If you had chickenpox as a child, the Shingles virus lies dormant in your body. The virus can reactivate later in life, and you’ll be desperately looking for some form of Shingles pain relief.
Skin rashes across the torso, blisters, itching, fever, fatigue, and sensitivity to light, are some of the symptoms of Shingles, a condition caused by the reactivated varicella-zoster virus. Yet pain is often the primary symptom of a Shingles infection, both during and after treatment.
A case of Shingles can be unique among many other viral infections. It can cause long-lasting and persistent burning pain even after any signs of infection have disappeared. More to the point, Shingles can reactivate decades after your first exposure to the virus. Shingles is primarily noticed dermatologically, but much of what it does happens below the surface.
Shingles pain can make it difficult to clean yourself, hug others, wear clothes, or even wrap yourself in a blanket. The slightest touch can irritate or hurt you. You might feel incredibly itchy, even though the offending rash has gone away. To understand why this is happening, we need to know how the Shingles virus works.
What is Shingles?
A Shingles infection is a recurring infection, meaning it’s only defined as Shingles if you have already suffered an infection with the same virus in the past. A first-time infection with the varicella-zoster virus is called chickenpox. This means you can never get Shingles from another human being or animal. You can only get chickenpox through viral transmission.
Shingles occurs when the dormant virus is reawakened later in life due to an unrelated infection, a weakened immune system, old age, autoimmune disorders, or conditions and procedures that medically weaken the immune system, such as organ transplants.
The varicella-zoster virus lays dormant around the spinal cord. When it re-emerges, it usually does so by affecting the nerves of the torso through your thoracic (upper back) nerve roots.
Because it attacks these nerves, most of the symptoms of Shingles occur in one or more dermatomes, which are regions of skin assigned to their respective spinal nerves. This is often why Shingles might only appear on one side of the torso, although symptoms can occur in multiple dermatomes.
Shingles vs. Chickenpox
Shingles and chickenpox are caused by the same virus, but they are two different diseases. Chickenpox primarily affects children, but adults are also susceptible, provided they’ve never been infected by it before. In addition to mostly being a childhood illness, chickenpox is also typically milder than a case of Shingles.
Otherwise, the symptoms for both chickenpox and Shingles are very similar: rashes, blisters, a fever, and pain.
While Shingles cannot cause Shingles, you can infect someone with chickenpox through a Shingles infection. Chickenpox is highly contagious, and the virus travels through contact with the rash and breathing. You have a much greater risk of developing a case of chickenpox as an adult if you are regularly in contact with kids, such as through school or daycare.
Most adults are well-equipped to deal with a chickenpox infection, but people with autoimmune conditions and compromised immune systems are more likely to experience severe symptoms and pain.
However, because most adults have healthy immune systems, it is very likely that they have had chickenpox and never noticed it. This means most people in the US (and the rest of the world) may develop Shingles later.
Shingles and Nerve Pain
So, we have established that the same virus is responsible for chickenpox and Shingles, that chickenpox and Shingles both present with rashes, and that both conditions involve an attack on the nerves. But how does the virus cause rashes through nerve damage?
Because the varicella-zoster virus lays dormant in the nerves of the upper back, its reactivation there causes symptoms in the dermatomes associated with those nerves. The virus travels along a nerve path from the spine. As the infection progresses, spreading on the skin like a girdle or belt of lesions. It multiplies by spreading itself along your neurons, like rust on a chain.
Shingles is a herpes virus, much like the herpes simplex virus, which causes recurring cold sores, often around the lips. The same principle applies here. The virus lays dormant in the body and reactivates when certain conditions are met (i.e., the immune system is sufficiently weakened).
Who Is at Risk for Postherpetic Neuralgia?
A case of Shingles is one thing, but postherpetic neuralgia is yet another matter entirely. Shingles pain can be combatted by treating the condition with antiviral medication and topical painkillers. For most people, the pain goes away with the infection.
Yet when the pain persists long after the rashes have gone, it’s a sign that a person may be suffering from postherpetic neuralgia (nerve pain).
The same rules apply; the weaker your immune system, the greater the risk of postherpetic neuralgia. It doesn’t have to be a matter of age. Certain illnesses can weaken your immune system. Procedures such as a recent organ transplant can take a toll on your body and force you to take immunosuppressant drugs to minimize the chance of transplant rejection.
There are unknown factors, too. Some people get postherpetic neuralgia; others don’t.
Treating Postherpetic Neuralgia
Treatment is a matter of pain management if the pain persists after the rash is gone. First-line treatment for postherpetic pain may be topical and oral pain medication, from over-the-counter painkillers like acetaminophen to topical drugs like capsaicin.
When these aren’t enough, other medication may be considered, including:
- Anticonvulsants
- Anesthetic patches
- Stronger painkillers
- Antidepressants
When the pain becomes treatment-resistant, it’s time to explore other options. If first-line treatments fail, it’s time to tackle the nerves themselves. Options for non-invasive direct nerve pain interventions include nerve blocks and epidural injections.
Both involve using a painkiller, numbing agent, or steroid, being injected through an x-ray guided needle, either directly into the area of the affected nerve or into the epidural layer of the affected portion of the spine.
These injections can bring lasting Shingles pain relief by blocking pain signals. The duration of the pain relief depends on the dose and a patient’s resistance. Relief can last hours, days, or longer.
Shingles Pain Relief & Preventative Care
Preventative care for postherpetic neuralgia isn’t a proven idea. Still, a few things might help reduce the severity of a recurring Shingles infection and any potential complications after that, including being vaccinated for Shingles. It is recommended that every adult over the age of 60 talks to their doctor about getting a Shingles Vaccine.
Shingles is a serious health concern that many people are unaware of. It is vital to be educated about your choices for treating them so that you can make an informed decision. Your best bet for long-lasting Shingles pain relief may be a neural intervention. While it looks like a skin condition, it’s primarily neural.
Contact PMIR today with any questions about Shingles pain relief.
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