What’s Involved In Treating Shingles?
Article by Matthew Cullen
Roughly a third of Americans will get shingles at some point in their life. For older Americans who live up to age 85, the chances increase to 50%. The likelihood is greatest for people 65 and older and is triggered when the varicella zoster virus causes the dormant chickenpox virus to reactivate. The Centers of Disease Control recommend that people over the age of 60 receive the Zostavax inoculation to prevent health complications related to shingles. For 15% of all patients, the severe pain of shingles persists for a month or more. This excruciatingly painful condition is called postherpetic neuralgia (PHN).
“Oftentimes patients are told that the rash will heal in two or three weeks anyway, and the pain will go away, so they’re not given something for the pain unless it’s excruciating,” explains Robert Dworkin, Ph.D. of Rochester. “But moderate pain can stop people from working, or enjoying their hobbies, and it can also make some people depressed or anxious.” Dworkin advocates getting early and aggressive treatment for shingles pain to prevent long-term effects.
Treatment for shingles pain can speed the healing of the painful rash, decrease the pain of the rash and make PHN less likely to occur. Within 72 hours of the rash’s appearance, doctors typically prescribe antivirals (like acyclovir) to combat the virus itself. Effective medicine for pain may include opioids (like morphine, codeine, oxycodone or fentanyl), anti-inflammatory medicine (like ibuprofen), anticonvulsants (like gabapentin or pregabalin) or anti-depressants (like amitriptyline or nortryptyline). The most common side effects of oral medication are drowsiness, nausea and constipation.
If it isn’t treated, patients increase their danger of experiencing chronic pain that may continue for months or even a year after the first outbreak. This occurs because the nerves often get damaged when the reactivated herpes zoster virus travels throughout the system.
A recent study discovered that a new surgical operation can provide pain management for those who suffer from PHN. In a short procedure, surgeons implanted a small pump system under the skin in the abdomen, with a narrow tube inserted into the spine to dispense pain relieving medicine such as morphine. This treatment led to a significant improvement in pain, and no negative reactions were reported.
Seventy-five is the average age of candidates for the pain pump treatment for shingles, and the patients who benefit most are those who cannot be helped by oral pain medication. Some patients respond to opioid medications but suffer severe nausea and debilitating drowsiness with the oral method, whereas there have been no side effects from the pump. It is, however, a surgical, invasive procedure, so patients should consider other options before receiving this type of medication treatment.
About the Author
Shingles disease looks a lot like chickenpox except it usually follows a nerve cluster. So you will notice that it looks to be in an odd pattern on the skin. The skin will be very red and will have blisters. You can even get shingles in the eye!
