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Shingles and Unrelenting Pain after Recovery

Shingles is caused by the varicella zoster virus – the same virus that also causes chicken pox. Anyone who has had chicken pox in the past may develop shingles and this is particularly pronounced as you get older. The virus does not go completely after you have had chickenpox. Some virus particles remain latent in the nerve roots next to your spinal cord. Some cases of shingles then appear for no apparent reason where the virus multiplies and travel along the nerve to the skin to cause shingles. In other cases, a period of lower immunity such as stress or illness can also trigger an episode of shingles. After the age of fifty, it becomes increasingly common to get shingles, probably due to the lower immunity as we age. Although it is uncommon to have it more than once, some people do experience it.

The most commonly involved nerves that cause shingles are those below the skin of the chest or tummy (abdomen). The upper face (including the eye) is also a common site. The back areas behind the body are also possible. The pain can range from mild to severe and can include constant dull, burning or gnawing pain. Acute and stabbing pains might also come and go. Itchy blisters will then develop after the rash. The blister will normally dry up, form scabs and gradually fade away. Slight scarring is possible after this ends. The whole duration usually lasts two to four weeks. Feeling feverish (running a temperature) and feeling weak is also commonly experienced during this episode.

You cannot contract shingles from someone who has shingles. However, you can get chicken pox from someone who has shingles if you have not had an immunization for chicken pox, contracted chicken pox before in the past or exhibit poor immunity. The shingles rash is highly contagious and it would be good if you can exercise responsibility whereby you try not to come in contact with young children (who might not be immunized) or weaker elderly persons if you have shingles.

Post-herpetic Neuralgia (PHN) is the most common complication where the nerve pain (neuralgia) of shingles persists after the rash is gone. It is a nerve pain that continues for three months or more due to damage caused by Shingles. Alternatively, if the pain goes away and returns at a later date, this is also called PHN. The problem is not so common in people with ages under fifty but for those over the age of sixty, one in five will have PHN that lasts more than a month.

Ways to alleviate the pain include wearing loose clothing to reduce irritation of the affected skin areas. Taking frequent cool baths or icing of the affected areas might also help. Taking common painkillers such as paracetamol are unlikely to help much. Hence, seeing a physician and getting the right medication is vital. They normally will prescribe an antidepressant medicine in the tricyclic group. In this case, it is not used to treat depression. Tricyclic antidepressants ease nerve pain (neuralgia) separately to their action on depression. However, amitriptyline is the one commonly used for nerve pain. Pain is stopped, or greatly eased, in up to 8 in 10 cases of PHN treated with amitriptyline. Tricyclic antidepressants sometimes cause drowsiness. This often eases in time. To try to avoid drowsiness, a low dose is usually started at first and then built up gradually if needed. It is also usually taken at night. A dry mouth is another common side-effect. Frequent sips of water may help with this. Please visit a qualified physician or doctor to ensure you have the right advice given your current medical condition.

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