Shingles is a disease of the nervous system. It is caused by the varicella-zoster virus, the same virus that causes chicken pox. When a person recovers from chicken pox, the virus remains in the body, specifically in nerve fibers that serve different dermatomes. Immune cells keep the virus in latency so that no signs of infection are present. If it happens that immune cells are not present or are not working as they should, the virus can reactivate, in which case shingles occurs.
The defining signs of shingles are a painful rash and blisters. But before these early symptoms of shingles, patients usually complain about fatigue, nausea and other flu-like symptoms. Pain, tingling and itching also occur but only in localized body areas and only on one side of the body. It is on these areas that a rash and blisters will form.
A shingles outbreak lasts for 2-4 weeks. After that period, most if not all signs and symptoms will have disappeared. Sometimes, patients experience prolonged and excruciating nerve pain after recovering from shingles. This pain can persist for weeks, months or years without signs of improving on its own. It is known as post-herpetic neuralgia. You can find more details on history of shingles ICD 10. In this article, we investigate the causes, symptoms and how shingles nerve pain is treated.
What does shingles nerve pain feel like?
Herpes zoster virus lies in nerves that innervate different dermatomes. After reactivation, it replicates and uses the nerve fibers it affects to reach the skin. This process can lead to damage or inflammation in affected nerves and ultimately cause nerve pain.
So what does shingles nerve pain feel like? Shingles nerve pain can be described as stabbing, stinging, burning, tingling or numbness. Some patients describe it as excruciating. It all boils down to how the pain occurs. The unique thing about shingles nerve pain is that it is localized to small areas, usually parts where the rash was.
Even the lightest touch can aggravate shingles nerve pain. Affected areas are usually very sensitive to touch. Note that the pain has nothing to do with external stimuli. It arises from within affected nerves. For this reason, the pain is present even when no external cause such as blisters or trauma is around. Pressure on the skin only aggravates but doesn’t cause the pain.
You know that you have post-herpetic neuralgia when shingles nerve pain lasts for more than 3 months. When that happens, medical attention is the best available option. How long does the nerve pain last after shingles? Normally, nerve pain goes away once a shingles outbreak is over. That takes about 2-4 weeks. If the pain is to return in a more severe and persistent form in about 2 weeks after recovery, it is a sign of post-herpetic neuralgia.
Can shingles cause severe headaches? Headache is a common early symptom of shingles. Severe cases occur when one or more complications of shingles are involved. For example, a shingles eye contagious infection can result in intense pain in eye which can cause intense headaches. Prolonged headaches can also be a sign of internal shingles or bacterial infection.
What causes nerve pain from shingles years later?
It is common to experience pain during a shingles outbreak. As mentioned earlier, the pain should go away by the 5th week after first symptoms. So what causes nerve pain from shingles years later?
Experts associate the pain with nerve damage and inflammation. The problem is that either cause can persist even after recovering from the primary infection. Risk factors include:
- Age – most cases are reported in people over age 70. This is why people over age 60 are recommended to get vaccinated against shingles. Age brings along many forms of complications in how our bodies work. Eventually, the immune system is compromised in one way or another. This allows the herpes zoster virus and other pathogens to easily cause infections.
- Severe outbreaks – if you had to deal with a severe rash or intense pain during a shingles outbreak, you are at higher risk of getting prolonged nerve pain. This is because more damaged is likely to be done to nerve fibers in that case.
- Having shingles on face – the forehead and the eyes are among the commonly affected areas. An outbreak on face and torso increases the risk of developing prolonged nerve pain.
- Weakened immunity – a healthy immune system keeps herpes zoster virus from replicating in large numbers. This means that even if present, damage to nerves will not be extensive.
Lasting shingles nerve pain can result in complications such as anxiety, depression, lack of sleep, lost appetite and difficulty concentrating. Patients are advised to seek medical attention. Can shingles be internal? Shingles is said to be internal when rash and blisters have not materialized.
And how does shingles spread? Shingles is not contagious. People get the disease as a result of reactivated chicken pox virus. However, direct contact with open blisters or their fluid can transit herpes zoster virus.
Treatment for shingles nerve pain
For best results, treatment for shingles nerve pain should be done with combined efforts. This means use of different medications and treatment options. It is therefore advisable to check with your doctor before commencing treatment. The following options are commonly used.
For normal nerve pain, pain killers like ibuprofen and paracetamol may do the trick. But when post-herpetic neuralgia is involved, stronger prescription pain relievers such as opioids are required.
Non-steroidal anti-inflammatory drugs are commonly prescribed with other narcotic medications to help reduce nerve pain caused by shingles.
A lidocaine patch is applied after shingles blisters are gone. It works by reducing nerve pain by introducing anesthetics into affected areas. Lidocaine patches are available over the counter and don’t have side effects.
Capsaicin is a substance found in chili peppers. It is said to be very effective in treating shingles nerve pain. Although it can be prepared as home remedy from chili peppers, over the counter ointments containing it are the better option.
Corticosteroids are commonly used alongside antiviral drugs. They mostly work by reducing inflammation and nerve pain. Use of topical corticosteroids in treatment for shingles in children is not advisable.
These medications are thought to block pain receptors in the body and in the process significantly reduce shingles nerve pain.
These medications are commonly used to treat seizures in epileptic patients but may help with shingles nerve pain. Good examples that may be used include phenytoin and gabapentin.
Narcotic analgesics are used to ease nerve pain but don’t address the actual cause of the pain. They should strictly be used according to a doctor’s instruction.
Nonmedicinal treatment for shingles nerve pain
Other than medications, you can ask your doctor about the following treatments:
TENS stands for transcutaneous electrical nerve stimulation. During the treatment, electrodes are placed nearby the painful nerves.
PRF stands for pulsed radiofrequency lesioning. As the name suggests, radio frequencies are used to promote pain relief in painful nerves.
Since affected nerves that are causing pain rarely recover with time, one option is to permanently destroy a branching terminal from whence pain is arising. This is done with phenol or alcohol injections. Phenol injections are more possible options for cases such as shingles leg pain treatment compared to on the face.
Acupuncture is a traditional Chinese treatment which uses many tiny needles to relieve pain. It has been shown to be effective with many kinds of pain and may help with shingles nerve pain.
From yoga to meditation and massage, exercises that promote relaxation may help with shingles nerve pain.
Home remedies for shingles nerve pain
For most conditions and diseases, treatment at home is mainly aimed at improving symptoms but not as curative options. This is the same case with shingles nerve pain. The following home remedies for shingles nerve pain may help but should not be wholly depended on.
Apple cider vinegar:
Apple cider vinegar is an anti-inflammatory and may help with shingles nerve pain. It can be used by applying directly with a cotton ball or ingested.
Essential oils are very popular when treating problems of the skin. Good examples you can try for nerve pain are frankincense oil and lavender oil. Such can be found on doTERRA oils.
Cool compress is effective in reducing both pain and itchiness. The good thing is that there are no chemicals or drugs involved and so it can be used even on the face or for shingles in mouth symptoms.
Vitamins and supplements:
Diet inclusions are very crucial in regards to immune strength. Vitamins C and zinc particularly improve immune health. Lysine supplements on the other hand prevent outbreaks and also promote faster recovery.
Cool baths help relieve itching and may reduce pain. Another option is to add colloidal oatmeal, apple cider vinegar or baking soda to bath water. This is more practical when dealing with genital shingles symptoms.
Can vaccines help reduce shingles nerve pain?
Vaccines are not curative but preventative options. Shingles vaccine can be taken to reduce risk of severe outbreaks and also ensure that shingles episodes do not last long. As mentioned earlier, people who experience prolonged and severe shingles outbreaks are at higher risk of developing intense nerve pain. So in a way, shingles vaccine can help reduce nerve.
Currently, there are two shingles vaccines that have been approved by the FDA. These are zostavax and shingrix. Zostavax is a live vaccine and is estimated to be effective for about 5 years. Shingrix is a nonliving vaccine and is estimated to be effective for more than 5 years. Both are recommended for people above age 60.
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