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What Most People Don't Understand About Shingles

What Most People Don't Understand About Shingles

Once you’ve had chickenpox (varicella), the virus stays in your nerve cells and can reactivate later in life, appearing as the painful, blistery, burning rash known as shingles

The shingles rash typically lasts several weeks. But the most common complication of shingles is postherpetic neuralgia, which can cause unrelenting pain for months to years.

John S. Michels, MD, is an award-winning pain management specialist with a busy practice in the Dallas-Fort Worth area of Texas. Read what Dr. Michels says about shingles, postherpetic neuralgia, and treatments to relieve your pain.

How do I know it’s shingles?

Only a physician can tell for sure, but there are common symptoms that make shingles easily recognizable.

Shingles usually begins with a burning or tingling sensation on one side of the body, most commonly on the torso or face, followed by a painful rash that includes small, fluid-filled blisters.

Discomfort associated with shingles can vary from person to person, but it is generally described as a sharp, burning, or shooting pain that may be constant or intermittent. You may also develop fever, headache, fatigue, and sensitivity to light.

Although shingles can occur at any age, it’s most common in older adults and people with weakened immune systems. About one in three people develop shingles at some point in their lifetime.

There is no cure for shingles, but antiviral medications started early in the course may help shorten its duration. In addition, vaccines that prevent shingles are available, typically recommended for people over 50.

Unfortunately, anyone who develops shingles is susceptible to postherpetic neuralgia.

What is postherpetic neuralgia?

Postherpetic neuralgia (PHN) occurs as a complication of shingles. Likely caused by nerve damage during a shingles infection, PHN is characterized by severe, often chronic, pain that persists after the shingles rash heals.

Pain associated with PHN, usually localized to the area where the rash occurred, is often described as periods of persistent burning or stabbing pain followed by deep throbbing discomfort. 

You may also experience extreme sensitivity to touch or tingling and numbness in the area. In addition, movement, temperature changes, or even a soft shirt covering the affected zone can aggravate your pain.

How do you treat postherpetic neuralgia?

Based on your symptoms and evaluation results, Dr. Michels develops a comprehensive treatment strategy for PHN that may include nerve pain medication (Gabapentin or Lyrica), physical therapy, and other conservative treatments.

You may also benefit from a nerve block. During this quick in-office procedure, Dr. Michels injects a local anesthetic and corticosteroid near the affected nerves. The anesthetic temporarily blocks nerves from transmitting pain signals, and the steroid reduces nerve inflammation and irritation.

The positive effects of a nerve block can last for weeks, months, or longer. Depending on your response, Dr. Michels may suggest another block to achieve optimal results.

Another treatment Dr. Michels may recommend for long-term pain relief, if all other conservative therapies have failed, is spinal cord stimulation. A spinal cord stimulator is a medical device that delivers painless, low-level electrical pulses to targeted spinal nerves. This action relieves your discomfort by disrupting pain signals traveling from nerves to your brain.

You don’t have to live with pain. Schedule an evaluation with Dr. Michels today for compassionate, comprehensive specialty care that relieves your symptoms and restores your overall quality of life.

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