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Reducing The Risk Of Long Term Pain From A Shingles Infection

Issue 38.12

The Chicken Pox, caused by Varicella Zoster Virus, is a common childhood disease which is self-limited and generally well tolerated without long term effects.  The problem which arises is that once infected, we never actually get rid of the virus.  It lies dormant in the nerves near our spine for years kept at bay by our immune system.   As we age and our immune system weakens, we are at increased risk of the virus manifesting itself once again as a Shingles infection.  Herpes Zoster or Shingles is the reactivated form of the Chicken Pox virus and can be painful both during the acute infection and, of greater concern, possibly lead to a chronic painful state.

Although symptoms and presentation of Shingles varies, the majority of patients experience pain in a linear or dermatomal pattern on one side of the body which precedes a rash in the same area.  The most common area to experience this painful rash is in the thoracic or chest wall region.  The second most common area is on the head and face.  The painful rash usually lasts 1-2 weeks, but in up to 20% of patients the pain will persist for greater than 6 months developing into a chronic state called Postherpetic Neuralgia.

Treatment of acute shingles infection should first be provided by your primary care doctor with an antiviral medication which will help reduce the duration and severity of pain and reduce the risk of Postherpetic Neuralgia.  Pain resulting from both the shingles infection and Postherpetic Neuralgia can be managed by non-narcotic oral pain medicines and even topical lidocaine patches, but to most effectively reduce the risk of long term pain; a series of x-ray guided injections performed by pain management specialists around the affected nerve is indicated.  The earlier in the course of the infection that these shots are administered the more effective they are at preventing long term pain.

If you experienced shingles in the past and are still suffering from pain in that area, there are options for you.  Along with the different types of oral medications, patches, and injections,  a pain specialist can evaluate you to see if you are a candidate for Spinal Cord Stimulator therapy – a minimally invasive option which replaces the painful sensation of Postherpetic Neuralgia with a pleasant sensation.

If you suspect that you are suffering from shingles, see your primary care provider first to confirm the diagnosis. 

If the pain from this infection is of concern to you, feel free to call our office, Desert Pain Specialists at 435-216-7000 for a consultation.

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