and taking painkillers may help, i.e. non-steroidal, anti-inflammatories and applying a cool compress.
To deal with complications
If bacteria infect the area of shingles, antibiotic cream or tablets may be prescribed. If shingles affects the eye, a specialist ophthalmic doctor may prescribe eye drops.
To prevent postherpetic neuralgia
Taking antiviral drugs as early as possible when shingles starts may reduce the risk of getting postherpetic neuralgia, and can shorten its duration if it does occur.
To treat the pain of postherpetic neuralgia
Using an anaesthetic ointment (lidocaine 5%) before applying a topical analgesic cream (capsaicin cream) may help. The lidocaine can be bought over the counter, but the capsaicin cream needs to be prescribed by a doctor. Treatments that are sometimes also used include antidepressants and anticonvulsant tablets, as well as pain killers, such as non-steroidal anti-inflammatory drugs.
A vaccine is licensed to prevent shingles in people who are 70 to 79 years old. If you are in this age group, please ask your GP for the vaccination. The shingles vaccine does not help a person who already has shingles or postherpetic neuralgia.
Another vaccine is available to prevent a vulnerable child or adult from catching chickenpox. It is not recommended for routine use in children.
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