Shingles is a painful viral infection of the nerves related to chicken pox, which affects approximately one million American adults every year. If most people think that chicken pox is a once in a lifetime struggle, then many also believe that once shingles is healed, it’s done forever — but unfortunately, this isn’t always the case.
Some people who get shingles — a less itchy but more painful version of the chicken pox rash — develop postherpetic neuralgia, nerve pain that lingers even after the rash and other symptoms have disappeared. This pain may last anywhere from a few weeks to a couple of months to several years; for some people, it appears only occasionally, while for others it can become a chronic and unwelcome part of life. For some patients, the pain may be set off by simple contact with the skin. The pain itself isn’t the only problem: depending on the severity as well as the length of time, it can affect daily activity and also tends to lead to sleep deprivation, irritability, and depression.
It’s not entirely clear why 10 to 20% of shingles patients go on to develop postherpetic nerve pain, but it’s thought to be related to more permanent damage or inflammation of the nerves. There’s no way to predict who will have post-shingles pain, but there are certain risk factors that make it more likely: the chances increase with each year over the age of 50, and Caucasians are more than twice as likely to develop it than other ethnicities. People whose immune systems are compromised by medical conditions like AIDS or cancer or by drug use are also at a higher risk.
Prevention and early treatment are the best options to avoid post-shingles pain. The vaccine is recommended for everyone over the age of 60, and if you suspect you have shingles, consult your doctor immediately: anti-viral drugs are most effective when administered within three days, and the sooner you begin treatment, the less damaging the illness can be.
If you have pain after shingles, talk to your doctor about how best to manage it. Treatments that can help include certain opioid medications, topical patches containing lidocaine or capsaicin, steroid injections, anticonvulsant drugs, and antidepressants. The course and type of treatment depends on the severity and duration of the nerve pain.
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