Bernie was a 70 year old woman who entered the nursing home for problems with hip pain from a replacement surgery. As her stay progressed, she noticed pain that seemed to occur in a thick band around her chest. To her surprise, a few days later blisters appeared where she complained of pain. Within a day, those blister broke open, formed a crust, and became very painful to the touch. When the doctor told her she had shingles from the chicken pox virus, she was stunned. She had chicken pox as a child, but never thought she would suffer from it again. Unfortunately, many older adults receive a return visit from this common childhood malady.
Shingles is a painful and blistering skin rash due to the varicella-zoster virus (chickenpox virus). After an individual gets chickenpox, the virus becomes inactive in some of the nerves in the body. You will likely develop painful rashes in bands around your torso. Blisters form over the area where the pain occurs, and they can open and form a crust. It is highly contagious and often very painful. Shingles can damage the nerve endings in the region of manfestation, and this can lead to months or even years of pain. This secondary condition is known as postherpetic neuralgia.
We at the SoCal Pain Center see cases of shingles frequently. We know how to treat the condition and help with the pain. With our cadre of dedicated pain professionals, we can help you find a way to cope with the pain. In addition, we know how to recognize and treat the consequences of shingles, such as nerve pain.
The chickenpox virus causes shingles. Once you have the condition, the virus remains dormant in the nerves, and it can manifest as the painful rash that is known as shingles. You are more likely to get shingles if you are over 60, but it is can occur if you had chickenpox before you were 1 year old or your immune system is weakened. If you never had chickenpox and come in to contact with someone who has shingles, you will likely get chickenpox from the exposure. Shingles and chickenpox are highly contagious, so it is important to avoid touching the rash contaminating those around you if you develop shingles.
Shingles usually starts with nerve pain. It is located on one side of your body and can feel tingling or burning. The pain appears long before any rash actually manifests. You will develop small blisters where you felt the pain, and these blisters will break open and crust over. It takes about 2 to 3 weeks for the crusts to fall off, but they do not usually leave any permanent scars. The rash may also appear in a band pattern around the torso or abdomen, and it may appear on the face, in the ears, and around the eyes and lips. You may have constitutional symptoms, as well, such as abdominal pain, fever, chills, genital sores, headache, joint pain, and swollen lymph nodes. In some cases, the shingles can affect specific nerves and cause facial drooping, facial numbness, trouble seeing, and difficulty tasting.
Antiviral drugs are the front line treatment for shingles. You should start one of these medications, such as acyclovir, when you first start feeling the pain and before the rash starts. In severe cases, you may need a steroid, such as prednisone, to help with the pain and swelling, but this treatment is not always effective. Antihistamines, such as Benedryl, can help with the itching, while pain medications, such as ibuprofen, can help with the discomfort. Topical creams for the rash are another treatment modality that may be used to ease the pain. You should try to keep your skin clean and refrain from infecting others with shingles. You can pass on the chickenpox or shingles to those who use your contaminated towels or other items.
At SoCal Pain Center, we’ve seen many older adults with shingles. Although we can help prescribe medications to fight the virus, we specialize in helping you to cope with the pain from the condition. We can help you with pain medications and other drugs that help with the neurogenic pain that is common during and after shingles outbreaks. Give us a call to set up a consultation about your pain.