Shingles

Shingles is a painful rash that is caused by reactivation of the virus that causes chicken pox, varicella-zoster virus.  With reactivation, the sleeping virus awakens and grows along nerves to the skin.  Although a small percentage of patients may not develop a rash, a rash usually occurs a few days after the initial pain occurs.  The fluid filled blister rash can occur anywhere on the body.  Often it occurs on one side of the torso but may affect the face and eye.  The virus is contagious until the blisters crust over.  Rapid treatment with anti-viral medications may prevent long-term complications.  When the pain persists long after the rash heals, this is known as post-herpetic neuralgia.  Early treatment of shingles pain is key to preventing long-term pain.  If you have uncontrolled pain after an episode of shingles, the physicians and advanced practitioners at the Pain Management Centers of New England can help reduce your chances that the pain will become permanent. Call today for a comprehensive consultation at one of our north shore  locations in Danvers or Gloucester, MA or our Newburyport office.

After the shingles rash heals, some will have chronic pain in the area of the rash.  This complication is called post-herpetic neuralgia and is the most common complication following a shingles outbreak.   Complications following shingles increase in those with weakened immunity and older adults (greater than 60).  Patients with post-herpetic neuralgia will describe severe pain as lancinating, burning, and shocking.  Others will feel deep aching pain.  The chronic pain negatively affects sleep, mood, appetite and energy levels.  

How can I reduce my chances of developing post-herpetic neuralgia?

• Contact your primary care provider immediately to start anti-viral medications.  Started anti-viral medications within the first 72 hours of the appearance of the rash reduces the chance of developing post-herpetic neuralgia.
• Schedule your injection of the Shingrix vaccine as is more than 90% effective in preventing shingles. The CDC recommends that adults 50 and older get the vaccine. If you are 19 and older, the vaccine is also recommended for those that have a weakened immune system.  The vaccine is given in two doses two to 6 months apart. The vaccine can usually be found at your local pharmacy such as CVS or Walgreens.

What can I do if I develop post-herpetic neuralgia?  What are the treatments?

• Schedule your appointment to see one of our Harvard trained pain medicine physicians for your comprehensive consultation.
• Post-herpetic neuralgia often responds to medication management when treated early. Medications that are often effective include gabapentin, pregabalin (Lyrica), duloxetine (Cymbalta), tri-cyclic antidepressants, lidocaine patches, capsaicin and opiates.
• Steroid injections into the spine
• Spinal cord stimulator implant HFX™

To learn more about your treatment options for post-herpetic neuralgia, call Pain Management Centers of New England or use the online booking tool to request a consultation today.