Shingles is a painful viral infection that causes a rash. Shingles is usually a single strip of blisters wrapping around either the right or left side of the torso, although it can appear anywhere on the body. The varicella zoster virus is responsible for shingles, which is the virus that also causes chickenpox.
When you have had chickenpox, the virus remains dormant in the nerve tissue then years later, usually during retirement, the virus reactivates as shingles. This is not a life threatening condition but it certainly is a painful condition. Early treatment may reduce the length of time you suffer from shingles and reduce the risk of complications. A Pain Management Doctor can help to reduce your pain.
Symptoms of Shingles
While less common fatigue, headache, fever, chills, and overall achiness may be experienced.
Usually, pain is the first symptom. This pain can be intense depending on where it is located and it can be difficult to treat the pain, which is Why seeing a pain management doctor is important. The location of the pain can cause confusion because if it is near the lungs, heart or kidneys it might seem like something else.
If you delay seeing a doctor your risk of developing complications increases and includes Disseminated zoster, cranial nerve complications, scarring, inflammation, bacterial infection, and muscle weakness. The most common complication is postherpetic neuralgia
Post herpetic neuralgia – This pain doesn’t go away lasting for months to years after your shingles has healed up and gone away. It is seen more commonly in people over 50 or when the immune system is weakened because of another disease like HIV or diabetes. A pain management doctor can be very helpful in these situations using a number of treatments to control the pain.
Treatment of Post Herpetic Neuralgia
Your pain management doctor will look at various modalities are used to treat the pain associated with herpetic neuralgia.
#1 Antiviral Agents
Antiviral agents decreases the severity of the pain associated with post herpetic neuralgia. In the treatment of post herpetic neuralgia, antivirals are very controversial. A number of studies evaluated the result so antiviral agents on post herpetic neuralgia, but the results have been varied. Acylovir or Zovirax therapy seams to create a modest reduction in the post herpetic neuralgia development.
Corticosteroids that are administered orally are commonly used in the treatment of post herpetic neuralgia. Some studies were designed to assess the efficiency of prednisone therapy in preventing post herpetic neuralgia have shown decreased pain at both 3 and 12 months, while other studies have showed no benefit.
Your pain management doctor will likely not spend too much time on analgesics, especially over the counter, as they have been shown to be ineffective for the most part. Lidocaine has shown relief of pain but only temporarily for not more than 12 hours. Capsaicin is very good at the treatment of post herpetic neuralgia.
#4 Tricyclic Antidepressants
Tricyclic antidepressants are often used to treat post herpetic neuralgia and they include nortriptyline (Pamelor), amitriptyline (Elavil), desipramine (Norpramin) and imipramine (Tofranil). These are all well tolerated when given at bedtime and stating with low dosages. The benefits are not seen for at least 3 months but once they do begin to work, they have long lasting pain management benefits.
Drugs like gabapentin (Neurontin) or Phenytoin (Dilantin) are used to control post herpetic neuralgia. A double-blind placebo-controlled study saw gabapentin as very effective in treating post herpetic neuralgia pain, as well as the sleep disturbance associated with it.
Shingles are painful and your doctor can help you with treatment options. But should you develop post herpetic neuralgia it is recommended that you see a Pain Management Doctor who can determine the best long-term treatment of your pain.