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Herpes Zoster Pain

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Herpes Zoster Pain

Herpes zoster (commonly called shingles) is an infection caused by the varicella-zoster virus, the same virus that causes chickenpox. In fact, chickenpox is the acute phase of the virus whereas herpes zoster is the reactivation of the virus. (In other words, after contracting chickenpox, the varicella-zoster virus lies inactive in nerve tissue until many years later where it may reactivate as herpes zoster.)

Because of the large gap in time, people customarily don’t connect chickenpox with herpes zoster. But, they do connect pain with it. Characterized as an incredibly painful rash, herpes zoster is widespread. Nearly one out of three people in the U.S. will develop herpes zoster during his/her lifetime. It is estimated that there are one million annual cases of this condition in this country.

Herpes zoster is most prevalent in the following categories:

  • Those over the age of 60
  • Those who take drugs known to weaken the immune system (e.g., steroids)
  • Those who have undergone chemotherapy or radiation
  • Those with HIV, AIDS or other diseases that weaken the immune system

Most cases of herpes zoster resolve in several weeks and represent a one-time outbreak. However, acute cases may have a possible complication: postherpetic neuralgia (PHN). This is pain that affects the nerve fibers and skin. It can remain several months – even after the rash resolves. As much as 15 percent of people with herpes zoster develop postherpetic neuralgia.

Symptoms

Symptoms prior to the outbreak of the rash may include:

  • Burning
  • Itching
  • Pain
  • Tingling

Symptom during the outbreak:

  • Painful rash with fluid-filled blisters (resembles chickenpox), usually in a band shape on one side of the torso or face

Symptoms that may accompany pain and rash include:

  • Chills
  • Fatigue
  • Fever
  • Headache
  • Muscle weakness

Treatment

There is no cure for herpes zoster, but treatments for the pain are most effective when acquired early. Medications can be used to control symptoms and may include:

  • Antihistamines for itching
  • Anti-inflammatory drugs
  • Antiviral drugs
  • Qutenza(R) patch
  • Zostrix cream to help reduce the risk of pain from postherpetic neuralgia

If you suspect that you have herpes zoster and you’re in a tremendous amount of pain, please contact The Center for Musculoskeletal Disorders today.